As her father lay dying in a hospital bed in Arizona, after testing positive for Covid-19, Lina Washington pleaded with him to keep fighting.
When they hung up, Washington scrolled through Instagram. She saw stories of friends and former classmates drinking and socializing at crowded bars and clubs, even as coronavirus infections rose exponentially across the state. Yet there they were, smiling, maskless, as if the threat had disappeared and life returned to normal.
Would they be so reckless, she wondered, if they knew that just a few miles away doctors and nurses were toiling around the clock to save her fathers life?
People dont think that it can happen to them, Washington, a high school friend and classmate, told me during a phone interview this week. And that carelessness, that hubris, that arrogance may have cost my dad his life.
Robert Edward Washington Jr died on 11 June from complications related to the virus, less than a month after returning to work as a security guard at a tribal casino in Chandler.
In the days since his death, Washington said, she has been on a warpath, demanding accountability and leadership from public officials and business leaders. She has directly challenged Arizona governor Doug Ducey over his response to the pandemic and implored him to do more to protect vulnerable residents.
His death was preventable, she said. Im just speaking out to ensure nobody else has to feel this pain.
In the last few days, as new coronavirus cases in Arizona have climbed to their highest levels of the pandemic, Washington has amplified her calls for stricter safety precautions. She is a television sports reporter in Sacramento, California, but she grew up in the Phoenix area. She has given interviews to every local TV news station and has spoken to the Arizona Republic. Nationally, she has been featured on ABC and MSNBC.
Some of her sharpest criticism has been expressed on Twitter.
I know my AZ friends arent taking this seriously, Washington tweeted on Thursday. I see what Old Town & Mill Ave look like every weekend on IG & its obscene. Youre putting people like my dad at risk by not wearing a mask at the very least. A Covid-19 death happened to me & could happen to you. Wake up.
On Friday, Washington filmed herself walking inside a Walmart in Tempe, after she saw multiple customers shopping without masks.
If you get sick, you get sick, a customer told her, which she shared in a tweet. She proceeded to call out Governor Ducey, writing: WHERE IS THE ACCOUNTABILITY?!
Two days earlier, Ducey had said he would no longer prohibit local governments from requiring masks, a reversal amid mounting pressure from mayors and public health officials. Wearing a mask for the first time at a news briefing, Ducey conceded that the virus was widespread in the state and urged Arizonans to act responsibly to protect one another.
Gila River Hotels & Casinos, which operates Lone Butte, where Washingtons father worked, posted a statement on Twitter to announce it was closing for two weeks, as the Gila River Indian Community moved to make protective face coverings mandatory on community lands.
This move comes after the death of one of your employees, my dad, who returned to work on 15 May, Washington responded. It was the same day Arizona lifted its stay-at-home order.
Were open, Phoenix! the casino tweeted that morning, encouraging guests to come and reclaim your fun.
Washington said she begged her father to stay home. But he was stubborn, a trait she says she inherited. He told her he needed to work, to ensure he had health and life insurance.
That night, he worked at the security desk, Washington said, exposing him to nearly every customer. Many employees were required to wear protective gear. Guests of the casino were encouraged to wear masks but not required to do so.
Washington said her father called her the next day and told her 80% of the people waiting to get into the casino at 4.30 in the morning werent wearing masks.
Within 10 days of him returning back to work he had tested positive for Covid and two weeks after that he was dead, she said.
I really wonder how many people were in that line that I knew, that we probably went to school with, she said, adding: I know so many people who would do that. Because its Arizona, and we dont really care about one another in ways like other communities do. Especially people who look like me and my dad.
Washingtons fathers death came amid a national reckoning over racism in America that has affected Washington professionally and personally. Inspired by the Black Lives Matter demonstrations, she helped start a community art project to benefit black youth organizations in Sacramento. It was just getting off the ground when she learned her father was ill.
It was a perfect storm, a black woman, in news, with a dad in the hospital with coronavirus, she said. It just all came down at once and then my worst fears were realized.
Washington said she was reluctant at first to speak out. As a sports reporter, she would rather be talking about the Sacramento Kings NBA season than her fathers death. But she said she felt a responsibility to use her platform to raise awareness.
Im just grateful that me expressing my pain is making a difference and putting a face to Covid in Arizona, she said.
Robert Washington was 68. He was a diabetic and had overcome prostate cancer. Black Americans infected with the virus are 2.3 times more likely to die from it than white Americans.
The last time Washington saw her father in person was in March. During a visit to Arizona, she asked him to sit for an interview.
Filmed in his backyard, Robert Washington recalled his adolescence in Ohio. A talented athlete, he excelled in nearly every sport he played. Football earned him a full scholarship to the University of Notre Dame in the early 1970s.
He was a devoted father who took her to dance, taught her to drive and prepared her for the challenges of being a black woman in an industry dominated by white men. He would take her to work at his shoeshine stand at America West Arena, so she could watch the Phoenix Suns play.
He was my best friend, she said, her voice breaking. I wish I could call him right now.
Washington will lay her father to rest on Sunday, Fathers Day.
JOPLIN, Mo. -- The Joplin, Missouri area is the nation's top spot for COVID-19 growth over the past week, according to data from the Dartmouth Atlas of Health Care Project.
In a seven-day stretch that ended June 18, the Joplin area's average daily growth rate of COVID-19 cases was 11.9 percent, according to the data. In that same span, the next closest daily growth rate was Tyler, Texas at 9.1 percent.
Jasper County, which includes Joplin and neighboring communities, has reported 196 cases as of Saturday afternoon. According to the Missouri DHSS, the county's case count has increased by 89.42 percent over the past seven days from 104 to 196.
Among the Joplin area's latest cases, 31 cases were reported at Spring River Christian Village, a retirement and assisted living facility in Joplin, retroactive to June 17.
According to a news release, the Christian Horizons COVID-19 Task Force reported one positive case at the facility. More than 300 tests were conducted in response, which determined 22 residents and 9 associates tested positive.
The Dartmouth Atlas of Healthcare Project analyzed on information from 306 hospital referral regions. Other data from the project includes new COVID-19 Cases, current cases and deaths per 100,000 over the past 14 days based on US hospital referral region.
The Joplin hospital referral region included parts of southeast Kansas, southwest Missouri to the Arkansas line, in addition to parts of northeast Oklahoma.
HILTON HEAD ISLAND, S.C. -- As illnesses go, Nick Watney likely proceeded like someone who simply was not at his best. He certainly was not violently ill Friday when he showed up at Harbour Town Golf Club. And despite warm, humid temperatures, he felt well enough to attempt to play the second round of the RBC Heritage.
But he knew something might be amiss due to the Whoop band he wears around his arm, a tool many golfers use as a way of regulating their health.
Watney, who tested positive for the coronavirus on Friday and withdrew from the tournament, relayed to Rory McIlroy via a text that an elevated respiratory rate via that band first told him "maybe I could have it.''
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And so Watney, 39, conveyed that to tour officials, consulted a physician, took another COVID-19 test -- he was negative for the one he took on Tuesday -- and then awaited the results at the course, while going about his business to prepare for the second round of the tournament.
It's fair to question why he was allowed to proceed in that manner, and perhaps that is a flaw in the PGA Tour's health and safety protocols as part of the coronavirus pandemic.
Why would you allow a symptomatic person to come to the course and practice?
Then again, doesn't Watney deserve credit for seeking medical attention when it's quite possible he could have tried to carry on and not said anything?
Therein lies the danger of banning someone who has "symptoms'' -- while also highlighting that no system can be perfect and there is some risk involved as sports attempt to come back after a lengthy shutdown.
"I hope not because it's not about yourself, right?'' McIlroy said when asked Saturday if he could see someone not reporting symptoms if they otherwise felt OK. "This virus isn't about ... most people that get it that are healthy are going to recover from it and be OK, but it's the people that you can infect. That's the big risk. I'd like not to think that people, if they were symptomatic, that they wouldn't report.''
And yet perhaps a player not in McIlroy's tax bracket might consider doing just that. Maybe he believes the risk is worth it, because he's in contention or needs the FedEx Cup points or sees an opportunity to make money after being denied that chance for so long.
There might be a hole in the PGA Tour's policy, but at least Watney took it upon himself to investigate.
"At this point, with who we have out here ... you have some older caddies out here, a lot of people out here. You have to err on the side of caution,'' U.S. Open champion Gary Woodland said. "Nick Watney is one of the nicest guys we have on tour. I hear he feels horrendous that he might infect someone else, which definitely wasn't the intent at all. I feel horrible for him, wish him the best.
"But for anybody's case, you better play it safe.''
As it stands now, the tour's policy allows a player who has been tested but not yet received a result to use practice areas. But he is not allowed to use the facilities, such as the locker room or clubhouse. Is that enough?
Perhaps a separate practice area could be set up. Maybe more of an emphasis on staying away from others until the result is known. While extreme, if as was the case on Friday when Watney was waiting for a result, hold his tee time so that there is not a rush to prepare and put yourself around others.
The tour also continues to stress to players and caddies their own responsibilities. It is not requiring them to stay in a specific hotel and it is not enforcing any lockdown orders away from the course. And depending on the area of the country the tour visits, outside variables come into play.
Carlos Ortiz told a story about the packed restaurants on Hilton Head Island, how he wanted to visit a few of them but ultimately decided to leave due to the crowds.
"It's a 30-minute wait and once you get in there, there's no social distancing, packed tables right by each other, kids running around,'' Ortiz said after shooting 63 at Harbour Town on Saturday. "Nobody wearing a mask. We talked about it on Tuesday when we saw it. We were like, "Oh, somebody's going to get corona here. It's crazy how busy it is here.''
Ortiz said he felt "paranoid'' when he learned of Watney's positive test.
"I think it's just a warning,'' he said. "We just need to be more careful.''
There is nothing to suggest Watney did anything but get unlucky. He did not test positive when he arrived on Tuesday. A few days later, he was feeling symptoms, and now the PGA Tour has its first COVID-19 case.
Watney, who has five PGA Tour victories, must now self-isolate in South Carolina for 10 days at the Tour's expense. There were 11 others the PGA Tour identified as having come in contact with him this week, all were tested on Friday, with the results negative.
McIlroy was not among those tested, feeling he was not close enough to Watney at any time to warrant it.
But he also knows this is a week-by-week endeavor. Positive tests are inevitable. Avoiding complacency remains the way for golf to continue safely.
"Starting up, people weren't nave,'' he said. "Statistically and looking at the numbers, someone was going to get it, and even being as careful as you can be, things happen, and you pick it up from somewhere.
"We're still in the middle of a pandemic. I think we've done really well to start golf again and get back up and play golf tournaments. I don't think anyone was blind to the fact that someone could catch the virus, and it's a shame that Nick did. But it's one case, and as long as it's contained to that and we move forward, we can keep playing.''
The Xinfadi Agricultural Wholesale Market in Beijing in February. The market was shuttered on 13 June after it became the center of a new COVID-19 outbreak.
By Dennis NormileJun. 17, 2020 , 4:55 PM
Sciences COVID-19 reporting is supported by the Pulitzer Center.
Beijings confirmation of a COVID-19 case on 11 June ended a run of 55 days without reported local transmission. Since then, the outbreak has burgeoned and the city has responded with fierce determination to rein it in. As of today, it has tested 356,000 people, confirming 137 cases, according to a news report by Xinhua, the state-owned news agency. The city has locked down some residential compounds, closed all schools, and canceled hundreds of flights.
Virtually all of the infections have been linked to a massive wholesale food market that has been temporarily shuttered. The link to the market has triggered comparisons to the seafood market in Wuhan that played a role at the early stages of the pandemic, and speculation that the virus arrived in fish imported from Europe. But the real source of the outbreak is still a mystery.
Beijing reported its last case of local COVID-19 transmission in mid-April. The current outbreak began when a man with no history of recent travel visited a doctor on 10 June with a fever and chills. He tested positive for SARS-CoV-2, the virus that causes COVID-19, and was hospitalized the following day. Officials think he or a close contact was infected at the Xinfadi Agricultural Wholesale Market, a massive 112-hectare complex housing 2000 stalls selling produce, seafood, and meat with 10,000 customers and workers visiting daily, according to Xinhua. This led to the massive effort to test market workers, customers, and even residents of nearby neighborhoods.
Authorities have reported that a number of surfaces in the market tested positive for SARS-CoV-2, including a cutting board in a booth handling imported salmona finding that has drawn lots of attention in the local media. There is no evidence coronaviruses infect fish, but one hypothesis is that infected workers in Europe contaminated the fish or its packaging during processing. Genomic sequencing shows the viral variant behind the new outbreak is related to strains China has found in people returning from Europe, according to a China Daily report that quotes Yang Peng, an official with the Beijing Center for Disease Prevention and Control. In addition to seafood, Yang suggested imported meat as a possible source. But he acknowledged that a market employee or visitor may have picked up the virus elsewhere and simply spread it to other people at the market. Where exactly the virus came from is still uncertain,Yang said.
Dirk Pfeiffer, a veterinary epidemiologist at the City University of Hong Kong, doubts the virus arrived at the market in fish: I think it is much more likely, and therefore plausible, that it was brought to the market by infected humans.If the contaminated seafood hypothesis is true, other places handling European salmon should have seen outbreaks, adds epidemiologist Keiji Fukuda of the University of Hong Kong. The genomic sequence, which has not been made public yet, could offer more clues, he says.
Six months ago, many of the earliest COVID-19 cases were linked to another market, the Huanan Seafood Wholesale Market in Wuhan, China. Such markets host dozens to hundreds of independent operators offering a range of meat, seafood, and produce, and sometimes live wild game. Many scientists believe SARS-CoV-2 likely originated in bats and may have passed through an intermediate host before jumping to humansperhaps at the Wuhan market.
But Pfeiffer says the meat and live animals sold at the markets may not be the only reason viruses spread there. The sheer volume of people passing through and working in the markets and the suboptimal hygienic conditions inherently represent an increased risk for amplification of virus.The humid, chilled air at markets may provide an environment in which viruses thrive.
The virus return to Beijing is another cautionary tale to not take anything about COVID for granted,Fukuda says. With the vast majority of the world population susceptible to infection and the virus still circulating, it is possible for any country, including [those] that have made major efforts to reduce transmission, to experience an outbreakhe says.
Dennis Yun, right, recently hosted a Memorial Day barbecue where guests had their temperatures taken and took Covid-19 antibody tests before they were allowed in.
Courtesy of NxtStop
As more locations around the U.S. re-open, people are starting plan social events again.
But for some, these gatherings include new precautions to reduce the risk of spreading Covid-19.
In Los Angeles, Jay Prasad and his roommate Dennis Yun, who is a physician, recently hosted a Memorial Day barbecue. Before guests could enter, Yun administered a Covid-19 antibody finger-prick test, then made them wait ten minutes for the results. Antibody tests typically register positive if a person has been exposed to the disease, even if they didn't show symptoms.
Prasad and Yunalso used an infrared forehead thermometer to check if any guests had a fever, a common symptom of Covid-19. Although no guests tested positive for antibodies or showed signs of a fever, Prasad said he and his roommates were prepared to turn people away if they had.
"That's just the smart thing to do, and I don't think we know anybody who would've objected to it," Prasad said.
Additionally, Prasad handed out face masks from NxtStop, a direct-to-consumer clothing brand that he invested in. Although the barbecue was a mostly outdoor event, guests were asked to wear the masks while inside.
"We got some sense of return to normalcy," Prasad said. "At least this was a path toward how that might happen."
Jay Prasad recently hosted a Memorial Day barbecue where guests had their temperatures taken and took Covid-19 antibody tests before they were allowed in.
Courtesy of NxtStop
From requiring Covid-19 tests to wearing masks indoors, people are creating new standards of social etiquette suited for the "new normal" of life amid the coronavirus.
To minimize the spread of the disease, the Centers for Disease Control and Prevention recommends staying six feet apart, wearing face coverings, and keeping tissues and hand sanitizers handy whenever people venture outside. The CDC also notes that indoor spaces are riskier than being outdoors, and that spending more time with people who may be infected increases the risk of transmission.
Ivan Malina is asking his friends to take Covid-19 tests before their planned trip for Fourth of July.
Courtesy of Ivan Malina
For the Fourth of July, Ivan Malina of Brooklyn is planning a trip with friends to Lake George, New York. The group of 10 is renting a large home where they can keep their distance from one another, and they have all agreed to use masks while inside. Additionally, the group is planning to use disposable plates and utensils throughout the gathering.
Most importantly, everyone has to take a Covid-19 test prior to the trip, Malina said.
"We're going into another community. It would be really bad if we went up there and someone had it and spread it," Malina said. "A lot of stuff with Covid is less about protecting yourself and protecting others."
Malina is asking his friends to take the test within a week before the trip, then refrain from any risky activities where they could become infected before the gathering. If anyone tests positive, Malina said, the group will refund that friend for their portion of the vacation rental.
"This is unprecedented," Malina said. "Paying a little bit more because your friend got sick, I don't think that's going to bother anyone."
Sara Broyles, center of bottom row, and her friends decided they will all take Covid-19 tests before her upcoming housewarming.
Courtesy of Sara Broyles
In San Francisco, Sara Broyles moved into a new apartment just before the city enacted its shelter-in-place order in March. The lockdown scuttled her plans for a housewarming party.
Recently, she decided to try again. She reached out to her close friends to ask how they would feel about that type of hangout, and collectively, the group decided that they would love to get together -- as long as everyone took a Covid-19 test before the event.
"I do want to make sure that everyone does feel comfortable being in close quarters together," Broyles said. "If we do this the right way, I feel like it will be OK to do."
For Broyles, who had never lived alone before, hosting friends at her place for the first time will be a milestone.
"We've all spoken on the phone and FaceTimed and Zoomed a bunch, and that's all great," she said. "But of course, we miss spending time together."
The U.S. is now confronting what public health experts have been warning about but many in the public had not absorbed: the coronavirus pandemic will be with us for many months, and lapses in vigilance will lead to more sickness and death.
The country as a whole is tacking on about 20,000 new Covid-19 cases to its 2.1 million infection tally each day, a clip thats been steady for weeks, according to STATs Covid-19 Tracker. But cases are surging in about half of states, some of which dodged major outbreaks in the spring as the Northeast and other pockets like New Orleans became inundated. The local outbreaks are leading to increasing hospitalizations in Arizona, Texas, Alabama, and the Carolinas raising concerns about capacity when the original rallying cry of flatten the curve was meant to prevent overwhelming health care systems.
Experts had envisioned localized ups and downs as the U.S. epidemic dragged on. But the new bursts of cases have not galvanized a commitment to rein in the spread and steer those rises into downturns. Instead, there is fading attention in Washington, and many Americans seem inured by the steady stream of 800 daily Covid-19 deaths and desperate to return to work and daily life.
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Im worried that people have kind of accepted where we are as a new normal, said Tom Inglesby, director of the Center for Health Security at Johns Hopkins School of Public Health.
Much of this was forecast. As states started easing back shelter-in-place restrictions last month, public health experts warned cases would increase. Thats simply the nature of the coronavirus: more people encountering more people provides more chances for the virus to pass from one to another. Plus, unlike in some countries, the U.S. lockdowns were eased at a time when there was still lots of virus circulating, so it was primed to resurge.
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We should expect to see that the virus will go wherever there are susceptible people, said Yonatan Grad, an infectious disease expert at Harvards Chan School of Public Health.
But if initial lockdowns were meant to cut off as much transmission as possible and reduce it to manageable levels, they were also supposed to buy health authorities time to design strategies for the long haul, to come up with plans to keep a brake on spread so people could emerge back into life without an explosion of cases. Hospitals were meant to gear up for future spikes of seriously and critically ill patients. Health agencies had to build testing and contact tracing networks, which could keep spread at a simmer and prevent dangerous flare-ups. Authorities had to communicate to the public that some measures including masks, distancing, and avoiding crowds had to be maintained for the duration.
Now, were seeing the fruits of those efforts and the lack thereof.
The U.S. has not hired enough contact tracers to satisfy expert estimates of whats needed. Mask wearing has become a political flashpoint, with many people simply refusing or not seeing the purpose. The shortcomings are not limited to states that have so far skirted the worst of the coronavirus; this week, New York Gov. Andrew Cuomo chastised local governments to do your job and enforce distancing policies after crowds gathered outside New York City bars.
In Arizona, local health departments raced during the states stay-at-home period to build up contact tracing fleets and prepare for more cases, said Kacey Ernst, an infectious disease epidemiologist at the University of Arizona. But they didnt have sufficient time to build the capacities that would prove to be necessary once the state reopened.
People were using that time, absolutely, she said. It wasnt long enough.
Now, the state is regularly reporting more than 1,000 new cases a day, compared to a few hundred in May. Hospitalizations are up. There isnt enough contact tracing in place to try to get a hold of the outbreak, Ernst said.
As cases are going up, youre just getting further and further behind the curve, she said. If you dont have all of the things in place, the contact tracing folks trained and operating seamlessly, the more cases will ramp up. And you just keep trying to catch up.
There are not clear answers as to why some states are seeing more intense outbreaks than others. Georgia and Colorado were two early states to ease back stay-at-home policies, but havent seen the rate of increases that others have. Southern California, where restrictions were in place longer, has seen worrying jumps. Density both at a community level and within households can influence spread. Some states are more vulnerable to a spike in hospitalizations if their populations have worse underlying health, meaning people who contract the coronavirus are more likely to develop severe disease.
Based on their connections to other hubs of spread, some communities will be later to experience cases than others. Social distancing strategies could have delayed or minimized the course of the outbreak in certain places, as could individual actions by people, including mask wearing, hand washing, and maintaining distance from others beyond what was mandated by local policies. As Harvard epidemiologist Caroline Buckee said, there are inherent differences in how people are responding to the coronavirus in terms of their fear and lack of fear of mixing in public.
Some communities have also dodged bullets; two Missouri hairstylists who had Covid-19 managed not to infect any of their 140 customers, perhaps because they were wearing masks and taking other precautions.
One explanation for the case increases is expanded testing a point President Trump and Vice President Mike Pence have tried to argue. As STATs Covid-19 tracker shows, with wider testing, states are getting a more accurate read of the true number of cases, compared to earlier in the U.S. epidemic when many more were being missed. (Even now, experts estimate that for every case detected, another seven or so exist.)
Many of the new cases are also being driven by outbreaks in congregate settings places including jails and prisons, nursing homes, and meatpacking plants. Those clusters are dangerous for those who work and live and are incarcerated there. But their relative isolation makes them easier to contain than transmission in the community.
But increased testing and those confined outbreaks do not account for the full rise in cases that many U.S. states are reporting. By other metrics, there are signs of growing community spread. In addition to more hospitalized patients and ICU beds filled, the rate of tests coming back positive is higher than 10% in Arizona, South Carolina, and Alabama, and rising elsewhere, according to Covid Exit Strategy. That indicates there is an increasing amount of spread that authorities are not capturing.
Governors have sought to project that caseloads remain manageable and that their states need to keep progressing toward full reopenings. Health systems and officials in states including Arizona and Texas also say they have built enough surge ICU capacity to handle the patients they are seeing. (The concern is that when hospitals get overwhelmed, not only does care for Covid-19 suffer, but other patients are harmed as well.)
But there are signals that more patients could be coming their way.
Hospitalizations now, for example, reflect spread that occurred two weeks ago, since people typically dont start feeling sick until about five days after they contract the virus, and it takes another week for symptoms to get bad enough to require a trip to the emergency department. In that interim, the spread could have snowballed, especially as all states have now lifted lockdown restrictions to some extent.
Soon, we may see spread related to the nationwide protests against racism and police brutality. Trump is also planning a return to campaigning, beginning with a rally scheduled for Saturday in Tulsa. That city saw a record number of new cases on Monday.
Whether and how widely the virus spreads at any of the protests, vigils, or rallies depends on a range of factors: How many infectious attendees were there? Were they distanced and wearing masks? Were they chanting close to other people? Did police fire tear gas and induce coughing? Did law enforcement mass people together in jails?
And whether those mass gatherings incite just spurts of spread or form bigger clusters depends on what people who contracted the virus at the events do. Do they live with five roommates or in a multigenerational home? Where do they work?
The initial effects after a protest might be two weeks later, but thats just the beginning, Inglesby said. What we worry about in this epidemic is the compounding next generation, next generation of cases.
That leaves the bigger question: what can be done to halt major surges in cases, particularly as they threaten health care systems? Because of new infections, Utah and Oregon pushed off the dates when they entered into the next step of their gradual reopenings; some cities and counties have urged businesses to limit capacities beyond what they were required to do by states. This week, New Yorks Cuomo raised the specter of imposing new restrictions on parts of the state if the numbers start to go up. But widespread lockdowns like those instituted in March and their accompanying damage to social, educational, economic, and health wellbeing do not seem palatable.
Its still not entirely clear to me whether theres the political and social will that could sustain another round of community lockdown, Grad said. So if not, what are we going to do? And as communities start to open up and go through phase 1, 2, 3 of reopening, what are going to be the triggers for introducing restrictions again, and which restrictions?
As a way to gauge if new restrictions are needed, some experts have called on health departments to report the number of unlinked infections those for which they cant determine where the infection came from. More unlinked infections signifies more uncontrolled spread and could require distancing measures to stem.
Experts are also trying to parse which components of lockdowns were necessary to drive down transmission, and which can be avoided. Theyre hoping a more nimble, targeted approach can allow officials to gain a hold over outbreaks without collapsing the economic and social fabric again. It could be more localized stay-at-home measures, or culling certain activities, or strategies that protect those most vulnerable to the effects of Covid-19, including older people.
There is a spectrum of interventions between no social distancing and normal behavior, and complete lockdown, Buckee said. Were going to have to be quite flexible about making decisions along that spectrum.
Already, bars and restaurants in Texas and Florida where cases have been found since reopening have had to briefly shut down. But those retrospective actions still leave communities on defensive footing. To live with the virus and keep cases at manageable levels requires an attack mentality: Widespread testing, quickly identifying and isolating people who are infected, tracing and quarantining as many of their contacts as possible. Those are the general strategies that other countries have used to drive down their curves.
As more people return to work, it will also be incumbent on employers to protect their staff. One of the reasons that the U.S. epidemic has disproportionately affected Black and Latinx populations is because they fill so many essential jobs.
The primary way the Latinx community is becoming infected is through going to work, said Rosa Gonzalez-Guarda, an associate professor at Dukes School of Nursing.
If employers arent implementing distancing rules in workplaces, providing protective gear when necessary, or allowing people to stay home when sick, Gonzalez-Guarda said, it will be very hard to contain the disease.
Black people, Hispanics and those with underlying conditions -- especially men and elderly people -- faced higher risks from Covid-19, the data show.
Below are a few major findings from the report, which samples data from January 22 through May 30.
Percentage of total cases vs. percentage of US population
Race and ethnicity data were available for about 600,000, or 45%, of cases studied, and specific underlying conditions were available for about 287,000, or 22%, of cases studied. But those partial numbers still highlight specific key trends within demographics.
A breakdown by race and ethnicity shows the disproportionate infection rates among Hispanics and Blacks, far beyond their share of the population. Included in the Other/multiple races category, American Indians and Alaska Natives were also disproportionately affected -- 1.3% of cases while making up only 0.7% of the US population.
Those with underlying conditions
Among the 287,320 patients for whom the status of underlying conditions was known, hospitalizations were six times higher among those who reported underlying conditions. A higher percentage of men with underlying conditions were hospitalized than women with underlying conditions.
For the same subset of 287,320 cases, deaths were 12 times higher, overall, among patients who reported underlying conditions. When broken down by gender, a greater percentage of male patients with underlying conditions died than did female patients with underlying conditions.
Data on the same subset of cases were also broken down by age group. Those with underlying conditions had hospitalization rates at least double the hospitalization rates of those without underlying conditions.
Shown here are the percentage of cases who were hospitalized, by age group:
Deaths were most commonly reported among persons aged 80 and older, regardless of the presence of underlying conditions. Across all age groups, those with underlying conditions were also more likely to die from the virus:
The most common reported underlying conditions among persons with laboratory-confirmed Covid-19 were cardiovascular disease, diabetes and chronic lung disease.
CNN's Andrea Kane and Paul LeBlanc contributed to this report.
Recent developments:
Hundreds of people flooded Ottawa's downtown Saturday to march in remembrance of Abdirahman Abdi, who died after a violent altercation with Ottawa police in 2016.
The group protested outside police headquarters. The march also comes amid calls for the police association president to resignafter he wascaptured on an audio recording using a sexist slur to describe a member of the city's Black community.
Emergency cooling centres are available this weekend at five community centres in Ottawa: Ron Kolbus Lakeside Centre, Hunt Club Riverside Park Community Centre, Hintonburg Community Centre, Sandy Hill Community Centre and St-Laurent Complex.
Splash pads are also open; however, beaches do not officially open until June 27.
Indoor and outdoor pools, along with wading pools, are still closed but set to open next month.
Like many events, theSummer SolsticeIndigenous Festival has had to move online. The three-day festival happens every year duringNational Indigenous History Monthand bookends thelongest day of the year.
Farmers markets are open and no longer require people to register in advance.
Starting Monday, Quebecers will be able to gather indoors in groups of up to 50 people and will only have to stay up to 1.5 metres apart.
There have been 2,054 confirmed cases of COVID-19 in Ottawa and 260 deaths.
There are3,275 known cases across eastern Ontario and western Quebec.
More than 2,750 people in the region have recovered from COVID-19.
COVID-19 has killed 102 people outside Ottawa: 52 in Leeds, Grenville and Lanark counties, 17 in other parts of eastern Ontario and 33 in the Outaouais.
Eastern Ontario is in "Stage 2" of the province's recovery plan, allowing "circles" of up to 10 people who don't have to distance as long as they limit close contact to that group.
Quebec also has different restrictions for different regions. Thursday evening it announced new rules for its long-term care homes that don't have a COVID-19 outbreak.
It plans to allow indoor, distanced gatherings of up to 50 people next week, including in places of worship, along with changes to daycare rules.
Kingston starts closing parts of some downtown streets next week to offer more space for businesses and pedestrians.
Ontario Parks says it's ready to begin opening some campsites and services starting next week.
Quebec's back-to-school plans bring older students to classrooms again. Post-secondary schools are moving toward more online classes in September.
The coronavirus primarily spreads through droplets when an infected person coughs or sneezes. People don't need to have symptoms to be contagious.
That means physical distancing measures such as working from home and in Ontario, staying at least two metres away from anyone they don't live with or have in their circle.
Children in Quebec can now be one metre apart at school and day camps. Starting Monday, all Quebecers can be within 1.5 metres of each other while seated at indoor venues such as theatres.
Ottawa Public Health now wants people to think about how to safely do certain things and recommends people wear a fabric or non-medical mask when they can't always stay two metres from strangers, such as at a grocery store.
Anyone who has symptoms or travelled recently outside Canada must self-isolate for at least 14 days.
Specifically in Ottawa, anyone waiting for a COVID-19 test result must self-isolate at least until they know the result.
The same goes for anyone in Ontario who's been in contact with someone who's tested positive or is presumed to have COVID-19.
People 70 and older or with compromised immune systems or underlying health conditions should also self-isolate.
COVID-19 can range from a cold-like illness to a severe lung infection, with common symptoms including fever, a dry cough, vomiting and the loss of taste or smell.
Less common symptoms include chills, headaches and pink eye. The Ontario government says in rare cases, children can develop a rash.
If you have severe symptoms, call 911.
Ontario hopes to test a federal contact tracing app next month that would let users know if they've been close to a confirmed case.
In eastern Ontario:
In Ottawa any resident who feels they need a test, even if they are not showing symptoms, can now be tested at one of three sites.
Inuit in Ottawa can call the Akausivik Inuit Family Health Team at 613-740-0999 for service, including testing, in Inuktitut or English on weekdays.
Testing has also expanded for local residents and employees who work in the Eastern Ontario Health Unit area.
There is a drive-thru test centre in Casselman and assessment centres in Hawkesbury and Winchester that don't require people to call ahead.
Others in Rockland and Cornwall require an appointment.
In Kingston, the assessment centre at the Kingston Memorial Centre is open seven days a week for walk-ins. Napanee's test centre is open daily for people who call for an appointment.
WATCH: 100 days of Canadian quarantine
The Leeds, Grenville and Lanark unit asks you to get tested if you have a symptom or concerns about exposure.
It has a walk-in site in Brockville open seven days a week at the Memorial Centre and testing sites in Smiths Falls and Almonte which require an appointment.
The public health unit in the Belleville area is asking people to call it, their family doctor or Telehealth if they have symptoms or questions.
You can arrange a test in Bancroft, Belleville or Trenton by calling the centre, or in Picton by texting or calling 613-813-6864.
There are weekly pop-up clinics in other communities and you may also qualify for a home test.
Renfrew County is also providing pop-up and home testing under some circumstances. Residents without access to a family doctor can call 1-844-727-6404 if they have health questions, COVID-19-related or not.
If you're concerned about the coronavirus, take the self-assessment.
In western Quebec:
Outaouais residents should call 1-877 644-4545 if they have symptoms for further assistance.
First Nations:
Local communities have declared states of emergency, put in a curfew or both.
Akwesasne has opened a mobile COVID-19 test site available by appointment only. Anyone returning to Akwesasne who's been farther than 80 kilometres away is asked to self-isolate for 14 days.
Anyone in Tyendinaga who's interested in a test can call 613-967-3603 to talk to a nurse.
Pikwakanagan's council let businesses reopen May 29 and is not running checkpoints at entrances during the day.
CORPUS CHRISTI, Texas This week has been one filled with many cases across the state of Texas and the Coastal Bend. Our Ashley Gonzalez joins us live to tell us more about the rise in cases here in the Nueces County.
Brian, just hours ago the Nueces County reported 49 new cases of COVID-19. This will be the highest week in cases this county has seen since the start of the pandemic," said 3News Reporter, Ashley Gonzalez.
With 200 cases and three deaths just this week alone, in the latest City Council COVID-19 update, Public Health Director, Annette Rodriguez, reminded the community until theres a vaccine we cannot drop the ball.
I want to reiterate the virus is real. It poses a huge risk to our community, but please practice good health strategies so that the virus can be controlled until we have a vaccine or antiviral viral medication to help mitigate the spread of this virus, stated Annette Rodriguez.
Rodriguez says the more people to get tested for COVID-19, the easier it is for the health department to navigate the spread and get ahead of it.
Being tested does not keep you from getting the virus, but it allows public health officials to contact trace every index person, so we can slow down the spread, added Rodriguez.
If you are experiencing COVID like symptoms, you can call the City-County Health Center hotline at 361-826-7200. You will be screened over the phone and then prompted on what to do next.
CHARLESTON, W.Va. The West Virginia Department of Health and Human Resources confirmed 33 new cases of the coronavirus and an additional death caused by the virus in its Sunday morning report.
The West Virginia Department of Health and Human Resources (DHHR) reports as of 10 a.m., on June 21, 2020, there have been 150,170 total confirmatory laboratory results received for COVID-19, with 2,533 total cases and 89 deaths.
DHHR has confirmed the death of a 74-year old female from Berkeley County. Please join with us in grieving the passing of this West Virginian, said Bill J. Crouch, DHHR Cabinet Secretary.
According to theDHHRs website, there are currently, 770 active cases and 1,674 recovered cases in the state.
In alignment with updated definitions from the Centers for Disease Control and Prevention, the dashboard includes probable cases which are individuals that have symptoms and either serologic (antibody) or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but no confirmatory test.
Listed below are the numbers of confirmed and positive cases of COVID-19 per county, according to the DHHRs latest report:
CASES PER COUNTY (Case confirmed by lab test/Probable case): Barbour (12/0), Berkeley (414/18), Boone (20/0), Braxton (3/0), Brooke (5/1), Cabell (80/3), Calhoun (2/0), Clay (10/0), Fayette (58/0), Gilmer (10/0), Grant (15/1), Greenbrier (50/0), Hampshire (40/0), Hancock (19/2), Hardy (40/1), Harrison (48/1), Jackson (141/0), Jefferson (210/5), Kanawha (258/8), Lewis (15/0), Lincoln (5/0), Logan (21/0), Marion (53/2), Marshall (36/1), Mason (15/0), McDowell (6/0), Mercer (22/0), Mineral (51/2), Mingo (11/3), Monongalia (137/14), Monroe (8/1), Morgan (19/1), Nicholas (7/0), Ohio (70/0), Pendleton (12/1), Pleasants (3/1), Pocahontas (23/1), Preston (48/13), Putnam (43/1), Raleigh (31/1), Randolph (150/0), Ritchie (3/0), Roane (12/0), Summers (1/0), Taylor (12/1), Tucker (5/0), Tyler (3/0), Upshur (10/1), Wayne (105/1), Wetzel (9/0), Wirt (4/0), Wood (52/4), Wyoming (7/0).
As case surveillance continues at the local health department level, it may reveal that those tested in a certain county may not be a resident of that county, or even the state as an individual in question may have crossed the state border to be tested.
Editors note: The numbers received from the West Virginia DHHR may include cases that have already been resolved. Therefore, these counts may need to be viewed as historical cases, rather than active cases.
Editors note 2: The total number of cases confirmed by the DHHR now includes probable cases, which are individuals that have symptoms and either serologic (antibody) or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but no confirmatory test.
