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

to several requests for comment. “The hospitals are overwhelmed, the health system is maxxed out,” said Taki Moreno, president of the Pulmonologists’ Association. A medical worker wears a mask and face shield at the entrance of the SERMESA hospital in Managua. (Alfredo Zuniga/AP) From the start of the pandemic, Nicaragua has been a radical outlier. As neighboring countries imposed strict quarantines and curfews, the Sandinista government encouraged festivals, beach tourism and professional sporting events. Nicaraguan authorities say they have made preparations for the pandemic, training tens of thousands of health-care workers, and sending teams door-to-door to promote measures to avoid contagion. But in April, the Pan American Health Organization criticized the government for “inadequate infection prevention and control.” Analysts say the government may be downplaying the epidemic for fear of more damage to the already slumping economy. Ortega, a former Marxist rebel who first came to power in the 1979 Sandinista revolution and returned to the presidency in 2007, has said the country will have to “learn to live with the pandemic.” But the government has declined to say how many people have been tested for the coronavirus. Authorities have said the confirmed cases in Nicaragua are all tied to foreign travel, and there has been no community transmission. Silvio Maltez thinks otherwise. He believes his father was infected while driving his taxi in Chinandega, a city of a half-million people. His family was not allowed to view the body before burial, he said. “They only let my brother see through a window that they’d wrapped him in black plastic,” he said. Guillermo Maltez is not one of the country’s eight recognized coronavirus deaths. [As coronavirus fears grow, doctors and nurses face abuse, attacks] Nicaragua’s official count pales beside those of its neighbors. Costa Rica, with one of the strongest health systems in Latin America, has reported 863 confirmed cases and 10 deaths from covid-19, according to a tally by Johns Hopkins University. Honduras had 2,565 cases and 138 deaths. “Of course there’s an undercount,” said Álvaro Ramírez, the epidemiologist who led Nicaragua’s response to the cholera epidemic that swept through Latin America from 1991-93. “The government isn’t reporting the real number of deaths or those infected.” A Sandinista legislator, Carlos Emilio López, said in a video on May 6 that Nicaragua was prepared to confront covid-19. “It’s not true that in Nicaragua, the hospitals are collapsed, full, overwhelmed or


before burial, he said. “They only let my brother see through a window that they’d wrapped him in black plastic,” he said. Guillermo Maltez is not one of the country’s eight recognized coronavirus deaths. [As coronavirus fears grow, doctors and nurses face abuse, attacks] Nicaragua’s official count pales beside those of its neighbors. Costa Rica, with one of the strongest health systems in Latin America, has reported 863 confirmed cases and 10 deaths from covid-19, according to a tally by Johns Hopkins University. Honduras had 2,565 cases and 138 deaths. “Of course there’s an undercount,” said Álvaro Ramírez, the epidemiologist who led Nicaragua’s response to the cholera epidemic that swept through Latin America from 1991-93. “The government isn’t reporting the real number of deaths or those infected.” A Sandinista legislator, Carlos Emilio López, said in a video on May 6 that Nicaragua was prepared to confront covid-19. “It’s not true that in Nicaragua, the hospitals are collapsed, full, overwhelmed or saturated,” he said. Outside hospitals, though, the reality is different: desperate families seeking information about their relatives, hearses driving away with bodies. Then there are the “express burials,” documented in cellphone videos shared on social media and in local news reports. Late last month, a 57-year-old government worker was quietly interred in Managua, after dying of what was classified as cardiogenic shock, a heart problem. The burial was so swift that “they put him in the coffin in his hospital gown,” said the man’s daughter, who spoke on the condition of anonymity for fear of reprisal. “At 5 in the morning they buried him without his family present.” A group of 600 Nicaraguan doctors and other health professionals signed a letter late last month calling on the government to impose social distancing, suspend classes in schools and provide protective equipment for health personnel. Ortega and his wife, Vice President Rosario Murillo, have not responded. They have also not appeared in public since April. Meanwhile, the hospitals are filling with mysterious cases of a severe respiratory disease. marybeth.sheridan@washpost.com Sheridan reported from Mexico City. Read more Nicaragua’s Ortega is strangling La Prensa, one of Latin America’s most storied newspapers Spies, harassment, death threats: the Catholic Church says it’s being targeted by Nicaragua’s government Photos show El Salvador’s crackdown on imprisoned gang members Today’s coverage from Post correspondents around the world Like Washington Post World on Facebook and stay updated on foreign news


Airplanes don’t make you sick. Really.

of other travelers; stay at a hotel or friend’s home; arrive in a different climate and change time zones, disrupting your sleep. All of these factors are known to affect your immune system. To be clear, I’m not suggesting we go about air travel as we did before covid-19. I’m just putting the risks of time spent on an airplane in context. It is prudent to take additional precautions during a pandemic. In 2013, I was one of the lead authors of a report for the Transportation Research Board of the National Academies on infectious disease mitigation in airports and airplanes. Let me distill some of the recommendations from that report to those that are most applicable now and add a few new ones based on what we now know about covid-19. For starters, airports should mandate mask wearing; increase ventilation rates; make bathrooms touchless; consider deploying upper-room germicidal UV fixtures in areas with high-occupant density; institute temperature screening; deploy hand-sanitizer stations; and, once passengers arrive at their gates, require that they stay in their designated area except for bathroom usage. Airlines should ensure gate-based ventilation is operating during boarding and disembarkation; carefully choreograph the loading of airplanes; mandate mask use; and provide meals and bottled water during boarding and discontinue in-flight meal and drink service. Individuals have an important role to play, too. First, stay home and do not travel if sick. Comply with rules for mask wearing; wash hands before and after each step at the airport; keep the personal overhead ventilation on and pointed down; and maintain physical distancing to the extent possible. If the necessary precautions are taken, and people do their part and behave according to rules, there is a path back to air travel. But we should all consider this a privilege — one that can be revoked quickly if conditions change or if crowds do not act appropriately. Watch Opinions videos: Read more: Leana S. Wen: As states reopen, here’s how you protect yourself from the coming surge Julie Gottman: In lockdown with your partner? Here’s how healthy couples survive. Kenneth Paul Rosenberg and Chirlane McCray: Don’t neglect your mental health during this pandemic Danielle Allen: We’ve wasted enough time. We must figure out how to reopen schools this fall. Leana S. Wen: Six flaws in the arguments for reopening Alexandra Petri: Oh, we’re supposed to wait until it is SAFE to reopen?


Despite financial hardships, there are signs of hope in the real estate market

We have had weeks of dreadful news about the economic repercussions of the coronavirus pandemic. And while there have been slight improvements here or there, much in the reports looks bleak. In the first week of the month, new claims for unemployment were about 3 million. The past eight weeks’ worth of claims have been 36.5 million. The Labor Department said the unemployment rate for April was 14.7 percent, the highest since the Great Depression. St. Louis Federal Reserve President James Bullard predicted about 30 percent of the U.S. workforce being unemployed before the tide turns. Many of the people who still have jobs are experiencing pay cuts. Unemployment claims for many have been held up due to outdated technology, stricter state rules about who can claim unemployment and confusion about who can apply for what. The Federal Reserve Bank announced it was far from done supporting the post-coronavirus pandemic recovery, and some economists are talking about 2022 as a recovery target. The stock market pushes ahead, waiting for all that cash from the Federal Reserve to filter into the far corners, down into consumers’ pockets. But if anyone doubted the idea that nearly 80 percent of Americans were living paycheck-to-paycheck before the pandemic, you only need look to the hours-long lines at food banks across the country. With many Americans unable to cover a month of expenses, there is hurt aplenty. Mortgage interest rates have been near historic lows in the past few weeks, even as some mortgage lenders indicated they would tighten credit and financial resource requirements for approving loans. If you’re thinking about refinancing, think about this: Rather than lose good customers, some lenders are offering the opportunity to simply lower the interest rate on existing loans, without paying additional fees. Ask your lender if this is an option before you start shopping around. The number of listings available is down significantly from a year ago, but buyers are still making offers on existing homes and new construction. While that is nowhere near a normal spring market, at least it’s a hopeful sign. Ilyce Glink is the author of “100 Questions Every First-Time Home Buyer Should Ask” (Fourth Edition). She is also the CEO of Best Money Moves, an app that employers provide to employees to measure and dial down financial stress. Samuel J. Tamkin is a Chicago-based real estate attorney. Contact Ilyce and Sam through her


The coronavirus pandemic is developing in the shadow of famine. The combination would be deadly.

of desert locusts in decades, endangering the food security of 25 million people. One recent swarm in Kenya was reportedly the size of Luxembourg. This adds to a tangle of complicating factors cited by Beasley. Lockdowns and resulting economic recessions in the developing world have pushed many of the working poor toward hunger. Nearly 370 million children are missing out on school meals. The level of remittances has fallen along with economic activity. Tourism — which accounts for a large portion of national income in many African countries — has collapsed. Oil-rich countries such as South Sudan and Nigeria have seen oil prices dramatically decline. And most destructively, more than 45 million people worldwide have been driven from their homes by violent conflict, leaving them particularly vulnerable to hunger and disease. Many African countries seemed successful in their initial efforts to contain covid-19 (though the general lack of testing may conceal a larger problem). But there are now hot spots in Somalia, Tanzania and Nigeria. The last is particularly disturbing. A roaring pandemic in Nigeria would soon engulf all of West Africa. And because many African health systems are fragile to begin with, even a moderate strain could break them. This would put other health gains — on diseases such as malaria, polio and HIV — at risk. What would an adequate response look like? Increasing resources for the WFP should be on the agenda. WFP planes and trucks provide the logistical backbone for global humanitarian relief. The WFP is also the rare U.N. program that does precisely what it was designed to do. It will be important for the United States and other nations to push for humanitarian access in conflict zones. It takes strong, consistent, outside effort to ensure that refugees and displaced people are not beyond the reach of help. Given Trump administration concerns, bulking up the World Health Organization is not on the table. But as the American covid-19 crisis moves to the downside of its curve, President Trump will have an extraordinary opportunity to reduce suffering and silence his critics. Were he to put together a large bilateral, pandemic/famine response on the model of the President’s Emergency Plan for AIDS Relief, or Pepfar, he might find some things he generally lacks: bipartisan support, global approval and historical credit. Read more from Michael Gerson’s archive, follow him on Twitter or subscribe to his updates on Facebook


Canada’s nursing home crisis: 81 percent of coronavirus deaths are in long-term care facilities

for an entire shift. She later tested positive for covid-19 — “a horrible experience,” she said, particularly because she had to isolate herself from her young children. Her youngest has woken in the middle of the night, crying, “I want my mommy. I love my mommy. I miss her.” For decades, expert panels and public inquiries have reported systemic deficiencies in long-term care. Lawmakers promised changes, but few materialized. Canada is far from the only country with calamitous outbreaks in long-term care homes. The World Health Organization said half of Europe’s covid-19 deaths occurred in such facilities. Nearly 40 percent of all U.S. deaths have occurred in nursing homes, according to the Kaiser Family Foundation. At least 1 in 10 U.S. nursing homes have reported outbreaks, according to a Washington Post analysis. Canada’s national health insurance does not cover long-term care. A mix of public, nonprofit and for-profit entities run the homes. The Ontario government last week adopted an emergency order granting it the power to take over facilities that are struggling with outbreaks. Sienna Senior Living, a publicly traded company that owns and operates 70 senior residences in Canada, pays shareholders an annualized dividend of $0.67. It did not mention covid-19 during a Feb. 20 quarterly earnings call. Lawmakers have delivered donated protective gear to the home during the outbreak. A spokeswoman for the company responded to questions with a statement saying it was “grieving the loss” of residents at Camilla Care, but noted that 71 residents and 15 staff members had recovered. “Thanks to the hard work of our team and health partners, we are now seeing positive progress in the fight against covid-19,” spokeswoman Natalie Gokchenian said. It is unclear how the coronavirus got into the 50-year-old facility. Health-care workers from a neighboring hospital have been dispatched to help. Families say they have struggled to get basic answers. A May 8 voice message to families obtained by The Post made no mention of deaths. Reporting lags meant the number of positive cases it reported conflicted with figures posted by the regional health body, which were different from those reported by the province. Lily Irwin’s 49-year-old sister, who has multiple sclerosis, tested positive for covid-19 last month. Her sister’s health aide has not been working, Irwin said; there was a two-week period when she was not bathed. She has called Irwin in tears because she needed help cutting


Citizen naturalists keep watch over at-risk dragonflies, butterflies, bugs

When I was a kid on road trips with my family, the bugs splattered on our windshield were such a distraction for my dad, who was driving, that we had to scrape them off when we stopped for gas. Today, when I stop for fuel, the unused squeegees are a poignant reminder of the environmental changes that have harmed animal populations, glaciers, forests — and insects. For more than 25 years, Jim Waggener of Alexandria, Va., has been paying attention to the environment and documenting changes, keeping careful watch over insects. What began as a survey to count odonatans and lepidopterans (dragonflies, damselflies, butterflies, caterpillars and moths) quickly grew to a group of citizen scientists who meet every week from the first Friday in April to the last Friday in October to count many different insect species found in Occoquan Bay and Meadowood parks in Northern Virginia. This group of over a dozen senior citizens can name almost every single species of dragonfly, damselfly and butterfly, and discuss with authority the different subclasses of flies, which they do regularly over a post-survey feast at a rotating list of favorite local restaurants. Although pandemic precautions have interrupted their group outings recently, they have begun a cautious and individual return to the open parks. The Ries Lab, a team from Georgetown University that studies butterflies, has recently started collecting and analyzing Jim’s data to determine how it might enhance understanding of climate change and protection of species. They put his team’s data on a national network so researchers worldwide can access it. Jim also produces a weekly report for every survey that goes to the participants as well as land managers. Different members of the survey group regularly post photos on iNaturalist, an online social network of citizen scientists and biologists who map and observe insects, plants and animals. The group has had the long-term support of the Audubon Society of Northern Virginia. With over 43 surveys and 1,569 hours of volunteer time just in 2019, Jim hopes the data will provide insight into a catastrophic insect decline that has alarmed scientists around the world. “Three-fourths of the world’s flowering plants and about 35 percent of the world’s food crops depend on animal pollinators to reproduce,” according to the Agriculture Department. Insects pollinate not only our plants but also feed many other animals. A study published in the journal Science in September


A highly contagious and fatal virus is spreading in several states. Its victims are rabbits.

occurred in March. “It’s moving from area to area. We’ve had bigger die-offs in some areas, and we’re still getting reports of dead rabbits — like, hundreds,” at each site, he said. As of Thursday, the virus had also killed 470 domestic rabbits in New Mexico, Zimmerman said. Nearly 600 others have been euthanized at affected sites that keep rabbits — as pets, or for breeding, meat or pelt — a step the state is requiring to prevent the virus’s spread. About 30 sites are under quarantine, he said. New Mexico received 500 doses of vaccine from France on Wednesday, he said. Rabbit hemorrhagic disease first emerged in China in 1984, where it may have been introduced by imported angora rabbits, according to a report by Iowa State University. Outside Europe, the newer variant, type 2, has occurred in Australia and Canada, and there have been a few domestic cases in the United States since 2018. But wildlife officials hoped North America’s native wild rabbits, which are different from European species, might be immune. So far, the virus has killed four native species, according to the World Organization for Animal Health, to which the USDA reports various animal diseases: desert and mountain cottontails and black-tailed and antelope jack rabbits. Those are all abundant, but wildlife officials say they are worried about more fragile members of the rabbit family, as well as broader ecosystem effects. In Europe, researchers have linked lynx declines in some areas to rabbit die-offs. In Texas, there is concern for the rare Davis Mountain cottontail but also the possibility lower rabbit numbers could force animals that eat them — among them, coyotes, bobcats and mountain lions — to target other prey, such as the dwindling population of pronghorn antelope. “It could have an effect on those predator numbers as well,” said Bob Dittmar, a wildlife veterinarian at the Texas Parks and Wildlife Department. In California, a handful of native rabbit species, including the federally endangered riparian brush rabbit, are at risk. It is possible the virus also could infect the pika, a mountain-dwelling mammal that belongs to rabbits’ lagomorph family and is threatened by climate change, Clifford said. “This has the potential to depress those populations, and if we have depressed prey, then potentially we have predators who often heavily rely on rabbits that may have trouble finding some food,” said Clifford, referring to species including golden


5 ways the coronavirus is making the world’s most vulnerable a lot more vulnerable

How are people in conflict-torn countries like Yemen, South Sudan and Syria affected by the pandemic? Crowded living conditions and insufficient access to water and health services put many of them at acute risk of infection, while lack of testing may exacerbate the spread of the virus. The covid-19 crisis adds new obstacles to how overextended humanitarian organizations including United Nations agencies, the Red Cross/Red Crescent movement, and nongovernmental organizations deliver aid to those in need. But the pandemic’s effects on humanitarian aid are likely to extend well beyond the immediate crisis. Here are five ways covid-19 may affect humanitarian aid: As of December 2019, an estimated 167.6 million people — 1 in 45 people worldwide — needed some sort of humanitarian assistance. Of these, some 71 million had to flee their homes and are displaced within or outside their countries of origin. And crises — even before the pandemic — tend to last longer than in the past. Covid-19 is likely to exacerbate existing crises in places like Burkina Faso, and northeast Nigeria, and further tax poorly resourced health systems in places like Venezuela and Congo. The pandemic is also likely to increase the numbers of people in need of aid as local economies suffer, and people lose access to remittances, livelihoods and basic resources. The World Food Programme projects the number in need of food aid may double — to 265 million — by the end of 2020. UNICEF warns that shifting health resources to respond to covid-19 could result in up to 1.2 million extra deaths in children under 5 in the next six months. Even before covid-19, levels of need around the world have been greater than the capacity of international humanitarian organizations to respond. In 2019 only 63 percent of needed funding was available to humanitarian organizations. Most of this funding came from wealthier donor countries. As of the end of April, the U.S. and other countries had donated only 13 percent of what humanitarian organizations needed for 2020. The economic impact of covid- 19 on these donor countries may lead to a decrease in aid — including humanitarian funding — in the near term. The data on the impact of previous global recessions on humanitarian aid are inconclusive. The International Monetary Fund, however, has warned that the magnitude of the economic effects of covid-19 will be significantly more severe than that of recent recessions.


the implementation of covid-19 control measures — while access to assistance has been decreasing. Intimate partner violence is the most common form of gender-based violence in humanitarian crises. My research suggests deep gendered biases within the humanitarian system affect what gets funded and what is considered urgent. One example of this is the humanitarian response to this type of violence. Despite high rates of gender-based violence in emergencies, a review of humanitarian funding data from 2016-2018 by VOICE and the International Rescue Committee found that only 0.01 percent of all humanitarian funding was for work related to gender-based violence. Two-thirds of humanitarian programs to address this violence received no funding. Despite recent efforts to increase funding to violence prevention and response activities, many working in this sector are concerned that donor funding will prioritize other pandemic-related work. In 2016, the U.N. convened the World Humanitarian Summit, which brought together humanitarian organizations and others to help reimagine and reshape humanitarian aid. One outcome of that meeting and related processes was a commitment to work toward giving greater power and more resources to local organizations to shape and lead humanitarian responses. While some countries have made progress toward this type of “localization,” overall the summit’s targets have not been met. But the border and financial restrictions may now result in reduced international capacity and staffing. Together these factors may help accelerate the process of localization — and there is some evidence of this already. The shift to greater reliance on local groups is not without challenges. These organizations may lack the capacity and technical skills to implement large-scale humanitarian responses, and they may not operate according to long-established humanitarian principles of neutrality and impartiality — or be equipped to meet donor reporting requirements and other criteria. In the short term, international humanitarian organizations have adjusted their relationships with local groups to continue their efforts during the pandemic. This approach includes reducing administrative barriers to funding — which means these organizations have access to funding previously unavailable to them. It’s not clear how this may play out beyond the pandemic response. Crises create challenges as well as opportunities. Covid-19 may change the nature of the humanitarian aid system in the future through increasing needs and decreasing international capacity and resources. But this emergency may also provide the impetus for humanitarian donors and organizations to innovate and to accelerate reform efforts. Chen Reis (


The Daily 202: Coronavirus death toll is possible casualty of growing rift between President Trump and CDC

they immediately suspected the coronavirus. Cases like Juliet’s, a puzzling inflammatory syndrome in children believed linked to covid-19, had been popping up in different parts of the world for months, but it wasn’t until recently that health authorities began tracking the phenomenon.” “When a sprinkling of a reddish rash appeared on Jack McMorrow’s hands in mid-April, his father figured the 14-year-old was overusing hand sanitizer — not a bad thing during a global pandemic. When Jack’s parents noticed that his eyes looked glossy, they attributed it to late nights of video games and TV,” the Times reports. “But over the next 10 days, Jack felt increasingly unwell. His parents consulted his pediatricians in video appointments and took him to a weekend urgent care clinic. Then, one morning, he awoke unable to move. He had a tennis-ball-size lymph node, raging fever, racing heartbeat and dangerously low blood pressure. … Jack, who was previously healthy, was hospitalized with heart failure that day, in a stark example of the newly discovered severe inflammatory syndrome linked to the coronavirus … Jack’s recovery and the experience of other survivors are Rosetta stones for doctors, health officials and parents anxious to understand the mysterious condition.” “Governments and drugmakers are weighing how to roll out coronavirus vaccines, including reserving the first batches for health-care workers, as several shots race to early leads,” the Wall Street Journal reports. “Of more than 100 vaccines in development globally, at least eight have started testing in humans, including candidates from Moderna Inc. and Pfizer Inc. At the same time, pharmaceutical giants like Johnson & Johnson, AstraZeneca PLC and Sanofi are building capacity to make hundreds of millions of doses of their own or their partners’ vaccines. … Yet there isn’t a guarantee that any of the most advanced vaccine candidates will prove to work safely on such a short timetable.” “A Post survey of governors’ offices and state health departments found at least a dozen states where testing capacity outstrips the supply of patients. Many have scrambled to make testing more convenient, especially for vulnerable communities, by setting up pop-up sites and developing apps that help assess symptoms, find free test sites and deliver quick results. But the numbers, while rising, are well short of capacity — and far short of targets set by independent experts. Utah, for example, is conducting about 3,500 tests a day, a little more than a


augmented the death toll. Host Jake Tapper pushed back, asking whether he was suggesting so many Americans had died because they were “unhealthier than the rest of the world?” Azar said no, but added the U.S has a “significantly disproportionate burden of co-morbidities,” including obesity, hypertension and diabetes. (Teo Armus) “The covid-19 deaths were piling up so fast that New York City bus driver Danny Cruz began to worry that no one understood the toll the virus was taking on his fellow transit workers. So in early April, he began keeping a list of those killed by the disease and posting it on Facebook. Cruz had lost a friend and fellow driver at his depot to the novel coronavirus a few days earlier. He also had tested positive for it himself,” Justin George and Greg Jaffe report. “By Cruz’s count, 129 New York City transit workers have died of covid-19. … For transit workers, the return to normal life only exacerbates their fears. … At least 10,000 Metropolitan Transit Authority employees have been quarantined during the outbreak.” “It was Day One of Phase 1 — when the stay-at-home order was lifted and New Orleans was supposed to begin coming back to life. For the first time in two months, most businesses were allowed to open. Restaurants and food-serving bars could seat customers at 25 percent capacity,” David Montgomery and Richard Webster report. But “on Bourbon Street alone, three huge hotels with many hundreds of rooms between them sat shuttered. … Food and beer trucks started appearing around town last week as some restaurants and bars laid in supplies. But in a sign of the ambivalent nature of this reopening, several business owners said they were going to pass up the opportunity for now. To them, it’s still too soon to bring customers in safely and make employees cook in cramped kitchens. And it doesn’t make economic sense to operate at 25 percent capacity, they said, which all but guarantees they will lose money.” “Nicaragua has stood out in Latin America for an almost complete lack of restrictions to contain [the virus]. The government of President Daniel Ortega has kept offices and schools open. Authorities deny the virus has spread widely; in this nation of 6 million, one of the poorest in the Western Hemisphere, they insist there have been only 25 cases and eight deaths,” Ismael López Ocampo and Mary


Breweries once viewed home delivery as a hassle. Now it’s a lifeline.

Coleman says, with delivery and the CSB, offering the small, one-off style beers that delight beer lovers who are always on a quest to try something new. “We’re using this as an opportunity for R&D,” Coleman says, “an opportunity to keep developing new recipes and to let our brewers explore their own creativity,” though, he admits, “there’s no making up for [losing on-premise] distribution in seven states.” As the CSB expands, Coleman says they’re planning partnerships with small local businesses that will allow delivery of, say, pickles from Gordy’s Pickle Jar, a pizza-making kit from All-Purpose, or a featured beer pairing: The return of Zombie Date Night, a porter made with raspberries and chocolate, might be accompanied by chocolate from a local confectioner. “As a community of small business owners, we can drive each other in a way that makes us all more viable,” Coleman says. “It’s not just ordering from Grubhub.” For brewers, selling directly to consumers, also has its surprises. While Bluejacket’s Engert says that IPAs are “even more dominant than before, even double IPAs,” he’s also “seeing a return to classic international styles,” such as mild and dunkel. In Droves, a low-alcohol dark lager, and Palace at 4 a.m., a sweet stout brewed with coffee, are both selling better in cans “than when they were on tap here.” True Respite’s O’Leary also sees changing tastes. Before, if True Respite released a Belgian-style dubbel, a vanilla porter, a lager and an IPA, “a retailer might say, ‘I’ll take three cases of the IPA and one of the lager,’” because those are the most mainstream styles, he explains. But True Respite customers, tracked through Biermi, have been more willing to experiment. “Our non-IPA styles have skyrocketed in popularity,” O’Leary says. “Our vanilla porter has become a hot commodity, but retail was hesitant to take a chance on it.” As states move slowly toward reopening taprooms and restaurants, breweries across the board are adamant that delivery should be a permanent offering, and not just a temporary fix. “When people can start going out, it’s not going to be everybody,” Verratti says. “I think consumers are going to be frustrated if regulators say, ‘Well, that was a fun experiment,’” and things go back to the way they were, with Denizens’ delivery customers limited to just a few Zip codes. At this point, she says, “The toothpaste is out of the tube.”


The Finance 202: Fed’s Powell keeps pressing Congress to spend more on economic relief

Jerome H. Powell keeps ringing the alarm, urging Congress to spend more to contain the growing economic wreckage from the pandemic lockdowns. The Federal Reserve chairman He suggested lawmakers consider providing more support to state and local governments and extend enhanced unemployment benefits that run through July. The approximately $3 trillion package of new emergency relief that House Democrats passed Friday included funding for both. Senate Republicans have said they won’t consider the bill and want to observe the effects of the $3 trillion Congress has already approved in coronavirus aid before acting again and President Trump issued a formal veto threat last week. Powell — who After moving with what in Washington terms counts as lightning speed to approve the largest economic rescue in U.S. history, lawmakers are split along party lines over what to do next. And the central bank chief is stepping gingerly. Republicans favoring a wait-and-see approach could find support for their views in his latest comments. Powell noted to Pelley he doesn’t give Congress advice on specific policies, adding the response from lawmakers has been “vastly larger than anything they’ve ever done. And also very, very quick. So a lot of that money is just starting to flow through the economy.” “The thing is that the coronavirus shock is also the biggest shock that the economy’s had in living memory,” Powell continued. “And the question is, will it be enough? And I don’t think we know the answer to that. It may well be that the Fed has to do more. It may be that Congress has to do more. And the reason we’ve got to do more is to avoid longer-run damage to the economy.” But as Pelley noted in a voice-over, Powell’s push for lawmakers to keep spending helped motivate his appearance on the broadcast Expect senators on the banking panel to try eliciting more support for their preferred view when he appears before them tomorrow morning. Powell will be testifying alongside Treasury Secretary Steven Mnuchin on the last economic relief package as part of a new quarterly requirement that law established. “There’s a lot more we can do,” Powell said of the central bank. “We’ve done what we can as we go. But I will say that we’re not out of ammunition by a long shot. No, there's really no limit to what we can do with these lending programs that we


The Health 202: The ACLU gives a thumbs down to coronavirus ‘immunity passports’

— particularly President Trump and his officials — say it’s time to start letting Americans return to work amid historic unemployment. Health and Human Services Secretary Alex Azar declared yesterday that it’s safe to reopens because half of counties reporting “haven’t had a single death” and more than 60 percent of all covid-19 cases are in just 2 percent of counties. “We have got to get this economy and our people out and about working, going to school again, because there are serious health consequences to what we have been going through,” Azar said on CNN’s “State of the Union.” As the lockdowns are lifted, experts agree the key to preventing large-scale outbreaks lies in expanding testing and contact tracing. Antibody testing, where a person’s blood is examined for clues about whether they were already infected, is considered a key part of thaty effort because it offers valuable information about who can spread the virus and who can’t. In theory, Americans with antibodies could be given more freedom to return to society because they’d be considered immune to the disease and unable to transmit it to others. Some policymakers think providing those who are immune with some kind of documentation to prove it would help people feel safer going back to work, school and other activiies. Several other countries, including Chile, Germany and Great Britain, have seriously considered so-called immunity passports. Its paper notes the science isn’t even clear on whether people who already had the coronavirus have developed enough antibodies to protect from future infections — or how long the immunity might last. Given how antibodies typically develop, it’s highly likely an infection will confer some level of protection, but it will be months before scientists are able to confirm that. There are also outstanding questions about how accurate antibody tests are. “Even small error rates could make reliance on antibody tests unworkable, or dangerous for those workers who get a false positive for antibodies,” Bhandari and Moore wrote. Imagine a system where workers were divided into two classes — the immune and non-immune. Those in the non-immune class would be at a serious disadvantage if an immune worker were available to fill a position. Business owners trying to make their own workplaces as safe as possible would have every reason to give priority to those who already survived covid-19. Such a system would be applied more often to


service-sector jobs in health care, caregiving, food production, emergency services, sanitation, transportation and delivery, which can’t be performed remotely like many white-collar roles, the ACLU notes. People who tend to work in these jobs — more often black and Latino Americans — would be at a particular disadvantage if bosses started discriminating based on immunity status. To get a job, people might even seek to get infected by the coronavirus to gain immunity. “It is foreseeable, maybe even inevitable, that an immunity passport system, with all its attendant pressures on workers to acquire immunity, would result in disproportionately more illness and death among people of color in the U.S.,” the ACLU paper says. A survey of governors’ offices and state health departments found ramped-up testing capacity is surpassing the patient supply, Steve Thompson, Juliet Eilperin and Brady Dennis report. “Many have scrambled to make testing more convenient, especially for vulnerable communities, by setting up pop-up sites and developing apps that help assess symptoms, find free test sites and deliver quick results,” they write. “But the numbers, while rising, are well short of capacity — and far short of targets set by independent experts. Utah, for example, is conducting about 3,500 tests a day, a little more than a third of its 9,000-test maximum capacity, and health officials have erected highway billboards begging drivers to ‘GET TESTED FOR COVID-19.’ ” Utah’s health department spokesman suggested the dearth of people getting tested could be because people don’t feel they need it, or they’re feeling only mild symptoms and believe a positive lab result wouldn’t make a big difference. Experts also point to distrust about testing operations or lingering concerns that tests are scarce. People across the country are still confused about who qualifies for a test, after initially strict rules designed to preserve tests for those who needed them the most. “Another major hurdle: lingering confusion about who qualifies. In the earliest days of the outbreak, Americans were told that only the sickest and most vulnerable should get tested while others should stay home,” Juliet, Steve and Brady write. “Last month, the Centers for Disease Control and Prevention relaxed its guidelines to offer tests to people without symptoms who are referred by local health departments or clinicians.” Late last week, the Centers for Disease Control and Prevention issued an advisory naming the condition multisystem inflammatory syndrome in children, or MIS-C, Ariana Eunjung


Cha and Chelsea Janes report. They wrote about a previously healthy 12-year-old, Juliet Daly, who survived after twice going into heart failure because of the rare condition. She was among the first known children in the United States to develop the syndrome. “It was still relatively early in the outbreak, April 6, and the hospital hadn’t seen other children in this condition. But the doctors knew enough about the pathogen’s effects on adults that they immediately suspected the coronavirus,” they write. “Cases like Juliet’s, a puzzling inflammatory syndrome in children believed linked to covid-19, had been popping up in different parts of the world for months, but it wasn’t until recently that health authorities began tracking the phenomenon.” “Heartbeats are controlled by electrical impulses that travel down the right and left branches of the heart at the same speed. Somewhere in Juliet’s heart, a block was causing the system to go haywire,” they write. “A team of pediatric cardiology specialists gave Jennifer a name for her daughter’s condition: acute fulminant myocarditis — a sudden onset of heart failure, shock or life-threatening arrhythmias.” Later, her nasal swabs came back positive for the coronavirus and adenovirus. In an op-ed in the Wall Street Journal, former FDA commissioner Scott Gottlieb cited the rare condition as an example of “how much we don’t know about Covid-19.” He wrote that data on covid-19 patients “isn’t being streamlined and shared with the public quickly.” “There are shortcomings in our ability to access the electronic systems designed to help glean facts from clinical data,” he wrote. “CDC hasn’t been filling its traditional role of promptly publishing medical findings that may help doctors care for patients. Instead, a lot of this information is being passed around social media, by email or even through word of mouth. It’s trial and error on a global scale.” Government inspectors found there were breakdowns in infection control and prevention in at least ten homes operated by Life Care Centers of America. The inspections were run by the Centers for Medicare and Medicaid Services, Debbie Cenziper, Sidnee King, Shawn Mulcahy and Joel Jacobs report. The breakdowns occurred in the past six weeks, as covid-19 began to spread in Life Care’s facilities nationwide. That’s according to batch of inspection reports obtained by The Post of more than two dozen Life Care homes. At these nursing homes, inspectors have since then discovered staff members who


Prince George’s lawmakers hammer Hogan over his response to county’s coronavirus crisis, saying they’ve been left to fight alone

surgical masks and 450 IR thermometers. Meanwhile, the number of coronavirus cases in the District, Maryland and Virginia combined continued to rise Sunday — topping 76,000 — even as officials in the region inched further toward reopening by adding testing sites and permitting some businesses to relaunch. Infections in the Washington region stood at 76,315 as the weekend drew to a close, with a total of 1,622 new patients added overnight Sunday. In the same period, the District, Maryland and Virginia recorded 50 new covid-19 deaths, bringing the cumulative number of fatalities from the virus to 3,384. Maryland, which leads the region in both cases and deaths, was responsible for most of the new infections and fatalities, adding 836 new cases and 35 deaths. However, in one hopeful sign, hospitalizations related to the virus hit a three-week low at roughly 1,400. “We have been making significant progress,” Hogan tweeted Saturday, along with a picture of himself wearing an Old Bay-themed face mask. He added that the sunny weekend weather made it “a gorgeous day to practice social distancing.” Maryland’s expanded testing strategy, announced last month, includes adding drive-through sites and mass testing facilities in areas experiencing outbreaks. Widespread testing is critical, experts say, to determine the impacts of the virus and make reopening decisions — as Hogan and Virginia Gov. Ralph Northam (D) have already begun to do. On Friday, both states allowed some businesses to reopen, albeit with restrictions. Restaurants in some parts of Virginia can reopen with half-capacity, outdoor seating, while barbershops and salons in both states can accept appointments. Crowds of visitors flocked to Ocean City during the first weekend since Maryland relaxed some coronavirus restrictions, and social media images from the beach left questions about how the tourist area will ensure visitors maintain proper social distancing. The summerlike weather Saturday and pleasant temperatures Sunday drew thousands to the popular Ocean City Boardwalk. On Saturday and Sunday, scores of people were seen walking on the Boardwalk, some very close to one another and only a few wearing face coverings. There were long lines at food stands and major traffic backups on Route 50. The Ocean City Police Department issued a “friendly reminder” about requirements in the state to wear face coverings in public indoor areas and to practice physical social distancing. Jessica Waters, acting tourism director for the city and communications director, said most people appeared to


The girl who died twice

The day Juliet Daly’s heart gave out started much like every other Monday during the quarantine. The 12-year-old from Covington, La., padded out of her room in her PJs shortly after 7 a.m., ate a half-bowl of Rice Krispies, and got on a Zoom call with her sixth-grade social studies class. She had been feeling unwell all weekend with twisting abdominal pains, vomiting and a fever of 101.5, but she seemed to be on the mend. The weird thing, she recalled, was that her lips looked bluish in the mirror and she was super tired. In fact, she kept falling asleep unexpectedly. On the couch. In front of her computer. In the bath. “I thought I was feeling a bit better,” she said, “but I couldn’t keep my eyes open.” With all the news swirling around them about the pandemic, her parents, Sean and Jennifer Daly, had been monitoring their daughter’s illness closely. She had been healthy and did not have a cough, shortness of breath or other typical symptoms of covid-19, so Jennifer, a radiologist, initially suspected appendicitis, some kind of stomach bug, or perhaps the flu. That afternoon, they took Juliet to the emergency department, where doctors noticed an unusual constellation of symptoms pointing to a different problem. Her heart rate was extraordinarily low, jumping around in the 40s when it should have been between 70 to 120 beats per minute. And when they squeezed her nails, they turned white and stayed white when they should have gone back to pink. Juliet was in a kind of toxic shock, and her heart had become so inflamed it was barely beating. It was still relatively early in the outbreak, April 6, and the hospital hadn’t seen other children in this condition. But the doctors knew enough about the pathogen’s effects on adults that they immediately suspected the coronavirus. Cases like Juliet’s, a puzzling inflammatory syndrome in children believed linked to covid-19, had been popping up in different parts of the world for months, but it wasn’t until recently that health authorities began tracking the phenomenon. The number of infected children, while still small, is estimated to be a few hundred — larger than anyone anticipated for a disease thought to inflict little, if any, harm on children. Doctors in Britain and Italy had issued alerts in April, and the American Heart Association warned last week that some pediatric patients


The girl who died twice

“are becoming very ill extremely quickly,” urging providers to evaluate them right away. On Thursday night, the Centers for Disease Control and Prevention issued an advisory and gave the unusual condition a name — multisystem inflammatory syndrome in children, or MIS-C. More than 145 children are believed to have it in New York City and at least about 50 more in New York state. Three have died. In recent days, medical centers in 14 other states have reported similar cases. Scientists still believe most children and young people experience only mild illness or none at all if they become infected with the coronavirus. But they’re concerned about the critical nature of the inflammatory syndrome cases, which seem to be appearing in children weeks after a wave of infections in their communities. “We’ve been seeing kids steadily for two months,” said Roberta DeBiasi, infectious disease specialist at Children’s National Hospital in the District. “But this presentation is clearly different. It’s not that we just didn’t notice this before. It’s a new presentation. And the fact that it’s happening two months after the initial circulation of the virus gives weight to the idea that it’s an immune-mediated phenomena.” Jennifer Owensby, a pediatric intensivist at Rutgers’s Robert Wood Johnson University Hospital in New Brunswick, N.J., said the first group of children she saw with covid-19 appeared to have classic respiratory symptoms, such as shortness of breath. Now, she said, “The vast majority are coming in with symptoms of cardiac failure, which is extremely rare in pediatrics, especially in normal, healthy kids — which is why this is so alarming.” Writing in the Lancet medical journal this week, Italian doctors reported on a cluster of 10 children struck with the inflammatory condition in the coronavirus epicenter of Bergamo. The cases appear to have characteristics of an illness first identified in Japan known as Kawasaki disease, which causes inflammation in blood vessels and includes a persistent fever. But these children were older than is typical with Kawasaki, which usually strikes those younger than 5, and they had more serious heart issues. Just like Juliet, who is among the first known children in the United States to develop multisystem inflammatory syndrome, according to her doctors. Sean Daly was at the hospital with “Jules,” as he sometimes called her, while Jennifer was on the phone from work. A transportation planning consultant with no medical background, Sean remembers


The girl who died twice

intensivist at Rutgers’s Robert Wood Johnson University Hospital in New Brunswick, N.J., said the first group of children she saw with covid-19 appeared to have classic respiratory symptoms, such as shortness of breath. Now, she said, “The vast majority are coming in with symptoms of cardiac failure, which is extremely rare in pediatrics, especially in normal, healthy kids — which is why this is so alarming.” Writing in the Lancet medical journal this week, Italian doctors reported on a cluster of 10 children struck with the inflammatory condition in the coronavirus epicenter of Bergamo. The cases appear to have characteristics of an illness first identified in Japan known as Kawasaki disease, which causes inflammation in blood vessels and includes a persistent fever. But these children were older than is typical with Kawasaki, which usually strikes those younger than 5, and they had more serious heart issues. Just like Juliet, who is among the first known children in the United States to develop multisystem inflammatory syndrome, according to her doctors. Sean Daly was at the hospital with “Jules,” as he sometimes called her, while Jennifer was on the phone from work. A transportation planning consultant with no medical background, Sean remembers feeling confused as doctors told him they were giving his daughter an epinephrine drip to help her heart, and were sending her to a larger hospital with more expertise and equipment. They said they would put her on a ventilator to stabilize her for the helicopter trip to Ochsner Medical Center, about 50 miles away in New Orleans. Sean, unaware of the gravity of his daughter’s condition, thought ridiculous thoughts about the absurdity of his shorts and flip-flops amid the alien-looking hospital workers in head-to-toe protective equipment. And he thought about how, just a few minutes earlier, his daughter had been well enough to walk across the parking lot and into the ER. He heard an announcement about something called a “code blue” and wondered why more and more people kept rushing into her room. When the attending doctor finally popped out, Sean recalled, she was shaking. She said Juliet had gone into cardiac arrest, and it took them nearly two minutes of CPR, or cardiopulmonary resuscitation, to revive her. “It didn’t process all that well with me,” he said. “She was telling me Juliet was ‘back,’ and I was like, ‘That’s good. I didn’t know she had gone anywhere.’


Why Belgium has recorded so many coronavirus deaths

BRUSSELS — By the official numbers, Belgium has been the country hit hardest in the world by the coronavirus. The nation of 12 million has the highest mortality rate among confirmed cases, at 16.4 percent. And it has the most deaths in terms of its population: 78 deaths per 100,000 people, according to statistics compiled by Johns Hopkins University. The United States, by comparison, has reported 27 coronavirus deaths per 100,000 people. Spain has reported 58. Italy has reported 52. Belgian officials have sought to tamp down concern by suggesting their chart-topping numbers are products of their accounting methods and commitment to capturing an accurate picture of their outbreak. Other ways of estimating virus-related deaths suggest that the Belgian method might indeed turn out to be among the most accurate in the world, and that other countries may be significantly undercounting their death tolls. The bad news for Belgium is that even in those other calculations, the country still comes off poorly compared to its neighbors, after adjusting for their size. According to figures released Sunday, Belgium has recorded 9,052 deaths from the coronavirus. Of those, about 40 percent are “possible cases,” not confirmed by tests. Most countries do not include suspected cases that weren’t positively confirmed. “Our way of counting things is the most scientifically correct and honest,” Yves Van Laethem, a virologist and Belgian government spokesman, told reporters Friday. Van Laethem showed reporters a slide of calculations from the Economist magazine indicating that Belgium’s official coronavirus toll closely tracks “excess deaths” for the pandemic period — the number of deaths that exceed what would be expected for the period, based on the country’s historical death rates. Belgium attributed 7,559 deaths between March 16 and April 26 to the coronavirus. The Economist estimated that the country had 7,397 more deaths in that time period than would have been expected. By comparison, a team of Yale researchers who analyzed U.S. mortality data in partnership with The Washington Post this month estimated that, with excess deaths as a guide, the true toll could be one and a half times higher than the official number. There are perils to using the method, and to drawing too much from country-to-country comparisons. Full data sets can be slow to roll in, leading to undercounts. The overall excess death estimate could also include other deaths, such as people who died of unrelated diseases because they


World champion gymnast Morgan Hurd has a new reason to love books: They help her train

will pose the trickiest challenge. “The hardest thing will be bars just because that feeling is irreplaceable — no matter what you do or how strong you are,” Hurd said in a recent telephone interview. Until then, the 18-year-old, who has done gymnastics since she was 3, knows her sport and her body well enough to realize what she needs to do to stay in contention for a spot on next year’s U.S. Olympic team. With rosters pared from five to four for the Tokyo Games, competing nations will prioritize gymnasts who are fluent on all four apparatuses. That should play into Hurd’s hands; at 16, she was the 2017 all-around world champion and also claimed a silver medal on beam. At the 2018 world championships, Hurd joined Simone Biles, who had taken 2017 off from competition following her dominance at the 2016 Rio de Janeiro Olympics, to lead the U.S. women to team gold. Hurd claimed silver on floor and bronze in the all-around. Hurd said she welcomed the International Olympic Committee’s decision to postpone the Games by a year despite the monumental disruption in the training regimens of the competitors. “I thought it was the best decision,” she said. “It wouldn’t have been fair, and it would have been dangerous to expect athletes to be in peak shape in such a short period of time.” Assuming the Tokyo Games begin July 23, 2021, as now planned, the postponement won’t disrupt Hurd’s college plans. Home-schooled by her mother, Sherri, who adopted her at 11 months in Wuzhou, China, Hurd graduated in June and signed her letter-of-intent in November to attend Florida with fellow U.S. national team member Riley McCusker. Hurd initially deferred enrollment until 2020, after the Olympics. But even before the Games were postponed, she pushed the start of her freshman year back further, until spring 2022, in hopes of competing at the 2021 world championships. These days, Hurd’s self-directed training regimen consists of two workouts daily — three hours in the morning, another two hours in the afternoon — six days a week. She is in regular touch with the coach she has worked with since fifth grade, Slava Glazounov. Hurd is in charge of her conditioning routine — the stretches, core work and exercises that maintain her strength and flexibility. Glazounov, a former Russian national team member, gives assignments to keep her aerials, turns and leaps


Reality star charged with spending funds from federal small business program on jewelry, Rolls-Royce

confusion for business owners needs to be addressed immediately as the PPP program is still in its infancy.” Although some PPP applicants have had difficulty navigating the program’s rules and some larger employers have decided to return funds, Fayne is charged with using the money for much different purposes than he allegedly stated on his application. According to the U.S. attorney’s office, Fayne, 37, stated on a loan application to United Community Bank that his trucking company had 107 employees and a monthly payroll of $1.5 million. He allegedly certified that the loan proceeds would be used to “retain workers and maintain payroll or make mortgage interest payments, lease payments, and utility payments, as specified under the Paycheck Protection Program Rule.” The FBI assisted with the investigation, along with the SBA’s Office of Inspector General. Agents searched Fayne’s home in Dacula, outside Atlanta, on May 11 and seized “approximately $80,000 in cash, including $9,400 that Fayne had in his pockets.” They also used seizure warrants to take control of approximately $503,000 of remaining PPP funds from three of Fayne’s bank accounts, according to the a. “The defendant allegedly egregiously sought personal gain from a program intended to assist hard-working Americans in this challenging time,” said Special Agent-in-Charge Kevin Kupperbusch of the SBA’s Office of Inspector General. Fayne, known as “Arkansas Mo” on the show, is one of the only people to be charged with a crime for misuse of funds from the SBA program. Treasury Secretary Steven Mnuchin and SBA Administrator Jovita Carranza have heralded PPP as a success, as more than 4.2 million businesses and nonprofit organizations have received a total of more than $531 billion in funding for the program through May, according to recent data. The SBA has so far refused to release the names of companies that have received PPP loans. The Washington Post and several other news organizations have filed a lawsuit against the SBA for access to these records. SBA officials say they rely on the good faith of applicants to self-certify that they are in need of the funds because of uncertainty created by the coronavirus, though officials plan to audit loans of more than $2 million. Loans will be forgiven so long as they are used appropriately. The ninth season of “Love & Hip Hop” premiered in March. Spokespersons at VH1, which produces the show, did not return a request for comment.


When it comes to coronavirus response, superpowers may need to study smaller nations

The coronavirus pandemic has upended the international hierarchy. Three of the world’s great powers — the United States, the United Kingdom and Russia — have the largest and most deadly outbreaks. Other major players on the world stage struggled with their initial responses. China is on the defensive, as rivals levy blame for its lack of transparency. Some smaller countries, however, have gained newfound recognition as the world takes note of their early, and still tentative, successes. Yanzhong Huang, a senior fellow at the Council on Foreign Relations, put it this way: The largest and most powerful nations will need to study what went right among smaller and less powerful ones. “I’d like to paraphrase what Leo Tolstoy said, that all successful countries are alike; each unsuccessful country is unsuccessful in its own way,” Huang said. Here’s a look at six examples. As the coronavirus rages in neighboring Russia, Georgia has emerged as an island of calm. The country of some 3.75 million people has kept confirmed cases below 700, with 12 deaths, earning the World Health Organization’s praise. Prompt government action, such as required temperature screenings at airports in late January and early restrictions on international travel, appear to have helped beat back the outbreak. With the pace of infections slowing and the country set to reopen for tourism, its ambassador to the United States, David Bakradze, said his office has been fielding travel and business requests from curious Americans. Georgia’s small geographic size made it alert to inbound travel risks, Bakradze said, and the country had weathered so much since the Soviet Union’s collapse that citizens were willing to make sacrifices, like accepting travel bans and a range of social control measures. “We are used to pulling together in tough times,” he said. Even among Asia’s early coronavirus success stories, Vietnam is an outlier. It is not a wealthy democracy like South Korea, nor a highly developed city-state like Singapore, and it has nowhere near China’s might. But Vietnam has marked only 318 known cases of the coronavirus, around 50 of which are active, and no recorded community transmission in a month. The country officially has no confirmed deaths from covid-19. U.S. experts are impressed. “Vietnam has done an exemplary job of implementing public health measures to contain covid-19,” said Matthew Moore, a Hanoi-based official with the U.S. Centers for Disease Control and Prevention, pointing to Vietnam’s rapid


some of Ghana’s techniques, including the potentially time saving practice of “pool testing,” in which multiple blood samples are tested together and processed separately only if a positive result is found. Osman Dar, the director of the Global Health Program at Chatham House, a London-based think tank, said Ghana has benefited from its demographics — the country is overwhelmingly young, with just 3 percent of the population more than 65 years old. But Ghanaian officials were also “quite proactive in using their own budget to get a grip on the outbreak,” he said, drawing from a government emergency fund rather than waiting for international aid. Other African countries acted decisively too. South Africa has mobilized thousands of nurses, while Senegal quickly went to work on $1 diagnostic kits that can detect the novel coronavirus in 10 minutes. Many countries acted concurrently to enact travel bans and curfews, under the guidance of Africa’s Center for Disease Control and Prevention, which has “played an important role in coordinating and having a consistent response,” said Dar. Costa Rica was the first country in Latin America to confirm a coronavirus case, on March 6. More than two months later, the country of 5 million is starting to emerge from a strict lockdown with less than 850 confirmed cases, 10 deaths, and one of the region’s more effective models. Juliana Martinez-Franzoni, an Associate Professor at the University of Costa Rica, cited two main factors that have worked in the country’s favor: its “very strong and unified health care system” and the centralized government mobilizing effectively to provide basic services and support. “Costa Rica’s response was faster than most Latin American countries and more disciplined,” she said. People “trust the government, trust the state to help them with a crisis, so the degree of compliance was higher.” Costa Rica, unlike other nations in South America, has a universal health care system, and services including water and electricity have not been privatized. Despite economic inequality and widespread poverty, these fundamental institutions have helped the country to cope with and contain the virus and the economic fallout, Martinez-Franzoni said. When the pandemic arrived, Lebanon was already in the midst of a severe economic crisis and political protests — the results of decades of corrupt and dysfunctional governance. The presence of more than a million Syrian and Palestinian refugees, in a country of fewer than 7 million people, poses


In Canada, virus hits nursing homes hard

those who do not. One colleague, who dropped her mask, was told to reuse it. The employee was told to reuse her gown and had one mask for an entire shift. She later tested positive for covid-19 — “a horrible experience,” she said, particularly because she had to isolate herself from her young children. Her youngest has awakened up in the middle of the night, crying “I want my mommy. I love my mommy. I miss her.” For decades, expert panels and public inquiries have reported systemic deficiencies in long-term care. Lawmakers promised changes, but few materialized. Canada is far from the only country with calamitous outbreaks in long-term care homes. The World Health Organization said half of Europe’s covid-19 deaths occurred in such facilities. Nearly 40 percent of all U.S. deaths have occurred in nursing homes, according to the Kaiser Family Foundation. At least 1 in 10 U.S. nursing homes have reported outbreaks, according to a Washington Post analysis. [Nursing homes linked to up to half of coronavirus deaths in Europe, WHO says] Canada’s national health insurance does not cover long-term care. A mix of public, nonprofit and for-profit entities run the homes. This week, the Ontario government adopted an emergency order granting it the power to take over facilities that are struggling with outbreaks. Sienna Senior Living, a publicly traded company that owns and operates 70 seniors’ residences in Canada, pays shareholders an annualized dividend of $0.67. It did not mention covid-19 during a Feb. 20 quarterly earnings call. Lawmakers have delivered donated PPE to the home during the outbreak. A spokeswoman for the company responded to questions with a statement saying it was “grieving the loss” of 57 residents at Camilla Care, but noted that 71 residents and 15 staff members had recovered. “Thanks to the hard work of our team and health partners, we are now seeing positive progress in the fight against COVID-19,” spokeswoman Natalie Gokchenian said. It is unclear how the coronavirus got into the 50-year-old facility. Health care workers from a neighboring hospital have been dispatched to help. Families say they have struggled to get basic answers. A May 8 voice message to families obtained by The Post made no mention of deaths. Reporting lags meant the number of positive cases it reported conflicted with figures posted by the regional health body, which were different from those reported by the province. [Canadian nurses


China’s Xi backs WHO-led review of covid-19 outbreak, proposes aid for developing world

at a time when the two countries are locked in a duel over economic primacy and global influence. Rather than address allegations that Chinese officials covered up early signs of the outbreak in Wuhan, Xi called on the world to “step up information sharing.” China provided information to the WHO and other countires in a timely fashion and released the genome sequence of the coronavirus at the earliest time, he said “All along we have acted with openness, transparency and responsibility,” Xi said. “We have done everything in our power to support and assist countries in need.” The Chinese government has repeatedly characterized the pandemic as a crisis that is global in nature and called any targeted inquiry that draws disproportionate attention to covid-19’s roots in Wuhan as an unfair plan by Washington and its allies to make it a scapegoat. After the Australian government proposed an international investigation last month, China threatened to boycott Australian products and later effectively cut imports of Australian beef. The draft resolution, submitted by the European Union on Monday and currently supported by over 100 nations, does not mention Wuhan or China. It asks the World Health Organization to work with other United Nations agencies to “identify the zoonotic source of the virus and the route of introduction to the human population, including the possible role of intermediate hosts.” The document does not propose a review to identify missteps in how countries handled the outbreak and is instead forward-looking and calls on the WHO to potentially arrange “scientific and collaborative field missions” to help prevent similar future outbreaks. It also appears to rule out the possibility that the virus was man-made or experimented upon — a possibility that U.S. officials have raised but is considered unlikely by most epidemiologists. The Trump administration, which has denounced China — and the WHO — as largely responsible for the global pandemic, has not signaled whether it would also back the resolution. Speaking to reporters on Monday, Chinese Foreign Ministry spokesman Zhao Lijian said a review that focused on finding the animal source of the virus and assessing the performance of the WHO response was “consistent with the Chinese position.” Zhao denied that China was opposed to an international inquiry and said China had participated in drafting the resolution all along. Read more Taiwan beat covid-19 and won friends. At the WHO, it’s still fighting for a seat


countires in a timely fashion and released the genome sequence of the coronavirus at the earliest time, he said “All along we have acted with openness, transparency and responsibility,” Xi said. “We have done everything in our power to support and assist countries in need.” The Chinese government has repeatedly characterized the pandemic as a crisis that is global in nature and called any targeted inquiry that draws disproportionate attention to covid-19’s roots in Wuhan as an unfair plan by Washington and its allies to make it a scapegoat. After the Australian government proposed an international investigation last month, China threatened to boycott Australian products and later effectively cut imports of Australian beef. The draft resolution, submitted by the European Union on Monday and currently supported by over 100 nations, does not mention Wuhan or China. It asks the World Health Organization to work with other United Nations agencies to “identify the zoonotic source of the virus and the route of introduction to the human population, including the possible role of intermediate hosts.” The document does not propose a review to identify missteps in how countries handled the outbreak and is instead forward-looking and calls on the WHO to potentially arrange “scientific and collaborative field missions” to help prevent similar future outbreaks. It also appears to rule out the possibility that the virus was man-made or experimented upon — a possibility that U.S. officials have raised but is considered unlikely by most epidemiologists. The Trump administration, which has denounced China — and the WHO — as largely responsible for the global pandemic, has not signaled whether it would also back the resolution. Speaking to reporters on Monday, Chinese Foreign Ministry spokesman Zhao Lijian said a review that focused on finding the animal source of the virus and assessing the performance of the WHO response was “consistent with the Chinese position.” Zhao denied that China was opposed to an international inquiry and said China had participated in drafting the resolution all along. Read more Taiwan beat covid-19 and won friends. At the WHO, it’s still fighting for a seat at the table. Chinese officials note serious problems in coronavirus response. The WHO keeps praising them. Early missteps and state secrecy in China probably allowed the coronavirus to spread farther and faster Today’s coverage from Post correspondents around the world Like Washington Post World on Facebook and stay updated on foreign news


The Swedish model

SWEDEN OFFERS an appealing model to many people who are fatigued by the hardships of pandemic lockdown or who were never convinced it was entirely necessary. The Nordic country took some measures to control the spread of the coronavirus: It banned groups larger than 50 people, called for social distancing and put older students on video learning. But it did not take a draconian approach. Schools for those under 16 remained open, as did many bars, restaurants and gyms, with social distancing. That raises the question of whether the example is worth emulating. In terms of illness and death, it appears Sweden has paid a higher price for its approach. As of Monday, it had suffered 3,698 deaths in a country of 10 million. By contrast, Denmark, Norway and Finland, with a combined population of more than 16.5 million, which all imposed tighter restrictions, have seen only 1,081 deaths. Sweden has reported 364.28 deaths per million people, compared with 94.4 for Denmark, 53.7 for Finland and 42.8 for Norway. However, Sweden’s death rate remained lower than those of Britain, France, Italy and Spain, which all imposed strict lockdowns. The virus ravaged Sweden’s nursing homes, which accounted for a large portion of the deaths; the government was slow to restrict visits to them. [Full coverage of the coronavirus pandemic] At the same time, Sweden will not escape the economic damage of the pandemic. Economists say its economy — tightly woven into global supply chains — will suffer a deep recession this year. Travel has plunged, and many businesses have closed, while joblessness is expected to rise. What Sweden may gain by its approach, over the longer term, is a population with a greater natural immunity to the virus if there is no vaccine. To achieve a level known as herd immunity, in which the virus is largely unable to spread, two-thirds or more of the population would have to acquire protection stemming from exposure. It isn’t known if Sweden will reach that level or something less. But it might have more natural resiliency against a second wave. Nations that took drastic measures to protect people at the outset will be left with populations that are more susceptible. But if a vaccine is found relatively soon, it will provide immunity with a far lower cost in lives. What Sweden has demonstrated is the advantage of a high degree of trust in government.


The Finance 202: Fed's Powell keeps pressing Congress to spend more on economic relief

with Brent D. Griffiths Jerome H. Powell keeps ringing the alarm, urging Congress to spend more to contain the growing economic wreckage from the pandemic lockdowns. The Federal Reserve chairman He suggested lawmakers consider providing more support to state and local governments and extend enhanced unemployment benefits that run through July. The approximately $3 trillion package of new emergency relief that House Democrats passed Friday included funding for both. Senate Republicans have said they won’t consider the bill and want to observe the effects of the $3 trillion Congress has already approved in coronavirus aid before acting again and President Trump issued a formal veto threat last week. Federal Reserve Chairman Jerome Powell testifying before the Senate Banking Committee in February. (Reuters/Yuri Gripas) Powell — who Powell’s advocacy for an even bigger fiscal response thrusts him into fraught territory. After moving with what in Washington terms counts as lightning speed to approve the largest economic rescue in U.S. history, lawmakers are split along party lines over what to do next. And the central bank chief is stepping gingerly. Republicans favoring a wait-and-see approach could find support for their views in his latest comments. Powell noted to Pelley he doesn’t give Congress advice on specific policies, adding the response from lawmakers has been “vastly larger than anything they've ever done. And also very, very quick. So a lot of that money is just starting to flow through the economy.” “The thing is that the coronavirus shock is also the biggest shock that the economy's had in living memory,” Powell continued. “And the question is, will it be enough? And I don't think we know the answer to that. It may well be that the Fed has to do more. It may be that Congress has to do more. And the reason we've got to do more is to avoid longer-run damage to the economy.” But as Pelley noted in a voice-over, Powell’s push for lawmakers to keep spending helped motivate his appearance on the broadcast Expect senators on the banking panel to try eliciting more support for their preferred view when he appears before them tomorrow morning. Powell will be testifying alongside Treasury Secretary Steven Mnuchin on the last economic relief package as part of a new quarterly requirement that law established. Powell said there is “no limit” to what the Fed itself can do. “There’s a lot more we can


decider,” Ashley Parker and Philip Rucker report. Major nursing home chain violated federal standards: “Nursing homes operated by Life Care Centers of America, one of the largest chains in the industry, violated federal standards meant to stop the spread of infections and communicable diseases even after outbreaks and deaths from covid-19 began to sweep its facilities from the Pacific Northwest to New England, inspection reports show,” Debbie Cenziper, Sidnee King, Shawn Mulcahy and Joel Jacobs report. Employees line up before the first day back at work this morning at the Fiat Chrysler plant in Warren, Mich. (Emily Elconin/Bloomberg) Reopening the auto industry is likely to be a long process. Like other industries, there's less consumer demand: “But rebooting more than 40 U.S. assembly plants—as well as the thousands of component makers that supply them—is likely to be a slow and arduous process, say industry executives and consultants. With paltry revenues for weeks, auto-parts suppliers are stretched financially and many still lack enough orders to recall the bulk of their staff. Factories in Mexico, which produce nearly 40 percent of the car parts imported to the U.S., aren’t yet permitted to reopen, and in many parts of that country the pandemic has yet to peak.” More from the corporate front: U.S. crude contract date approaches: “A month after sellers had to pay nearly $40 a barrel to get rid of U.S. oil futures, the next watershed moment looms with the expiry of the June contract on Tuesday - and so far there is little sign of a repeat of the historic plunge,” Reuters's Devika Krishna Kumar reports. JC Penney wants to spin its properties into a real estate company: “As part of a plan filed with the bankruptcy court, Penney would reorganize into a new retailer (“JCP”), along with a REIT that would collect rent checks from the retail business," CNBC's Lauren Thomas reports. Around the world: Japan falls into a recession: This is the first time the nation has hit a recession in four years. “Government statistics show that [Japan's] economy shrank by an annualized rate of 3.4 percent between January and March,” Antonia Farzan reports. Brazil's largest city warns of hospitals on the brink: “Bruno Covas, the mayor of Sao Paolo, … told reporters that intensive care units in the city’s hospitals had reached 90 percent occupancy,” Antonia Farzan reports. When superpowers collide A man in a face mask


Coleman says, with delivery and the CSB, offering the small, one-off style beers that delight beer lovers who are always on a quest to try something new. “We’re using this as an opportunity for R&D,” Coleman says, “an opportunity to keep developing new recipes and to let our brewers explore their own creativity,” though, he admits, “there’s no making up for [losing on-premise] distribution in seven states.” As the CSB expands, Coleman says they’re planning partnerships with small local businesses that will allow delivery of, say, pickles from Gordy’s Pickle Jar, a pizza-making kit from All-Purpose, or a featured beer pairing: The return of Zombie Date Night, a porter made with raspberries and chocolate, might be accompanied by chocolate from a local confectioner. “As a community of small business owners, we can drive each other in a way that makes us all more viable,” Coleman says. “It’s not just ordering from Grubhub.” For brewers, selling directly to consumers, also has its surprises. While Bluejacket’s Engert says that IPAs are “even more dominant than before, even double IPAs,” he’s also “seeing a return to classic international styles,” such as mild and dunkel. In Droves, a low-alcohol dark lager, and Palace at 4 a.m., a sweet stout brewed with coffee, are both selling better in cans “than when they were on tap here.” True Respite’s O’Leary also sees changing tastes. Before, if True Respite released a Belgian-style dubbel, a vanilla porter, a lager and an IPA, “a retailer might say, ‘I’ll take three cases of the IPA and one of the lager,’” because those are the most mainstream styles, he explains. But True Respite customers, tracked through Biermi, have been more willing to experiment. “Our non-IPA styles have skyrocketed in popularity,” O’Leary says. “Our vanilla porter has become a hot commodity, but retail was hesitant to take a chance on it.” As states move slowly toward reopening taprooms and restaurants, breweries across the board are adamant that delivery should be a permanent offering, and not just a temporary fix. “When people can start going out, it’s not going to be everybody,” Verratti says. “I think consumers are going to be frustrated if regulators say, ‘Well, that was a fun experiment,’” and things go back to the way they were, with Denizens’ delivery customers limited to just a few Zip codes. At this point, she says, “The toothpaste is out of the tube.”


For most of Afghanistan war, America ‘never really fought to win,’ Trump declares

President Trump on Monday declared that the United States had “never really fought to win” in Afghanistan, except early in the nearly two-decade-long war, making a sweeping statement about military efforts as thousands of U.S. troops continue to serve, and sometimes die, in counterinsurgent operations there. In a series of tweets, the president pushed back against a May 17 Wall Street Journal editorial cautioning against abrupt decisions regarding Afghanistan, where U.S. officials are seeking to facilitate a peace deal between Taliban militants and the Afghan government ahead of a planned reduction in U.S. forces. “Could someone please explain to them that we have been there for 19 years,” Trump wrote. “The Taliban is mixed about even wanting us out. They make a fortune $$$ out of having us stay, and except at the beginning, we never really fought to win.” “We are more of a police force than the mighty military that we are, especially now as rebuilt. No, I am not acting impulsively!” he said. Since the war began in the wake of the Sept. 11, 2001, attacks, more than three-quarters of a million Americans have deployed to Afghanistan, and more than 2,300 U.S. troops have died. During President Barack Obama’s troop surge, about 100,000 military personnel were arrayed across the country, fighting to win remote areas from Taliban control. Today, the military mission is focused on pummeling militants with airstrikes and supporting Afghan forces in an effort to induce the Taliban to embrace political talks outlined in a Feb. 29 U.S.-Taliban deal. That deal halted U.S. attacks on the Taliban and outlined a path toward an American departure. Officials have declined to give an exact number for the U.S. force, who serve there as part of a NATO-led coalition, but say the number is being brought down to 8,600 this spring as an initial step in the recent agreement. While officials have acknowledged that the war has been locked in an extended stalemate and that many hard-won battlefield gains have not been sustained, Trump’s commentary was unusual for a commander in chief. Typically, presidents have heaped praise on military efforts no matter their outcome. At other moments, Trump has also lauded the military effort in Afghanistan, including during a surprise Thanksgiving visit last year. Speaking to troops at a U.S. airfield outside Kabul, Trump praised troops who had deployed to “defend liberty” since the start of the war


she seemed to be on the mend,” Ariana Eunjung Cha and Chelsea Janes report. When she was taken to the emergency department, “doctors noticed an unusual constellation of symptoms pointing to a different problem. Her heart rate was extraordinarily low, jumping around in the 40s when it should have been between 70 to 120 beats per minute. And when they squeezed her nails, they turned white and stayed white when they should have gone back to pink. Juliet was in a kind of toxic shock, and her heart had become so inflamed it was barely beating. … The doctors knew enough about the pathogen’s effects on adults that they immediately suspected the coronavirus. Cases like Juliet’s, a puzzling inflammatory syndrome in children believed linked to covid-19, had been popping up in different parts of the world for months, but it wasn’t until recently that health authorities began tracking the phenomenon." Similarly, 14-year-old Jack McMorrow woke up one day with heart failure. “When a sprinkling of a reddish rash appeared on Jack McMorrow’s hands in mid-April, his father figured the 14-year-old was overusing hand sanitizer — not a bad thing during a global pandemic. When Jack’s parents noticed that his eyes looked glossy, they attributed it to late nights of video games and TV,” the Times reports. “But over the next 10 days, Jack felt increasingly unwell. His parents consulted his pediatricians in video appointments and took him to a weekend urgent care clinic. Then, one morning, he awoke unable to move. He had a tennis-ball-size lymph node, raging fever, racing heartbeat and dangerously low blood pressure. … Jack, who was previously healthy, was hospitalized with heart failure that day, in a stark example of the newly discovered severe inflammatory syndrome linked to the coronavirus … Jack’s recovery and the experience of other survivors are Rosetta stones for doctors, health officials and parents anxious to understand the mysterious condition.” Frontrunners in the race for a vaccine are emerging. “Governments and drugmakers are weighing how to roll out coronavirus vaccines, including reserving the first batches for health-care workers, as several shots race to early leads,” the Wall Street Journal reports. “Of more than 100 vaccines in development globally, at least eight have started testing in humans, including candidates from Moderna Inc. and Pfizer Inc. At the same time, pharmaceutical giants like Johnson & Johnson, AstraZeneca PLC and Sanofi are building capacity to


The venue built an outdoor stage, installed a sound system and divided the parking lot to accommodate 75 cars so socially distanced audience members could enjoy local bar-band singer Tim Theriault. (Geoff Edgers) A 45-day shutdown saved 6,202 lives and kept 57,072 out of the hospital in Philadelphia, a Drexel University study found. (ABC Philadelphia) The foreign fallout Gravediggers, wearing suits and face masks to prevent the spread of covid-19, bury a dead person in Managua. (Inti Ocon/AFP) “Express burials” are raising fears Nicaragua is hiding a coronavirus tragedy. “Nicaragua has stood out in Latin America for an almost complete lack of restrictions to contain [the virus]. The government of President Daniel Ortega has kept offices and schools open. Authorities deny the virus has spread widely; in this nation of 6 million, one of the poorest in the Western Hemisphere, they insist there have been only 25 cases and eight deaths,” Ismael López Ocampo and Mary Beth Sheridan report. “Health officials give far higher estimates. And the speedy burials are hardly the norm for victims of common respiratory illnesses. Often, they are carried out at night by white-suited medical personnel, with police or members of pro-government paramilitary groups watching nearby. They come as signs of the outbreak are multiplying. … Late last month, a 57-year-old government worker was quietly interred in Managua, after dying of what was classified as cardiogenic shock, a heart problem. The burial was so swift that ‘they put him in the coffin in his hospital gown’ said the man’s daughter, who spoke on the condition of anonymity for fear of reprisal. ‘At 5 in the morning they buried him without his family present.’” Belgium, by official numbers, has been the country hardest-hit in the world by the virus. “The nation of 12 million has the highest mortality rate among confirmed cases, at 16.4 percent. And it has the most deaths in terms of its population: 78 deaths per 100,000 people, according to statistics compiled by Johns Hopkins University,” Michael Birnbaum reports. “Belgian officials have sought to tamp down concern by suggesting their chart-topping numbers are products of their accounting methods and commitment to capturing an accurate picture of their outbreak. Other ways of estimating virus-related deaths suggest that the Belgian method might indeed turn out to be among the most accurate in the world, and that other countries may be significantly undercounting their death tolls. The


Alongside pandemic, famine looms

was reportedly the size of Luxembourg. This adds to a tangle of complicating factors cited by Beasley. Lockdowns and resulting economic recessions in the developing world have pushed many of the working poor toward hunger. Nearly 370 million children are missing out on school meals. The level of remittances has fallen along with economic activity. Tourism — which accounts for a large portion of national income in many African countries — has collapsed. Oil-rich countries such as South Sudan and Nigeria have seen oil prices dramatically decline. And most destructively, more than 45 million people worldwide have been driven from their homes by violent conflict, leaving them particularly vulnerable to hunger and disease. Many African countries seemed successful in their initial efforts to contain covid-19 What would an adequate response look like? Increasing resources for the WFP should be on the agenda. WFP planes and trucks provide the logistical backbone for global humanitarian relief. The WFP is also the rare U.N. program that does precisely what it was designed to do. It will be important for the United States and other nations to push for humanitarian access in conflict zones. It takes strong, consistent, outside effort to ensure that refugees and displaced people are not beyond the reach of help. [ The Opinions section is looking for stories of how the coronavirus has affected people of all walks of life. Write to us. ] Given Trump administration concerns, bulking up the World Health Organization is not on the table. But as the American covid-19 crisis moves to the downside of its curve, President Trump will have an extraordinary opportunity to reduce suffering and silence his critics. Were he to put together a large bilateral, pandemic/famine response on the model of the President’s Emergency Plan for AIDS Relief, or Pepfar, he might find some things he generally lacks: bipartisan support, global approval and historical credit. Read more from Michael Gerson’s archive, follow him on Twitter or subscribe to his updates on Facebook . Read more: Michael Gerson: Coronavirus presents a crisis for Africa. We have a duty to help. Palesa Morudu: This is South Africa’s third major pandemic in 100 years. It has learned its lessons. Devi Sridhar: The next two weeks will decide Africa’s fate on the coronavirus Obiageli Ezekwesili: China must pay reparations to Africa for its coronavirus failures Rokhaya Diallo: No, France. Africa is not your testing ground.


The Swedish model

SWEDEN OFFERS an appealing model to many people who are fatigued with the hardships of pandemic lockdown, or who were never convinced it was entirely necessary. The Nordic country took some measures to control the spread of the coronavirus: It banned groups larger than 50 people, called for social distancing and put older students on video learning. But it did not take a draconian approach. Schools for those under 16 remained open, as did many bars, restaurants and gyms, with social distancing. That raises the question of whether the example is worth emulating. In terms of illness and death, it appears Sweden has paid a higher price for its approach. As of Monday, it had suffered 3,698 deaths in a country of 10 million. By contrast, Denmark, Norway and Finland, with a combined population more than 16.5 million, which all imposed tighter restrictions, have seen only 1,081 deaths. Sweden has reported 364.28 deaths per million people, compared with 94.4 for Denmark, 53.7 for Finland and 42.8 for Norway. However, Sweden’s death rate remained less than those of Britain, France, Italy and Spain, which all imposed strict lockdowns. The virus ravaged Sweden’s nursing homes, which accounted for a large portion of the deaths; the government was slow to restrict visits to them. [Full coverage of the coronavirus pandemic] At the same time, Sweden will not escape the economic damage of the pandemic. Economists say its economy — tightly woven into global supply chains — will suffer a deep recession this year. Travel has plunged, and many businesses have closed, while joblessness is expected to rise. What Sweden may gain by its approach, over the longer term, is a population with a greater natural immunity to the virus if there is no vaccine. To achieve a level known as “herd immunity,” in which the virus is largely unable to spread, two-thirds or more of the population would have to acquire protection stemming from exposure. It isn’t known if Sweden will reach that level or something less. But it might have more natural resiliency against a second wave. Nations that took drastic measures to protect people at the outset will be left with populations that are more susceptible. But if a vaccine is found relatively soon, it will provide immunity with a far lower cost in lives. What Sweden has demonstrated is the advantage of a high degree of trust in government. People


The Health 202: The ACLU gives a thumbs down to coronavirus 'immunity passports'

dearth of people getting tested could be because people don’t feel they need it, or they’re feeling only mild symptoms and believe a positive lab result wouldn’t make a big difference. Experts also point to distrust about testing operations or lingering concerns that tests are scarce. People across the country are still confused about who qualifies for a test, after initially strict rules designed to preserve tests for those who needed them the most. “Another major hurdle: lingering confusion about who qualifies. In the earliest days of the outbreak, Americans were told that only the sickest and most vulnerable should get tested while others should stay home,” Juliet, Steve and Brady write. “Last month, the Centers for Disease Control and Prevention relaxed its guidelines to offer tests to people without symptoms who are referred by local health departments or clinicians.” OUCH: A puzzling inflammatory syndrome in children believed to be linked to covid-19 now has a name. Late last week, the Centers for Disease Control and Prevention issued an advisory naming the condition multisystem inflammatory syndrome in children, or MIS-C, Ariana Eunjung Cha and Chelsea Janes report. Juliet Daly, 12, rides her bike outside her home in Covington, La., after recovering from a rare heart condition believed to be triggered by an inflammatory response to covid-19. A nasal swab confirmed she also had a second viral infection, adenovirus. (Gerald Herbert/AP) They wrote about a previously healthy 12-year-old, Juliet Daly, who survived after twice going into heart failure because of the rare condition. She was among the first known children in the United States to develop the syndrome. “It was still relatively early in the outbreak, April 6, and the hospital hadn’t seen other children in this condition. But the doctors knew enough about the pathogen’s effects on adults that they immediately suspected the coronavirus,” they write. “Cases like Juliet’s, a puzzling inflammatory syndrome in children believed linked to covid-19, had been popping up in different parts of the world for months, but it wasn’t until recently that health authorities began tracking the phenomenon.” “Heartbeats are controlled by electrical impulses that travel down the right and left branches of the heart at the same speed. Somewhere in Juliet’s heart, a block was causing the system to go haywire,” they write. “A team of pediatric cardiology specialists gave Jennifer a name for her daughter’s condition: acute fulminant myocarditis — a sudden onset