Category: Corona Virus

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.

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Coronavirus Live News and Updates - The New York Times

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.

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Fears grow in Germany of second wave of coronavirus infections - The Guardian

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.

The Times is committed to publishing a diversity of letters to the editor. Wed like to hear what you think about this or any of our articles. Here are some tips. And heres our email: letters@nytimes.com.

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We Treated Older Coronavirus Patients. Heres How to Save More of Them. - The New York Times

Editors note: The Salt Lake Tribune is providing free access to critical stories about the coronavirus. Sign up for our Top Stories newsletter, sent to your inbox every weekday morning. To support journalism like this, please donate or become a subscriber.

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.

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Only one new coronavirus death reported Sunday, but Utah saw its deadliest week since the pandemic began - Salt Lake Tribune

Hi, Poonam. Hi. Nice to meet you. My contractions are about 15 minutes apart. And Im about to get pulled into an O.R. at Cornell to have a C-section. Like any minute now, theyre going to come pull me through that door. And Im gloved-up and masked-up. And my husbands all suited-up. Hes literally in a hazmat suit. Doctor: Dad, do you want to grab those shoes and throw them? Theyre pulling me in. I have to go. Thank you. My name is Poonam Sharma Mathis. My husband is Kris Mathis. We have a 4-year-old, Pierce Mathis. I need some Monday motivation, Pierce. My first birth was pretty uneventful. The baby came out, we made eye contact and then I closed my eyes, and I woke up in the recovery room. Everybody was kissing him and hugging him. And I felt like the community and the village that hes so blessed to be a part of was there. I grew up with a lot of extended family and a lot of love. Wed been wanting a girl in this generation so badly. So when we found out we were having a girl, we were just grateful. I was 37 weeks pregnant when they started to issue stay-at-home orders. OK, so I am officially scared. Im having contractions this morning. I am not a hypochondriac. Im not somebody whos really prone to general mass hysteria. But we are Im breathless. We are dealing with something we dont understand. Kris: Only a couple of days prior to our birth, they had been saying no partners, no spouses. I was probably one of the first spouses that was allowed into the hospital. I was walking, and it was like, do not touch anything. Make sure your mask is on. Put the booties over your shoes. My husband could catch it right now. Right? He could bring it home, and give it to my son whos 4 and a half. And theres a thought about going home with my daughter, and then just immediately quarantining myself and my daughter. Doctor: All right, Mom, are you ready? Do you want to open your eyes for me? No? Her name is Asha: 7 pounds, 11 ounces. They put her skin on my chest. But I had a mask on, so I wasnt breathing on her. Daddy is cuddling with her. Its weird. She opened her eyes right when she was born really wide. And then I havent seen her eyes since. She didnt like what she saw or something. Our expectations were that I probably wasnt going to be there anyway. So just being there for the delivery and seeing the baby, meeting the baby, it was a really exciting thing for me. You realize you have to do a father-daughter dance, and give her away one day? But then immediately after the birth, I had to say goodbye. Say, good night. Sweet dreams. Its 11:30 at night. Im in my room. I just breastfed. [Asha crying] I wore a mask, and I threw up. The only good news is they let her stay in my room because babies are not being kept in the nursery right now. Theyre being kept with the mom. The next step is that we are waiting for news of my coronavirus status. Based on that result, theyll decide how much interaction Ill be having with her, for her own safety. So now we wait. I just want to kiss her. It was really exciting to find out that we tested negative, because that meant I could kiss her head. But its definitely different delivering and recovering in a hospital during coronavirus, and it hit me yesterday. Yesterday was the worst day of physical pain in my life. I genuinely thought I might die. This is one of the most intense surgeries you can have, is a C-section. But if you have any air bubbles that go into your stomach when they cut you open, which is normal, those air bubbles dont come out right away. Then they float around your body, I guess, and they feel like knives stabbing you from the inside until they come out. And they dont want to come out. It is so traumatic being here without somebody to advocate for you when things go wrong, because theres too much going on. They are overwhelmed. Im pushing the call button to get care, and they dont come right away. And last time I gave birth here, four and a half years ago, they did everything right away because they were able to. I was in so much pain for so long, and waiting for my medication for so long, that I was throwing up. I threw up eight times from pain. It feels like I was in a horror movie where they chopped somebody up, but then the person escapes and is running to safety. And thats a ridiculous thing to say. We have the best health care. Were in the best city. But thats how it feels. I just want to get her home as soon as possible. And hopefully then Im able to walk and stand, and do something to help my husband take care of these kids. Thursday at around 1:30, my husband and son came and picked us up. She was so excited to meet you she didnt know what to do. Asha. I havent left the upstairs from Thursday till now. Its Monday morning. Theres so much family thats just waiting, itching to rush in and be with us. And who knows if that will happen before shes 3 months old. One toe is kind of curving. Yeah. Will she wrap her finger around your finger if you put it in there? Poonam: Shes like a little animal, huh? Youre going to be such a good big brother. Poonam: Mm-hmm. Im just grateful that shes healthy. Im grateful that so far, my husband and myself and my son are healthy. I look at her eyes, and I do believe that the eyes show something even from birth. Whenever she does open her eyes, she just looks and shes just laser-focused. And its not a curious focus. Its like like she knows she needs to be calm right now or something. I had a great aunt who always said that if she could come back, shed come back as my daughter. So maybe thats her, I hope. If so, nothings going to keep her down.

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Mothers Day and Coronavirus: Advice From 5 Mothers - The New York Times

Boris Johnson has announced a five-tier alert system to rank the threat from coronavirus although experts said it was not immediately clear how independent or effective the scheme would be.

The current threat level of the pandemic will be categorised on a scale of one to five in different parts of the country, based on assessments by a new joint biosecurity centre.

The system is designed to mirror the independent terror alert system, which ranks the threat to the public from low to critical and helps decide what protective measures are required.

The prime minister said in his broadcast to the nation that the alert system would help the country avoid going back to square one. Alert levels, he added, would be determined by the number of cases and the R number, or transmission rate, of the virus.

R, or the 'effective reproduction number', is a way of rating a diseases ability to spread. Its the average number of people on to whom one infected person will pass the virus. For an R of anything above 1, an epidemic will grow exponentially. Anything below 1 and an outbreak will fizzle out eventually.

At the start of the coronavirus pandemic, the estimated R for coronavirus was between 2 and 3 higher than the value for seasonal flu, but lower than for measles. That means each person would pass it on to between two and three people on average, before either recovering or dying, and each of those people would pass it on to a further two to three others, causing the total number of cases to snowball over time.

The reproduction number is not fixed, though. It depends on the biology of the virus; people's behaviour, such as social distancing;and a populations immunity.

Hannah DevlinScience correspondent

In turn, that Covid alert level will tell us how tough we have to be in our social distancing measures. The lower the level, the fewer the measures. The higher the level, the tougher and stricter we will have to be, Johnson said.

Terror threat levels are agreed by the Joint Terrorism Analysis Centre, which is independent of ministers but includes representatives of 16 government departments plus police and intelligence agencies.

Further details are expected to be announced when the full lockdown easing plan is presented in detail to parliament on Monday.

No detailed information has yet been released on the specific criteria for setting a level of alert.

A former senior Whitehall security source said the existing terror threat level system was useful because it helped set a reference point to shape behaviour across Britains wider national security system.

They questioned, however, whether a biosecurity centre would be able to make its assessments independently. Technocratic measures are being politicised, and blamestorming and political manoeuvring seem to be the order of the day at the moment, they said.

Johnson said the UK was currently under the second highest level of threat, but the situation was improving. Over the period of the lockdown, we have been in level four, and thanks to your sacrifice we are now in a position to begin to move in steps to level three.

The new system will apply only to England at first. Scotland has led criticism from the three devolved administrations of Downing Streets decision to drop the stay at home slogan in favour of stay alert. No 10, however, said it would seek to work with Scotland, Wales and Northern Ireland to create an integrated approach across the UK.

New Zealand adopted a four-tier coronavirus alert system in late March, in the early stages of the outbreak, so that people can see and plan for the kinds of restrictions we may be required to put in place, according to its government.

Its guidelines cover how people are expected to behave at each level, how the healthcare system should be set up, and what public facilities and businesses are allowed to remain open.

New Zealand, which has suffered relatively mildly from coronavirus compared with the UK and others in Europe, is poised to decide on Monday whether to reduce the threat level from three to two. Any decision has to be signed off by the prime minister, Jacinda Ardern, and her cabinet.

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Boris Johnson announces five-tier coronavirus alert system - The Guardian

It comes as no surprise to its ardent followers that the Ultimate Fighting Championship, known as U.F.C., will be the first organization to stage a major professional sports event in the United States since the spread of Covid-19 induced a monthslong live sports hiatus. Its brash president, Dana White, never wanted to cease operations in the first place.

I wanted to keep right on going; well figure this thing out, Mr. White told Sports Illustrated. If this thing is that deadly, its gonna get us no matter where we hide or what we do.

In April, through U.F.C., Mr. White rented a private island where he is planning to put on fights by late June, involving international mixed martial arts fighters who may have difficulty securing visas. The territory which Mr. White has crowned Fight Island could stage bouts for the duration of the pandemic, or perhaps beyond, he says.

The mixed martial arts, or MMA, fighters he oversees who are of various cultural and political leanings have a similar attitude. And so, the athletes will be back in action even sooner: Theres a fight Saturday night. Not on Fight Island, where the venue is still under construction, but in Florida at the Jacksonville Arena, where lightweights Tony Ferguson and Justin Gaethje will square off in the headline bout. Neither man seems concerned. I hope he breaks my nose, Ive been waiting to get it fixed. Mr. Gaethje said tauntingly. Maybe hell plant an elbow on there.

The road to this return, which will be without fans in the stands, was rocky. The first attempt resulted in a false start, as a planned April 18 card on Native American tribal land in California was scuttled amid objections from top state officials and television partners. But the efforts never stalled, nor did they lack for outlandish ingenuity.

While most in official quarters have excoriated these moves, many grass-roots sports fans on Twitter, Reddit, Instagram and other forums have cheered on the U.F.C.s gung-ho determination to fight on in the face of a tsk-tsk from the powers that be. That scorn for politesse, the embrace of gritty, defiant independence and the nihilism toward the consequences are all a microcosm of what makes the combat sport excite so many people.

Its what took U.F.C. from a ragtag competition held in tents in the 1990s (a sport that the late Senator John McCain once famously dismissed as human cockfighting) to the signature franchise for mixed martial arts, airing on ESPN in prime-time cable ever since the network agreed to a $1.5 billion megadeal to gain its television rights.

There are, of course, countless people who would be happy to watch any live sport right now. Still, the U.F.C. has a unique and enduring appeal to a coarsened America that was there before this pandemic and that will thrive in its aftermath.

Back in November, when Covid-19 was on the verge of spreading in China, President Trump, flanked by two of his sons, Eric and Donald Jr., entered the arena at Madison Square Garden, prompting a raucous reaction from the crowd. Watching the viral videos of it, posted right away from the smartphones in attendance, you could have understandably mistaken the scene for one of the presidents own clamorous political rallies, but for the low hum of boos mixed in with the ecstatic cheers and gravelly rock music. Not everyone was a fan.

Mr. Trump was, instead, in the role of star guest as he attended a big U.F.C. event. It was a remarkable sight, given that competitions of mixed martial arts were not even legal in New York until 2016.

For the wide group of people on the outside looking in at this cultural phenomenon with furrowed brows, the question of its specific appeal beyond the age-old attraction humans have to combat is common. Five action-packed minutes this past August, before a prime time face-off between Anthony Pettis and the welterweight superstar Nate Diaz (on his hyped return from a three-year hiatus) may provide something like an answer.

Hours before that top card fight, nearly every seat was filled to watch little-known lightweights Khana Worthy and Devonte Smith battle. Both men in the octagon immediately began parrying each others blows, prepared to defend against a combo of Brazilian jiu-jitsu and American wrestling moves, or of karate kicks and boxer-like jabs (or maybe just an improvised knee to the face.)

Just four minutes into the first round, Mr. Worthy landed a punishing left hook beneath Mr. Smiths right ear, who crashed, back-first, onto the canvas. The crowd exploded 17,000-odd people giving a big schoolyard Ooo! at the same time. Mr. Worthy charged at his wounded opponent, who was still on the deck and landed several more punches. Mr. Smith curled up. The referee rushed in to stop the fight and Mr. Worthy, a massive 6-1 underdog according to the gambling bookies, climbed atop the octagon, threw himself over it and toward the rapt crowd in celebration.

It all happened in roughly 10 seconds. An instant jolt and turn of events few other sports can rival. The knockout took place at 9:42 p.m. By 9:43 the U.F.C.s official account had posted a clip to Twitter: WORTHY PULLS OFF THE HUGE UPSET! Other trending posts quickly went up from fans and sponsors as well as peers of the fighters, who often have as many millions of followers as professional football players.

I began following M.M.A. out of professional necessity. I was a boxing writer by trade until editors at outlets, including The Times, began inquiring a few years ago about my interest in covering U.F.C. as it ascended into mainstream acceptability.

Dr. Bhrett McCabe, a sports psychologist, who has worked with mixed martial artists, explained to me the vicarious rush that people of all stripes feel watching U.F.C. matches by recalling one of the first times he took his young teenage daughter, who was not already a hard-core fan, to a fight.

We were three rows back from the cage, and you could hear the fists hitting the chest, and the air leaving the lungs, Dr. McCabe said. And youre sitting there, and its this moment between I dont want to see a broken leg, but I also want to see a victory. Its this weird psychological moment. I look over at my daughter shes 14 at the time and shes over there yelling and screaming.

For fans, theres this idea of there being just enough distance between them and the fighters to provide a guilt-free viewing experience. We watch them through a cage. But theyre also packaged by the franchise on television as well as by themselves on social media as Tekken-esque arcade game characters. The audience gets close, but not too close, to the blood.

Despite the vague conventional wisdom that those who watch U.F.C. are mostly working-class MAGA guys, a fairly diverse group of young men make up the majority of the actual fan base.

You go to a U.F.C. event, you see men, you see women, you see children, said Dr. Jennifer McClearen, a feminism and media scholar at the University of Texas Austin, whose book on women in U.F.C. will debut in spring 2021. You see people who are doctors, and lawyers, and construction workers.

Its a shift that was years in the making. When the Ultimate Fightng Championship was getting its start in the 1990s, it wasnt inaccurate to describe some of its fights as glorified cage matches. There were always rules, Joe Silva, a U.F.C. technical adviser from 1994 to 2000, said in a U.F.C. documentary released this summer. Obviously, in the beginning, there was a lot less.

As active bans on mixed martial arts fighting spread from state to state, some fights were forced to be held in tents. Dana White took over as president of the U.F.C. in the early 2000s under new ownership who understood, as Mr. White put it in the same documentary, that you cant beat the government. You have to work with them and run toward regulation and try to figure out how to make it safer, in order to turn it into a real sport.

The New Jersey Athletic Commission approved the competition soon after renegotiations and U.F.C. 30 (the 30th match in the promotions series) was held on Feb. 23, 2001, at the Trump Taj Mahal in Atlantic City. Dana White still credits that tentpole event which Mr. Trump facilitated as the first domino that led a slew of states to accede to popular demand and legalize regulated mixed martial arts competition over the past two decades.

Im never going to say anything bad about Donald Trump, ever, Mr. White told Fox News last year. That guy gave us our start when nobody would talk to us.

M.M.A. is gory, without question. But clinical research is showing the dangers of M.M.A. arent quite as pronounced as once feared, specifically in relation to boxing. A groundbreaking study first published in 2015 by researchers at the Sather Sports Medicine Clinic at the University of Alberta which examined 1,181 mixed martial artists and 550 boxers over the course of a decade found that boxers are far more susceptible to major harm from concussions and other head trauma and more likely to experience loss of consciousness than M.M.A. fighters, who are instead at greater risk of more minor injuries.

Most of the blood you see in mixed martial arts is from bloody noses or facial cuts, the lead author Dr. Shelby Karpman explained. It doesnt tend to be as severe, but looks a lot worse than it actually is.

In addition to its tactful rule changes, the U.F.C.s reputation of being raw, unlike boxing, and real, unlike W.W.E.-style entertainment wrestling, has allowed it to take full advantage of its openings and competitors vulnerabilities like any good fighter.

For a generation, as premium cable and pay per view became boxings main broadcasters, its popular exposure decreased: A rare canonical fight, between Floyd Mayweather and Manny Pacquiao, in 2015 had a pay per view price tag just shy of $100. Big-name boxers have also shied away from even fights, to preserve their precious undefeated records, whereas there is a widespread duel mentality in M.M.A that publicly shames fighters on top whom repeatedly decline challenges.

The embodiment of this mentality may be Conor McGregor, U.F.C.s most controversial and bankable star, who went as far as fighting boxier Floyd Mayweather in 2017 under strict boxing rules. Mr. McGregor lost that $100 million dollar fight, but his boldness and scintillating style only brought him and U.F.C. more fans. Those fans were out in full force on Jan. 18 in Las Vegas, when Mr. McGregor made a victorious return to the octagon for a prime time bout with Donald Cowboy Cerrone, whom he knocked out in just 40 seconds.

Within hours of the TKO, Mr. Mayweather and several M. M. A fighters issued fresh challenges to Mr. Mcgregor his response? Every one of these little mouth fools can get it!

Not too long ago, the W.W.E. quenched the thirst of those who wanted to watch combat, unleashed from boxings formalities including President Trump, who has starred in some of its story lines. But Mr. Trumps embrace of U.F.C. over both W.W.E. and boxing, which he also patronized, is a signal of whos on top.

Its popularity also appears tied to the very things that made Donald Trump, a bombastic real estate guy who hosted fights, presidential material. The internet has made us all skeptical cynics. And American society coarsened as the economy for working people stagnated. Cheering along to a scripted, predestined contest like W.W.E. might have started to make too many people feel like suckers.

In an era defined by trolling, economic insecurity, social isolation, shortened attention spans and memes like LOL, nothing matters, the U.F.C. has come to the fore, giving its fans the ability to feel and see something real if only for 10 seconds, one knockout at a time.

Joe DePaolo (@joe_depaolo) is a sports journalist and senior editor at Mediaite. His biography of the late boxing champion Arturo Gatti is forthcoming.

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Why UFC Is the First Sport to Return During the Coronavirus - The New York Times

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.

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One-Third of All U.S. Coronavirus Deaths Are Nursing Home Residents or Workers - The New York Times

The week before Sally Campbell sent her year 1 student back to school was a big worry week. The Sydney mother had been trying to manage home schooling her daughter, caring for her four-year-old son and working four days a week as a safety adviser in charge of the Covid-19 plan at a large manufacturing plant while her husband worked full-time outside the home and found it entirely impossible.

She took on the advice of her GP and closely monitored news about infection rates and the safety of schools. Eventually, Campbell decided to send her daughter back to school in week one of term two. It wasnt an easy decision, she says. I pondered and mulled it over for a good couple of weeks.

And despite being convinced it was the best possible course for her mental health, her daughters schooling and her ability to conduct her job, and that the Covid risks were low, she remained anxious. There was definitely a motherly worry through it all, wondering whether I was doing the wrong or right thing in sending her back.

Emerging from weeks of strict coronavirus lockdown, itself a cause of serious mental health disruption, the lifting of restrictions brings for many a sense of trepidation and unease. While some are bucking at the gate, waiting to return to life in the new normal, others are experiencing a lingering fear of contagion of the virus about which little is still understood. Others yet are experiencing a sadness about the loss of things gained during lockdown. Questions for many remain: what is safe? Where is the line between precaution and paranoia? And what do I not want to leave behind?

Anxiety across Australia has increased around twofold, according to the Australian Bureau of Statistics.

Coronavirus has caused a mass emotional event, says Roger Patulny, an associate professor of sociology at Wollongong University. This general climate is likely to continue, he says, but he has found that for some people life in lockdown has brought with it fewer pressures. In particular these are people who live in family situations partner, kids and the quality of their relationship is reasonably good and they are actually quite enjoying the lockdown because they are having some of the pressures of modern life reduced.

For those people, the end of lockdown may bring some reticence about re-entering a more hectic life. However, if youre a single person who lives on your own, you cant wait for it to be over.

Melissa Norberg, associate professor of clinical psychology and deputy director of the Centre for Emotional Health at Macquarie University, agrees that for different people the return to a new normal will have a different emotional implications. She says the return to stricter schedules, alarms, commutes and the need to wear something other than activewear marks a significant change for many people who have been isolating and working from home.

With time and with practice, you start to get used to things. This has been a heightened period of uncertainty for us, but during the past six weeks or so we have started to get used to that new normal, she says. As we go back, the evidence from previous pandemics where there has been a lot of social isolation is that within a month or two, people should start to readjust to that prior normal.

Australians have been warned to expect more coronavirus cases as restrictions are lifted and we socialise more freely. Norberg urges people to reach out with their worries. Its OK to feel uncertain, she says. Its OK to feel a little bit of distress. You will get through this.

Professor Ian Hickie, co-director of the Brain and Mind Centre at the University of Sydney, says that isolation and the unravelling economic situation is a far greater threat to mental health than returning to social groups. However, he says, the pandemic has caused a fundamental shift.

We generally take for granted that we go out in the world and nothing will happen to us, whereas [coronavirus] has been: rush into your homes, dont talk to anyone, dont interact with anyone, you might catch something that might kill you. Theres a sort of loss of security in that. It has challenged peoples fundamental optimism about the world.

But, Hickie says, the treatment for any such anxiety is to return to the world and social interaction as much as guidelines allow. Human beings, he says, are social animals and cope in a crisis by coming together. Our mental health is better when we are at school, work and socially connected. Anxiety leads to avoidance, which in turn heightens the fear, he says.

The treatment, the cure, is to go out there in the world and discuss with others and get back to your normal life.

In time, we will return to not just a new normal, but a close approximation of the old normal, says Patulny. Kisses hello and handshakes will re-emerge, he says. That sort of stuff is a pleasant part of human nature and a longer term part of our culture its just having a rest.

Meanwhile, Campbell is satisfied that the risks associated with going back to school and work are low. I have greater anxiety going to Kmart, to be honest.

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Return anxiety: 'Coronavirus has caused a mass emotional event in our lives' - The Guardian

Doctors and police reacted to the governments new stay alert slogan and Boris Johnsons lockdown-easing measures with warnings of growing non-compliance and the impossibility of policing.

The Police Federation, representing 120,000 rank-and-file officers, attacked a week of mixed messages from ministers, fuelled by media speculation, while medical experts said they increasingly expected to see a second rise in infections.

New guidance is hurriedly being drawn up for officers around the country about the new rules set out by the prime minister, and what they should and should not police.

John Apter, national chair of the Police Federation of England and Wales, said: Police officers will continue to do their best, but their work must be based on crystal clear guidance, not loose rules that are left open to interpretation because that will be grossly unfair on officers whose job is already challenging. If the message of what is expected of the public is not clear then it will make the job of policing this legislation almost impossible.

Prof Dame Til Wykes, of the Institute of Psychiatry, Psychology and Neuroscience at Kings College London, said the new communication strategy would hinder progress against the coronavirus.

She said: The communication plan of stay alert, control the virus and save lives unlike the first step in the plan is very confused. We need clear rules and messages that are concise, clear and accurate. This is just short.

A woolly message will hinder not promote the next phase of this lockdown. The previous message to stay home was at least clear. What does stay alert mean? It will just be confusing, be open to misinterpretation and likely to increase risky behaviour. That means taking risks that will affect everyone and increase infections.

Dr Michael Head, a senior research fellow in global health at Southampton University, said: For these revisions [to government strategy] to be successful, we need consistent communications from the government, and the new stay alert messaging is ambiguous and lacks clarity.

Prof Sir Simon Wessely, former president of the Royal College of Psychiatrists, said the problem with stay alert was that its hard to be clear what that means, as opposed to stay inside.

Having seen photos and video showing a lack of physical distancing at VE Day street parties on Friday including a conga line and in parks over the weekend, intensive care doctors shared concerns on social media that more people would end up in hospital with coronavirus.

Dr David Hepburn, an intensive care consultant in Wales, tweeted: Just watched the conga lines/street parties on the news. The nation has lost its fucking mind. Were strapping in for the second wave. Im so, so tired, and so pissed off. Weve had a few days of respite and I was starting to feel hopeful. Cant believe I was so naive.

Dr Ami Jones, another intensive care specialist, tweeted a link to a table showing the UK with the highest death rate in the world from the disease. She said: Showing our supremacy in the world stats as we irresponsibly flout lockdown to celebrate VE Day in the worst fashion. Glad Ive had a couple of weeks away from ITU to recuperate as the next wave is going to make this horrific statistic even worse. Things are about to get busy.

Large numbers of people sunbathing and picnicking on Saturday in London Fields in Hackney, east London, led local police to tweet that they were fighting a losing battle with the public over their behaviour.

A senior police officer who survived a spell in intensive care with Covid-19 criticised the publics attitude towards observing the lockdown. Ch Supt Phil Dolby, of West Midlands police, wrote on Twitter: A month ago today, on a ventilator and in a coma, I started to breathe for myself. I am very disturbed by the increasingly blas way [people] are treating the lockdown. With lack of answers around immunity, my family and I are going to remain shielding. I cant go through that again.

One chief constable told the Guardian: There is far less compliance following mixed government messaging. It will be difficult to police anything other than large groups if freedom of movement is increased. What does that mean to people? It will be ignored. 90% ish doing the right thing at present. That will reduce dramatically over the coming weeks.

Senior police sources believe significant parts of their role in enforcing the lockdown are effectively over, other than policing large groups. Impossible, said one senior source.

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Doctors and police warn of new coronavirus wave as UK lockdown weakens - The Guardian