Chicago's O'Hare International Airport appeared nearly empty Thursday with one traveler calling it 'surreal.'The U.S. is offering airlines a $25 billion aid package, but analysts say it could be five years before the industry fully recovers. (April 16) AP Domestic
A photo of a crowded flight posted on Twitter by a cardiologist returning from the New York City area may hint at the difficulties of social distancing as air travel picks up again.
Dr. EthanWeiss tweeted a photo Saturday showing what appears to be a full United Airlines flight from Newark, New Jersey, to San Francisco. Though passengers are wearing masks, he said the crowded cabin runs counter to United's assurancesthat it wouldleave middle seats empty in order to promote social distancing to help prevent the spread of the coronavirus.
"I guess @united is relaxing their social distancing policy these days? Every seat full on this 737," tweetedWeiss along with the photo. He is both a physician and a scientist at the University of California San Franciscowho had been in New York working to aid withthe coronavirus crisis.
In a separate tweet, Weiss included a statement from United's chief customer officer, sent to all passengers, saying, "We're automatically blocking middle seats to give you enough space on board."
He said in a tweet he was among the medical workers who had been flown to New York for free by United to help care for the flood of patients due to the pandemic. He addedthat "people on this plane are scared/shocked."
Weisstold USA TODAYhe had no further comment beyond his tweets.
Reached for response, a United spokeswoman said the airline has taken steps to address the coronavirus.
Weve overhauled our cleaning and safety procedures and implemented a new boarding and deplaning process to promote social distancing," spokeswoman Kimberly Gibbs said in an email. "Our flight to San Francisco had an additional 25 medical professionals on board who were flying for free to volunteer their time in New York. Weve provided complimentary flights for more than 1,000 doctors and nurses in the past few weeks alone and all passengers and employees were asked to wear face coverings, consistent with our new policy.
A passenger flying from Newark to San Francisco says his flight was packed, with little opportunity for social distancing.(Photo: Julio Cortez, AP)
United is among several airlines that have established policies of trying to keep middle seats open,though for some it appears more of a goal than a guarantee. Airline passenger traffic has plunged to levels not seen since the 1950s and recentlydomestic flights averaged 17passengers, Nicholas Calio, CEO of the industry trade group Airlines for America, told a Senate Committee last week.
But as the nation starts to reopen, airline traffic is starting to pick up and thereis more pressure to fill middle seats.
The Transportation Security Administration said it screened 215,444 people passing through checkpoints Friday as the usually busy Mothers Day weekend began, the highest daily number since March 25 and more than double the low of 87,534 on April 14. Airline executives have repeatedly said this month that they believe travel demand bottomed in mid-April.
Fridays figure is still down nearly 92% from the same Friday a year ago, however, when 2.6 million passengers, crew members and airport employees were screened at TSA checkpoints.
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When an Ebola epidemic erupted in West Africa, in 2014, the United States and China, the worlds two largest economic powers, responded in starkly different fashions. The Obama Administration dispatched the 101st Airborne and other troops to build treatment hospitals, and donated more than half of the $3.9 billion in relief funds collected from governments worldwide. Within six months, the outbreak was under control, and the U.S.-led effort was hailed as a template for handling future epidemics.
Chinese mining and construction firms had big businesses in Liberia, Guinea, and Sierra Leone, but Beijing struggled to mount a humanitarian response. Between August and October of that year, nearly ten thousand Chinese nationals fled those countries in a panic. China, unaccustomed to such missions, sent medical teams and supplies, but, over all, it contributed less than four per cent of the relief funds.
Six years later, however, neither nation can claim to have led the way in managing the COVID-19 pandemic, which has so far killed more than a quarter of a million people around the world. The efforts of both have been marred by denial, coverup, and self-deception. President Donald Trumps trade war and President Xi Jinpings hostility to Western influence had already frayed the countries relationship to its most fragile point in decades. Now, in a bid to deflect criticism, they are turning against each other in perilous ways.
For President Xi, containing the disease, which first emerged in Hubei Province four months ago, has been a race against both a public-health and a political calamity. After initially silencing doctors who reported the virus, Beijing gained control of the outbreak by locking down Hubei, testing millions of people, and quarantining suspected cases, even if it required forcibly removing residents from their homes. By mid-March, China was reporting nearly no new cases, a claim that outside experts considered doubtful but in the neighborhood of truth.
Shaping the narrative of Chinas role in the pandemic will be more difficult. In April, the Associated Press obtained government documents showing that leaders in Beijing knew the potential scale of the threat by January 14th, but Xi waited six days before warning the publica catastrophic interlude of dinners, train rides, and handshakes that helped unleash the pandemic. The government staged a public-relations offensive, touting Chinas exports of medical gear to other nationsa tactic dubbed mask diplomacy. It also suggested, with no evidence, that the source of the virus was a delegation from the United States that had participated in the Military World Games in Wuhan in October. The offensive backfired: buyers complained of faulty or undelivered shipments, and U.S. officials accused China of using social media to promote divisive and false information.
The Trump Administration, for its part, has cut off funds to the World Health Organization and declined to join the European-led fund for vaccine research. Trumps delusionsthat the virus would vanish in a miracle, that an antimalarial drug would shortcut science, that ingesting disinfectant could helphave further reduced the Administrations reputation to a baleful farce. Last week, Kevin Rudd, the former Prime Minister of Australia, wrote in Foreign Affairs that the Administration had left an indelible impression around the world of a country incapable of handling its own crises, let alone anybody elses. In Rudds view, the uncomfortable truth is that China and the United States are both likely to emerge from this crisis significantly diminished.
The Administration could credibly have criticized Chinas early mishandling of the virus, and its efforts to control international scrutiny of the viruss origins. Instead, the White House seized on a blame-Beijing strategy to undermine Chinas growing global power and shore up Trumps bid for relection. (An ad from a pro-Trump super PAC says, To stop China, you have to stop Joe Biden.) Unnamed Administration officials floated revenge fantasies to reporters, such as abandoning U.S. debt obligations to China, an act that, investors noted, would gut Americas financial credibility. As Adam Posen, the president of the Peterson Institute for International Economics, told the Washington Post, In economic terms, this is worse than telling people to drink bleach.
In the riskiest line of attack, members of the Administration, conservative lawmakers, including Senator Tom Cotton, and Fox News have promoted an unverified theory that the coronavirus may have originated in an accidental leak from a Chinese virology lab. On April 30th, Trump said that he had seen convincing evidence of this, but gave no details. Secretary of State Mike Pompeo followed up three days later, claiming simply that there was enormous evidence to support the theory. More credible voicesincluding those of Anthony Fauci, the governments top expert on infectious diseases, and General Mark Milley, the chairman of the Joint Chiefs of Staffhave declined to endorse that view.
Yet Trump and Pompeos rhetoric has some in the intelligence community concerned that the Administration may try to push on the origins of the virus much the way that, in 2002, Vice-President Dick Cheney and his chief of staff, Scooter Libby, pressured intelligence agencies to provide material that might support the theory that Saddam Hussein had weapons of mass destruction. Chris Johnson, a former China analyst at the C.I.A. who now heads the China Strategies Group, said, If we have a smoking gun, the Administration would have leaked it. There are specters of Libby and Cheney, and it worries me.
More worrying, perhaps, this month in Beijing the Ministry of State Security presented to Xi and other leaders an assessment that reportedly describes the current hostilities as creating the most inhospitable diplomatic environment since the Tiananmen Square massacre. According to Reuters, some members of Chinas intelligence community regard the assessment as a Chinese version of the Novikov Telegram, a 1946 dispatch that the Soviet Ambassador to Washington, Nikolai Novikov, sent to Moscow, forecasting the advent of the Cold War.
To John Gaddis, the dean of Cold War historians, Americas advantage over the Soviet Union hinged less on aggression than on competent governance. The country can be no stronger in the world than it is at home, he said. This was the basis for projecting power onto the world scene. Weve lost that at home right now. If the Trump Administration uses the coronavirus to heighten its conflict with China, it will not only have ignored a basic lesson of U.S. history; it will expose America to yet another crisis for which it is plainly unprepared.
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The good news is that the Utah Department of Health on Sunday announced only one new COVID-19 death. The bad news is that even without that figure, the state saw its deadliest week since the pandemic began.
For the seven-day period beginning May 4 and ending Sunday, 17 people died as a result of the highly-contagious coronavirus. With 67 total deaths through Sunday, 25.4% occurred over that seven-day span.
Salt Lake County continues to take on the brunt of the coronavirus. Of the 6,251 confirmed COVID-19 cases in the state, 3,921, or 52.6%, belong to Salt Lake County. With Salt Lake County accounting for about one-third of the states population, it should come as no surprise.
The one death announced Sunday was a Salt Lake County male over the age of 60. That is the 44th death in the county, which accounts for nearly two-thirds of the total deaths, which now sit at 67.
The problems Utah is facing pale in comparison to those across the United States, which crossed a total of 79,000 deaths Sunday morning. That is more than double the number of deaths in the United Kingdom and Italy, while tripling the total of Spain.
As of Sunday, the United States had over 1.3 million cases, accounting for almost one third of all cases globally. Of those 1.3 million cases, about 212,000 have been marked as recovered. There have been 8.7 million tests administered, and while the precise number of hospitalizations nationwide is unclear, it is in the neighborhood of 250,000, according to Johns Hopkins University & Medicines exhaustive dashboard.
In Utah, the Bear River health district saw cases shoot up by over 20% over the same seven-day period, going from 62 on May 4 to 78 on Sunday. Davis County had an 11% increase, San Juan County nearly 20%, Southwest Utah over 27%, and Utah County almost 17%.
As coronavirus cases have gone up, active hospitalizations have remained relatively steady. On May 4, there were 101 active hospitalizations. That number dropped to 95 on May 5 and was at 93 as of Saturday. Steady hospitalizations statewide indicate that there has not yet been increased pressure on hospitals. Across the state, there are about 700 ICU beds available.
The news was not all bad over the last week, as many areas saw significant slowdowns. Summit County had just eight new cases, no new hospitalizations and no new deaths. Wasatch County had 11 new cases, one new hospitalization and zero deaths.
Utah is defining a recovered person as someone whose first positive laboratory test was reported at least 21 days ago. The percentage of people who are estimated to have recovered continues to be on the uptick.
Through Saturday, there were 6,103 cases statewide, of which 3,033, or 48.5%, are estimated to have recovered. The recovered percentage rose for the fifth straight day Saturday, while the number recovered rose for the 39th straight day.
We are emergency and I.C.U. doctors who have worked in three hothouses of the Covid-19 pandemic: Northern Italy, New York City and Miami. Treating scores of critically ill patients, we all observed similar patterns: Many of the patients we saw in our emergency rooms had advanced cases of Covid-19 pneumonia when they arrived and many of those critically ill patients came from nursing homes.
More often than not, these older pneumonia patients wound up on ventilators. This is almost always a bad outcome. In New York City, an astronomical 80 percent of patients who required a ventilator at the height of this pandemic died, according to city and state officials. (In our experience, the death rate among patients not requiring a ventilator has been relatively low.) Similarly, we see evidence that the incidence of blood clots and renal failure in patients on ventilators is significantly greater than in patients who were less sick and didnt need a ventilator.
This data does not mean that the machines themselves are killing people, just that by the time those patients are being hooked up to ventilators, they are already in dire condition.
How then do we identify patients with Covid-19 pneumonia earlier so that they can be treated before requiring a ventilator? As one of us, Dr. Levitan, noted in an earlier Op-Ed in these pages, clinicians have a universally available, quick and remarkably effective tool to detect the attack on the lungs caused by Covid-19 pneumonia: pulse oximetry.
The pulse oximeter is a small device that attaches to the tip of a finger, and in 15 seconds measures oxygen saturation of the blood. Invented by Takuo Aoyagi and Michio Kishi in 1974, it is now considered one of the vital signs in medicine (along with pulse rate, respiratory rate, temperature and blood pressure). Mr. Aoyagi, who died on April 18, has had an incalculable impact on patient safety worldwide and his contribution is especially significant in this pandemic.
In an analysis of more than 4,000 Covid-19 patients evaluated between March 1 and April 7 at NYU Langone Health facilities, one of the strongest predictors of critical illness defined as involving I.C.U. care or mechanical ventilation was the patients oxygen saturation on arrival at the hospital.
It is time, then, for the federal government, led by the Centers for Disease Control and Prevention, to mandate that all nursing homes and long-term-care facilities tied to a third of the Covid-19 deaths do pulse oximetry monitoring at least daily. In facilities with known coronavirus infections, we suggest this be checked twice a day.
Covid-19 pneumonia generally develops between five and 10 days after infection. It does not cause shortness of breath in most patients. Oxygen levels drop over days, and patients gradually increase their respiratory rate. The low oxygen saturation happens silently silent hypoxia, we call it and patients do not realize it. By the time patients feel shortness of breath or have evident trouble breathing and head to the hospital, they already have alarmingly low oxygen saturations.
A majority of Covid-19 pneumonia patients that we treated or observed during the surges in New York City and Italy had severe lung injury on first presentation. They were, in other words, arriving at the hospital too late, and many were winding up on ventilators.
In all medicine whether in patients who have traumatic injury, cancer, diabetes or an infectious disease earlier identification and treatment leads to better outcomes. Covid-19 is no different. We must continue improving the I.C.U. care of patients with advanced Covid-19 pneumonia. But we will have the greatest public health impact if we prevent it from occurring in the first place.
The value of early detection has become apparent in northern Italy, once the epicenter of the pandemic. The surge there has abated, and patients are no longer afraid to come to the emergency department. That means patients with symptoms of Covid-19, such as fever, muscle aches and cough, are coming to the hospital earlier and their illness is less severe.
There is some heartening evidence admittedly inconclusive that earlier treatment makes a difference. In a small pilot study of 250 Covid-19 cases conducted by Dr. Cosentini in Italy, half were found to have mild pneumonia but their oxygen saturation was not yet compromised. All of these patients were able to be discharged from the E.R., and they were sent home with pulse oximeters. Only 5 percent returned and were hospitalized when their oxygen saturation levels declined slightly. None of these patients required a ventilator. And none of these 250 patients died.
While there is no specific cure for Covid-19 and we have nothing that directly kills the virus, we do have treatments that help patients and prevent the need for a ventilator. These include various noninvasive methods of delivering oxygen, patient positioning maneuvers that open up parts of the lungs, and close monitoring and treatment of inflammation. There is no panacea; some patients will still have the disease worsen, and there are some patients who will still have serious injury from Covid-19 unrelated to the lungs.
Until now the manner in which our health care system has addressed this crisis has failed. But doctors, nurses and respiratory therapists want to win. We want to tell families their loved ones are recovering and not dying. Everyone hopes new therapies and ultimately a vaccine will help defeat Covid-19. But until the magic bullets arrive, we must engage this disease differently that is, earlier if we are going to save lives and reduce the immense cost of care.
For our country to benefit from this strategy, we need to completely change public health messaging and create a new standard of care and that messaging must come from the federal government. If the C.D.C. leads, health agencies around the world will follow.
Dr. Richard Levitan is an emergency doctor at Littleton Regional Health in Littleton, N.H. Dr. Nicholas Caputo is an emergency doctor at Lincoln Hospital in New York. Dr. Roberto Cosentini is an emergency doctor at Papa Giovanni XXIII Hospital in Bergamo, Italy. Dr. Jorge Cabrera is a critical care doctor at the University of Miami Hospital.
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With the Covid-19 pandemic stretching into its third month in Europe, Germany is discovering that a competent handling of the crisis in the early stages can become a burden later on.
As the kind of dramatic scenes of overstretched health services witnessed in Italy or Spain never fully materialised in Germany, politicians have increasingly struggled to convince the public of the need for strict adherence to social distancing. Now this phenomenon, which the virologist Christian Drosten has called the prevention paradox, is fuelling fears of a second wave of the pandemic.
On Wednesday, chancellor Angela Merkel announced the latest gradual reopening of large shops, schools, nurseries, and even restaurants and bars seemingly bowing to a growing impatience with lockdown restrictions that was manifesting itself in political pressure from the leaders of the 16 federal states, the mass tabloid Bild, and growing conspiracy theory-driven protests across major cities.
New hygiene rules announced on Wednesday were supposed to go hand in hand with this relaxation, but are so complicated that many feel they can ignore them altogether. Throughout the week there was a noticeably less cautious mood on the streets of German cities, with clusters of people once again dotting parks to share drinks in the sunshine.
In cities including Berlin, Munich and Stuttgart, demonstrators including rightwing extremists and anti-vaxxers gathered in their thousands on Saturday, protesting against lockdown restrictions that are already being rapidly loosened.
The wearing of hygiene masks, while now mandatory in shops and on public transport, is not consistently policed, and often only casually adhered to.
Over the weekend, the empirical findings of the Robert Koch Institute, the governments disease control agency, seemed to match the anecdotal evidence that many people had gathered over the past few days.
The RKI announced on Sunday that the reproduction number (R), indicating how many new cases one infected person generates on average, had for two consecutive days risen above the critical threshold of one, to 1.1. As recently as Wednesday, when Merkel announced the latest steps of the exit strategy, the R number had been as low as 0.65.
There are several reasons to handle these figures with caution. The R number is an estimate that deliberately ignores lag-prone data from the last three days and backdates known cases to their likely day of infection, around a week earlier.
Rising R numbers over the weekend therefore do not indicate how the spread of the virus developed following this weeks lockdown relaxation, though it could account for a new mood in the country following the first step of relaxation on 20 April.
The RKI itself urged caution on the latest R number since new infections in Germany have dropped to relatively low figures, it said, the estimate was more prone to statistical fluctuations.
Other mathematicians analysing the spread of the pandemic also believe they are witnessing a new dynamic, however. There are signs that the reproduction number is going back up again, said Prof Thomas Hotz of Technische Universitt Ilmenau, which has used a differently weighted model. Hotz added: And if you see how people have started acting in the big cities, it doesnt completely surprise me.
There is some positive news among the latest negative numbers. The number of active cases in Germany on Sunday sank to 17,423, now making up only 10% of confirmed cases in the country, meaning if the virus is indeed accelerating again, it is doing so from a considerably smaller and more controllable base than a month ago.
Under the new emergency mechanism Merkel announced last week, hospitals, care homes or entire municipalities can be put under lockdown if they cumulatively register more than 50 new infections per 100,000 inhabitants within seven days.
By the weekend, only three German municipalities were in breach of this new limit: one in the northern state of Schleswig-Holstein, one in eastern Thuringia, and one in western North-Rhine Westphalia.
The hope is that the new, more localised braking system can prove an efficient replacement for a nationwide lockdown and slow down the spread of the virus before it grows into a second wave.
The kit was developed by a Rutgers University laboratory, RUCDR Infinite Biologics, in partnership with Spectrum Solutions and Accurate Diagnostic Labs. The kits must be ordered by a physician and have the potential to widen the audience for virus screening. By keeping symptomatic people home, the spit kits could reduce the risk of infecting health care workers.
The agency has come under fire in recent weeks for allowing myriad companies to offer diagnostic and antibody tests without submitting timely data for review, under its emergency use authorization policy because of the pandemic. Tests have varied widely in terms of their accuracy, and there have been shortages of tests and the materials required to process them.
To date, 8.1 million people in the United States have been tested. But public health experts said testing needed to double by the end of May.
Last week, the F.D.A. ordered dozens of companies it had allowed to market antibody tests to submit data proving accuracy within 10 days. Some states and public health experts hope the tests will help indicate the depth of infection in communities and quantify who has recovered and perhaps developed some immunity.
The F.D.A. said that Rutgers had submitted data showing that testing saliva samples collected by patients themselves, under the observation of a health care provider, was as accurate as testing deep nasal swabs that the health professional had collected from them. The agency said it still preferred tests based on deep nasal samples.
The American economy plunged deeper into crisis last month, losing 20.5 million jobs as the unemployment rate jumped to 14.7 percent, the worst devastation since the Great Depression.
The Labor Departments monthly report on Friday provided the clearest picture yet of the breadth and depth of the economic damage as the coronavirus pandemic swept the country.
Job losses have encompassed the entire economy, affecting every major industry. Areas like leisure and hospitality had the biggest losses in April, but even health care shed more than a million jobs. Low-wage workers, including many women and members of racial and ethnic minorities, have been hit especially hard.
Its literally off the charts, said Michelle Meyer, head of U.S. economics at Bank of America. What would typically take months or quarters to play out in a recession happened in a matter of weeks this time.
From almost any vantage point, it was a bleak report. The share of the population with a job, at 51.3 percent, was the lowest on record. Nearly 11 million people reported working part time because they couldnt find full-time work, up from about four million before the pandemic.
If anything, the numbers probably understate the economic distress.
Millions more Americans have filed unemployment claims since the data was collected in mid-April. And because of issues with the way workers are classified, the Labor Department said the actual unemployment rate last month might have been closer to 20 percent.
The one bright spot in Fridays report was that nearly 80 percent of the unemployed said they had been temporarily laid off and expected to return to their jobs in the coming months.
Pences press secretary has tested positive for the virus.
Vice President Mike Pences press secretary tested positive for the virus on Friday, forcing a delay in the departure of Air Force Two while a half-dozen other members of his staff were taken off the plane for further testing.
The latest positive test further rattled a White House already on edge after the presidents military valet came down with the virus. Katie Miller, the vice presidents press secretary and a top spokeswoman for the White House coronavirus efforts, had tested negative on Thursday but then tested positive on Friday morning.
Neither President Trump nor Mr. Pence regularly wears a mask, but both are now tested daily. Both tested negative after the latest infections were discovered.
The result of Ms. Millers latest test forced Mr. Pences scheduled flight to Des Moines to be delayed for more than an hour, even though she was not traveling with him, so that six other aides who had been in contact with her could be escorted from the plane at Joint Base Andrews before its departure.
All six later tested negative but were sent home out of caution, officials said. Ms. Miller is married to Stephen Miller, the presidents senior adviser, and he too was tested again on Friday and the results came back negative.
Multiple presidential aides are now tested daily, as are about 10 members of Mr. Pences staff, an official said. But tests are conducted less frequently on other White House officials who work next door in the Eisenhower Executive Office Building.
The California governors office of emergency management warned three counties that they could lose disaster funding if they continued to loosen coronavirus restrictions in defiance of Gov. Gavin Newsoms orders.
The stern letters from the Governors Office of Emergency Services were sent on Thursday to Yuba, Sutter and Modoc Counties, a spokesman for the state agency said, and were the latest effort by Mr. Newsom to rein in the mostly rural counties that have allowed many businesses to reopen, including restaurants and hair salons.
Mark S. Ghilarducci, the director of the emergency office, wrote in letters to each of the counties that if they believed they could ignore the executive orders, their county would not be able to demonstrate that it was extraordinarily and disproportionately impacted by Covid-19.
He also said that if the counties saw a rise in coronavirus cases as a result of hasty and careless actions, then they could make themselves ineligible for the funds.
The Los Angeles Times reported that Yuba and Sutter Counties, which border each other and sit just north of Sacramento, said in a joint statement that they were trying to do what is best for the overall health of our communities.
Dr. Phuong Luu, the Yuba-Sutter health officer, wrote a letter to the community on Wednesday warning that many businesses were not taking proper efforts to protect their customers. Dr. Luu emphasized that in order to open, indoor businesses must follow social distancing and facial covering protocols.
I understand that some of your customers may strongly object to a facial covering requirement, Dr. Luu wrote, but the long-term safety of our community is at stake.
When the Food and Drug Administration granted an emergency approval to an antiviral drug, remdesivir, for treatment of hospitalized virus patients, doctors were overjoyed. The drug is the first shown to be even mildly effective against the virus.
But bafflement soon followed as doctors and hospitals tried to obtain the drug. Small community hospitals with few beds received it, while medical centers besieged with cases were denied.
Only four hospitals in Massachusetts, for example, are known to have received remdesivir: three small community hospitals and Massachusetts General, a Harvard University teaching hospital, where officials said they had not even asked for it. Yet other major hospitals were left out, including Boston Medical Center, which has many vulnerable African-American patients.
Remdesivirs approval should have been a clear victory, but its distribution has been tripped up by seemingly capricious decision-making and finger-pointing.
Like other drugs used in hospitals, remdesivir is supplied not by the manufacturer, Gilead Sciences, but by a wholesale distributor, in this case a company called AmerisourceBergen. After the F.D.A. granted the emergency approval, Gilead Sciences said it would donate its existing supply of the drug: 1.5 million vials, enough to treat roughly 140,000 patients.
It is not clear how federal officials then came up with a list of hospitals most in need, or even what hospitals are on it. The Infectious Diseases Society of America and the H.I.V. Medicine Association have written to Vice President Mike Pence, who oversees the coronavirus task force, pleading for an explanation of the criteria used to allocate remdesivir.
The Small Business Administrations inspector general said on Friday that flaws in the agencys enactment of the $660 billion Paycheck Protection Program have probably left some minority- and women-owned businesses, as well as those in rural areas, unable to get loans and could leave thousands of borrowers saddled with debt.
The report is the first formal review of the embattled program, which is the centerpiece of the governments economic relief effort. The program, created as part of the $2 trillion stimulus package, has been criticized for favoring bigger businesses and for complex requirements that are out of step with economic realities.
According to the inspector generals report, the S.B.A. did not carry out the requirement of the law to issue guidance that would ensure that lenders prioritize underserved communities.
The inspector general, Hannibal Ware, said the S.B.A. overlooked the need to ask for demographic information on loan applications, making it difficult to tell if loans were actually going to the prioritized markets.
The report also highlights another concern that has gripped borrowers, raising questions about the S.B.A.s rule that 75 percent of loan proceeds be used to cover payroll costs and 25 percent go overhead costs such as rent.
Separately, a special House subcommittee created to oversee the Trump administrations virus response took its first official action on Friday, urging five publicly traded companies to return loans they had received through the Paycheck Protection Program.
The Democrats in charge of the committee said the companies which each have market capitalizations of more than $25 million and more than 600 employees had taken advantage of a program that Congress intended to help much smaller businesses. The companies, which include transportation and pharmaceutical firms, each received loans of at least $10 million.
California voters will get mail-in ballots for the November election.
Gov. Gavin Newsom of California on Friday ordered ballots to be sent to the states 20.6 million voters for the November election, becoming the first state to alter its voting plans for the general election in response to the coronavirus pandemic.
While California has greatly expanded its vote-by-mail operation in past elections roughly 65 percent of the state voted by mail in the 2018 midterm elections the decision by the largest state to greatly reduce in-person voting is a recognition by state officials that the coronavirus outbreak is unlikely to subside by the fall.
Mr. Newsom said officials would determine how in-person voting would be conducted in November. That responsibility will largely fall to county officials, who must find larger polling places and will have to eliminate senior centers and retirement homes that have long served as sites.
In shifting to a broader vote-by-mail system, California is trying to avoid the public health debacle wrought by the April 7 elections in Wisconsin, where voters and poll workers weighed the health risks of congregating en masse during a pandemic with their right to vote.
Mr. Newsom also said on Friday that state and county officials had shut down several bars and more than 30 hair salons that were violating Californias coronavirus restrictions.
Well see more of that if people get ahead of themselves, he said.
The state began lifting restrictions on Friday for some retailers, including those selling clothing, books and flowers. But stores are open only for pickup, and customers are not allowed inside.
Mr. Newsom held his news briefing from a flower shop in Sacramento. I know theres deep anxiety people are feeling a desire to reopen, he said, framed by bamboo canes and pink roses.
A federal agency said a whistle-blower should be reinstated for now.
A federal investigative office has found reasonable grounds to believe that the Trump administration was retaliating against a whistle-blower, Dr. Rick Bright, when he was ousted from a government research agency combating the coronavirus, and said he should be reinstated for 45 days while it investigates, his lawyers said on Friday.
The lawyers, Debra S. Katz and Lisa J. Banks, said in a statement that they were notified late Thursday afternoon that the Office of Special Counsel, which protects whistle-blowers, had made a threshold determination that the Department of Health and Human Services violated the Whistleblower Protection Act by removing Dr. Bright from his position because he made protected disclosures in the best interest of the American public.
The finding comes just days after the lawyers filed a whistle-blower complaint saying that Dr. Brights removal last month as head of the Biomedical Advanced Research and Development Authority was intended as payback. They said Dr. Bright, who was reassigned to a narrower job at the National Institutes for Health, had tried to expose cronyism and corruption at the Department of Health and Human Services while pressing for a more robust virus response and opposing the stockpiling of drugs championed by President Trump.
It will now be up to the secretary of health and human services, Alex M. Azar II, to decide whether to bring Dr. Bright back to BARDA during the inquiry.
People are protesting a killing in Georgia, but at a distance.
On Friday, Ahmaud Arbery would have turned 26.
Instead, more than two months after he was shot to death near Brunswick, Ga., on Feb. 23, people are finding ways to protest and mourn his death in person and from a distance.
To commemorate his birthday and to honor the date of his death supporters went for 2.23-mile runs. And at a time when many people are reluctant to gather in person to rally, they connected instead under the hashtag #IRunWithMaud.
In Brunswick, there was a protest in person. Demonstrators, almost all of them wearing masks, packed in front of the Glynn County Courthouse to demand justice.
It was yet another example of the way the virus has changed life in this case the way it has helped shape the protests that followed the death of Mr. Arbery, a young black man.
Mr. Arbery, a former high school athlete and avid jogger, was running through a residential neighborhood when he was confronted by two white men, a former police officer and his son, and fatally shot. The men were arrested on Thursday night after an international outcry.
By Friday morning, the hashtag #IRunWithMaud had been used tens of thousands of times on Twitter, and people shared photographs of themselves outside in running gear, often alongside photos of Mr. Arbery.
Medical examiners report how the virus killed at least 1,600 Floridians.
A 71-year-old woman with nausea who was sent home from the emergency room, even though a doctor wanted to admit her. A 63-year-old nurse who was self-isolating while she waited for results from her virus test. A 77-year-old man who was prescribed antibiotics by a doctor out of state for his fever and dry cough.
All were found unresponsive at home, their lives claimed by Covid-19 before they ever had a chance to check into a hospital.
The agony of how the virus has killed at least 1,600 Floridians, many of them older, is brief and matter of fact in the unadorned language of medical examiners, who summarize death in sometimes less than 200 words.
But a trove of short narratives from nearly all of the states deaths show that a substantial number of people have died suddenly after returning home from a hospital or visiting a doctor or a clinic. Many worsened, returned to a hospital and died there.
A 5-year-old in N.Y.C. has died of a mysterious illness linked to the virus.
A 5-year-old died in a Manhattan hospital on Thursday from what appeared to be a rare syndrome that causes life-threatening inflammation in children and that may be linked to the virus, officials said.
The Mount Sinai Kravis Childrens Hospital, where the child was being treated, did not release any further information about the victim.
While it is concerning that children are affected, we must emphasize that based on what we know thus far, it appears to be a very rare condition, said Lucia Lee, a spokeswoman for the Mount Sinai Health System.
On Friday, Gov. Andrew M. Cuomo said that the death was under investigation and that there had been 73 reported cases of children in the New York area who had dealt with the illness, which doctors have labeled pediatric multisystem inflammatory syndrome.
This would be really painful news and would open up an entirely different chapter, Mr. Cuomo said, because I cant tell you how many people I spoke to who took peace and solace in the fact that children were not getting infected.
In New York City, Mayor Bill de Blasio pledged to address the glaring racial disparity in the enforcement of social distancing rules. Of the 374 people who had received social distancing summonses, the police said on Friday, more than 80 percent were black or Hispanic. Those groups make up about half the citys population.
Polls show Americans want the virus contained more than they want to reopen the economy.
Recent polling suggests Americans are heeding the advice of health officials and do not want a quick return to normalcy, despite skyrocketing unemployment and Mr. Trumps cheerleading to reopen the economy.
Mr. Trump said this week that he was eager to get our country open again, adding, People want to go back, and youre going to have a problem if you dont do it.
But more than two-thirds of respondents said in a Pew Research Center poll released Thursday that they were more concerned that state governments would reopen their economies too quickly than that they might take too long roughly on par with past responses to the same question.
And in a survey released late last month by The Associated Press and NORC, 68 percent of Americans said they had a great deal of trust in the Centers for Disease Control and Prevention to provide them with reliable information about the pandemic. That is three times as much as the dismal 23 percent who said they trusted Mr. Trumps statements on the virus.
The viruss effects are being felt most acutely in states with a high concentration of people in cities, and the six most-infected states per capita all trend Democratic politically. Black people and Latinos are showing some of the highest rates of infection: More than a quarter of all confirmed cases have been among Latinos, according to C.D.C. statistics, and even more have been among African-American people.
According to a Quinnipiac University poll of residents in the New York, New Jersey and Connecticut area the center of the virus in the United States 71 percent of respondents said they wanted their state government to focus on controlling the virus, not on reopening.
Some Montana schools have begun to open, a preview for the rest of the country.
All 14 enrolled students showed up on Thursday morning to the two-room schoolhouse in Cohagen, Mont., one of the first communities to reopen school doors across the country as tens of millions of children remain home.
Parents were given the option to keep their children at home, but none chose to do so, according to Joni Carroll, the schools sole teacher, who handles preschool through the eighth grade.
A handful of other rural Montana districts, where cases have been rare, are also reopening. On Thursday, 35 students showed up to class in Willow Creek, Mont., according to superintendent Bonnie Lower, just over 60 percent of the small districts population.
In the farming and ranching town of Circle, some of the local public schools 190 students are expected to trickle back next week for tutoring day appointments with their teachers and a shortened school day.
With a total of 35 staff members and just 10 seniors in the graduating class, the district does not face big-school challenges like overflowing hallways or packed classrooms. Still, the school is going to stagger the days when different grades are allowed back, and it is limiting the number who can meet with teachers at any one time a preview, perhaps, of what is in store for the rest of the nations students in the fall.
The nations largest cities emerge as focal points for the virus.
The three largest cities in the United States New York City, Los Angeles and Chicago are also the primary generators of new cases each day, data shows.
Cook County, Ill., which includes Chicago, and New York City are now reporting roughly the same case numbers each day; Los Angeles County, Calif., consistently has the third-most cases.
Mayor Lori Lightfoot of Chicago is soon expected to unveil a plan to gradually reopen the city, but cautioned that Chicago is not yet ready to return to normal. We cant send people back to work, we cant open up our city yet when we dont see a decrease in the cases, which we have not seen yet at all, Ms. Lightfoot said on Thursday, adding: When we dont see a sustained decline in hospitalizations, I.C.U. beds, all of those things are really important and the data has to drive what we do from a public policy standpoint.
New York, though vastly improved, still usually reports the countrys most new cases and deaths every day. Another 216 people in the state have died of the virus, the governor said Friday.
The emergence of the nations largest cities as focal points for the virus comes as state leaders wrestle with growing tensions over when and how to restart economies. Amtrak said Friday that its Acela rail service from Boston to Washington would partly resume on June 1, with three round trips every weekday. Passengers will be required to wear facial coverings and capacity will be capped at 50 percent.
Across the country, about 29,000 new cases and about 1,900 new deaths were reported on Thursday, but the picture is uneven, state to state and even county to county, stirring a mix of responses about how best to proceed now.
The areas around Lincoln, Neb., Des Moines and St. Cloud, Minn., are seeing rapid, rising case numbers, as are parts of western Kentucky. Yet the situation in Miami, Detroit and New Orleans has improved sharply in recent weeks. Alaska, Hawaii, Vermont and Montana are identifying few new cases.
Trump says hell provide rapid virus testing to the Biden campaign if they ask him for it.
Id love to see him get out of the basement so he can speak, because you know hes locked in a basement somewhere, and every time he talks, its like a good thing, Mr. Trump said.
Ill give them the test immediately, we would have it to them today, Mr. Trump said. Nobody has ever asked me for the test.
He added that he would make sure that it was one of the Abbotts, referring to a quick response testing capability developed by Abbott called ID Now. Its a great laboratory and we would have them a machine or two today if they needed it, he said.
Mr. Trump said he has been tested often and would continue to be tested on a daily basis after learning that one of his personal valets had tested positive for the virus. The president said he had yet to take an antibody test, but he expected that he would at some point.
Some retails stores in Los Angeles will be able to open starting Friday, Mayor Eric Garcetti announced in a news conference Wednesday.
Garcetti said he plans to modify the safer at home order in the city of Los Angeles.
Florists, toy stores, music stores, book stores, clothing stores and sporting goods stores in Los Angeles may offer curbside pickup, he said. Car dealerships will also be able to open.
Some context: This is in line with what Los Angeles County Department of Public Health Director Dr. Barbara Ferrer said in an earlier news conference.
He clarified that stores will only able to offer curbside pickup and that people will not able to go inside the stores.
Starting Saturday, the city will open its trails, parks and golf courses.
Face coverings will be required at all city trails and golf courses, Garcetti said. Runyon canyon will remain closed.
Friday May 8 marks the beginning of phase two, a slow and gradual loosening of some of the restrictions, he said.
See the latest coronavirus updates in Idaho as we work together to separate facts from fear.
BOISE, Idaho BOISE, Idaho (Scroll down for the latest news updates.)
Idaho's number of deaths and cases of the novel coronavirus, COVID-19, continue to climb amid a worldwide pandemic.
Latest Idaho coronavirus updates
Sunday, May 10
ICYMI:A Boise mother and son graduated from Boise State together during the university's first virtual commencement ceremony.Read the full story here.
Saturday, May 9
Boise State University held its first ever virtual commencement ceremony at 10 a.m. on Saturday morning.
In case you missed it, you can watch the ceremony online or on the school's Facebook page.
5:17 p.m. - Idaho adds only 19 confirmed cases, 3 probable cases, no new deaths
Health departments are Idaho updated their data on the coronavirus in Idaho. For Saturday, May 9, Idaho only added 19 confirmed cases, which brings the statewide confirmed number of coronavirus cases to 2,049. Idaho's number of cases in which the patient recovered from COVID-19 increased to 1,473.
Friday, May 8
5:11 p.m. - Idaho adds 22 new confirmed cases, no new deaths
The Idaho Department of Health and Welfare and public health districts across Idaho updated their daily totals on the coronavirus pandemic in the Gem State. Statewide, Idaho added 22 confirmed cases, bringing the Gem State's confirmed cases total to 2,030, and no new deaths. The number of people who have recovered from COVID-19 increased to 1,442.
3:07 p.m. - Emmett Cherry Festival canceled
The Gem County Chamber of Commerce announced the 86th annualEmmett Cherry Festival has been canceled due to the stage 4 COVID-19 restrictions. The festival was scheduled for June 17-20, 2020.
3 p.m. - Boise State University to hold virtual commencement Saturday
Boise State University will hold its first-ever virtual celebration for graduates on Saturday morning.
In all, 2,785 students are eligible for more than 3,000 degrees and almost 800 are students that are eligible for honors.
If you would like to tune in, you can watch the ceremony online or on the school'sFacebook page at 10 a.m.
2:20 p.m. - Idaho Power announces updated plan to open campgrounds, boat ramps
Idaho Power could reopen some campgrounds as soon as May 29. Other recreational sites such as boat ramps and day-use areas may open sooner.
The company owns more than 60 recreational sites along the Snake River, including campgrounds in Hells Canyon and at C.J. Strike and Swan Falls reservoirs. All were closed in mid-March in response to the coronavirus pandemic. Since then, a handful of boat ramps and day-use areas have reopened, and the company hopes to open additional outdoor recreation sites May 15.
A full list of open sites is available atidahopower.com. Visitors should check the website to make sure their destination is open before traveling, as dates could change.
8:40 a.m. - Western Idaho Fair still making preps for a 2020 fair
The Western Idaho Fair posted on itsFacebook page that no decision has been made whether the fair will go on as planned for August 21-30 or be canceled for 2020. Organizers say they are optimistically planning and making preparations for a 2020 fair and continuing to monitor the facts regarding COVID-19.
They are working with government officials, local health officials and community partners to modify plans with the priority of keeping patrons, partners, and employees safe. And are working hard to create an experience people want and love. They will provide updates as information becomes available.
At KTVB, were focusing our news coverage on the facts and not the fear around the virus. To see our full coverage, visit our coronavirus section, here: www.ktvb.com/coronavirus.
See our latest updates in our YouTube playlist:
At least 27,700 residents and workers have died from the coronavirus at nursing homes and other long-term care facilities for older adults in the United States, according to a New York Times database. The virus so far has infected more than 150,000 at some 7,700 facilities.
States that provide some facility data
States that provide no facility data
Nursing home populations are at a high risk of being infected by and dying from the coronavirus, according to the Centers for Disease Control and Prevention. Covid-19, the disease caused by the coronavirus, is known to be particularly lethal to older adults with underlying health conditions, and can spread more easily through congregate facilities, where many people live in a confined environment and workers move from room to room.
While just 11 percent of the countrys cases have occurred in long-term care facilities, deaths related to Covid-19 in these facilities account for more than a third of the countrys pandemic fatalities.
Cases in long-term care facilities
All other U.S. cases
Deaths in long-term care facilities
All other U.S. deaths
In the absence of comprehensive data from some states and the federal government, The Times has been assembling its own database of coronavirus cases and deaths at long-term care facilities for older adults. These include nursing homes, assisted-living facilities, memory care facilities, retirement and senior communities and rehabilitation facilities.
Some states, including Colorado, Illinois, Maryland, Nevada, New Jersey and South Carolina, regularly release cumulative data on cases and deaths at specific facilities. California, Massachusetts, Michigan and Ohio, among others, provide some details on the number of cases but not on deaths. Others report aggregate totals for their state but provide no information on where the infections or deaths have occurred. About a dozen report very little or nothing at all.
The share of deaths tied to long-term care facilities for older adults is even more stark at the state level. In 15 states, the number of residents and workers who have died accounts for more than half of all deaths from the virus.
The Timess numbers are based on official confirmations from states, counties and the facilities themselves. They include residents and, in cases where reporting is available, employees of the facilities. Given the wide variability in the type of information available, the totals shown here almost certainly represent an undercount of the true toll.
State reporting comprehensive aggregate data
Note: In New York, the case count is the same as the death count because the state only reports the number of people who have died but not the number of overall infections.
Based on The Timess analysis, some 850 of the countrys 3,100 counties have at least one coronavirus case related to a long-term care facility for older adults.
Hover overTap on each county to see the number of coronavirus cases at long-term care facilities, as well as the total number of cases in that county.
Note: Not all states report facility-level data.
The New York Times is tracking the coronavirus at nursing homes and long-term care centers. Do you or a family member live or work in one of these facilities? If so, wed like to hear from you.
Here is a list of cases and deaths at long-term care facilities that have had at least 50 cases. We update the numbers as we are able to confirm them with state, county and facility officials.
