Japan’s coronavirus response is too little, too late

Saitama, Chiba, Osaka, Hyogo and Fukuoka — with about 56 million of Japan’s 126 million people. According to polls, the move is too little, too late. With a recent surge in coronavirus cases taking the country’s total to the 5,600 mark, 70 percent of respondents to Mainichi newspaper agreed that Abe should have moved sooner. Though Japan has only a fraction of the U.S. caseload, its steepening curve and the relative paucity of testing have health officials fearing the worst. Kentaro Iwata, an infection control specialist at Kobe University, told CNN that Tokyo could be “the next New York City.” Yet the vast majority of Japanese are still going to the office and taking crowded rush-hour trains. Japan Inc.’s traditions and rigidities are proving quite incompatible with teleworking booms abroad. Old habits die hard in paper-based Japan. Documents of all kinds require a physical stamp from an employee’s hanko, or personal seal. Another roadblock is the outsize influence of Keidanren, Japan’s main business lobby and a major political contributor. Its power explains the epic foot-dragging over postponing the Summer Olympics until 2021. These priorities have Abe sparring with Tokyo Gov. Yuriko Koike, who favors a broader clampdown to halt the spread of covid-19, in Japan’s version of President Trump’s daily tussle with New York Gov. Andrew Cuomo. The central government is more focused on limiting economic damage. Abe also is involved in a Trumpian spat with prefectural leaders over who stomachs the costs of the emergency declaration. As clashes unfold, Japan is losing valuable time needed to stem the outbreak. And rather than get more serious about social distancing, Abe’s government is putting out lists of “businesses asked to continue operating” to maintain economic continuity. Abe should dispense with the pandemic kabuki and call for a strict shelter-in-place policy. Though there are legal questions about enforceability, Abe could use the bully pulpit to urge Japanese — and companies — to comply. He should streamline the stimulus process and add more funding where necessary to restore vibrant growth. Otherwise, the economy could be in a state of emergency long after covid-19 leaves the theater. Read more: Jeff Kingston: Goodbye, Tokyo 2020. It’s time to start hoping for 2021. The Post’s View: The Olympics must be canceled or postponed William Pesek: How the coronavirus is shaking up Asia’s political order Jeff Kingston: Japan’s response to the coronavirus is a slow-motion train wreck


How a surge of coronavirus patients could stretch hospital resources in your area

assault. That leaves decision-makers operating in the dark as the virus — which has now killed more than 16,000 people in the United States — surges, spreading from urban areas like New York City and New Orleans into the rest of America. Given the limitations, The Washington Post assembled data to analyze the availability of the critical-care resources needed to treat severely ill patients who require extended hospitalization. The Post conducted a stress test of sorts on available resources, which revealed a patchwork of possible preparedness shortcomings in cities and towns where the full force of the virus has yet to hit and where people may not be following isolation and social distancing orders. More than half of the nation’s population lives in areas that are less prepared than New York City, where in early April officials scrambled to add more ICU beds and find extra ventilators amid a surge of covid-19 patients. The analysis draws on key metrics: total hospital beds, ICU beds and ventilator usage, as recorded in data sets assembled by Definitive Healthcare, an analytics company that mines government filings, including those of the Centers for Medicare and Medicaid Services (CMS), as well as commercial insurance claims. Locations of these critical-care resources were mapped by hospital referral zones, or areas where residents receive their hospital care, as determined by Dartmouth College. As the virus has spread, researchers globally are continuing to model outcomes that reflect varying assumptions about the disease, including the number of infections in different countries, the availability of testing and the impact of social distancing. To compare available resources across the country, The Post examined a year-long scenario in which the coronavirus would sicken 20 percent of U.S. adults, and about 20 percent of those infected would require hospitalization. Under that scenario, about 11 million adults would need hospitalization for nearly two weeks, and almost 2.5 million would require intensive care. This level of hospitalization is considered by Harvard researchers to be a conservative outcome for the pandemic, while others have described it as severe. In The Post’s scenario — which does not predict deaths or the effects of social distancing — about 76 million people, or 30 percent of the nation’s adult population, live in areas where the number of available ICU beds would not be enough to satisfy the demand of virus patients. The scenario for ventilator availability is even more dire:


because the curve of infections in Washington appears to be flattening, according to officials. Johnson said Harborview’s surge plan could double its existing 89 ICU beds by converting other hospital rooms into critical-care units. The plan would boost ICU staffing by teaming up surgeons and other doctors with ICU experience with nurses and respiratory therapists under the direction of critical-care physicians. “I think of a critical-care doctor in the ICU as sort of being the quarterback of the team,” Johnson said. “We rely on and count on a lot of different people to contribute to the care of these really complicated patients. But it’s our job to sort of maintain the broad view and situational awareness over what’s happening with the entire patient.” The Society of Critical Care Medicine estimates that there are nearly 29,000 critical-care specialized physicians like Johnson who are trained to work in ICUs in the United States. Yet about half of all acute-care hospitals have no specialists dedicated to their ICUs. Because of the demands of treating covid-19 patients, the lack of dedicated physicians “will be strongly felt” through a lack of high-quality care, the society said in a statement. The society also projects that the nurses, respiratory therapists and physician assistants specially qualified to work with ICU patients may be in short supply as patient demand increases and the ranks of medical workers are thinned by illness and quarantine. “We want to protect our health-care workers. They’re our greatest resource,” said Megan Brunson, president of the American Association of Critical-Care Nurses. “And I would say that is one of my greatest concerns. If people ask me what keeps me up at night, that definitely would be it.” Experts say experienced critical-care physicians and nurses are essential to executing techniques that can save lives. One example is prone ventilation — sometimes known as “proning” — for acute respiratory distress syndrome. Patients are carefully placed on their stomachs, sometimes for hours, allowing gravity to do the heavy work of alleviating fluid buildup in the back of the lungs. Early studies out of China and Italy have shown that proning has helped some covid-19 patients. “It’s mostly executed by the ICU nurses,” Johnson said. “The doctors are sort of asked to collaborate and to provide some general oversight and help with safety, but it definitely can be done by experienced teams of nurses.” On paper, Iowa City is


New pressures arise as disease seems to level off but economy plummets

The curve is getting a little flatter. That was Thursday’s good news: In some states, graphs showing new infections of the novel coronavirus seem to be leveling out, after a long period of sharp increases that have given America the worst confirmed outbreak in the world. Thursday’s bad news was that, in the process, the U.S. economy has been flattened. The Labor Department said that 6.6 million Americans filed for unemployment last week and another 6.9 million the week before that. That was a massive surge: The previous record high was 695,000, set in 1982. Overall, about 17 million Americans have suddenly become jobless, thanks to business closures and limits on movement that were imposed in March, after spotty testing and a slow federal response gave the virus a two-month head start. So as epidemiologists turned to restrained positivity this week — “We are hoping with cautious optimism” said Anthony S. Fauci, the government’s top infectious-disease doctor — it was the economists’ turn to sound somber. “This isn’t a recession, it’s the Great Depression II,” wrote Chris Rupkey, chief financial economist at MUFG Bank, in a note to clients. These crosscurrents — the apparent slowing of the pandemic and a virtual collapse of the economy — are certain to increase pressure on leaders to figure out how and when to ease restrictions that are costing jobs and growth. Some will probably push to relax the restrictions faster, while others warn that doing so prematurely could invite a resurgence of the outbreak. More broadly, the news was sobering. In the United States, the virus’s death toll continued to mount rapidly, with the total coming to roughly 16,300. Overseas, British Prime Minister Boris Johnson was moved out of intensive care, where he had spent three days suffering from the virus, though he remains hospitalized. President Trump is expected to name a second coronavirus task force within days, this one aimed specifically at reviving the economy. On Capitol Hill, competing proposals for more financial help failed in the Senate on Thursday, as Democrats objected to a proposed $250 billion increase in a small-business program, saying it was insufficient, and Republicans shot down the counteroffer. That left the prospects of more aid unclear. Top officials began chiming in on when restrictions can be loosened. Attorney General William P. Barr said it should be next month. Treasury Secretary Steven Mnuchin said it might be next


Record set for single-day covid-19 deaths in D.C., Maryland and Virginia at 53; black residents hit hardest

The District, Maryland and Virginia on Thursday reported 53 additional coronavirus fatalities combined, another single-day record, as the region’s leaders braced for the death toll to continue rising and confronted the disproportionate impact the pandemic was having on the area’s black residents. Officials again raised alarms that the worst has yet to come across the greater Washington region, making it even more important for residents to practice social distancing to stave off a surge in infections that could overwhelm hospitals. The region also saw jobless claims grow as the federal government reported 6.6 million Americans applied for unemployment benefits in the week ended April 4. The number of claims filed in the District, Maryland and Virginia reached 272,559 during that time. Nonessential businesses have been closed in all three jurisdictions for three weeks as leaders scrambled to contain the spread of the virus. The three jurisdictions now have a combined 11,766 confirmed coronavirus cases and 280 deaths. Experts say official tallies do not reflect an accurate snapshot of the virus’s toll on communities. People infected today may not show symptoms for days and may take weeks to receive positive test results. Many will not be tested at all as health authorities and doctors prioritize tests for high-risk groups and first responders. Authorities are monitoring the death counts to see whether the region will turn into a hot spot like New York City or succeed in slowing the spread of the disease. Virginia reported 34 fatalities Thursday morning — more than the previous six days combined. Officials said the single-day jump is partially because of delays in adding deaths at a Richmond-area long-term care facility to the state tally. Officials Thursday reported the deaths of six more residents at the Canterbury Rehabilitation & Healthcare Center, the site of one of the worst outbreaks in the country with 39 dead. Those victims make up a large share of Virginia’s 109 fatalities. The District reported five new deaths and Maryland reported 14 new fatalities. Neither marked a significant increase. In a court filing Thursday, District health officials announced the covid-19-related death of a 69-year-old patient at St. Elizabeths public psychiatric hospital. It is the first known death of a person at a city facility for the vulnerable. Kenneth Ellison, who was admitted to the hospital in 1975, after being found not guilty by reason of insanity on rape and burglary charges, was found


authorities and doctors prioritize tests for high-risk groups and first responders. Authorities are monitoring the death counts to see whether the region will turn into a hot spot like New York City or succeed in slowing the spread of the disease. Virginia reported 34 fatalities Thursday morning — more than the previous six days combined. Officials said the single-day jump is partially because of delays in adding deaths at a Richmond-area long-term care facility to the state tally. Officials Thursday reported the deaths of six more residents at the Canterbury Rehabilitation & Healthcare Center, the site of one of the worst outbreaks in the country with 39 dead. Those victims make up a large share of Virginia’s 109 fatalities. The District reported five new deaths and Maryland reported 14 new fatalities. Neither marked a significant increase. In a court filing Thursday, District health officials announced the covid-19-related death of a 69-year-old patient at St. Elizabeths public psychiatric hospital. It is the first known death of a person at a city facility for the vulnerable. Kenneth Ellison, who was admitted to the hospital in 1975, after being found not guilty by reason of insanity on rape and burglary charges, was found dead Thursday morning, according to a letter signed by a clinical administrator at the hospital. Ellison had been admitted to George Washington University Hospital on April 2 and tested positive for the coronavirus, the letter said. He was discharged to St. Elizabeths on April 3. As of Wednesday, 29 St. Elizabeths employees had tested positive and 73 were under quarantine, while 14 patients had tested positive and 142 were in isolation, according to city statistics. District officials also reported 22 residents of homeless shelters had tested positive for the coronavirus as of Wednesday. City officials said they were using three hotels as remote quarantine sites for nearly 150 people who lived at shelters. On Thursday, Maryland for the first time also released racial demographics of its covid-19 cases and fatalities, confirming that black residents are disproportionately affected in all three jurisdictions. Maryland is about 30 percent black, but African Americans made up half of the deaths and cases where race is known. That includes 55 of 103 fatalities where officials have demographic information. Maryland Gov. Larry Hogan (R) said the “data shows troubling disparities and points to a persistent public health challenge that we must address.” He did not directly


tested positive for the virus. “We cannot afford to overlook how densely populated our prisons are and how overwhelmingly black they are, to put it bluntly,” Lewis said. The ACLU of Virginia and more than 40 other groups called Thursday for the swift release of any nonviolent inmates in the state’s prisons and jails and greater transparency from officials as the coronavirus spreads among incarcerated populations. To date, 42 inmates and staff have tested positive for the coronavirus at Virginia state correctional facilities, according to the state Department of Corrections. Five inmates have been hospitalized. Racial disparities are also apparent in unemployment claims. A breakdown of census data and claims filed by county shows that at least 7 percent of Maryland’s African American and 5 percent of its white workforce have filed for unemployment insurance. In the Washington suburbs, at least 5 percent of the workforces in Prince George’s and Montgomery filed for unemployment. Additional data obtained and analyzed by The Washington Post also shows that while African Americans make up about 26 percent of the state’s workforce, they made up 32 percent of unemployment claims. In Montgomery, black residents make up at least 16 percent of the workforce and a quarter of unemployment claims. In the District, city officials also announced new relief measures for residents. Events DC, the city’s tourism arm, announced it would provide $5 million in assistance to undocumented immigrants who do not qualify for unemployment insurance or stimulus checks. The mayor also said the District would launch a hotline to deliver essential items, including groceries, at no-cost to those under self-quarantine or unable to leave their homes. Bowser said the city would also start distributing groceries at meal distribution sites for D.C. Public Schools. The city will have a rotating schedule across 10 sites, with groceries available on a first-come, first-served basis. Bowser said the distribution is “geared toward vulnerable families in areas of our city where it’s more difficult to access groceries.” The mayor's announcements came the same day her order took effect placing restrictions on grocery stores and open-air food markets to limit close contact between customers. Bowser said residents should cover their faces while shopping for food, and businesses should enforce the rule. Montgomery health officials said Thursday evening that the county will require shoppers to wear face coverings in grocery stores, pharmacies and other retail establishments starting Monday. State officials in


How Trump is sabotaging the coronavirus rescue plan

Last month, when the “phase three” coronavirus relief bill was being negotiated, the Trump administration and Republican lawmakers fought to limit how much public accountability there would be, demanding as few strings attached to bailout funds as possible. Fortunately, congressional Democrats managed to get substantial oversight provisions written into the bill anyway. Unfortunately, even as problems with the relief bill’s execution mount, virtually none of those oversight provisions is anywhere close to functional, partly due to deliberate sabotage. Needless to say, in a republic built on checks and balances, independent oversight of executive branch activity is necessary. That independent oversight is especially necessary when the executive branch is tasked with spending an unprecedentedly large fiscal relief package, totaling more than $2 trillion of taxpayer money. It’s especially, especially necessary when much of that $2 trillion comprises completely new, built-from-scratch, never-before-attempted government programs, prone to glitches and hiccups even when implemented by the most competent administration. And it’s especially, especially, especially necessary when that program is being managed by an administration riddled with incompetence, cronyism and political vendettas, and led by a president who has refused to rule out benefiting from the program personally. Congress dealt with this imperative primarily by creating three separate, independent oversight entities, with overlapping remits: (1) a new, special inspector general there solely to monitor how the treasury secretary distributes $500 billion in aid; (2) a Congressional Oversight Commission, which scrutinizes the Treasury Department’s and the Federal Reserve’s implementation of the law; and (3) a Pandemic Response Accountability Committee, made up of inspectors general from different executive branch agencies. This last body has the broadest jurisdiction and will monitor any past or future coronavirus response measures across government. The sabotage began as soon as President Trump signed the In a signing statement, Trump said he wouldn’t abide by the law’s requirement that the new special Treasury watchdog notify Congress immediately if the administration “unreasonably” withholds information. Which, considering the administration’s record of stonewalling, seems quite likely to happen. It’s a bad sign when a president signals his intention to obstruct oversight before there’s even anything to oversee. But it’s even worse when the president continues to obfuscate oversight once there’s already exhaustive evidence of screw-ups. Last week, reports began to gush in about problems with the small-business lending program, delays in how quickly stimulus checks could be sent to households, and other issues with how funds


U.S. government evacuation flights from Peru will soon be phased out

More than 53,000 stranded Americans have been evacuated from countries that closed their borders during the coronavirus pandemic, but few of those nations have posed as many challenges for the State Department as Peru. The U.S. Embassy in Lima arranged a riverboat operation with the Peruvian navy to get 34 Americans out of the Amazon jungle and onward to the Lima airport. Consular affairs officers chartered buses that traveled up to 18 hours to reach Americans stuck in the mountains near Machu Picchu. With curfews in place, authorities manning roadblocks asked for permission slips to pass. About 6,800 Americans have been evacuated from Peru, and 1,800 more have expressed an interest in returning home. Now, the government-chartered rescue flights from Peru are about to be phased out, after a flight Saturday from the Amazon city of Iquitos. In their place, the State Department is arranging irregular flights on commercial airlines. One tour operator already has started soliciting registrations for a private charter flight, and more are expected to follow. U.S. officials were taken aback by the large number of Americans seeking assistance getting home on government planes, said Julie Chung, the principal deputy assistant secretary of state for Western Hemisphere affairs, who was dispatched to Lima two weeks ago with a team of six consular officers to oversee the evacuations. “Initially, when we started this evacuation process, people were estimating there were about 5,000 Americans interested in going, and now we’re at 6,800,” Chung said in a telephone interview from the U.S. Embassy in Lima shortly before she left for the airport to return to Washington. “So I think we have now at this point gotten the majority of those who want to leave out.” The evacuation of tens of thousands of Americans is an unparalleled event, and the State Department has met its share of praise and criticism. Dan Honig, who teaches international development at the School of Advanced International Studies for Johns Hopkins University, was evacuated from Senegal on April 3 with his wife and young son. Before liftoff, another passenger asked a consular officer wearing full protective gear if he was getting overtime pay. “No. This is our job,” the man replied, adding, “This is why I signed up for this job. I’m proud to do this — I’m honored to help y’all get home.” A passenger started clapping, and soon all of about 100 evacuees joined


Cash-starved hospitals and doctor groups cut staff amid pandemic

Hospitals across the country have deferred or canceled non-urgent surgeries to free up bed space and equipment for covid-19 patients. But that triage maneuver cut off a main source of income, causing huge losses that have forced some hospitals to let go of health-care workers as they struggle to treat infected patients. Last week, Bon Secours Mercy Health, which runs 51 hospitals in seven states, announced it would furlough 700 workers. On Wednesday, Ballad Health, which operates 21 hospitals across Tennessee and southwest Virginia, delivered the same bad news to 1,300 employees and said executives would take pay cuts. Employees at Children’s National Hospital in the District were informed this week that they must take off one week, using either vacation time or, if they have none, unpaid leave. Hospital executives and analysts emphasize that not all the furloughed or fired workers are directly involved in treating covid-19 patients. Others say the furloughs help reduce the number of people in hospitals, slowing the spread of the virus. But the absences have put a strain on doctors, nurses and other health-care workers treating a surge of patients that has already stretched some health-care systems to the breaking point. Remaining front-line workers face longer hours, and some have seen their pay cut and benefits reduced. For hospitals already in bad financial shape before the outbreak, the loss of income has raised doubts about their ability to keep treating patients. “I’m concerned about the [financially] weakest 25 percent of hospitals, because there’s no way the other hospitals can absorb their covid patients,” said John Fox, the CEO of Beaumont Health, Michigan’s largest hospital system. “If they start going down, that changes the whole algebra for the size of the system to handle the pandemic,” Fox added. He worries that a surge in patients could overwhelm more stable hospitals. “That’s when you’re treating people on the front lawn.” It has also made it harder for some hospitals to finance the considerable costs of treating covid-19 patients — from efforts to purchase personal protective equipment and ventilators to setting up drive-by testing sites. A report this week by the Inspector General for the Health and Human Services Department blamed the cash crunch for ill-timed layoffs and furloughs. “Hospitals reported laying off staff due to financial difficulties, which further exacerbated workforce shortages and the hospitals’ ability to care for covid-19 patients and the routine patient population,”


America is in a depression. The challenge now is to make it short-lived.

40 percent," JPMorgan wrote to clients. “All of these readings were similar to last week’s, suggesting a bottom has been reached.” The Fed’s sweeping new loan programs unveiled Thursday will provide $2 trillion in additional loans to small, medium and large companies as well as cash-strapped states and cities. These latest Fed actions are in addition to slashing interest rates to zero in March and buying numerous government bonds in an effort to keep borrowing as cheap as possible for American families and businesses. Still, the gravity of one in 10 Americans suddenly being out of work is hitting families and communities across the country. Several cities have experienced modern-day bread lines, with lines of cars stretching over a mile long as people wait to visit food banks and restaurants handing out free meals. Government relief has been slow to reach people losing their jobs as states have been overwhelmed with claims. The Washington Post spoke with more than a dozen workers across the country who lost their jobs and filed a claim in March. The majority have not received money yet. To get by, they have dipped into savings, begged online for aid, and waited in line for hours at food banks. “How are people supposed to live a whole month without income?” said Tammy Devitoe, a single mother living paycheck to paycheck as a waitress in New York. “I’ve had to resort to begging online to complete strangers just so I can have enough money to eat and pay my bills.” Devitoe lost her job March 11, when the diner she worked at closed because of coronavirus fears. She applied the next day for unemployment help, but New York’s online form said she needed to call to complete the process. “That’s when the horror began,” she said. Despite calling hundreds of times a day, she was unable to get through to anyone at New York’s unemployment office until March 31. She expects her first payment Monday — a month after she started the application process. Out of desperation, she started a GoFundMe page to ask strangers for aid. She was heartened that over a hundred people donated, but others berated her for not saving or seeking a job at a grocery store during the pandemic. Consumer spending is the backbone of the economy, and all indications are that it has plunged sharply as so many Americans lose their


What UFOs can tell us about life on Earth

Searching for evidence of extraterrestrial life is trickier than it would seem. Just listen for a signal, we say. But what kind of signal? How do we know if it is a signal? What would be used to send the signal? We think automatically of large radio telescopes, their concave dishes pointing skyward. But what frequency should we monitor looking for non-random noise? Scientists have reasoned that you often find different kinds of life around a water hole, so we should look at the telescopic water hole. Chemical elements emit telltale frequencies when excited. Hydrogen peaks at 1420 MHz and a molecule of hydrogen and oxygen at 1666 MHz. Since the two combine to create water, the radio telescopes keep track of what they hear between those two frequencies — the water hole. It would make sense if there was someone out there like us trying to contact us. But would the life out there be like us? What other kinds of intelligences could there be? Cooper points out that there are other sorts of intelligences right here on Earth: dolphins, octopi, elephants. We need to understand how they think to broaden our sense of what we might be looking for. And what has been the result of contact between earthly cultures? Sometimes the interactions are friendly, but often they are exploitative. Should we be afraid of extraterrestrial life? Are we better off not knowing whether there is anyone out there, lest they actually be like us? Cooper weaves together the thoughts of leading scientists, science fiction writers and social scientists to ponder these questions. The great virtue of Cooper’s discussion is that it gives readers a picture of living science. Too often, science is presented as fixed, solved, completed. Cooper shows us scientists disagreeing, presenting and supporting alternative theories, and gives clear discussions of the differing views, letting the science live. So, is there intelligent life beyond Earth? This Sagan of books will not answer that question. But what these three books will do is make you think much more deeply about what such questions mean. If you look into a telescope backward, it becomes a microscope. Looking from both ends can be the source of fascinating insights. They Are Already Here By Sarah Scoles Pegasus. 248 pp. $27.95 Intimate Alien By David J. Halperin Stanford. 292 pp. $26 The Contact Paradox By Keith Cooper Bloomsbury. 336 pp. $28


About 70% of small businesses have applied for a Cares Act loan. It’s unclear how many have received them.

About 70 percent of U.S. small business owners have already tried to apply for an emergency loan through a new $349 billion program, according to an industry survey released Thursday. However, it is unclear how many of the thousands of businesses that have applied for these loans have received them, if any. The Small Business Administration has not released data showing how many businesses have received the funds and has not answered basic questions about the program. More than half of the small businesses that have not yet applied plan to or are considering it, according to the National Federation of Independent Business (NFIB), a trade group for small and independent businesses. A report by the trade group says the program, largely operated by banks, and a second operated by the SBA to provide immediate cash while struggling businesses wait on loan approvals “have yet to deliver the loans, frustrating small business owners who are in immediate need of financial support.” The survey found that just over half of small businesses have applied for the SBA’s smaller disaster loan program but that just 4 percent had been approved. The survey reinforces the concerns of banks and small-business owners that the $349 billion Congress set aside for the Paycheck Protection Program will quickly be exhausted. Republicans and Democrats clashed on a proposed $250 billion increase in the program Thursday, leaving the path forward for additional federal intervention uncertain as the virus continues to tear through the economy. The emergency small-business lending program got off to a rocky start, with most big banks saying they were not prepared to start processing applications when the program launched last Friday. But in less than a week, banks have said, they have received or processed applications worth at least $100 billion. “Sometime next week #PPP will stop & no more #PPPloans will be made, leaving millions of #smallbusiness locked out,” Sen. Marco Rubio (R-Fla.) said Thursday on Twitter. About 72 percent of those who tried to apply for a loan say they were successful in submitting an application, according to the survey. But since many banks are screening companies before supplying a formal application, it may be that some of those companies had completed only the first step, according to the trade group, which surveyed 884 small businesses Monday and Tuesday. Most banks have limited applicants to existing customers, and the survey found that 1


Black Md. residents disproportionately hurt by virus; more than 270,000 filed for unemployment in D.C. area last week

The number of known coronavirus cases in the District, Maryland and Virginia stood at 11,766 on Thursday, with 6,186 cases in Maryland, 4,053 in Virginia and 1,527 in the District. The number of virus-related deaths was 138 in Maryland, 109 in Virginia and 33 in the District, for a total of 280 fatalities. Here are some of the most significant and recent developments as the region responds to the pandemic of the novel coronavirus, which causes the disease covid-19: • Maryland released coronavirus data by race for the first time Thursday that shows black residents are disproportionately being hit by the virus — a trend that has shown up in data elsewhere. The state is about 30 percent black, but black residents make up more than half of the deaths in cases in which a person’s race is known. • Applications for unemployment benefits in the Washington region spiked again Thursday as the covid-19 outbreak continued to severely rattle the local and national economies. The number of claims filed in the District, Maryland and Virginia reached 272,559 over the last week. • The District, Maryland and Virginia added 53 new fatalities on Thursday, the region’s largest single-day increase in fatalities, bringing the national capital region’s death toll to 280. What a stay-at-home order means for you


Why the coronavirus models aren’t totally accurate

Something important is happening as the coronavirus crisis continues: Estimates of its lethality keep going down. On March 31, the White House estimated that, even with social distancing policies in place, between 100,000 and 240,000 Americans would die of covid-19. Anthony S. Fauci recently indicated the government’s estimates will soon be revised downward. The University of Washington model — which has been cited by the White House — predicted on March 26 that, assuming social distancing stays in place until June 1, U.S. deaths over the next four months would most likely be about 81,000. By April 8, it had made more than five revisions, to get to the current number: 60,415. That’s on par with the number of people estimated to have died of the flu in the 2019-2020 season. What is going on? Perhaps social distancing has worked better than was imagined. But still, there is a puzzle about the numbers. Predictions for hospitalization rates have also proved to be substantial overestimations. On March 30, University of Washington researchers projected that California would need 4,800 beds on April 3. In fact, the state needed 2,200. The same model projected that Louisiana would need 6,400; in fact, it used only 1,700. Even New York, the most stressed system in the country, used only 15,000 beds against a projection of 58,000. It’s best to plan for the worst, but this has meant that patients with other pressing illnesses might have been denied care — or not sought care — for no good reason. Why is this happening? The modelers are doing their best with what data they can get, much of which initially came from China and Italy. A group of Stanford University scholars believe that the basic reason that estimates of deaths have had to be revised downward is because without widespread testing from the start, we didn’t realize how many mild or asymptomatic cases there would be. That means the denominator — those who have been infected — is larger than initial estimates and the fatality rate for covid-19 is lower. (If two out of 100 people with the virus die, the fatality rate is 2 percent; if two out of 1,000 die, it is 0.2 percent.) In March, the World Health Organization announced that 3.4 percent of people with the virus had died from it. That would be an astonishingly high fatality rate. Fauci suggested a week


Trump may want to be a bit more judicious about referring to pandemics as ‘debacles’

This article has been updated. A few weeks ago, President Trump’s efforts to contrast the federal government’s response to the current pandemic with President Barack Obama’s handling of the H1N1 pandemic in 2009 seemed like a reasonable political bet. Trump decided to say that former vice president Joe Biden was in charge of the response that year (which he wasn’t) and to criticize the death toll that resulted. Two birds, one stone: bash his likely 2020 general-election opponent and show how he’d done a better job than Obama. But that was back when there were only a couple thousand confirmed cases of the coronavirus in the United States and only about 40 people had died of covid-19, the disease the virus causes. Since then, the comparison has gotten substantially worse. To compare the virus to H1N1 now, with more than 10,000 dead and hundreds of thousands of confirmed infections in the United States, is dubious. To further call the Obama administration’s response a “debacle,” as Trump did in a tweet Tuesday? It’s a descriptor Trump might want to avoid. Trump was using the comparison to disparage an inspector general’s report that documented the extent to which hospitals are unprepared for the current outbreak. Setting aside the various problems with Trump’s personal disparagement of the inspector general, there are multiple issues with the specific comparison to the H1N1 outbreak. The first is that Trump is using — and misstating — an estimate of the number of deaths calculated after the first year of the outbreak by the Centers for Disease Control and Prevention. That estimate put the number of U.S. deaths from the flu over the first year at 12,469, the most likely value from a range extending from just below 9,000 to 18,000 deaths. Trump has in the past compared that figure with the number of deaths on record from the coronavirus. Those figures are tallies of what health officials have recorded on a daily basis and don’t include estimates aimed at capturing underreporting of covid-19-related deaths. The numbers we see and discuss counting how many people have been infected or have died of the coronavirus are necessarily inaccurate, which is why authorities later make estimates that better capture the virus’s toll. In 2009, there was the same murkiness as the H1N1 virus spread. The contemporaneous counts of infections and deaths recorded over the course of that year, then, offer


the current outbreak. Setting aside the various problems with Trump’s personal disparagement of the inspector general, there are multiple issues with the specific comparison to the H1N1 outbreak. The first is that Trump is using — and misstating — an estimate of the number of deaths calculated after the first year of the outbreak by the Centers for Disease Control and Prevention. That estimate put the number of U.S. deaths from the flu over the first year at 12,469, the most likely value from a range extending from just below 9,000 to 18,000 deaths. Trump has in the past compared that figure with the number of deaths on record from the coronavirus. Those figures are tallies of what health officials have recorded on a daily basis and don’t include estimates aimed at capturing underreporting of covid-19-related deaths. The numbers we see and discuss counting how many people have been infected or have died of the coronavirus are necessarily inaccurate, which is why authorities later make estimates that better capture the virus’s toll. In 2009, there was the same murkiness as the H1N1 virus spread. The contemporaneous counts of infections and deaths recorded over the course of that year, then, offer a better point of comparison with where we are now. They are also necessarily smaller than the eventual 12,000-plus estimate. Looking at the number of reported coronavirus infections in mid-March and the number of confirmed H1N1 infections during the same relative period — that is, the number that was being counted in the same way that coronavirus infections are currently being counted — the increase in cases seen with both viruses was about the same at first. The H1N1 strain that year, though, was a much less contagious and much less deadly virus. Even within the first three weeks after the 60th infection from each virus was confirmed, the relative deadliness of the coronavirus was obvious. That takes us only to about mid-March. Since then, the number of coronavirus infections and deaths has soared past where the H1N1 outbreak was in the same period. That graph takes us through Tuesday. As of writing, Johns Hopkins University’s estimate of the number of U.S. deaths from covid-19 is now above 17,000 — north of Trump’s apparent baseline for a “debacle” and well over the after-the-fact H1N1 estimate compiled by the CDC. An estimate that, again, covered the first year. It’s important to


a better point of comparison with where we are now. They are also necessarily smaller than the eventual 12,000-plus estimate. Looking at the number of reported coronavirus infections in mid-March and the number of confirmed H1N1 infections during the same relative period — that is, the number that was being counted in the same way that coronavirus infections are currently being counted — the increase in cases seen with both viruses was about the same at first. The H1N1 strain that year, though, was a much less contagious and much less deadly virus. Even within the first three weeks after the 60th infection from each virus was confirmed, the relative deadliness of the coronavirus was obvious. That takes us only to about mid-March. Since then, the number of coronavirus infections and deaths has soared past where the H1N1 outbreak was in the same period. That graph takes us through Tuesday. As of writing, Johns Hopkins University’s estimate of the number of U.S. deaths from covid-19 is now above 17,000 — north of Trump’s apparent baseline for a “debacle” and well over the after-the-fact H1N1 estimate compiled by the CDC. An estimate that, again, covered the first year. It’s important to reiterate that this is in large part a function of the differences between the viruses. The novel coronavirus is simply much deadlier. But that’s a good reason for Trump not to compare the two: the picture will likely only grow worse. Even in this apples-to-oranges comparison, the H1N1 pandemic looks like something less than a debacle. If we convert everything to apples, comparing estimates of the eventual toll from the coronavirus to the CDC estimates of what happened with H1N1, the difference is even starker. The University of Washington’s Institute for Health Metrics and Evaluation estimates that the coronavirus will lead to 521,000 hospital admissions and 82,000 deaths, compared with 274,000 H1N1 hospitalizations and 12,000 deaths. Oh, and the IHME estimate is only though Aug. 1. So it’s a six-month period that overlaps only partially with the tail end of the flu season, during which it’s expected that the coronavirus will return. How many deaths will the coronavirus ultimately cause? Well, there’s this estimate, released at the end of last month, which shows a possible range of 100,000 to 240,000 deaths. That’s between eight and 19 times as many deaths as were seen from H1N1 during the first year it


Philip Roth’s epidemic and ours

Several weeks ago, just as the coronavirus was laying siege to my home city of New York, I began watching the HBO adaptation of Philip Roth’s novel “The Plot Against America.” Even more so than when I read the book soon after publication in 2004, a time when some basic rules still applied to American politics, the cable version attested to Roth’s ruthless perceptiveness in depicting the United States sliding toward fascism. As the covid-19 pandemic has deepened its grip, emptying the streets of my neighborhood and filling the air with ambulance sirens, my mind began turning to a different Roth novel. That one, “Nemesis,” takes place in the same Jewish section of Newark as “Plot,” Weequahic, and in the same decade, the 1940s. Its catastrophe, however, is a polio epidemic. Now, having reread “Nemesis” for the first time since its release exactly a decade ago, I cannot help but be unnerved by its prophetic perspicacity. As in “Plot,” Roth’s imagined past foretold our lived present. “Nemesis” offers a psychic map to our current struggle with an invasive and ineradicable disease, one that leaves every individual wondering who else might be carrying it and passing it lethally along. Roth set “Nemesis” in 1944, in part to establish a parallel between polio’s ravages and those of the world war. Newark did not have a major outbreak that summer, but it did endure them in both 1916 and 1952, and hardly any summer in between passed without a major surge of cases somewhere in America. The people of Roth’s book, like so many people across the globe now, cannot know precisely how and when the disease spreads. Is it from flies, mosquitoes, public pools, water fountains, toilets, sewage? Can it be carried on coins or dollar bills or animal fur? In Roth’s fractious Newark, the Italians think it’s the Jews’ fault and the Jews wonder if the malady travels into their homes with their “colored cleaning women.” What is statistically certain is the growing caseload and death toll during the torrid summer. Then, as now, an initial dismissal of the threat gives way to parental panic, shutdowns of parks and movie theaters, houses bearing quarantine signs. The local hospitals run out of equipment — iron-lung machines, the ventilator equivalent of its time. Roth centers all of the burgeoning terror and anguish on his protagonist, Bucky Cantor, a 23-year-old phys-ed teacher with a


The U.S. was beset by denial and dysfunction as the coronavirus raged

began making plans to charter aircraft to evacuate 6,000 Americans stranded in Wuhan. They also debated language for travel advisories that State could issue to discourage other travel in and out of China. On Jan. 29, Mulvaney chaired a meeting in the White House Situation Room in which officials debated moving travel restrictions to “Level 4,” meaning a “do not travel” advisory from the State Department. Then, the next day, China took the draconian step of locking down the entire Hubei province, which encompasses Wuhan. That move by Beijing finally prompted a commensurate action by the Trump administration. On Jan. 31, Azar announced restrictions barring any non-U.S. citizen who had been in China during the preceding two weeks from entering the United States. Trump has, with some justification, pointed to the China-related restriction as evidence that he had responded aggressively and early to the outbreak. It was among the few intervention options throughout the crisis that played to the instincts of the president, who often seems fixated on erecting borders and keeping foreigners out of the country. But by that point, 300,000 people had come into the United States from China over the previous month. There were only 7,818 confirmed cases around the world at the end of January, according to figures released by the World Health Organization — but it is now clear that the virus was spreading uncontrollably. Pottinger was by then pushing for another travel ban, this time restricting the flow of travelers from Italy and other nations in the European Union that were rapidly emerging as major new nodes of the outbreak. Pottinger’s proposal was endorsed by key health-care officials, including Fauci, who argued that it was critical to close off any path the virus might take into the country. This time, the plan met with resistance from Treasury Secretary Steven Mnuchin and others who worried about the impact on the U.S. economy. It was an early sign of tension in an area that would split the administration, pitting those who prioritized public health against those determined to avoid any disruption in an election year to the run of expansion and employment growth. Those backing the economy prevailed with the president. And it was more than a month before the administration issued a belated and confusing ban on flights into the United States from Europe. Hundreds of thousands of people crossed the Atlantic during that interval.


Hogan freezes non-coronavirus spending, seeks broad cuts as pandemic’s grip on region grows

another 1,389 cases Friday, for a total of 13,157 — a reflection of both the increase in testing being done and the fact that the virus continues to seep into virtually every corner of society. Deaths in the region jumped by 51 for a total of 331 midday Friday. With Easter arriving Sunday and the eight-day Passover holidays in full swing, officials repeated their warnings for residents to stay home and avoid gathering in large groups or risk the region becoming another major center for covid-19. To mark Good Friday, D.C. Mayor Muriel E. Bowser held a “moment of prayer and silence” to honor those affected by the virus. “Sunday, from my home, I will celebrate Easter,” Bowser (D) later said, before a bagpiper played “Amazing Grace” at a news conference held inside Gonzaga College High School, whose president, Stephen Planning, came down with the virus in mid-March. Planning, a Jesuit priest now fully recovered, attended. “Many of our traditions are on hold this year, but our faith is not,” Bowser said. Maryland had the most new fatalities Friday with 33, another in a string of record single-day increases. Overall, the state had 6,971 known cases of coronavirus infections. The District’s tally of cases grew to 1,664, with 39 deaths. Virginia reported 469 new infections — also another single-day record — for a total of 4,522. The state had 121 covid-19 fatalities as of Friday. Among the cases in Maryland are 57 people inside the state’s prison and jail system who have tested positive, said Baltimore City State’s Attorney Marilyn Mosby. Mosby (D) hammered Hogan as not taking early steps to prevent the disease from spreading among the states’ inmates and corrections officers. “More than two weeks ago, my office provided the Governor with a plan that was signed onto by criminal justice and public health experts from across the state,” Mosby said in a statement. “To date, the Governor has yet to respond to that plan nor come up with his own.” Instead, her statement charged, the governor suggested that “‘they’re safer where they are,’ a comment as heartless as it is false,” the statement said. Hogan’s chief spokesman, Michael Ricci, declined to respond to Mosby’s statement. Instead, Ricci provided a March 19 letter from the governor’s legal counsel to the state’s attorney that said her proposals would be taken “under advisement.”. By contrast, Northam announced a proposal Friday


District’s tally of cases grew to 1,664, with 39 deaths. Virginia reported 469 new infections — also another single-day record — for a total of 4,522. The state had 121 covid-19 fatalities as of Friday. Among the cases in Maryland are 57 people inside the state’s prison and jail system who have tested positive, said Baltimore City State’s Attorney Marilyn Mosby. Mosby (D) hammered Hogan as not taking early steps to prevent the disease from spreading among the states’ inmates and corrections officers. “More than two weeks ago, my office provided the Governor with a plan that was signed onto by criminal justice and public health experts from across the state,” Mosby said in a statement. “To date, the Governor has yet to respond to that plan nor come up with his own.” Instead, her statement charged, the governor suggested that “‘they’re safer where they are,’ a comment as heartless as it is false,” the statement said. Hogan’s chief spokesman, Michael Ricci, declined to respond to Mosby’s statement. Instead, Ricci provided a March 19 letter from the governor’s legal counsel to the state’s attorney that said her proposals would be taken “under advisement.”. By contrast, Northam announced a proposal Friday to begin expediting the release of as many as 2,000 prison inmates who have less than a year remaining in their sentences to reduce the possibility of an outbreak, a measure likely to be approved by the Democrats who control the General Assembly when it meets for a veto session on April 22. To be eligible, offenders “must have demonstrated good behavior and not be a threat to public safety,” Northam said. In the District, seven additional members of the D.C. fire department have tested positive for coronavirus, officials said Friday. That brings to 56 the number of firefighters, paramedics and emergency medical technicians who have contracted covid-19. Eleven of them have recovered and returned to duty. Fire officials said the number of members under quarantine is 269. An additional 300 members who had been quarantined have returned to work. Amid a push by President Trump to restart much of the country’s economy by May, Bowser allowed the first open-air food market to reopen on a limited basis Friday. The Arcadia Mobile Market in Southeast Washington, which focuses on providing produce to low-income neighborhoods, got permission to operate between 3 and 5 p.m., with the possibility of receiving permission to


The military’s medical ‘relief valves’ remain mostly empty in New York. This is why.

1-2 days, that a trip to Javits may be more of a burden than a help.” The Comfort arrived at Pier 90, on Manhattan’s West Side, on March 30 as many New York hospitals were morphing into coronavirus centers. Only a few dozen patients, none with covid-19, were treated aboard the ship during its first week in the city. The ship began accepting covid patients Tuesday. Its 1,000-bed capacity has been reduced to 500 to account for the higher care needs. There are 100 ICU beds with ventilators plus operating rooms for treating higher-risk patients, officials said. As of Friday morning, 62 patients were onboard the ship, half of them with covid-19, officials said. One crew member also has tested positive for the disease. Lt. Marycate Walsh, a Navy spokeswoman, said, “USNS Comfort’s support to New York cannot be accurately captured through the quantity of patients onboard,” adding that, on Thursday, doctors there performed a 10-hour lifesaving surgery on a coronavirus patient. Earlier in the week, 37 military personnel transported 18 covid-19 patients to the Comfort and other hospitals when one hospital’s oxygen system went on the fritz. It was only a month ago when Cuomo and New York Mayor Bill de Blasio (D) suggested that the crisis would blow over. But as the need for more hospital beds became clear, Cuomo, at his daily news briefings, described his forceful push on the Federal Emergency Management Agency, and then his calls to President Trump, to allow covid-19 patients at the Javits Center. Yet until the admission criteria were updated this week, the threshold for sending patients to either the Javits Center or the Comfort were so restrictive that few people qualified, said one frustrated New York doctor, who spoke on the condition anonymity to be candid. “The hospitals are housing ICU-level patients in the lobbies and the cafeterias,” the doctor said, while the Javits beds added “nothing.” The military has attempted to streamline the transfer process. Because they’re both taking covid patients now, the Javits Center and the Comfort are working as one unit. Military doctors have been dispatched to hospitals around New York City where they help identify potential patients who can be transferred to the temporary sites. A command center within Javits decides whether ambulances ferry them to the convention hall or the ship. But even that is a complicated process. The Comfort was built to rescue trauma


Small businesses are still awaiting emergency loans — and facing a dilemma about how to spend them

some who make it through the application process say they’re facing dilemmas about how to use the money. The Small Business Administration, which is overseeing the program, said more than 600,000 loans totaling $161 billion had been approved as of Friday. It didn’t provide a figure for the amount of money disbursed. “Overall, this is the largest economic recovery program in our country’s history and it is underway after being built in five short days,” the agency said in an emailed statement. “The overwhelming response of applications for PPP assistance since the program launched illustrates how much America’s small businesses — and those they employ — need our help.” Small businesses across the country are pouncing on the program. About 70 percent of 900 entrepreneurs surveyed said they tried to apply for a PPP loan, according to the National Federation of Independent Business. Of those, about three-quarters successfully submitted an application, with the rest reporting problems. Some entrepreneurs have had trouble finding a bank that will accept their application, in some cases because banks are limiting the loans to preexisting customers, according to the NFIB’s survey. The taxpayer-funded program relies on banks to vet and approve loans of up to $10 million. Gusto, a company that helps small businesses manage their payrolls, said its clients are having more luck applying through local banks, rather than large, national lenders. “Anecdotally we’ve found small community banks have done a better job getting the money distributed,” Gusto co-founder Edward Kim said. After a slow start, big banks have stepped up their participation in recent days. Citigroup began taking applications Thursday. JPMorgan Chase and Bank of America say small businesses have applied for about $40 billion in loans from each bank. But the banking industry remains frustrated by the rollout. Banks say the Treasury Department and SBA are still clarifying how the program will operate, making it more difficult to finalize the terms of the loans. “Clear and concise instructions are still sorely needed on access to the SBA loan programs,” the Independent Community Bankers of America and more than two dozen state banking associations said in a letter Thursday to Treasury Secretary Steven Mnuchin and Small Business Administrator Jovita Carranza. “Community bankers throughout the country have worked around the clock to make this critical program work for cash-starved small businesses.” Patrick Ryan, chief executive of the New Jersey-based First Bank, said small businesses


Why starchy processed food causes us to overeat, gain weight and become ill

resisting.” Nearly half of all American adults are obese, and almost one-tenth are severely obese, according to the Centers for Disease Control and Prevention. Moreover, both have increased since 1999, the CDC says. The agency says that obesity also now affects 1 in 5 children. For years, most experts believed fat, sugar and salt were the killers in American diets. This is still true, but it’s more complicated, Kessler says. A decade ago, he wrote about the threesome’s addictive qualities in “The End of Overeating,” pointing out how eating foods overloaded with fat, sugar and salt contributes to obesity. His latest book builds upon that evidence, essentially connecting their relationship to starch, arguing that by cutting out many processed foods, we can curb starch intake and the dangerous substances they transport. That doesn’t mean that foods without starch — but that contain sugar, salt and fat — are okay; their dietary dangers haven’t changed, he says, one reason he also avoids sugar-laden puddings, ice cream and sweetened sodas. Nevertheless, eliminating most processed foods will limit the intake of fat, sugar and salt, he says, adding that, until now, starch has been overlooked in the dietary debate. “Everyone knows fat, sugar and salt are bad for you, but no one paid any attention to starch,” he says. “That’s the story we missed.” Kessler began to view processed foods with suspicion during a San Francisco supermarket excursion in 2017, when he paused to scrutinize the label on a cereal box. “I wondered what was in the box,” he recalls. “It didn’t say ‘starch.’ It said ‘wheat.’ I started talking to scientists and people who worked in industry, and realized that the processing techniques really pummel the intact nature of wheat in a major way. If you look at the cereal in your bowl, it looks nothing like wheat. The mechanical forces have changed it. What’s in that box are short chains of glucose — which is sugar.” To be sure, right now we are living in trying times. The novel coronavirus pandemic has confined most of us to our homes, forcing us to become dependent on home grocery deliveries, takeout orders and abbreviated shopping trips. Many foods are out of stock, including nutritious ones. It’s also when we often seek “comfort” foods to ease our anxiety, many of them unhealthy. “If you want to understand the power of food, there is no


Money can’t go everywhere, but it can do some good right here

was director of national and public health issues at the Government Accountability Office from 1990 to 1995. The April 8 Health Unfortunately, our medical providers are without the physical or mental armor they need, which exposes them to psychological trauma and moral injury when they must make decisions about who lives and who dies. We must do more to protect our health-care providers from the emotional guilt and shame of perceived moral failure inflicted by impossible health-care choices. Our hospital leaders must develop strong organizational strategies to bolster protective protocols, spread the workload and support self-care for the caregivers. Health-care workers need the latitude to show vulnerability in safe and constructive ways. These dedicated healers are risking their lives every time they walk into the hospital. We must spare no effort to protect their physical, mental and spiritual well-being. Wayne Jonas The writer, executive director of Samueli Integrative Health Programs, is retired from the Army Medical Corps, a practicing medical doctor, and author of “How Healing Works.” Regarding the April 8 Black Americans have made up a large percentage of people who die from the disease. The prevalence of chronic conditions, such as hypertension and diabetes, contributes to the increased risk of coronavirus-related deaths for blacks; however, the cause of these disparities is much more complex. Health is impacted by several factors, including access to care, adequate housing, education, employment and a stable income. The high mortality rates of covid-19 are often occurring in communities where many black, Hispanic and Latino individuals struggle to meet some of these basic needs. Working remotely is a luxury not easily afforded by everyone, especially when a paycheck is not guaranteed. Social distancing is harder when relying on public transportation or living in crowded conditions, such as prisons or shelters. The reported rates of covid-19 may underestimate the true numbers given barriers to care that further limit testing. Obtaining care for chronic conditions may also be challenging in a pandemic, potentially increasing the risk for non-covid-19-related deaths. This makes it difficult to truly understand the impact of covid-19 on communities of color. We need socio-demographic data about who is tested, affected and dying from covid-19. This includes data by race, ethnicity, gender, income, insurance status and census tract. Data helps us develop a better response to the current pandemic as well as prepare for future threats. Janice Blanchard Read more letters to the editor.


Disruption to football season would be very bad for all of college sports

As Iowa State Athletic Director Jamie Pollard talked with peers and reporters about the novel coronavirus this month, he used a weather-based analogy to describe how the pandemic could affect his department’s finances. If the crisis subsides soon, Pollard said, it could be akin to a bad blizzard. If it delays the beginning of the football season, it could be like a long, hard winter. And if the pandemic forces the cancellation of the football season? “It’s an ice age,” Pollard said in a phone interview. “I don’t know how any of us, how the current NCAA model, could survive if we’re not playing any football games.” Just four weeks after the pandemic forced the cancellation of the NCAA men’s and women’s basketball tournaments and other sports, athletic directors, conference commissioners and network executives are turning their attention to the upcoming football season. In interviews this week, several athletic directors and college sports officials acknowledged a distressing reality: A canceled football season would cost the industry billions, forcing athletic directors to consider layoffs, drastic pay cuts and potentially canceling so-called Olympic or nonrevenue sports. “Everything is on the table,” Pollard said. “It’s hard today to wrap your head around how challenging that would be if we can’t play any football games. . . . We’d essentially be bankrupt.” Iowa State’s annual athletics budget hovers around $90 million, and about 75 percent of its revenue comes from football, Pollard said. To deal with a $5 million drop in this school year’s revenue created by the coronavirus-related cancellations, Pollard already has instituted an across-the-board 10 percent pay cut for all coaches and athletic department employees. But he said that wouldn’t come close to helping deal with plummeting revenue in the 2020-21 school year if no football is played, which is why hybrid season models are under discussion. “There’s a lot of really smart people out there who will do everything humanly possible to try to find a way to play some or all of the football games,” Pollard said. For the past few weeks, Tom McMillen, chief executive of Lead1 — a nonprofit that represents the 130 schools in the Football Bowl Subdivision — has had regular virtual happy hours with small groups of athletic directors, sipping wine and discussing how the coronavirus might affect the football season. They weighed the pros and cons of options that included delaying the season into


Covid-19 outbreak transforms NJ hospital rushing to meet demand

increased protective measures. Areas for infected patients were converted into negative pressure spaces, drawing out air to prevent contamination inside. New procedures were put in place to minimize the number of staff needed to enter a patient’s room. Monitoring equipment was placed outside the pressurized room, which reduced the amount of personal protective equipment used from 30 per day to only five to six per day. This helped the hospital conserve a critical resource during a supply shortage. Staff describe the independent hospital as a family that has only become closer during the crisis. And the already grueling days take on added emotion when their own staff becomes infected. They recently lost members of the food services and transportation teams to the virus. The wider community has rallied around the hospital staff as well, donating meals and collecting and sewing masks. Artwork by children lines the entrances so staff see it as they arrive to work, and on a few evenings rounds of clapping can be heard as a thank you. With the contagion quickly spreading across the state, contingency plans had to be enacted before the hospital ran out of its 19 ICU beds. “We realized very quickly that our second, third and fourth level plans had to be put into place,” said Chief Medical Officer Adam Jarrett. In less than a week, the team transformed a raw space without electricity or running water into a new ICU that could accommodate 36 additional patients. When those beds immediately filled up, they looked for more areas. They now have 106 ICU beds as they continue to build out to accommodate increasing demand. But Jarrett expects numbers will continue to rise. With the highly contagious novel coronavirus, patients must remain in isolation at the hospital. Family members can only communicate with them over video chat. One of the disease’s most cruel moments is when final goodbyes cannot happen in person. Holy Name has had 79 deaths so far. Occasionally, over the loudspeaker, the “Rudy” theme song can be heard playing across the hospital. It is a welcome sound, marking the moment a covid-19 patient has been discharged. “It really changes the mood for the nurses and the staff that are taking care of the critically ill,” Jarrett said. “By playing this music, it lets everyone know that sometimes it’s a very difficult battle, but there is an awful lot of victory."


Hogan joins other governors in asking Congress for $500 billion as coronavirus cases rise in the D.C. region

support, states will have to confront the prospect of significant reductions to critically important services,” Hogan wrote in the letter, sent on behalf of other governors. This “hamper[s] public health, the economic recovery, and — in turn — our collective effort to get people back to work.” The District, Maryland and Virginia reported a total of 53 new covid-19 fatalities Saturday, bringing the regional death toll to 384. In a joint statement on behalf of the National Governors Association, New York Gov. Andrew M. Cuomo (D) and Hogan said the most recent federal rescue package contained no money to help states balance their books. The Cares Act gives $150 billion to states, although there are restrictions on how the money can be used — it’s meant to assist in areas including housing, education and access to healthy food — and governors say it’s not nearly enough. House Speaker Nancy Pelosi (D-Calif.) has called the $150 billion “a down payment.” Some states, such as Pennsylvania, have started laying off workers. New York predicted a $10 billion deficit. Unlike the federal government, cash-strapped states cannot run deficits and must slash budgets when revenue falls short. Cuomo and Hogan said the half-trillion dollars that states need is in addition to a rescue package for local governments. The letter follows a Thursday call between governors and Treasury Secretary Steven Mnuchin, Hogan spokesman Michael Ricci said. The District, Maryland and Virginia disclosed 1,415 new known coronavirus cases as of Saturday morning, bringing the regional total to 14,572. Still, experts say official tallies do not reflect an accurate snapshot of the virus’s toll on communities. People infected today may not show symptoms for days and may take weeks to receive positive test results. Many will not be tested at all, as health authorities and doctors prioritize tests for high-risk groups and emergency workers. The region has had 384 covid-19-related deaths so far: 48 in the District, 206 in Maryland and 130 in Virginia. The District and Virginia each reported nine deaths Saturday, while Maryland reported 35. Prince George’s County added eight deaths Saturday, bringing its total death toll to 50, the most of any Maryland jurisdiction. All of the District’s new victims were black, further exacerbating racial disparities in the death toll. In a city in which 46 percent of residents are African American, covid-19 victims have been more than 70 percent black. fenit.nirrapil@washpost.com erin.cox@washpost.com hannah.natanson@washpost.com


Far-right and radical Islamist groups are exploiting coronavirus turmoil

become biological weapons,” said Steven Stalinsky, executive director of the Middle East Media Research Institute (MEMRI). “Sites for spreading infection are discussed, among them supermarkets, hospitals and power stations. Also discussed is visiting synagogues and coughing in the faces of rabbis.” Like extremists on the far right, radical Islamist groups have aggressively exploited the pandemic, largely through the same means used in other crises. Al-Qaeda’s central media outlet issued a statement in English and Arabic last month that claimed the pandemic was a sign of God’s fury toward humanity for its sins and failure to adhere to God’s rules. It urged Muslims to repent and fight against “the Crusader Enemy,” and condemned “the tyranny” of Muslim leaders and the “obscenity and moral corruption” sweeping majority-Muslim countries. In an editorial in an online magazine last month, the Islamic State urged “lone-wolf” attacks to capitalize on the paralysis and fear. MEMRI and SITE found that Shiite groups — including Kataib Hezbollah in Iraq and the Houthis in Yemen — and their supporters on social media platforms have accused the U.S. government of deploying the coronavirus as a bioweapon. Experts and security officials say they are concerned about the swell of calls from extremists to strike at a time when they believe they could get away with terrorist acts and not be detected. On March 24, a man who authorities say was planning to bomb a hospital where covid-19 patients were being treated was killed during a shootout with FBI agents in Belton, Mo. Timothy R. Wilson, 36, who had been active on right-wing extremist online groups, intended to use an explosive-laden vehicle in the attack, officials said. U.S. security officials say they have noticed an uptick in threats against targets in New York and surrounding areas — which lead the country in covid-19 infections and deaths. Last month, the FBI told police agencies in New York that white supremacists intended to spray Jews and police officers with virus-infected bodily fluids. On March 21, the New Jersey Office of Homeland Security and Preparedness warned that a neo-Nazi media group had encouraged supporters “to incite panic while people are practicing social isolation during the COVID-19 outbreak, which includes discharging firearms in cities and putting bullet-sized holes into car windows.” The fact that people are under quarantine makes them safer from attacks, said Mitchell D. Silber, executive director of the Community Security Initiative, a program


Rare voices from Iran’s epic coronavirus outbreak tell of stumbling government, deluged hospitals

ISTANBUL — Iran has been struck by one of the most severe coronavirus outbreaks in the world, but the voices of Iranians affected by the pandemic have remained largely unheard outside the country’s borders. The scale of their suffering has been obscured by often upbeat stories about survivors in Iran’s official media and by an inscrutable government many suspect is underplaying the toll. Aided by Iranian hospital records obtained by The Washington Post, however, reporters were able to contact covid-19 survivors and the families of victims. They recounted tales of valiant medical workers, overtaxed hospitals and a government that had been far too slow to raise the alarm. “Awareness-building was way too late,” said a young architecture student who was hospitalized. “Many people were already infected.” Nearly 70,000 Iranians have tested positive for the virus and more than 4,000 people have died, including some of Iran’s most prominent officials, according to the government health ministry. The human toll has gone largely unremarked upon in Western countries absorbed by the wave of deaths in places such as Italy, Spain and the United States. The medical records, from 56 hospitals in Tehran, include detailed information about thousands of coronavirus-related cases between late February, when Iran reported its first infection, and mid-March. The hospitals — which represent about a quarter of the approximately 200 medical facilities in the city admitting virus-related cases — tested at least 5,500 patients in that period. Just under half tested positive, while many more tests appeared to be pending. Beyond the numbers, the records provide a glimpse of a nation reeling from its latest terrible trial and seized with anxiety and confusion. Some people who were interviewed were not even aware that the hospital records showed that their relatives had tested positive for coronavirus. In interviews, a farmer said he took his sick father to a Tehran hospital and was horrified at the chaos they saw inside. An infected Iranian student said she feared she had passed the coronavirus along to her already ailing father. A widow recalled how Iran’s failing economy had already left her husband hopeless and no longer interested in caring for himself, long before the virus took his life. In the hospital, she said, “we saw many families losing dear ones.” The following accounts have been edited for clarity and were provided on the condition of partial or complete anonymity because of the sensitivity


With tennis tournaments halted, lower-ranked players plead for financial help

As snowflakes fell around him, Roger Federer, in sweats and knit cap, practiced trick shots against a wall outside his Swiss home. Under the South Florida sun, Venus Williams relaxed on a poolside chaise and vowed to be ready when the tennis season resumes. And on the island of Mallorca, Rafael Nadal logged miles on his treadmill while trying to buoy others’ spirits via home video. For the champions of tennis, the hiatus mandated by the novel coronavirus pandemic has offered a rare chance to relax and recover from nagging injuries while leading charitable initiatives, sharing upbeat social media posts or both. But for the hundreds of players ranked outside the top 150, players who struggle to make ends meet even in good times, the suspension of the men’s and women’s tennis schedules has jeopardized their careers and sent one to social media with a different intent. Classified for employment purposes as “independent contractors,” tennis pros are essentially mini corporations that must balance their ledgers after covering expenses that include international flights, hotels, meals and coaching fees. For the sport’s elite, prize winnings more than cover those costs, plus luxuries such as a traveling hitting partner, physiotherapist and family members joining them on the road. Sponsorship deals often represent millions more. As the highest-paid male and female tennis players in 2019, according to Forbes, Federer earned $93.4 million last year, of which $86 million was from corporate sponsors, and Serena Williams earned $29.2 million, of which $25 million came from sponsors. For players ranked roughly 150th or lower, however, life on tour is a break-even proposition. And that tenuous math is breaking down for many now that the pandemic has halted all tournaments until at least July 13. Explained 375th-ranked Sofia Shapatava, 31, of the former Soviet republic of Georgia: “There is a huge gap, and it’s insane. If we compare it to the 300th-best player in [soccer], they get millions for sitting on the bench for a secondary club. The 300th-best player in tennis — most cannot even afford a taxi to the hotel with their bags.” To draw attention to the financial hardships of lower-ranked players, Shapatava launched a petition on Change.org on March 19, calling on the International Tennis Federation and the men’s and women’s pro tours to help those at the margins make ends meet until tournaments resume. She initially got pushback from sports fans who


Russia’s state-backed media uses the pandemic to spin anti-Western views. They are not alone.

MOSCOW — After a Russian military contingent with medical equipment arrived in Rome last month, the Kremlin's English-language media outlets RT and Sputnik found video gold. They highlighted an Italian man replacing an E.U. flag with a Russian one — deriding how Italy’s European partners “failed” to provide assistance to the coronavirus-stricken country while Russia “filled in.” But when questions were raised about Russia’s aid, the state-funded outlets went on the defensive. Italian newspaper La Stampa reported that roughly 80 percent of the supplies were “useless,” citing high-level political sources. RT called the story “ingratitude” and “ripping a page straight out of the U.S. media’s ‘Russiagate’ playbook.” Another RT headline read, “How disinformation really works: Activists linked to pro-NATO think tank smear Russian covid-19 aid to Italy.” As the coronavirus pandemic has forced people across the globe to stay inside — and spend more time scanning the news — state-sponsored media outlets have tried to spin it to their advantage, according to an Oxford Internet Institute report. The study — which analyzed coronavirus-related news from state-backed English-language media in Russia, China, Iran and Turkey — found some common themes that have the potential to cloud and complicate global efforts to tackle the pandemic. Among them: portraying responses by others to the pandemic as “incompetent,” pushing conspiracy theories about the origins of covid-19, the disease caused by the novel coronavirus, and positioning their countries as world leaders in the fight against the virus. Some of the narratives are far from limited to media in those four countries. Fox News has provided an ample platform for President Trump’s touting of hydroxychloroquine as a coronavirus treatment despite no consensus from health experts on the drug’s effectiveness. In Brazil, President Jair Bolsonaro has described the outbreak as a “fantasy” and a “little flu,” and Twitter even deleted two of his tweets for spreading misinformation about the coronavirus. Philip N. Howard, director of the Oxford Internet Institute, said that criticism of the World Health Organization is also prevalent in the content the report studied — something that’s been boosted by Trump’s own attacks on the U.N. agency in recent days. “ The intended audience for English-language media in China, Turkey, Iran and Russia is the country’s diaspora as well as “people who like conspiracy theories in the West,” Howard said. The majority of the content has heavy political spin rather than outright lies. During a


Your life may feel totally out of control. ‘Tiger King’ is a reminder that it isn’t.

A global pandemic can make even the most rational person feel flattened by fate, wondering whether a trip to the grocery store will bring doom. But as covid-19 continues to rage throughout the United States, most of us can take comfort in one certainty: neither you nor I will ever have an arm amputated because we’re worried about causing bad publicity for a maniacal Oklahoma zoo owner. If you think I invented that scenario, then you haven’t been watching “Tiger King.” Netflix’s documentary series about big cats and the people who love them — or, at least, who breed them, sell them and use their furry friends as tools of seduction — has become what passes for a hit these days, and for good reason. At a moment when all of us feel vulnerable, “Tiger King” is an affirmation that there are some fates that we can avoid. “Tiger King” is too baroque to summarize, but its breakout subject is a former zookeeper with the moniker Joe Exotic, whose feud with sanctuary operator Carole Baskin ultimately lands Joe in prison after he is convicted of hatching a murder-for-hire plot against her. Joe is the most colorful person chronicled in “Tiger King,” though not for lack of competition: the episodes are full of polyamory; alleged reality-show-related arson and body-disposal-via-hungry-tiger; meth-taking; and ill-advised political campaigns. Joe’s zoo is closed, but the humans remain on display. That makes the series entertaining, if not exactly moral. But “Tiger King” wouldn’t be a sensation if it was a routine nature documentary rather an opportunity to cast judgment. The key to grasping the show’s appeal is understanding precisely what we’re judging its subjects for. The series begins with a warning: “Don’t own big, dangerous animals because it’s a time bomb.” But while the appeal of wildlife is understandable, even if you have no plans to pony up for a black market cross-bred liger, that’s not why “Tiger King” exerts a kind of horrified fascination. Rather, both the relief the show provides and its moral dubiousness stem from the distinction we can draw between ourselves and the series’ characters. We might share their desires to pet a tiger, but we can reassure ourselves that we would never make the same awful decisions in our interactions with humans. Many of us occasionally get angry on the Internet. Few have the malice or energy to carry on years-long harassment


This is how the world is celebrating Easter during the covid-19 pandemic

By now, the spread of covid-19 has affected just about everyone around the globe. From Rome to Barcelona to New York and beyond we have been cautioned to practice social distancing to help contain the virus outbreak. This has affected everything we do, from work to school and now, today, to how we celebrate Easter. These photos show how people are approaching the holiday around the globe.


Amid pandemic, some struggle to abide by new distancing demands

“We don’t worry about problems like this.” A week ago, large crowds at the Wharf in Southwest Washington prompted the District to shut down the fish market and allowed it to reopen only after the businesses came up with a plan to ensure that shoppers kept their distance. As an added precaution, the District deployed the police and National Guard. On Saturday, a couple hundred people waited their turn, some abiding reminders from a security officer to separate when they drifted too close together. “He’s not even six feet away from us when he’s telling us what to do,” said Sade Barber, 26, of Alexandria, as she waited, a mask over her face. The police made themselves visible at Lincoln Park on Capitol Hill and at Meridian Hill Park on 16th Street NW, where an officer in one of the two cruisers present said people could sit on benches for 15 minutes and discouraged anyone from settling in to, say, read a book. The park was largely vacant Saturday when Andrew Small, 30, the author of an urban affairs newsletter, and his girlfriend, Sarah, stopped during a bike ride to rest on a bench. After 10 minutes, a National Guardsman approached. “ ‘Hey, I’m sorry, no one is allowed to sit on the benches,’ ” the guardsman said, Small recalled. “ ‘You have to keep moving.’ ” Dustin Sternbeck, a spokesman for the D.C. police, said the District is encouraging residents to use parks to exercise but not to play sports or linger. “Too many people are congregating,” he said. The police and National Guard were not present at all parks. At Kalorama Park on Columbia Road NW, several basketball players shot hoops on Sunday, ignoring a sign that said the court was closed. On a grassy field, people sat on lawn chairs. The day before, more than a few dozen people — couples and small groups — could be found on blankets, many trying to maintain distance. “I just came out to get some air,” said a 67-year-old man, a translator, who spoke on the condition on anonymity, a mask over his face as he sat on a bench. “I am very aware of what the mayor says. No one is sitting next to me. I’m trying to be very careful. It’s a very scary time.” A few yards away, Aidan O’Shea, 30, who works in public relations, sat


The second-most-dangerous contagion in America: Conservative irrationality

right lives in a world of “alternative facts,” we are back to where we were a few weeks ago, with many conservative commentators and administration officials once again braying for the economy to reopen. Trump — Fox viewer No. 1 — is listening intently, and he is receptive to the message because he is seeing his poll numbers fall as the unemployment numbers rise. The Post reports that Trump is now aiming to restart the economy by May 1. Luckily, he does not have the “absolute authority” to do that, as he claimed on Friday, but, unfortunately, he does have the ability to persuade many of his followers — including red-state governors — to go back to business as usual. Doing so prematurely would be extraordinarily dangerous. The University of Washington model that so many conservatives cited to minimize the risk explicitly states that it is premised on maintaining “full social distancing through May 2020.” Internal government projections, reported by the New York Times, show that “if the administration lifts the 30-day stay-at-home orders, the death total is estimated to reach 200,000.” The consensus of experts — you know, the people whom right-wingers don’t listen to — is that it will be impossible to lift social distancing requirements until much more widespread testing and contact tracing are in place. One study from two Microsoft researchers estimates we will need to perform millions of tests a day. U.S. testing levels have increased but are still far short of that goal. Only 137,297 tests were reported on Saturday. But will Trump listen? It’s hard to talk sense into a president who thinks that a virus can be defeated by antibiotics. Public health officials such as Anthony S. Fauci and Deborah Birx are like the passengers in a car that Trump is slowly driving down a winding mountain road: Can they convince the president that we won’t get to our destination faster by simply going straight off the cliff? Read more: Max Boot: Now we know: The conservative devotion to life ends at birth Danielle Allen: The best way out of this pandemic is to massively scale up testing. Here’s how to do it. Eric Topol: How digital data collection can help track covid-19 cases in real time Megan McArdle: My dad has covid-19. All we can do is wait. Max Boot: The right-wing media’s contempt for truth has never been more dangerous


What an infectious disease specialist learned about the virus — from getting it

Michael S. Saag is associate dean for global health and the director of the Center for AIDS Research at the University of Alabama at Birmingham. Nearly a month ago, on March 12, I was taking the train from Boston to New York City where I was meeting my son, Harry, a physician in Manhattan, for a long drive back to Alabama. On the train, I wrote an op-ed for the Birmingham News warning that the coronavirus was coming to our region and that we were not ready. The piece was published the next day. When we pulled into our driveway in Birmingham that evening, Harry spiked a fever. We looked at each other and, as physicians, knew what this likely meant: covid-19. By Saturday afternoon, I, too, developed symptoms. We both tested positive on Monday. Harry’s symptoms were mild and lasted five days, as might be expected for a young, otherwise healthy 34-year old. At 64, I was more concerned. My initial symptoms were mild — fatigue, cough, headache, fuzzy thinking and loss of my sense of smell. By day six, things took a big turn for the worse. I began a daily cycle of afternoon chills, fever (101 degrees), profound muscle aches, loss of appetite, inability to concentrate and hypesthesia — numbness — on the top of my head. The symptoms would largely dissipate by the morning, leading me to believe I had “turned the corner,” only to cruelly, relentlessly, return the next afternoon. And the next. And the next. It was like “Groundhog Day.” The cumulative effect over time was draining, both physically and spiritually. My fear of going to the hospital and being placed on a ventilator led to a desperate move: I started hydroxychloroquine plus azithromycin on day seven, based on anecdotal reports of 20 patients who received this treatment in France.I took the medication for five days. I couldn’t tell whether it worked, which is why we need clinical trials to prove its efficacy and safety, as Anthony S. Fauci has stated repeatedly. After 14 days of battling the Mephistophelean virus, I finally won. The symptoms left completely a week ago. What did I learn? First, despite all of my knowledge of infectious diseases and how this virus was predicted to behave, I was not prepared for the personal battle and the toll it takes. The horror of going through the symptoms is less about


International relations’ hottest states are not the great powers

As the novel coronavirus has spread, so have the number of think pieces by international relations analysts about What It All Means. A few weeks ago, the hard-working staff here at Spoiler Alerts read the first wave of these analyses and tentatively concluded, “after the pandemic has died down, nothing much will have changed.” That said, any crisis that moves at an exponential pace has the capacity to make even week-old predictions seem absurd. So: Has anything changed in the past two weeks to update my prior belief that world politics will remain fundamentally unchanged? What is striking about the latest surge in analyses is the degree to which so many of them conclude with the reinforcement of preexisting trends. Sino-American relations were already pretty rocky, and covid-19 has made things worse. Don Lee of the Los Angeles Times noted last week that the pandemic “has moved the United States and China a big step closer to a new cold war. It has strengthened hard-liners in both countries.” Maybe that is a change from what a post-phase-one-trade-deal world would have looked like, but that premise is highly dubious. Adam Tooze has been disgustingly prolific during these days of quarantine. As his recent Foreign Policy column observed, U.S. financial hegemony remains undisturbed by the crisis — because Fed Chair Jerome H. Powell has exercised international leadership in ways that President Trump cannot even conceive of doing. His London Review of Books essay on the pandemic’s consequences for the global economy highlights the ways in which the pandemic has exposed the weaknesses of the United States, European Union and China: “What caused the panic last month was the realisation that Covid-19 has exposed all three weaknesses simultaneously.” One can extend Tooze’s analysis beyond economics. An important element of both soft power and hard power during a pandemic is an actor’s ability to move quickly and contain the spread of the pandemic within its borders. What stands out over the past month has been that no great power has done this well at all. China was the epicenter of the outbreak and was less than completely transparent at the outset. The fragility of its one-party regime is hampering its research efforts right now. Beijing has moved further down the mitigation curve than others, but its offers of aid have proven to be shoddy. The longer-term effect of this virus will probably be further


Why Trump and his allies’ criticisms of the WHO are wrong

Lawrence O. Gostin is a professor and director of the O’Neill Institute for National and Global Health Law at Georgetown University and director of the World Health Organization Collaborating Center on National & Global Health Law. Matthew M. Kavanagh is assistant professor of global health and director of global health policy and politics at Georgetown’s O’Neill Institute. The crisis in the United States cannot end if the covid-19 pandemic rages elsewhere in the world. It’s that simple: In our interconnected world, Americans are vulnerable to infection. The World Health Organization urgently needs U.S. funding to scale up the response in low- and middle-income countries where epidemics are growing. The pandemic could kill millions in Africa, where test kits are scarce and only small numbers of ventilators are available to help more than 1 billion people. The WHO has urgent work to do. Instead of leading with global cooperation, however, the discourse in Washington is becoming dangerous and disingenuous. There are valid critiques of the WHO. But many criticisms recently lobbed by the president and political allies are simply wrong. Critics have accused the WHO of being too close to Beijing and too “political.” This rings hollow. The WHO is a political institution, overseen by 194 governments. Its director-general is elected by a vote of member states. Every director-general has to balance the WHO’s political mission of building global cooperation with its mandate to support science-based health efforts. Dr. Tedros Adhanom Ghebreyesus has been remarkably effective. It is fair to debate whether the WHO struck the right balance in early messaging on covid-19 in China. We would have preferred to hear more about China’s muzzling of independent scientists, lack of transparency and human rights violations. But WHO leaders have long walked a fine line to keep communication open while coaxing international cooperation. U.S. personnel got key early epidemiological data from China only because the WHO brokered access. In late January, President Trump was thanking President Xi Jinping on Twitter. “China has been working very hard to contain the Coronavirus,” he wrote. “It will all work out well.” Critics have decried the WHO’s advice in January not to impose restrictions on travel from China, which the organization said is not effective in stopping transmission. The Trump administration focused much of its policy response in February on travel bans of foreign nationals who had visited China. As we all know, border restrictions did