Category: Corona Virus

The words are straining to come out. Boris Johnson hero worships Winston Churchill so it is obvious how the prime minister will pitch this weeks announcement of the plan to get Britain out of lockdown.

In late 1942, victory in the north African desert had suggested that the tide of the war might have turned but Churchill was cautious. Now this is not the end, he said in a speech at Londons Mansion House. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.

Yet one reason it had taken Britain more than three years for this moment to arrive was that the country had been ill-prepared for war, something Churchill had complained about ceaselessly in speeches during the 1930s demanding rearmament against the fascist threat.

Johnson is unlikely to dwell on this chapter of Churchills career, but the fact remains that the country was ill-equipped to fight Covid-19 in February 2020, just as it was to fight Hitler in September 1939. Whats more, everything the government has done in the past two months makes that clear.

As in the 1930s, a decade of austerity, of penny-pinching and cheeseparing has taken its toll. Then it was a shortage of Hurricanes and Spitfires; this time it was a lack of trained nurses, intensive-care beds and ventilators.

One consolation for Neville Chamberlain when he eventually abandoned appeasement was that Britain still had formidable industrial capacity that could be converted to war production. The hollowing-out of manufacturing in successive waves over the past 40 years means that option no longer exists.

Britain still has world-class manufacturers but they operate in only a small number of sectors. The aversion to anything resembling an industrial strategy has left the country highly exposed to long supply chains. Most of these start in China, which as the NHS found when it took delivery of unusable ventilators cannot always be relied upon.

Nor has the UKs much-vaunted financial sector proved to be all that useful in a crisis. Despite government guarantees, the high street banks have been reluctant to lend, with the result that many businesses will not survive. Banks are quite prepared to provide mortgage loans where they can lend against an asset that on past form will appreciate over time: they are not really interested in lending to newly formed IT companies with bags of growth potential but which lack a financial track record. The decision by the chancellor, Rishi Sunak, to provide 100% loans for small businesses is proof that the system of providing business support is not fit for purpose.

The same applies to the welfare safety net. One of the lessons of the 1930s was that many of the men who were called up were in poor physical shape to fight as a result of disease, malnutrition and poor housing. Britain is a much richer and healthier country than it was 80 years ago, but poverty still kills. The Office for National Statistics data showing that the death rate in the most deprived parts of the Britain is double the rate in affluent areas tells its own story.

For the past decade, the governments narrative has been that the benefits system is too generous and that savings must be made. Yet within days of the lockdown being announced Sunak was increasing universal credit because the payments were not enough to live on. That remains the case.

The job of actually fighting the current war the poor bloody infantry in this instance has been groups whose role in keeping the economy going has long been overlooked: bus drivers, supermarket shelf-stackers, care home workers, nurses prominent among them. These are people who cant do their jobs from home, but who are putting themselves at risk after having just suffered a decade of public sector pay freezes and stagnant living standards. They are unlikely to react well to any attempt by the government to reimpose austerity once the economy is out of quarantine. The lesson of Labours landslide election victory in 1945 is that voters will look back at the pre-crisis world and come to a simple conclusion: never again.

Johnson knows this, which is why he is saying that this time the government will look after the people who suffer and not just the banks. Making good on this pledge will take some doing, and means learning some lessons.

The first is that getting the right big picture, macro-economic structure, right is crucial. It is not, though, just a question of repudiating austerity and gunning for as much activity as possible: growing the economy has to be consistent with greening the economy.

The second lesson is a bigger state has to be a smarter state, and that requires ceding more power to a local level. Britains heavily centralised approach to Covid-19 testing has compared badly to Germanys devolved model, for example.

A switched-on state would demand a price for the unprecedented amount of support it is providing. That might mean taking a stake in mid-sized manufacturing businesses, as the employers group Make UK has suggested. It would also mean bigger companies agreeing to put workers on boards, signing up to carbon-reduction targets or domiciling themselves in the UK for tax purposes. There should be no free lunches.

The Covid-19 pandemic has exposed the imbalances in modern Britain. It has highlighted the need for more community-based banks, for more investment in vocational education, for an industrial strategy that encompasses the everyday economy as well as trendy hi-tech sectors, and for a stronger social safety net. Above all, it has made the case for greater national self-sufficiency so that we will be more resilient next time.

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The coronavirus has exposed the imbalances in modern Britain - The Guardian

Not even Warren E. Buffett was spared financially from the coronavirus, as his conglomerate, Berkshire Hathaway, reported a $49.7 billion loss in the first quarter on Saturday, reflecting the outbreaks toll on an investment portfolio that includes big stakes in major airlines and financial firms.

The loss was Berkshires biggest ever and a sharp swing from a $21.7 billion profit in the same quarter a year earlier. The conglomerates vast array of investments exposed it and Mr. Buffett, long considered one of the worlds top investors to huge swaths of the battered American economy.

Its total investment loss for the quarter, without accounting for operating earnings, was $54.5 billion. By comparison, its investment gain in all of 2019 was $56.3 billion.

Berkshire said it continued to sell stock in April, totaling $6.5 billion, plowing that money primarily into supersafe Treasury bills. Later Saturday, at his annual shareholders meeting, Mr. Buffett suggested that some of those sales involved Berkshires reversing its roughly 10 percent in the four largest U.S. airlines.

Berkshires investment loss tracked the overall slide in stock markets: The S&P 500 dropped 20 percent in the first quarter. (The companys biggest holdings are also mainstays of the S&P 500: American Express, Apple, Bank of America, Coca-Cola and Wells Fargo, with those stakes amounting to nearly $125 billion.)

The loss overshadowed a 6 percent rise in Berkshires operating earnings, which track the performance of the companys owned-and-operated businesses like the insurer Geico. Mr. Buffett regards that as a better measure of the companys overall performance and has long argued that quarterly paper gains or losses on its investments are often meaningless in understanding its overall health.

But it is hard to ignore the damage to a portfolio that includes stakes in financial firms like Bank of America and American Express, both of which reported steep drops in earnings for the first quarter, and four of the biggest U.S. airlines. (Berkshire also disclosed that the value of its stake in Kraft Heinz on its books exceeds the market value of that holding by about 40 percent, and warned that it might have to take a write-down on the investment in the future.)

Even some of the conglomerates wholly owned businesses, like the Burlington Northern Santa Fe railroad and retailers like Sees Candy, were hurt by the lockdowns that have shaken the U.S. economy. Still, Geico reported a 28 percent gain for the quarter, to $984 million, while Berkshires overall insurance investment profits rose modestly because of increased dividend income for the company.

The first-quarter results, in which Berkshire reported having $137.3 billion in cash, were released ahead of its first-ever online-only shareholder meeting. Sometimes described as a kind of Woodstock for capitalists, the meeting is usually a weekend-long Omaha extravaganza celebrating all things Buffett and Berkshire.

This year, it was a decidedly more subdued affair, reflecting the limits on mass gatherings and travel of the Covid-crisis era. Mr. Buffetts longtime business partner, 96-year-old Charlie Munger, did not attend, staying at home in Los Angeles.

It just didnt seem like a good idea to have him make the trip to Omaha, Mr. Buffett said, adding, Charlie is in fine shape, and hell be back next year.

Mr. Buffett was joined instead by Greg Abel, Berkshires vice chairman overseeing all of the companys non-insurance companies, who sat at a separate desk some distance from Mr. Buffett.

Instead of facing thousands of adoring and affluent shareholders, Mr. Buffett, noting that he hadnt had a haircut in seven weeks, held forth in an almost completely vacant Omaha arena that seats more than 17,000, as his comments were livestreamed.

Discussing the breakdown in the financial markets that prompted the Federal Reserve to drastically ramp up efforts to pump in fresh cash, he said, We came very close to having a total freeze of credit.

When it came to Berkshires stake in the airlines, Mr. Buffett said, I just decided that Id made a mistake.

He added that because of the pandemics impact on travel, the airline business and I may be wrong, and I hope Im wrong but I think it, it changed in a very major way.

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Berkshire Hathaway Lost $49.7 Billion in First Quarter Stung by Coronavirus - The New York Times

WASHINGTON As lawmakers gathered in the well of the House in the early hours of March 14 to vote on a sweeping coronavirus relief bill, Representative Max Rose, Democrat of New York, felt that the pandemic that had already begun spreading through the ranks of Congress was about to upend life as he knew it.

Hundreds of miles away in New York, his wife Leigh Rose, unaware that votes had finished just before 1 a.m., was frantically calling him, and then his roommate, Representative Jared Golden, Democrat of Maine, to let him know that his life was about to change in a much different way.

Buddy! Mr. Rose recalled Mr. Golden saying when he finally tracked Mr. Rose down. Youre having a kid.

The baby the Roses had long planned to adopt was about to be born, three weeks early. Now, the pair is navigating the first months of parenthood in the middle of a pandemic, figuring out how to secure formula and diapers in a shuttered city all while Mr. Rose juggles trips back and forth from Washington to vote. In the middle of it all, the first-term congressman from Staten Island deployed for two weeks with the National Guard to assist with coronavirus relief.

Think about this world that hes been brought into, startlingly different than the world was just several months before, Mr. Rose said of his newborn son. We just really want him to be safe, and happy, and healthy. Its scary.

But what a story of his birth, he added.

The prospect of parenthood had been simmering beneath the tumultuous events of Mr. Roses freshman term: a month after he took office during the nations longest government shutdown, the couple began pursuing the adoption process. The months of arduous paperwork and uncertainty continued through Mr. Roses adjustment to a weekly commute between Staten Island and Washington, and a summer of congressional investigations.

In November, as the impeachment inquiry consumed Capitol Hill, the couple learned they had been matched with a birth mother, whom they declined to identify out of respect for her privacy, and began preparing to welcome their baby in April. But in the wee hours of a Saturday morning in March, as Mr. Rose voted on coronavirus relief legislation, Ms. Rose learned that their son was about to be born right then. She jumped in her car and drove through the night to reach New England.

Miles Benjamin Rose was born at 2 a.m., and Mr. Rose got the first flight out of Washington later that day to meet his son.

Theres so many families that are going through exactly what were going through I mean with newborns with young children at home, Ms. Rose said. Were definitely not alone.

As the couple drove back to New York with their son, the city had begun to completely shutter to stem the spread of the virus. They agreed that Mr. Rose, an Afghanistan combat veteran who is a captain in the Army National Guard, should deploy to help with the citys response to the pandemic. He was the first member of Congress to do so, citing a desire to take a more personal role in providing relief to his constituents.

It was a decision that kept Mr. Rose physically apart from Ms. Rose and Miles for a month, during the deployment and then the mandated two-week isolation period to ensure that Mr. Rose had not contracted the coronavirus.

It was the right thing to do, Mr. Rose said. It was important to serve in this capacity at this moment.

Everybody is sacrificing far more than we have, he added, pointing to the doctors and nurses he met who were isolating in basements or hotels for far longer periods of time to protect their families and maintain their work.

Ms. Rose acknowledged the challenge of the circumstances, but added: Theres so many people that are struggling, and its so important for Max to take care of the people in our district.

In the moments when Mr. Rose could come home during his deployment, he would eat dinner on the trunk of their car in the garage 10 feet away from where Ms. Rose would stand with the baby. But then Mr. Rose had to isolate himself for another two weeks, keeping him from holding Miles, who is just starting to coo and smile, until Friday.

The pair has also tapped into the growing network of parents on Capitol Hill with young children. They ticked off a list of Mr. Roses Democratic colleagues Representatives Abigail Spanberger of Virginia, Pete Aguilar of California, Josh Gottheimer, Mikie Sherrill of New Jersey and Antonio Delgado of New York among them and their spouses, who have repeatedly checked in on the couple in recent days.

I lean on them they understand the experiences that we have, said Ms. Rose, who recently joined a Zoom call with a dozen congressional spouses to check in.

It remains unclear, they said, how the couple will handle Mr. Roses trips to Washington, where coronavirus cases continue to escalate. The House is expected to return the week of May 11. Mr. Rose said having a newborn at home had only intensified his desire to institute a remote voting policy in times of emergency, to ease the burden on congressional families.

And the work on Capitol Hill and its consequences, he said, have become even more personal for him now that he is a father.

Were going to continue to find joy in our family, and the little moments each and every day, Mr. Rose said. And that joy and that optimism and that hope is even more important right now, because when we say that were all in this together, its our family with everyone elses.

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Representative Max Rose's Son Was Born Amid the Coronavirus Pandemic. - The New York Times

Coronavirus: BofA says US consumer spending starting to rebound as it happened  Financial Times

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Coronavirus: BofA says US consumer spending starting to rebound as it happened - Financial Times

Before the coronavirus outbreak, Dr. Lindy Fox, a dermatologist in San Francisco, used to see four or five patients a year with chilblains painful red or purple lesions that typically emerge on fingers or toes in the winter.

Over the past few weeks, she has seen dozens.

All of a sudden, we are inundated with toes, said Dr. Fox, who practices at the University of California, San Francisco. Ive got clinics filled with people coming in with new toe lesions. And its not people who had chilblains before theyve never had anything like this.

Its also not the time of year for chilblains, which are caused by inflammation in small blood vessels in reaction to cold or damp conditions. Usually, we see it in the dead of winter, Dr. Fox said.

Dr. Fox is not the only one deluged with cases. In Boston, Dr. Esther Freeman, director of global health dermatology at the Massachusetts General Hospital, said her telemedicine clinic is also completely full of toes. I had to add extra clinical sessions, just to take care of toe consults. People are very concerned.

The lesions are emerging as yet another telltale symptom of infection with the new coronavirus. The most prominent signs are a dry cough and shortness of breath, but the virus has been linked to a string of unusual and diverse effects, like mental confusion and a diminished sense of smell.

Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing. (Covid-19 is the name of the illness caused by the coronavirus.)

Several medical papers from Spain, Belgium and Italy described a surge in complaints about painful lesions on patients toes, Achilles' heels and soles of the feet; whether the patients were infected was not always clear, because they were otherwise healthy and testing was limited.

Most cases have been reported in children, teens and young adults, and some experts say they may reflect a healthy immune response to the virus.

The most important message to the public is not to panic most of the patients we are seeing with these lesions are doing extremely well, Dr. Freeman said.

Theyre having what we call a benign clinical course. Theyre staying home, theyre getting better, the toe lesions are going away.

Scientists are just beginning to study the phenomenon, but so far chilblain-like lesions appear to signal, curiously enough, a mild or even asymptomatic infection. They may also develop several weeks after the acute phase of an infection is over.

Patients who develop swollen toes and red and purple lesions should consult their primary care doctor or a dermatologist to rule out other possible causes. But, experts said, they should not run to the emergency room, where they risk being exposed to the coronavirus or exposing others if they are infected.

The good news is that the chilblain-like lesions usually mean youre going to be fine, Dr. Fox said. Usually its a good sign your body has seen Covid and is making a good immune reaction to it.

Patients who get the painful lesions are often alarmed. They appear most frequently on the toes, often affecting several toes on one or both feet, and the sores can be extremely painful, causing a burning or itching sensation.

At first, the toes look swollen and take on a reddish tint; sometimes a part of the toe is swollen, and individual lesions or bumps can be seen. Over time, the lesions become purple in color.

Hannah Spitzer, 20, a sophomore at Lafayette College who is finishing the academic year remotely at her home in Westchester County, has lesions on all 10 of her toes, so uncomfortable painful during the day, and itchy at night that she cant put anything on her feet, not even socks.

Walking is difficult, and she has trouble sleeping. At first I thought it was my shoes, but it got worse and worse, Ms. Spitzer said. Most of my toes are red, swollen, almost shiny. It looks like frostbite.

She has used hydrocortisone and Benadryl to alleviate the discomfort, and said ice is also helpful. Doctors say the lesions disappear on their own within a few weeks.

Adding to the mystery is that some teens and young adults with the lesions have tested negative for the coronavirus.

Dr. Amy Paller, chair of the department of dermatology at Northwestern University Feinberg School of Medicine, said one possible explanation is that these patients had such a mild disease and that viral replication was limited, making the virus undetectable.

Another possibility, she said, is that the lesions are what is called an epiphenomenon a symptom may accompany a disease without being causally related. For instance, perhaps more people are developing the lesions because they are staying inside and walking around barefoot more than usual.

But she also dismissed that idea as highly unlikely. I dont think thats it I think its a mild inflammatory process manifesting in this way, Dr. Paller said. Its a real phenomenon. We dont really understand it at all.

Ms. Spitzer had a test shortly after developing the lesions, and the result was negative, but she is convinced the toe lesions are a delayed response to an earlier infection that was so mild she barely noticed it.

Most of the patients were teens or young adults, including one 15-year-old who found out he had Covid-19 pneumonia when he went to the emergency room seeking medical attention for his toes.

Another patient was a 91-year-old man who had been hospitalized with the coronavirus three weeks earlier, and had recovered and returned home.

While dermatologists say its not unusual for rashes to appear along with viral infections like measles or chickenpox the toe lesions surprised them.

Other problems like hives have also been linked to the coronavirus, but Covid toes have been the most common and striking skin manifestation.

Patients with viral infections often get a pink bumpy rash called morbilliform, or hives, Dr. Fox said, but added that the toe lesions were unexpected.

No one knows exactly why the new coronavirus might cause chilblain-like lesions. One hypothesis is that they are caused by inflammation, a prominent feature of Covid-19. Inflammation also causes one of the most serious syndromes associated with the coronavirus, acute respiratory distress syndrome.

Other hypotheses are that the lesions are caused by inflammation in the walls of blood vessels, or by small micro clots in the blood. (Clotting has been another feature of the disease.)

The lesions seen in otherwise healthy people appear to be distinct from those that doctors are seeing in some critically ill Covid-19 patients in intensive care, who are prone to developing blood clots.

Some of these clots may be very small and can block the tiny vessels in the extremities, causing rashes on the toes, said Dr. Humberto Choi, a pulmonologist and critical care physician at the Cleveland Clinic.

Some experts now believe Covid toe should be recognized as sufficient grounds for testing, even in the absence of other symptoms.

This should be a criteria for testing, just like loss of smell, and shortness of breath and chest pain, Dr. Fox said.

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What Is Covid Toe? Maybe a Strange Sign of Coronavirus Infection - The New York Times

A facility in Camden, N.J. conducts COVID-19 testing in view of the Benjamin Franklin Bridge. States across the country are working to ramp up their testing capacity. Matt Rourke/AP hide caption

A facility in Camden, N.J. conducts COVID-19 testing in view of the Benjamin Franklin Bridge. States across the country are working to ramp up their testing capacity.

Updated May 11 at 9:44 p.m. ET

Part of a series on coronavirus-related restrictions across the United States.

Jump to a State: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, other states

The first version of this page was originally published on March 12. This is a developing story. We will continue to update as new information becomes available.

NPR's Brakkton Booker, Merrit Kennedy, Vanessa Romo, Colin Dwyer, Laurel Wamsley, Aubri Juhasz and Bobby Allyn contributed to this report.

This is part of a series about coronavirus-related restrictions across the United States.

Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont

Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin

South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, West Virginia

West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming

Continued here:

Northeast: Coronavirus-Related Restrictions And Reopenings - NPR

When will it hit and what will it look like? Those are just a few unanswered questions about a possible second wave of COVID-19. USA TODAY

If COVID-19 follows a pattern set by the 1918 Spanish flu, the pandemic is likely to last up to two years and return with a vengeance this fall and winter a second wave worse than the first, according to a study issued fromthe University of Minnesota.

"States, territories and tribal health authorities should plan for the worst-case scenario," warns the report out of the university'sCenter for Infectious Disease Research and Policy, "including no vaccine availability or herd immunity."

"Risk communication messaging from government officials should incorporate the concept that this pandemic will not be over soon and that people need to be prepared for possible periodic resurgences of disease," the authors suggest.

The study team, headed by Dr. Kristine A. Moore, medical director at the University of Minnesota center, includedpandemic experts from Harvard and Tulane universities.

Antibody tests were supposed to help guide reopening plans. They've brought more confusion than clarity amid coronavirus.

In a preface to the report, researchers said they are striving to produce critical and timely information "with straight talk and clarity."

The worst-casescenario with a major resurgence by year's end is one of three laid out in the paper.

A second possibility suggests the outbreak this yearcould be followed by a series of smaller waves into 2021.

And a third scenario, not seen in previous pandemics, would feature a "slow burn" of viral transmission with no clear pattern.

"The virus caught the global community off guard, and its future course is still highly unpredictable," says the report. "There is no crystal ball to tell us what the future holds and what the 'end game' for controlling this pandemic will be."

However, it stresses,a COVID-19 vaccine is not likely to be available until 2021. And, because up to aquarter of those infected may have no symptoms and others spread the disease for days before feeling ill historic influenza pandemics provide the best model.

Second wave: When will it hit, and what will it look like?

Because humans don't have natural immunity and the virus is so easily transmitted, up to 70%of the population may have to develop immunity before COVID-19'sspread diminishes naturally. That means the pandemic length "will likely be 18 to 24 months," and the virus will remain endemic afterward.

The worst-case scenario a more lethal resurgence this fall and winter is based on the Spanish flu outbreak a century ago, when a small wave hit in early 1918, followed by a huge spike that falland a third major wavein early 1919.

Studies suggestsocial distancing measures had workedagainst the 1918 epidemic until they were hastily lifted by some cities, like Denver, in early celebrations. Instead of continuing to flatten the curve, these cities experienced a second spike in cases.

A lot of the confusion, in general, is premised on the misunderstanding that if you control the epidemic once, then youre done, Harvard epidemiologist Marc Lipsitch told the USA TODAY Editorial Board last month. Theres no reason to think that.

The researchers urged government agencies and officialsto gird for resurgencesand develop triggers for re-instituting mitigation measures so health care systems won't once again be overwhelmed.

Contributing: Adrianna Rodriguez, USA TODAY.

Fact Check: Herd immunity would not fully stop the spread of coronavirus

Antibody tests: Theycould be key to reopening the country. Here's how they work.

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Coronavirus may last 2 years, study warns. And its second wave could be worse. - USA TODAY

The coronavirus moved so rapidly across the globe partly because no one had prior immunity to it. Failure to check its spread will result in a catastrophic loss of lives. Yet some politicians, epidemiologists and commentators are advising that the most practical course of action is to manage infections while allowing so-called herd immunity to build.

The concept of herd immunity is typically described in the context of a vaccine. When enough people are vaccinated, a pathogen cannot spread easily through the population. If you are infected with measles but everyone you interact with has been vaccinated, transmission will be stopped in its tracks.

Vaccination levels must stay above a threshold that depends upon the transmissibility of the pathogen. We dont yet know exactly how transmissible the coronavirus is, but say each person infects an average of three others. That would mean nearly two-thirds of the population would need to be immune to confer herd immunity.

In the absence of a vaccine, developing immunity to a disease like Covid-19 requires actually being infected with the coronavirus. For this to work, prior infection has to confer immunity against future infection. While hopeful, scientists are not yet certain that this is the case, nor do they know how long this immunity might last. The virus was discovered only a few months ago.

But even assuming that immunity is long-lasting, a very large number of people must be infected to reach the herd immunity threshold required. Given that current estimates suggest roughly 0.5 percent to 1 percent of all infections are fatal, that means a lot of deaths.

Perhaps most important to understand, the virus doesnt magically disappear when the herd immunity threshold is reached. Thats not when things stop its only when they start to slow down.

Once enough immunity has been built in the population, each person will infect fewer than one other person, so a new epidemic cannot start afresh. But an epidemic that is already underway will continue to spread. If 100,000 people are infectious at the peak and they each infect 0.9 people, thats still 90,000 new infections, and more after that. A runaway train doesnt stop the instant the track begins to slope uphill, and a rapidly spreading virus doesnt stop right when herd immunity is attained.

If the pandemic went uncontrolled in the United States, it could continue for months after herd immunity was reached, infecting many more millions in the process.

By the time the epidemic ended, a very large proportion of the population would have been infected far above our expected herd immunity threshold of around two-thirds. These additional infections are what epidemiologists refer to as overshoot.

Some countries are attempting strategies intended to safely build up population immunity to the coronavirus without a vaccine. Sweden, for instance, is asking older people and those with underlying health issues to self-quarantine but is keeping many schools, restaurants and bars open. Many commentators have suggested that this would also be a good policy for poorer countries like India. But given the fatality rate, there is no way to do this without huge numbers of casualties and indeed, Sweden has already seen far more deaths than its neighbors.

As we see it, now is far too early to throw up our hands and proceed as if a vast majority of the worlds population will inevitably become infected before a vaccine becomes available.

Moreover, we should not be overconfident about our ability to conduct a controlled burn with a pandemic that exploded across the globe in a matter of weeks despite extraordinary efforts to contain it.

Since the early days of the pandemic, we have been using social distancing to flatten its curve. This decreases strain on the health care system. It buys the scientific community time to develop treatments and vaccines, as well as build up capacity for testing and tracing. While this is an extraordinarily difficult virus to manage, countries such as New Zealand and Taiwan have had early success, challenging the narrative that control is impossible. We must learn from their successes.

There would be nothing quick or painless about reaching herd immunity without a vaccine.

Carl T. Bergstrom is a professor of biology at the University of Washington. Natalie Dean is an assistant professor of biostatistics at the University of Florida.

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What Coronavirus Herd Immunity Really Means - The New York Times

michael barbaro

From The New York Times, Im Michael Barbaro. This is The Daily.

Michigan has been one of the most aggressive states when it comes to taking steps to combat the coronavirus.

Bans on all gatherings outside a single household, travel to in-state vacation homes, and the use of motorboats

Michigans restrictions on its citizens movements have been at the center of a national debate about public health versus economic survival.

Protests in Michigan are growing because the governor, Democrat Gretchen Whitmer, has told us citizens they cant leave the city and stay in their summer homes.

Dont buy paint, dont buy roses, dont buy I mean, shes got all these crazy things.

Today: A conversation with the governor who ordered those restrictions and a demonstrator who is protesting them.

Its Wednesday, April 29.

So I just want to start by asking you to introduce yourself. Your name and where youre talking to us from.

My name is Phillip Campbell and Im coming to you from Jackson County, Michigan, which is about an hour west of Detroit and about an hour away from the capital of Lansing.

And how long have you lived there?

Ive been here in this particular location for five years, but Im a born and raised Michigander my whole life.

And did you say how old you are?

Yeah, 39. Im turning 40 in June. I had a massive party planned. I was inviting everyone I know and now I just dont know whats happening with that, so.

When you say massive, how massive?

I invited 1,000 people so, we were going to be

[LAUGHS]

I have five acres and I was going to rent Port-a-Johns. And we were going to camp. And it was going to be a multi-day bash, you know?

It turns out youre very popular, too.

[LAUGHS] Well, Ive made a lot of friends over the years.

So tell me about what you do for a living.

Im the vice president of a pest and wildlife control company. We are the ones you call if you wake up at 1:00 a.m. and theres a bat flying around your kids bedroom, and you need somebody to go get it. We will climb on your roof and pull down the hornets nest. We will take care of the mice in your basement. Well do this sort of work.

Mm-hm.

We have about 30 employees. Ive been with the company for about 10 years now. I think Im one of the most senior employees there. We started when we were in the basement of the owners house. And now we have a very large industrial building with a depot and a shop. So its been cool to see that grow over the years.

So at this point, how would you describe the company and its success?

I mean, I think were on the threshold of breaking through to the next level of growth. Were grossing about $3 million a year.

Wow.

Just this year were able to for the first time provide health benefits for our employees. So weve been working towards that for a long time, trying to get to where we have the sort of revenue and the growth that we could take on those costs, which are not insignificant, you know? We like to think that were one of the companies or industries that can still offer regular old Joes without a college education a very decent middle class livelihood with insurance benefits, things like that.

Mm-hm.

The majority of technicians are what I would just call blue-collar people, you know? They like to hunt, they fish. They go out on the lake on the weekends and drink beer on their pontoons and listen to music. And just regular old folks, you know?

Mm-hm. And what kind of a living do the people generally make?

I mean, many of the people in our company, they provide for their families. You know, theyre the breadwinner. You know, a new technician like starting might make 35.

Mm-hm.

And then a technician whos been with us for a while and knows what hes doing, he can make in the high 50s or 60s. So with the 30 employees we have, we feed about 100 mouths, with their children and families. So we feel responsible for about 100 peoples well-being.

And what did the first Michigan lockdown, the one ordered by Governor Whitmer what did it mean for your pest control business?

Her order did not exempt us. The text of the order itself, it did not make an exemption for wildlife control, pest control. And we were preparing to shut down. And then I noticed that it said for its definition of essential services, for further clarification, see this document by the Department of Homeland Security. And we found that we were allowed to stay open.

Got it.

But very quickly after that we had to furlough a couple people after that, because even though we were allowed to stay open, our customer base, many of them arent working. So if your customers arent working, theyre not spending money. And it doesnt really matter if youre open if all the people you serve arent working, you know what I mean?

Right. I dont want to pry too much, but if you were bringing in I think you said almost $3 million a year in revenue before this, what did it start to look like once the lockdown was in place and the calls from customers began to taper off?

At first, it was a 50 percent drop.

Wow.

Again, this is for a company that was allowed to stay open.

Right.

And then around this time, the second shutdown order came in, which was the one that everybody started protesting about.

Tell me what you mean.

Yeah, the second shutdown order just ramped down on the first. This was the one that went in and shut particular sections of stores that were still open. So like it said, you cant buy paint products, you cant buy gardening products. Because what was happening is people thinking, OK, I got to stay home, I might as well work on my house, you know? So a lot of those people were going to Home Depot, were going to whatever to get their supplies. And then the governor said, no, you cant get that stuff.

So this was the order that said you cant go out on a lake by yourself in your boat in your private lake, if the boat has a motor. But if it doesnt have a motor, you can go. Things that seemed a lot more arbitrary. The one that said you cant have someone come mow your lawn, even though they pull up in a truck, they drive the lawnmower off, they dont touch you, they dont go into your house. Its just one guy mowing your lawn. You know, things that people started thinking, like, the economys already in freefall, is it really necessary to go this far with it?

From my own experience, if the economy takes a dump and we cant get back to where we were, we have to cut their health insurance or were going to have to lay people off. Were going to take other measures to stay afloat. I dont know what were going to have to do. I dont want to hypothesize. I dont want my employees to listen to this and be like, what did you say is going to happen? I dont know, were going to have do something. We cant just suddenly take a 30 percent to 50 percent decline. Thats huge. What if you got a 50 percent pay cut? It would affect your life.

And so Im thinking about the ripple effect. We take a 30 percent to 50 percent drop. Our employees take a dip. Maybe they cant afford to pay their debts. Maybe they cant afford to pay their own mortgages or whatever. I dont know. I havent assessed the financial situation of each of my employees.

But I guess what I am frustrated about and I dont want to minimize the risk of Covid-19 or the people whove had it but as someone whos worked for 10 years in this business trying to build it up, get it to where it is, Im frustrated with the attitude of some people that we can just shut it off for a while, and then just turn it back on when everythings safe, and just pick up where we left off. Like, no, thats not how business works. Thats certainly not how small business works. If you take a big enough hit, its hard to recover from it, you know?

So Im curious when you first hear about the possibility of a public demonstration, a protest, in Michigan of these lockdown rules?

I saw an event on social media, I think, or I saw people talking about it like, hey, lets go down to Lansing and protest. So the owner and I works been slow, so we said, hey, we got time. Lets drive down to Lansing on Thursday. The way I understood it, we were going to drive by the capitol and honk our horn, basically.

And what was that honked horn going to mean?

The honked horn was going to mean like, we are workers, and we want the freedom for people to be able to work. Please consider opening things back up a little more. The capitol in Lansing, its on a loop, so you drive around in like a circle around the capitol. So I thought that all the traffic would come in, wed kind of loop around and wed honk, and then wed go back home, you know? But they were anticipating a certain amount of people I think 10 times more than they anticipated showed up. So it took us two hours to get to Lansing. We got in Lansing, and then we were just Michael, it was a traffic jam. Thats what it was. It was just a big traf it was like an organized traffic jam.

But what did it feel like to be in that traffic jam? Because its a particular kind of traffic jam with like-minded people there to protest something.

It was really neat. It was nice to not feel so alone, because I was really sick of people on social media telling me Im selfish because I dont want the company I helped build for 10 years to just collapse.

Whos calling you selfish, do you feel like?

Oh, just people on social media, my friends. People in my broader circle. You know, not people Im necessarily close to, but Id say I lost some friends over this, honestly. When the governor shut the economy down, I said this is going to be very hard on businesses and this is going to be very hard on us. And a lot of peoples response seemed to be like, what, do you want people to die or something, you know? And it kind of degenerated into, like, either you want people to die or you hate my business and stuff like that. And I was really glad, because I was starting to feel kind of isolated, to see a solidarity of so many other Michiganders who were similarly frustrated at the situation. Afterwards, when I got home, I saw there was a lot of people with a lot of Trump stuff, and I was kind of thinking, like, no, this isnt political. Dont make it into a political thing because this isnt about the governor happens to be a Democrat or a woman or something. Because I would have gone down there if it was a Republican, you know? It wasnt about her party affiliation. So I was frustrated

What did you make of the flavor of the protest? It seems like you didnt see this yourself in your car, but as youve hinted, there were strong strains of libertarianism and conservatism, and pro-Trump posters, as well as people with guns, as well as some, you know, some more vulgar and extreme sentiments. Some people compared Governor Whitmer to Hitler.

Oh, like Governor Whitler? [LAUGHS] Oh, I dont know, I think thats just juvenile. I mean, I think its pretty juvenile in public discourse when the only thing you go to is compare your opponent to Hitler. I wish it wouldnt have been so much anti-Whitmer, because this isnt about like Governor Whitmer, the person, you know? I wish that it would have been more on point and focused about let me work, you know?

I wonder where you fall in the political spectrum. Did you vote for Trump? Did you vote for Whitmer? And how did your political views apply to this event?

My political views didnt apply to this event really at all. You know, like, I wouldve been there if this was a Republican. I did vote for Trump. I dont particularly think hes doing that great of a job. So Im not a gung-ho Trump supporter. I didnt vote for Whitmer, but I didnt like the guy running against her, either. So.

Youre saying youre not seeing this crisis or the lockdowns through a political lens?

No, no, not at all. Not at all. The little match between President Trump and Governor Whitmer is making it more political. When Trump tweets, Liberate Michigan, when he refers to her as that woman from Michigan, obviously, that sets Governor Whitmer up as a foil against President Trump, which politicizes it. When rumors start coming out that Biden wants to consider her as V.P. material, that politicizes it. I really liked when I was there that it simply seemed like a spontaneous expression of working class frustration.

Phil, I want to tick through what your governor said when she began this process of locking down the state and basically enforcing social distancing. And heres what she said: The only tool we have to fight the virus at this moment and to support our health care system is to give them the opportunity by buying some time.

Yeah.

And she went on to say, Without aggressive measures, more people will get sick, more people will die, and our economy will suffer longer. And in her telling, the disease spreads if people are out there. If people arent out there, the disease doesnt spread. So she is making the case in the beginning that these sacrifices are required to prevent a system overload. What do you think of that?

Well, we were willing to go along with that, because we were all expecting this huge crunch on all our hospitals. We were worried about not enough beds, not enough ventilators. But the fact is the curve is flattened now. We now have hospitals, theyre not overwhelmed anymore. So what were saying is that was all well and good, but now, we can start to open up again because we flattened the curve. Even if infections go back up at this point, as I grant they could if we start being more economically active, it seems highly unlikely, given all the empty hospitals, that were going to get to another crush where we dont have enough beds or something like that.

So I want to make sure I understand what youre saying when you talk about where things are in Michigan. The Times has maps about where the virus is in each state. And just pulling this up, Michigan has about 38,000 infections, and theres been about 3,300 deaths.

Yeah, were the third highest state, I think.

So when you talk about your frustrations with the different phases of this lockdown, how do you square it with those numbers?

Well, I square it because my understanding is that the lockdown wasnt supposed to be like, were going to lockdown until this goes away. What we were told was that this lockdown was to distribute those amount of cases over a longer period of time, so that the health system doesnt get overwhelmed. So I look at the total number of deaths and infections and say, OK, this thing is here to stay whether we like it or not. The hospitals do have the ability to take people in. So it seems like to me that the goal has been met. The goal is not to

It sounds like youre saying that if we assume that the measures taken so far have flattened the curve to some degree in Michigan, that youre willing to accept the risks of restarting the economy, even if that means that the curve might go up a little bit. That you think that so far the measures taken have done enough to merit that kind of experimentation with, essentially, taking the risk of reopening.

I think so. And again, Im not saying just a full, like the economy isnt a switch, you just turn it on, everybody comes back out, you know? But I think people who want to work and can work in a way that is maintaining safe protocols, I think they should be able to. Because the thing is, what I would like people to understand is that its not like either we stay home and stay safe, or we all get the coronavirus and die. Its like staying home and nobody working has its own inherent risks and dangers and devastation thats going to come. When I talk about the economy, Im not saying Im worried about the stock market or the financial sector. Im talking about the ability of the average person to provide sustenance for himself and ones family. So we could have negative outcomes because of the shutdown, not because of Covid negative outcomes that dwarf Covid.

Mm-hm. So were now talking on Monday, April 27. And that protest was about two weeks ago.

Yeah.

And Im curious if you think that protest, which was one of the very first protests, had any kind of impact?

Yeah, I think it did. I mean, this is just me kind of blue skying this, but I think it let her see that she only had a limited amount of political capital that she could keep carrying this out indefinitely. She started to say, well let lawn service in again, well let various things start.

She rolled back some of the more, in your mind, problematic restrictions.

Yeah. She rolled back some of the more problematic restrictions and she started talking about an end game, you know? So in that respect, I think it was helpful. I think it got the message across.

We plan to talk to Governor Whitmer and I wonder what you most want to communicate to her about what you think she may not understand, what she might not be getting in this moment?

Well, first, I would say to her, Americans are responsible people. Were creative people. Tell us what social distancing guidelines you think we should be maintaining when were out there, and let us find a way to do it. If you think we need to be six or seven feet apart, if you think we shouldnt have more than six people in a room, give us a safe paradigm of personal behavior and let us work within it. Dont lock us down and say that we cant provide for ourselves. Thats the most basic human right is to provide for your own well-being. Just let us find some way to work.

Well, Phil, thank you very much. We really appreciate your time.

Yeah, thank you. I was very happy to be with you today.

Well be right back.

Hi, there.

Hi.

Governor Whitmer, its Michael Barbaro. How are you?

Im doing all right. How are you doing?

Im doing great. Where are you right now? That looks like it might be home.

Yes. Yes, Im at the governors residence in one of the rooms.

Is that a sign of you that says, The Gov?

Its a beer that was named after me. So yes, thats the poster.

And the beer is called The Gov?

Yep.

Is that any good?

It is pretty good. Its an Indian pale ale.

[LAUGHS] So governor, over the past few weeks, it feels like a lot of people have learned your name. But I sense a lot of Americans, a lot of our listeners dont know all that much about you, and how it is you became the governor of Michigan. So in brief, what is that story?

You know, Im a lifelong Michigander. Ive lived here my whole life. I was brought up in a household with a father who was kind of a Republican, a mother who was kind of a Democrat. I decided to run for governor after spending some time practicing law and teaching, and I did a stint as a prosecutor in my hometown. But I think that part of my nature is when I see a problem, and I dont see the right people there to fix it, I just kind of want to jump in and do it. The tagline of the campaign was fix the damn roads. And it wasnt because it was poll-tested. Its how everyone in the state talks about their frustration with infrastructure that hasnt been attended to properly for a long period of time. And it is the most visceral daily reminder of government thats not getting the fundamentals right.

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Coronavirus Updates: White House Blocks Fauci From Speaking to Congress - The New York Times

The tension between private liberty and public health in the United States is hardly new. Americans have demanded the latter in times of plague and prioritized the former in times of well-being since at least the Colonial Era. Politicians and business leaders have alternately manipulated and deferred to that tension for about as long.

In 1701, members of the Massachusetts Bay Colony fought a yearlong political battle to enact the nations first quarantine laws against opponents who said such measures were too severe. In 1918, during the flu pandemic, the mayor of Pittsburgh brought a ban on public gatherings to a swift and premature conclusion over concerns about a coming election.

In 2020, the same tension is back with a vengeance. The nation is under siege from the worst pandemic in a century, and the United States is on track to suffer more deaths than any other industrialized country from SARS-CoV-2, the medical name for the novel coronavirus.

Attorney General William Barr last Monday ordered Justice Department lawyers to be on the lookout for state and local directives that could be violating the constitutional rights and civil liberties of individual citizens. He was talking about state and local orders closing businesses and requiring people to shelter in place to help combat the spread of the virus. The Constitution is not suspended in times of crisis, Mr. Barr said in an April 27 memo.

Yet the same Mr. Barr, early in the outbreak, was seemingly so concerned about its impact that he proposed letting the government pause court proceedings and detain people indefinitely without trial during emergencies effectively suspending the core constitutional right of habeas corpus.

Temporary limitations on some liberties dont seem to concern most Americans at this moment. Polls show that 70 percent to 90 percent of the public support measures to slow the spread of the virus, even if those measures require temporarily yielding certain freedoms and allowing the economy to suffer in the short run.

Indeed, it is wealthy and powerful conservatives and their allies, including President Trump and Fox News, who are driving the relatively small protests demanding a liberation of the states from oppressive lockdowns as opposed to any overwhelming public sentiment to that effect.

Whats more, every country that has managed to get its Covid-19 outbreak under control has done so with measures far more aggressive than anything tried in the United States so far.

In China, South Korea and Singapore, the authorities quickly established comprehensive testing, along with rigorous contact tracing, isolation and quarantine. In the United States, such efforts are still under construction and are proceeding at a snails pace; three-plus months into the crisis, just a tiny fraction of the needed tests, contact tracers and quarantine facilities are operational anywhere.

Civil liberties may feel to some like a second-order problem when thousands of Americans are dying of a disease with no known treatment or vaccine. Yet while unprecedented emergencies may demand unprecedented responses, those responses can easily tip into misuse and abuse, or can become part of our daily lives even after the immediate threat has passed. For examples, Americans need look no further than the excesses of the post-Sept. 11 Patriot Act.

As the nation starts looking ahead to the next phase of its battle against the coronavirus, we need to have a more honest conversation about the extent to which governments may impose restrictions on their citizens that would not and should not be tolerated under normal conditions.

FREEDOM OF SPEECH AND RELIGION

Consider the rights to free speech, association and religious exercise under the First Amendment: These freedoms are central to our self-definition, and yet they have all been infringed on to varying degrees across the country, as states ban gatherings where the virus can spread quickly and easily. In Maryland and Iowa, for example, all types of large events and gatherings, including church services, have been prohibited. (Many other states have exempted religious services from their bans, which raises the separate question of whether the government is impermissibly favoring religion.)

Bans like these are legal, as long as they are neutral and applicable to everyone. A state may not shut down only certain types of events, or prohibit speakers expressing only certain viewpoints. Under Supreme Court precedent, any infringement on speech or religion must be incidental to the central goal of the restriction, which in this case is clear: stopping the spread of the coronavirus.

But even if all these bans are legal on their face, what happens as the 2020 election approaches? Speech and association rights are at their peak in the political context, and Americans will be especially wary of any incursions on those rights in the months or weeks before Election Day. What if a state lifts some restrictions on large gatherings, then reimposes them in the days before an election? That may be necessary if there is another wave of the virus, and yet in a highly polarized political environment, citizens might well distrust official motivations behind a crackdown, and that could generate public unrest.

This is why its so important for the authorities to build that trust now, and to rely openly on scientific consensus when imposing and lifting bans on gatherings and other events.

SURVEILLANCE AND CELLPHONES

Another area of concern is the governments ability to know where we are and whom were with. In normal times, the authorities generally have to obtain a warrant to search your personal property, like a cellphone, or to retrieve its data to find your location.

But giving the government access to all that data carries huge risks. There were already far too many examples of law-enforcement officials abusing their access to cellphone data in the pre-Covid era, taking advantage of revolutions in technology to track people in ways that no one would imaginably consent to. Even if people give their consent to be tracked during the pandemic, governments have a very poor track record of relinquishing new powers once they have them.

The question then becomes: Can cellphone data be used in a way that helps stem the spread of the coronavirus while also being kept out of the hands of the government to avoid abuse, now or down the road?

Apple and Google are in the process of producing an app that would use secret codes to track people through their phones, while leaving the location data on those phones. People who test positive would be given the choice of putting their phone on a list. Other peoples phones could automatically check that list, and if any were within range of the infected person, those people would be notified that they could be at risk.

Fine, in theory. But for a system like this to work, the public needs to buy into it. Enough people have to use these apps to make them effective at least 60 percent of cellphone users, by some estimates and no city or country is anywhere close to that level of adoption. In Norway, only 30 percent of people have downloaded this type of location app.

Another hurdle is that the big technology companies have a poor record of protecting their users private information.

In the end, contact tracing a central feature of any comprehensive public-health response will need to be a cooperative endeavor, involving not only downloadable apps but perhaps hundreds of thousands of human beings, all doing the hard work of direct outreach to find those people at the highest risk of infection.

LIBERATING AMERICA

It would be one thing if the calls to reopen America from President Trump and his allies were part of a coordinated pandemic response strategy by a federal government that had taken strong and science-based measures from the start. But the White House failed to do that at virtually every turn, which makes the current protests ring hollow.

Its possible that at least some of the current lockdowns could have been avoided had the Trump administration led the way back in January when we still had time to take advantage of the information coming out of China and prepare the United States for what lay ahead. In that sense, these devastating shutdowns represent a catastrophic failure of timely government action. Even today, top officials are refusing to take the most basic safety measures. On Tuesday, Vice President Mike Pence toured the Mayo Clinic but refused to follow the clinics requirement to wear a mask. What message does he think that sends to the American people? (On Thursday Mr. Pence visited a plant producing ventilators in his home state, Indiana, and wore a mask.)

In a large self-governing society, civil liberties exist as part of a delicate balance. That balance is being sorely tested right now, and there is often no good solution that does not infringe on at least some liberty. At the same time, the coronavirus provides Americans with an opportunity to reimagine the scope and nature of our civil liberties and our social contract. Yes, Americans are entitled to freedom from government intrusion. But they also have an obligation not to unnecessarily expose their fellow citizens to a deadly pathogen. Protecting Americans from the pandemic while also preserving our economy and our civil liberties is not easy. But its essential.

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We the People, in Order to Defeat the Coronavirus - The New York Times