Category: Corona Virus

A global pandemic of the novel coronavirus has now killed more than 174,000 people worldwide.

Over 2.5 million people across the globe have been diagnosed with COVID-19, the disease caused by the new respiratory virus, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. The actual numbers are believed to be much higher due to testing shortages, many unreported cases and suspicions that some governments are hiding the scope of their nations' outbreaks.

Since the first cases were detected in China in December, the United States has become the worst-affected nation, with more than 804,000 diagnosed cases and at least 43,200 deaths.

Today's biggest developments:

Here's how the news is developing today. All times Eastern. Please refresh this page for updates

Officials in hard-hit Albany, Georgia, are concerned after Gov. Brian Kemp said Monday he's lifting someof the states restrictions on businesses, including hair and nail salons, starting this Friday.

Albany Mayor Bo Dorough said Tuesday that the lifting of restrictions should be gradual.

"Social distancing cannot be maintained in a barber shop, in a beauty shop or in a nail salon," Dorough said.

"The governor, in addition to receding the shelter in place order, essentially precluding your local officials from taking action to protect the citizens of this community," the mayor said. "A community where 15 funerals were held just last weekend."

"I pray that the number of Georgians who are infected and die will not increase significantly in the coming weeks as a result of the lifting of these restrictions," Dorough said.

Tune into ABC at 1 p.m. ET and ABC News Live at 4 p.m. ET every weekday for special coverage of the novel coronavirus with the full ABC News team, including the latest news, context and analysis.

With Massachusetts in the midst of a rise in coronavirus cases, Gov. Charlie Baker announced Tuesday that schools will stay closed through the end of the school year.

"We know that the lack of child care for many families has created an unanticipated burden and its hard to look after young children and balance the demands of working at home, but maintaining this structure is the best way to keep our kids and our providers safe from the spread of this insidious disease," he explained.

"There were a lot of mixed feelings in the education community on whether or not to go back. But we have got to do this right, and we have got to respect the virus," Baker added.

Massachusetts' death toll has climbed to 1,566. Over 39,000 people had been diagnosed as of Monday.

"The data shows we are still very much in the grip of the pandemic," Baker said.

The United Kingdom will begin trials of a vaccine developed at Oxford on Thursday, U.K. Health Secretary Matt Hancock said on Tuesday.

If it works it will be made available to the British people as soon as possible, he said.

The U.K.'s death toll has reached17,337, according to the Department of Health and Social Care.

A worker wearing protective equipment moves a stretcher at a temporary morgue set up at a mosque as the spread of the Coronavirus disease (Covid-19) continues, in Birmingham, Britain, April 21, 2020.

The U.K. has the fifth highest death toll, behind the U.S., Italy, Spain and France.

Over 129,000 people in the U.K. have been diagnosed with the coronavirus, including Prime Minister Boris Johnson, who was released from the hospital after receiving treatment.

A fourth TSA employee has died from COVID-19.

Victor Chung, a Miami International Airport supervisory TSA officer, worked for the agency for over 17 years. He died on Sunday, the TSA said.

"Victor was known to his colleagues as a compassionate leader, always willing to support officers in need, whether financially or by donating his leave to others who were in need," TSA officials said in a statement.

As of Tuesday morning, 459 TSA employees have tested positive for COVID-19, the agency said. Of those,110 have recovered and 4 have died.

Beginning April 27, Spain will ease somelockdown restrictions for children under the age of 14,Spanish government spokesperson Maria Jesus Montero said.

Children will be allowed to accompany a parent who is leaving the house for a specific, essential task.But it will be the responsibility of the adult to ensure that children follow social distancing guidelines and avoid playground and parks where close contact may not be avoided.

Toy houses stand on a deserted schoolyard during the lockdown amid the coronavirus (COVID-19) outbreak in Ronda, Spain, April 20, 2020.

Spain's death toll has climbed to 21,282. Over 204,000 people have been diagnosed.

Spain's state of emergency, which was implemented on March 14, has been extended to May 9.

In New York state, 481 people succumbed to the coronavirus on Monday, including 29 people in nursing homes, Gov. Andrew Cuomo said Tuesday.

An officer from the New York Police Department helps workers carry a body out of a house amid the coronavirus disease (COVID-19) outbreak, in the Brooklyn borough of New York City, April 20, 2020.

Cuomo, who banned elective procedures when the pandemic struck, announced Tuesday that he will now allow elective outpatient treatment in counties and hospitals without significant risk of a surge in the near future.

Cuomo said testing will be the focus of his conversation with President Donald Trump later on Tuesday at the White House. Cuomo said there isn't enough material for the test kits and he needs federal help.

New York City -- the U.S. epicenter of the pandemic --is "seeing definite progress" overall,Mayor Bill de Blasio said Tuesday.

A sign on a building across from NYU Langone Medical Center in Manhattan, says 'THANK YOU' to healthcare workers, during the outbreak of the coronavirus disease (COVID-19) in New York City, April 20, 2020.

On Sunday, 204 people were admitted to hospitals for suspected COVID-19 -- down from 212 on Saturday.

Additionally, 857 patients were in intensive care units on Sunday, only slightly up from 853 patients on Saturday.

Thirty-five percent of the people tested citywide were positive Sunday. On Saturday, 34% of those tested were positive.

"Let's keep with it," de Blasio said. "It'll take some time, but we can do it."

The #NewYorkTough installation by Tishman Speyer in partnership with New York State is on display at The Rink At Rockefeller Center during the coronavirus pandemic on April 20, 2020 in New York City.

De Blasio announced Tuesday that New York City is starting its own strategic reserve program to hold vital medical equipment and supplies for any future wave of the pandemic, without having to rely on the federal government. The reserve will include face shields, surgical gowns, test kits and bridge ventilators.

Once the social distancing restrictions have been lifted, the city will throw the "biggest and best" parade to honor and thank the "heroes" of the pandemic and mark "the beginning of our renaissance," the mayor said.

On Monday, de Blasio announced all parades and other nonessential permittedevents for June were canceled. Among the annual June events in New York is the LGBTQ Pride March, which would have been celebrating its the 50th anniversary this year.

No decision has been made on 4th of July celebrations in New York City.

Nashville Mayor John Cooper won'textend the current stay-at-home order past April 30, hetold ABC News anchor Amy Robach on Tuesday.

Lower Broadway is mostly deserted in downtown Nashville, Tenn., March 25, 2020, during the coronavirus outbreak.

Davidson County, which includes Nashville, has 1,936 confirmed cases as of Tuesday morning.

The mayor mandated a stay-at-home order early on in the pandemic, even before the state's governor issued one.

TennesseeGov. Bill Lee announced Monday that the "vast majority" of businesses in 89 of the state's 95 counties can reopen on May 1. The governor said his administration will work with the remaining six counties -- which includes Nashville -- "as they plan their own reopen strategies."

Cooper said he hopes that reopening the lively city will increase consumer confidence.

"Were excited to get restarted," he told ABC News. "We're with COVID for a long time. Were going to have to learn how to live with it ... lets get back to work."

To the protesters rallying around Nashville, Cooper said, "Its their right to protest and it's our right to keep people safe."

Protesters rally at the Tennessee state capitol to speak out against the state's handling of the COVID-19 outbreak, April 19, 2020, in Nashville, Tenn. Tennessee is under a stay-at-home order due to the coronavirus outbreak except for essential workers.

"I hope youre social distancing appropriately," he cautioned.

More than 50 journalists have contracted the novel coronavirus in Mumbai, India.

The Brihanmumbai Municipal Corporation, the governing civic body of Mumbai, tested 171 journalists working in the field and reporting on the health crisis in the city, and at least 53 tested positive for COVID-19. Most of the infected journalists -- cameramen, photographers and reporters -- don't show any symptoms, according to the Mumbai Press Club.

All those who tested positive are now in quarantine and being looked after by local health authorities.

A doctor takes a swab sample during a COVID-19 testing drive inside the Dharavi slums amid a government-imposed nationwide lockdown as a preventive measure against the spread of the novel coronavirus, in Mumbai, India, on April 16, 2020.

The Mumbai Press Club has called on Maharashtra state's chief minister, Uddhav Thackeray, to take "immediate steps to safeguard our lives and profession."

"It must be pointed out that as Mumbai City locked down to face the challenge of the coronavirus, these field journalists even today continue to stand by their duty, filing their reports, taking photographs and recording videos in the most hazardous locations," the Mumbai Press Club wrote in an open letter Monday. "Most media houses have shut their offices and have not provided any protective gear, or special insurance to these frontline personnel. However, they continue to demand reports and visuals and expect the journalists to move around the city risking life and limb."

Indian Minister of Information and Broadcasting Prakash Javadekar said his ministry would issue an advisory to all media organizations to ensure precautions are being taken.

"It is shocking that more than 50 journalists of electronic media, particularly camera persons, have been found corona positive in Mumbai," Javadekar tweeted Monday. "Every journalist should take proper care."

There are nearly 19,000 diagnosed cases of COVID-19 in India, and at least 603 people there have died, according to a count kept by Johns Hopkins University. The bulk of the country's cases have been recorded in Maharashtra state, of which Mumbai is the capital.

The U.S. Food and Drug Administration on Tuesday authorized the first diagnostic test with a home collection option for COVID-19.

The federal agency reissued the emergency-use authorization for LabCorp's molecular test to permit testing of samples collected by patients at home using a designated self-collection kit that contains nasal swabs and saline.

"Throughout this pandemic we have been facilitating test development to ensure patients access to accurate diagnostics, which includes supporting the development of reliable and accurate at-home sample collection options," FDA Commissioner Stephen Hahn said in a statement Tuesday. "With this action, there is now a convenient and reliable option for patient sample collection from the comfort and safety of their home."

A health worker uses a nasal swab to test a man for COVID-19 in the Harlem neighborhood of New York City on April 20, 2020. While many laboratories and companies are now offering tests, there are still only two main types available. The nasal swab test tells you if you have an active viral infection right now. A separate blood test tells you if you were previously exposed to the virus and fought off the infection.

After a patient uses the self-collection kit to swab their own nose, they mail their sample in an insulated package to a LabCorp lab for testing. The North Carolina-based company intends to make its Pixel by LabCorp COVID-19 Test home collection kit available to consumers in most U.S. states -- with a doctor's order -- in the coming weeks, according to a press release from the FDA.

"The FDA's around-the-clock work since this outbreak began has resulted in the authorization of more than 50 diagnostic tests and engagement with over 350 test developers," Hahn said. "Specifically, for tests that include home sample collection, we worked with LabCorp to ensure the data demonstrated from at-home patient sample collection is as safe and accurate as sample collection at a doctor's office, hospital or other testing site."

Spain's iconic running of the bulls festival has been canceled this year due to the coronavirus pandemic.

The San Fermin festival takes place every year in the northern town of Pamplona between July 6 and 14. But the town's acting-mayor, Ana Elizalde, announced Tuesday that the event could not be held this year because of the health crisis.

In this file photo taken on July 9, 2019, participants run next to Jose Escolar Gil fighting bulls on the third bull run of the San Fermin festival in Pamplona, northern Spain. Spain's best-known bull running festival in the northern town of Pamplona, held annually between July 6 and 14, has ben cancelled this year due to the coronavirus pandemic, city hall announced on April 21, 2020.

Spain is one of the world's worst-affected countries in the ongoing pandemic, with more than 204,000 diagnosed cases of COVID-19 and over 21,000 deaths.

The worldwide number of people suffering acute hunger could almost double by the end of the year due to the crippling economic impact of the coronavirus pandemic, the United Nations' World Food Program warned Tuesday.

Unless swift action is taken, that figure stands to rise to 265 million in 2020, up from 135 million in 2019, according to a WFP projection, which was announced alongside the release of the Global Report on Food Crises.

People shop in the old city market of Yemen's capital, Sanaa, ahead of the holy Muslim fasting month of Ramadan, on April 18, 2020. From cancelled Iftar feasts to suspended mosque prayers, Muslims across the Middle East are bracing for a bleak month of Ramadan fasting as the threat of the coronavirus pandemic lingers.

"COVID-19 is potentially catastrophic for millions who are already hanging by a thread," WFP's senior economist, Arif Husain, said in a statement on Tuesday, "It is a hammer blow for millions more who can only eat if they earn a wage. Lockdowns and global economic recession have already decimated their nest eggs."

"It only takes one more shock -- like COVID-19 -- to push them over the edge," he added. "We must collectively act now to mitigate the impact of this global catastrophe."

Russia on Tuesday morning reported 5,642 new cases of the novel coronavirus, bringing the national tally to 52,763, according to the country's coronavirus response headquarters.

Another 51 people died from COVID-19 overnight, bringing Russia's death toll to 456.

Two police officers patrol an almost empty Red Square, with St. Basil's Cathedral (center) and Spasskaya Tower in Moscow, Russia, on April 20, 2020. Officials in Moscow and other regions have ordered most people except those working in essential sectors to stay home through April 30. Residents are only allowed to shop at nearby food stores and pharmacies, walk their dogs and remove trash.

Moscow still has the bulk of the country's infections, with 3,083 new cases registered in the city over the past 24 hours.

Authorities in Moscow and other areas have ordered most residents -- except those working in essential sectors -- to stay home through April 30. Residents are only allowed to leave their homes to shop at nearby grocery stores and pharmacies, walk their dogs and take out trash.

Italian Prime Minister Giuseppe Conte announced Tuesday that the hard-hit country can start reopening on May 4, but he said a total loosening of the lockdown measures "would be irresponsible."

In a Facebook post, Conte explained that Italy was preparing to move into "phase two" of its response plan, the details of which will be announced by the end of next week. Officials will also take into account the situation in each region.

"It is too easy to say, 'let's open everything,'" Conte said.

Dr. Marco (right) and nurse Manu, wearing protective gear, react at the end of their shift in a corridor of the level intensive care unit, treating COVID-19 patients, at the San Filippo Neri hospital in Rome, Italy, on April 20, 2020. Italy on April 20 reported its first drop in the number of people currently suffering from the novel coronavirus since it recorded its first infection in February.

Italy is one of the world's worst-affected countries in the coronavirus pandemic, with more than 181,000 diagnosed cases of COVID-19 and over 24,000 deaths, according to a count kept by Johns Hopkins University. The country became the first in Europe to impose a coronavirus-related nationwide lockdown, which has been in place since March 10.

On Monday, Italy recorded its first drop in the number of people currently sick with the virus since the country reported its first case in February.

Germany's iconic Oktoberfest, the world's largest beer festival, has been canceled this year due to the coronavirus pandemic.

Every year, around 6 million people flock to the festival grounds in Munich, the capital of southern Germany's Bavaria state. This year, the annual festival was slated to run from Sept. 19 to Oct. 4.

After meeting with Munich's mayor on Tuesday, Bavaria's Minister-President Markus Soder said they agreed the risk is "too high" to let Oktoberfest 2020 take place since "you can neither keep your distance nor work with facial protection" at the festival.

This combination of pictures shows a festival tent of the Oktoberfest beer festival in Munich, southern Germany, on Oct. 3, 2019 (top) and on Sept. 16, 2016 (bottom, as preparations are under way for the festival's opening). Oktoberfest will be cancelled in the year 2020 as "risks are too high" from the coronavirus pandemic, Bavarian state premier Markus Soeder announced on April 21, 2020.

"We are living in different times," Soder told a press conference.

Munich Mayor Dieter Reiter added, "It is an emotionally difficult moment and of course it is also an economically difficult moment for our city."

Germany, which has more than 147,000 diagnosed cases of COVID-19, lifted some social distancing measures on Monday, but major events with large audiences remain banned until at least the end of August.

As many countries seek to lift lockdowns and other social distancing measures put in place to contain the spread of the novel coronavirus, the World Health Organization warned on Tuesday that easing restrictions too soon would likely lead to a resurgence of infections.

"This is not the time to be lax," Dr. Takeshi Kasai, the WHO regional director for the Western Pacific, said during an online press conference. "Instead, we need to ready ourselves for a new way of living for the foreseeable future."

Read the rest here:

Coronavirus updates: WHO warns people must be ready for 'new way of living' - ABC News

In the Santa Clara County study, researchers tested 3,330 volunteers for antibodies indicating exposure. Roughly 1.5 percent were positive. After adjustments intended to account for differences between the sample and the population of the county as a whole, the researchers estimated that the prevalence of antibodies fell between 2.5 percent and a bit more than 4 percent.

That means that between 48,000 and 81,000 people were infected in Santa Clara County by early April, the researchers concluded.

In Los Angeles County, researchers conducted antibody tests for two days at six drive-through test sites in early April and estimated that between 2.8 percent to 5.6 percent of the countys adult population carried antibodies. If accurate, that would mean that 220,000 to 442,000 residents have been exposed.

By comparison, only 8,000 cases had been confirmed in the county at that time the testing was done.

Antibody studies in other countries have produced similar numbers, noted Dr. John Ioannidis, a professor of medicine at Stanford University and an author of the paper on Santa Clara County.

If the numbers prove accurate, he added, the virus may be much less deadly than originally expected, with a fatality rate more closely resembling that of a bad flu strain than a pandemic of profound lethality.

Neither report has been peer-reviewed or published in a scientific journal, and both pieces of research have met with criticism. Both relied on volunteers, which may have skewed the results, and the investigators say they are now probing their data to see how significant this bias may have been.

They maintain, though, that so-called participation bias would not alter the data enough to negate the overall conclusions.

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Coronavirus in the US: Live Updates - The New York Times

Which one, Mr. Walsh asked on Monday, The tank driver, or the one with the Mossad?

There was also the Puerto Rican Jewish karaoke jockey who strode along the bar, promising that she, like Gloria Gaynor, would survive, and getting you to buy in and pump your fist.

The surgeon pulling in millions a year at the hospital down the block, NewYork-Presbyterian/Columbia, sat one stool over from a school custodian making a fraction of that. Thursday nights, hospital paydays, were a whirl.

Besides medical workers, Coogans served world-renowned runners from the Armory Track and Field arena, off-duty cops and teachers blowing off steam.

A couple of years ago, Lin-Manuel Miranda, the creator of Hamilton, joined Mr. Walsh to serenade a woman celebrating her birthday; as a boy growing up, Mr. Miranda had his own birthdays there. So did my kids. We had baptism parties at Coogans and an 85th birthday, held a Ph.D. bash in the back room and wolfed down a meal between the afternoon and evening sessions at a funeral parlor.

The owners could spot people who had just come from a rough visit to a sick relative in the hospital and knew to give them the right dose of warmth or quiet. Or they shouted a merry greeting to the older woman who arrived every evening for her one highball and a dinner that was technically solitary, but not really, with Mr. Hunt or Mr. Walsh or Ms. McDade invariably pulling over a chair for a chat.

Herman D. Farrell, when he was chairman of the Manhattan Democratic Party, would interview people for judgeships at a table in the front room, where everyone could, and did, see what he was up to, and with whom.

During the crack wars, Coogans was a sanctuary. A peace treaty was negotiated at one of its tables during the Washington Heights riots of 1992. In defiance of crime, Mr. Walsh organized a Salsa, Shamrocks and Blues five-kilometer run through the streets on the first Sunday in March.

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This Is the New York That Were Losing to Coronavirus - The New York Times

A sign about being 6 feet apart is posted along the main road through Bolinas, Calif. Residents are undergoing testing as part of a coronavirus study. Haven Daley/AP hide caption

A sign about being 6 feet apart is posted along the main road through Bolinas, Calif. Residents are undergoing testing as part of a coronavirus study.

A small town in northern California will become the first in the nation to try to test everyone for the Coronavirus, regardless of symptoms, in an effort to better understand how the virus spreads and how antibodies against the disease are built.

Researchers at the University of California, San Francisco who are running the project in unincorporated Bolinas, home to some 1,600 people, started Monday.

"We don't have enough data to tell people how to lift those (stay at home) measures safely," Dr. Aenor Sawyer with UCSF tells NPR. "What we need to understand is how does the virus spread through communities so that we know how to open up people's lives again. How do we contain this virus and how do we safely move forward and try to move past it?"

The pop-up, drive-through testing center is up and running at a local park. It will do what's called PCR tests to determine if a resident currently has the virus as well as antibody tests to see if a person has been infected and has developed antibodies against the virus.

More antibody testing is vital, Dr. Sawyer says, to better understand how and in what ways infection builds immunity.

"We will see people who have antibodies, people who don't. But what isn't clear right now is does that mean they have immunity? We don't know that," Dr. Sawyer says. "And if it does eventually seem like they have immunity, we don't know how long the window for that immunity is."

Researchers hope Bolinas serves as an ideal ecosystem socially and demographically to study. It's rural but before the shelter-in-place order, it always had a steady stream of recreational visitors and tourists from outside. The community also has a large number of older adults.

"The median age here is 62. So we have a lot of high-risk people," says Dr. Sawyer, a longtime resident of Bolinas. "And we have a significant (number) that are under the poverty level. We have social economic disadvantage and we have some minorities."

Starting this weekend, UCSF researchers will launch a companion testing program in San Francisco's Mission District, an economically and ethnically diverse neighborhood. That will allow them to carefully compare urban and rural test data.

Residents of the unincorporated community raised the money, some $300,000, via a GoFundMe campaign to buy the testing materials and tents needed to set up the site.

The researchers hope the data is useful to public health officials making tough decisions about when and how to reopen society. But they also hope the testing might serve as a template for other communities.

As Dr. Sawyer puts it, "The epidemiological data will be helpful in policy decision-making for their communities. But what's really important is, could they get their own community tested? Because we need to be able to do more community-wide testing to safely advance through this pandemic."

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Town's Residents Will Be Tested For Coronavirus Research : Coronavirus Live Updates - NPR

Gage Skidmore/Flickr; Stephen Melkisethian/Flickr; Caroline Amenabar/NPR

Gage Skidmore/Flickr; Stephen Melkisethian/Flickr; Caroline Amenabar/NPR

Updated at 11:15 a.m.

With near-daily task force briefings, President Trump has delivered an ever-evolving message to the American public about the coronavirus pandemic.

The constant is the inconsistency. At times he has been in sync with the public health experts advising him on the response and with actions initiated by his administration. But often he has undercut or even contradicted his experts or White House policy.

Trump has gone from downplaying the risk early on, to overselling the availability of test kits, to encouraging strict social distancing measures, to questioning whether those measures were causing too much economic and emotional pain. He has claimed "total" authority and then insisted it's really up to the states to manage the response.

As the message from public health experts became increasingly dire, Trump often accentuated the positive, saying he was trying to give Americans hope.

Although Trump's partial ban on travelers from China is seen by many as having bought time for the U.S. to prepare, coronavirus testing failures obscured the severity of the outbreak here and hampered efforts to contain its spread. By the time the deadly scope of the virus came into focus, it was too late for containment, and mitigation shutdowns brought a heavy economic toll.

Below, we compare Trump's remarks and actions to those of his administration:

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Timeline: What Trump Has Said And Done About The Coronavirus - NPR

Residents of a suburban New York City county that was one of the earliest US hotspots for the coronavirus sued the World Health Organization on Monday, accusing it of gross negligence in covering up and responding to the Covid-19 pandemic.

In a proposed class action, three residents of Westchester county accused the WHO of failing to declare a pandemic in a timely fashion, monitor Chinas response to the original outbreak, provide treatment guidelines, advise members on how to respond including through travel restrictions, and coordinate a global response.

They also accused the WHO of conspiring with Chinas government, which was not named as a defendant, to cover up Covid-19s severity.

The WHO did not immediately respond to a request for comment.

The lawsuit by Richard Kling and Steve Rotker, both of New Rochelle, and Gennaro Purchia, of Scarsdale, was filed in the federal court in White Plains, New York.

It seeks unspecified damages for what they called WHOs incalculable harm to the roughly 756,000 adult residents in Westchester county who would make up the class.

Westchester is north of New York City, and last year had about 967,506 people, of whom roughly 78% were adults, according to the US Census Bureau.

Lawyers for the plaintiffs did not immediately respond to requests for comment.

New Rochelle became a hotspot after a lawyer who attended the Young Israel of New Rochelle synagogue was diagnosed with Covid-19 on 2 March, the first person in the community to test positive.

Through 18 April, a total of 242,786 people in New York had tested positive for the coronavirus, including 23,803 in Westchester, according to the states health department.

The number of total hospitalizations for Covid-19 and the daily death toll have fallen in recent days, Andrew Cuomo, the New York governor, said on Monday.

The case is Kling et al v World Health Organization, US district court, southern district of New York, No 20-03124.

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New Yorkers sue World Health Organization over coronavirus response - The Guardian

When President Trump told governors that they needed to step up their efforts to secure medical supplies, Gov. Larry Hogan of Maryland took the entreaty seriously and negotiated with suppliers in South Korea to obtain coronavirus test kits.

The No. 1 problem facing us is lack of testing, said Mr. Hogan, a Republican, who has been among the many critics of the Trump administrations repeated claims that states have adequate testing provided by the federal government. We cant open up our states without ramping up testing.

In recent days, his wife, Yumi Hogan, a Korean immigrant who speaks fluent Korean, had been on the phone in the middle of the night helping to secure the final deal with two labs to sell Maryland the tests.

Luckily we had a very strong relationship with Korea, Mr. Hogan said. But it should not have been this difficult.

On Saturday, a Korean Air flight arrived at Baltimore-Washington International Airport carrying 5,000 test kits, which officials said would give the state the ability to make 500,000 new tests. The Food and Drug Administration and other agencies gave their seal of approval for the kits as the plane was landing.

I was frosted because my team was saying that the F.D.A. approval was going to hold it up, Mr. Hogan said in a telephone interview. I didnt care and was going to get the tests anyway.

So far, Maryland has conducted 71,577 tests for the virus, and nearly 14,000 infections have been recorded, a number that continues to rise. More than 500 people have died in the state.

A number of South Korean vendors were considered for the new test kits, and ultimately the state went with LabGenomics.

Mr. Hogan, Ms. Hogan and a group of state officials greeted the flight to receive the kits on Saturday. The new tests, once they have passed muster in two local labs, will be distributed to the testing centers the state has set up in sporting fields, repurposed vehicle emissions testing centers and other locations.

We want to get to the point where we can test as many people as possible, Mr. Hogan said, noting that the state, like most others, has been limited to testing only the very sick and emergency and health care workers.

Expanded testing capacity will go to high-priority areas, such as nursing and group homes, expanded drive-through sites, primary care practices and urgent care centers.

Other states, desperate for things like personal protective equipment and other medical gears, have moved to acquire it, often stealthily, from other nations.

On NBCs Meet the Press on Sunday, Vice President Mike Pence said there was a sufficient capacity of testing across the country today for any state in America to help the nation emerge from the coronavirus shutdown, something that Mr. Hogan and other governors from both parties disputed.

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Frustrated by Lack of Coronavirus Tests, Maryland Got 500,000 From South Korea - The New York Times

Dr. Lowell has struggled to obtain treatment for his own wife. Shortly before the virus hit New York, she had back surgery and then developed a complication called a seroma, which flooded her abdomen with several liters of fluid. The specialist who could drain the fluid did not want to bring her in, afraid of exposing her to the virus. Finally, it was scheduled for April 21. She has waited more than a month.

Any other time, this would have been done the same day, he said.

Some of his patients have had far more serious problems, he said.

One called him, saying she felt depressed and weak, and couldnt eat.

They were communicating via telemedicine, which Dr. Lowell like many other doctors in the New York region has been using to avoid in-person visits that could spread the virus.

In the past, her tests suggested that she was prone to a blood cancer, multiple myeloma. Listening to her, seeing her on his screen and knowing her history, Dr. Lowell suspected a serious illness, possibly the cancer. He told her that, and urged her to go to the hospital. The patient, who was 60, declined, fearing she would contract the coronavirus.

Five or six days passed, and her husband called, saying she felt even worse. Again, Dr. Lowell implored them to go to the hospital. Again, she refused.

A few hours later, she died.

I have no idea why, Dr. Lowell said.

Some of his other patients with serious illnesses have also refused to go to the hospital, for the same reason. One who wanted to go, and whose family called 911, was urged by paramedics to stay home because the hospital was overwhelmed by coronavirus cases. He did stay home, and died a few days later.

Many colleagues share similar stories.

Im a primary care doctor, Dr. Lowell said. Im totally hogtied trying to take care of people. Its sad. It brings tears. Were all on the front line.

Jan Hoffman contributed reporting.

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The Pandemics Hidden Victims: Sick or Dying, but Not From the Coronavirus - The New York Times

The nudge came in an email in early March from an Italian friend alarmed by how fast the deadly coronavirus was spreading in his country.

A shortage of ventilators, he told Scott Cohen and Marcel Botha, was a critical problem in Italy, and he warned that it soon would be in the United States, too. He urged the pair to apply their skills to the ventilator challenge.

Both Mr. Cohen, co-founder of a technology center for researchers and start-ups, and Mr. Botha, chief executive of a product design and development company, were skeptical. A standard ventilator, with thousands of parts requiring a complex global supply chain, was hardly a device that could be manufactured quickly and affordably.

I was dismissive at first, said Mr. Botha, whose company is called 10XBeta. It looked impossible.

But they soon found a design for a basic ventilator that could serve as their core technology. Since then, they have orchestrated from New York a far-flung collaboration of scientists, engineers, entrepreneurs, physicians and regulatory experts and accomplished in a month what would normally take a year or more.

The result are machines known as bridge ventilators, or automatic resuscitators, priced at $3,300. They are mainly meant to help less critically ill patients breathe. If patients become sicker, with lung function more compromised by the disease, they still need to be placed on standard ventilators, which typically cost more than $30,000.

On Friday, the Food and Drug Administration approved the new device, the Spiro Wave, to be used on patients in hospitals, under an expedited process called emergency use authorization.

The project was initially targeted at New York City as a stopgap solution for what only a month ago appeared to be a looming, life-threatening shortage of ventilators in the city.

But the urgency has receded for now. While the citys coronavirus death toll continues to mount, hospital admissions are trending down, and intensive-care units seem to have enough ventilators.

But health experts say a machine like the Spiro Wave should be a valuable tool in the arsenal of treatment. It can, they say, expand access to breathing assistance in other parts of the country as the pandemic spreads, and especially to rural communities without major medical centers. And capable, low-cost machines could greatly expand access to treatment in developing countries in Asia, Africa and Latin America.

The New York group has fielded inquiries from across the United States and from companies and governments worldwide. It plans to license its design for free.

The project is one of several pushes in America and abroad to streamline ventilator design and lower costs. This month, Medtronic got F.D.A. approval to offer in the United States a ventilator that it sells in 35 other countries for an average price of less than $10,000. The company is also making the machines blueprint freely available to other manufacturers.

The hurry-up engineering feat relied on human networks; two in particular stand out. The original design came from a classroom project at the Massachusetts Institute of Technology a decade ago. Since the coronavirus outbreak, M.I.T. professors and students have worked to upgrade the design in collaboration with outside groups. And several key contributors to the project are M.I.T. alumni.

The other network is the government and business community of New York, where Mr. Cohen and Mr. Botha are based. The city government took on the role of a risk-taking venture investor, first with a $100,000 research grant and then a nearly $10 million agreement to buy 3,000 of the basic ventilators.

Its essentially a start-up that has made unbelievable progress in a short time, said James Patchett, chief executive of New York Citys Economic Development Corporation, which backed the project.

The New York ventilator effort got underway after widespread warnings of shortages. In mid-March, Mayor Bill de Blasio held a conference call with top staff members. Mr. de Blasio recalled that the looming ventilator shortage was scary as hell. New York had no ventilator producers, but he told his staff to do and spend what it took to solve the problem.

The citys economic development chief, Mr. Patchett, who was on the call, knew Mr. Cohen and his technology center, New Lab, which is in the Brooklyn Navy Yard. Mr. Cohen told him about the ventilator-design project that he was putting together. It sounded promising, and the city made its initial grant.

Later, on March 25, after further development of the M.I.T. design, critical care physicians from citys public hospitals and two private hospitals saw the most recent version of the machine. That evening Mr. Patchett called Dr. Mitchell Katz, who leads the Health and Hospitals Corporation, which operates the citys public hospitals.

We should definitely do this, Dr. Katz recalled telling Mr. Patchett.

The project had launched about 10 days earlier, after Mr. Cohen, on the recommendation of a scientist friend in San Francisco, got in touch with Alex Slocum, a renowned mechanical engineer at M.I.T. whose class created the design in 2010.

A group of faculty and students Mr. Slocum led hardware design, and Daniela Rus, a professor and robotics expert, led software development worked to upgrade the design to help coronavirus patients. The device would have to be able to push air into badly impaired lungs at several times the force used to resuscitate a normal lung.

This was going to take a serious machine, Mr. Slocum recalled.

The New York group began closely collaborating with the M.I.T. team. Dr. Albert Kwon, an M.I.T. graduate and a medical adviser on the project who is an anesthesiologist at the Westchester Medical Center, and Mr. Botha, also an M.I.T. alumnus, and others from New York made several trips to Boston for joint work and testing.

The M.I.T. academics goal has been mainly to develop designs and share information on a website. But the mission for the New York group was to make the low-cost ventilators quickly. The hub of that effort is a former perfume factory in Long Island City, Queens, that is now home to a high-tech manufacturer, Boyce Technologies.

The temperature of everyone who enters the brick building is taken, a precaution against infection. The 100,000-square-foot facility combines engineering and production with robots, a clean room, and circuitry and software design departments.

Manufacturing, engineering and medical experts have worked side by side for three weeks. Dozens of versions of the machine have been carted off to the dumpster, as upgrades and improvements were made. In recent days, M.I.T. engineers traveled to Queens to help with last-minute software tweaks.

Theres a lot you cant see in a model, said Charles Boyce, the founder and chief executive of Boyce Technologies. And if you cant manufacture something at scale, it doesnt matter. Its not going to have an impact.

Producing thousands of machines means lining up sometimes scarce supplies. One of those parts was an air-pressure sensor to ensure that a patients lungs were not overinflated, which could cause damage. Mr. Cohen knew that Honeywell was a leading producer of the sensor, and he tapped his network of personal contacts to secure it in volume.

Late one night, Mr. Cohen called Kathryn Wylde, chief executive of the Partnership for New York City, a business group of the citys top executives. Kevin Burke, a former chief executive of New York-based Con Edison, is a Honeywell board member. Introductions were made, and after a series of calls to Honeywell executives in America and Asia, a supply of the sensors was secured.

The New York ventilator project was intended to address a seemingly urgent need before large-scale initiatives such as a Ford-General Electric partnership began to produce ventilators.

While New Yorks crisis has eased, Dr. Katz cautioned that pandemic viruses are unpredictable and mutate. A later variant, or second wave, in the fall could be less lethal or more, as was the case with the second wave of the 1918 flu pandemic.

This is still a useful option to have, even if there is not the urgency there was, he said.

The low-cost ventilator, Mayor de Blasio said, is an invaluable tool and part of the stockpile of medical equipment and supplies the city needs as insurance against a Phase 2 of the pandemic.

We have to get through this first, he said. But for the future, we have to have an ongoing self-sufficiency effort in New York. What weve gone through should be a never-again moment.

See the rest here:

NY Needed Ventilators for Coronavirus. They Developed One in a Month. - The New York Times

People who think theyve been exposed to the novel coronavirus are clamoring for antibody tests blood screens that can detect who has previously been infected and, the hope is, signal who is protected from another case of Covid-19.

But as the tests roll out, some experts are trying to inject a bit of restraint into the excitement that the results of these tests could, for example, clear people to get back to work. Some antibody tests have not been validated, they warn. Even those that have been can still provide false results. And an accurate positive test may be hard to interpret: the virus is so new that researchers cannot say for sure what sort of results will signal immunity or how long that armor will last.

They caution that policymakers may be making sweeping economic and social decisions plans to reopen businesses or schools, for example based on limited data, assumptions, and whats known about other viruses. President Trump last week unveiled a three-phased approach to reopen the country; he said some states that have seen declining case counts could start easing social distancing requirements immediately. And some authorities have raised the idea of granting immunity passports to people who recover from the virus to allow them to return to daily life without restrictions.

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Before we embark on huge policy decisions, like issuing immunity certificates to get people back to work, I think its good that people are saying, Hold up, we dont know that much about immunity to this virus, said Angela Rasmussen, a Columbia University virologist.

To be clear, most experts do think an initial infection from the coronavirus, called SARS-CoV-2, will grant people immunity to the virus for some amount of time. That is generally the case with acute infections from other viruses, including other coronaviruses.

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With data limited, sometimes you have to act on a historical basis, Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, said in a webcast with JAMA this month. Its a reasonable assumption that this virus is not changing very much. If we get infected now and it comes back next February or March we think this person is going to be protected.

Still, the World Health Organization has stressed that the presumed immunity can only be proven as scientists study those who have recovered for longer periods. The agency is working on guidance for interpreting the results of antibody tests, also called serologic tests.

Right now, we have no evidence that the use of a serologic test can show that an individual is immune or is protected from reinfection, the WHOs Maria Van Kerkhove said at a briefing last week.

Below, STAT looks at the looming questions about antibodies and immunity that scientists are racing to answer.

What are antibody tests? How widely available are they? And how accurate?

The tests look for antibodies in the blood. Because antibodies are unique to a particular pathogen, their presence is proof the person was infected by the coronavirus and mounted an immune response. The hope is that the presence of the antibodies is an indication that the person is protected from another infection.

These are different from the tests used to diagnose active infections, which look for pieces of the virus genome.

Commercial antibody tests are starting to appear on the market, but so far, the Food and Drug Administration has only cleared a few through Emergency Use Authorizations. And already, health regulators are warning that the ones on the market may vary in their accuracy.

I am concerned that some of the antibody tests that are on the market that havent gone through FDA scientific review may not be as accurate as wed like them to be, FDA Commissioner Stephen Hahn said on Meet the Press earlier this month. He added that no test is 100% accurate, but what we dont want are wildly inaccurate tests.

Even the best tests will generate some false positives (identifying antibodies that dont actually exist) and some false negatives (missing antibodies that really are there). Countries including the U.K. have run into accuracy issues with antibody tests, slowing down their efforts for widespread surveys.

The fear in this case with imprecise tests is that false positives could errantly lead people to think theyre protected from the virus when they have yet to have an initial infection.

Serology testing isnt a panacea, said Scott Becker, the CEO of the Association of Public Health Laboratories. When its used, we need to ensure there are good quality tests used.

One specific concern with antibody tests for SARS-CoV-2: they might pick up antibodies to other types of coronaviruses.

Globally, there have only been a few thousand people exposed to the other coronaviruses that have caused outbreak emergencies, SARS and MERS. But there are four other coronaviruses that circulate in people and cause roughly a quarter of all common colds. Its thought that just about everyone has antibodies to some combination of those coronaviruses, so serological tests for SARS-CoV-2 would need to be able to differentiate among them.

What can be gleaned from serological results?

Detecting antibodies is the first step. Interpreting what they mean is harder.

Typically, a virus that causes an acute infection will prompt the bodys immune system to start churning out specific antibodies. Even after the virus is cleared, these neutralizing antibodies float around, ready to rally a response should that virus try to infect again. The virus might infect a few cells, but it cant really gain a toehold before the immune system banishes it. (This is not the case for viruses that cause chronic infections, like HIV and, in many cases, hepatitis C.)

The infection is basically stopped in its tracks before it can go anywhere, said Stephen Goldstein, a University of Utah virologist. But, Goldstein added, the durability of that protection varies depending on the virus.

Scientists who have looked at antibodies to other coronaviruses both the common-cold causing foursome and SARS and MERS found they persisted for at least a few years, indicating people were protected from reinfection for at least that long. From then, protection might start to wane, not drop off completely.

The experience with other viruses, including the other coronaviruses, has encouraged what Harvard epidemiologist Marc Lipsitch summed up as the educated guess in a recent column in the New York Times: After being infected with SARS-CoV-2, most individuals will have an immune response, some better than others. That response, it may be assumed, will offer some protection over the medium term at least a year and then its effectiveness might decline.

But many serological tests arent like pregnancy tests, with a yes or no result. They will reveal the levels (or titer) of antibodies in a persons blood. And thats where things can get a bit trickier. At this point, scientists cant say for sure what level of antibodies might be required for a person to be protected from a second Covid-19 case. They also cant say how long people are safeguarded, though its thought that a higher initial titer will take longer to wane than low levels.

Further investigation is needed to understand the duration of protective immunity for SARS-CoV-2, a committee from the National Academies of Sciences, Engineering, and Medicine wrote in a report this month.

Its not just whether someone is immune themselves. The next assumption is that people who have antibodies cannot spread the virus to others. Again, that hasnt been shown yet.

We dont have nearly the immunological or biological data at this point to say that if someone has a strong enough immune response that they are protected from symptoms, that they cannot be transmitters, said Michael Mina, an epidemiologist at Harvards T.H. Chan School of Public Health.

The challenge, as the National Academies report highlighted, is that no one knew about this virus until a few months ago. That means they havent been able to study what happens to people who recover from Covid-19 and if and how long they are protected for more than a short period of time.

One key uncertainty arises from the fact that we are early in this outbreak and survivors from the first weeks of infection in China are, at most, only three months since recovery, the report said.

What else can antibody tests show?

In addition to identifying those who have been infected, antibody tests can also suggest at a broader level how widely the virus has spread. These data have implications for how severe future outbreaks of cases might be and what kind of restrictions communities might need to live under. If more people have been infected than known a strong likelihood, given the number of mild infections that might have been missed and testing limitations in countries including the United States then more people are thought to be protected going forward.

In the United States, the Centers for Disease Control and Prevention and the National Institutes of Health have both launched serosurveys to assess how many people might have contracted the virus. Even employees of Major League Baseball teams have been enlisted in a study enrolling thousands of patients.

What have data from serosurveys shown thus far about antibody generation?

A number of countries have launched large serosurveys, so hopefully well have a better sense soon of the levels of antibodies being generated by individuals who recover from Covid-19 and among the general population. For now, though, there have only been limited data released from a couple small studies.

Scientists in Europe have pointed to strong antibody production in patients within a few weeks of infection. One study found that people were generally quick to form antibodies, which could help explain why the majority of people do not develop severe cases of Covid-19.

But one preprint released this month complicated the landscape. (Preprints have not been peer-reviewed or published yet in a research journal.) Researchers in Shanghai reported that of 175 patients with confirmed Covid-19, about a third had low antibody levels and some had no detectable antibodies. The findings suggest that the strength of the antibody response could correlate to the severity of infection, though thats not known for sure. They also raised concerns that those with a weaker antibody response might not be immune from reinfection.

But outside researchers have said that conclusions about immunity cant be drawn from what the study found. For one, there are different kinds of antibodies, so some might exist that the test wasnt looking for. Secondly, studies in other coronaviruses have shown that antibody responses vary from person to person, without clear implications for how protected someone is from another infection.

And, researchers say, antibodies are not the only trick the body has to protect itself. Immune cells also form memories after an initial infection and can be rallied quickly should that same pathogen try to strike again, even without antibodies or after antibody levels fade.

People that lose that serum neutralization it doesnt mean necessarily that theyre not going to have some level of immunity, said virologist Vineet Menachery of the University of Texas Medical Branch. Your immune system hasnt forgotten. It may just take them a couple of days to generate that immune response and be able to clear a virus.

He added that its likely that if and when protection starts to wane and people contract the coronavirus a second time, its likely to cause an even milder illness.

Ive heard reports of reinfection or reactivated virus. Whats going on there?

Health officials in some countries have said theyve seen examples of people recovering from Covid-19 only to test positive for the virus again what theyve taken to calling reactivation, to differentiate it from a second infection.

But experts are skeptical that either is occurring.

While no possibility can be eliminated at this early stage of the outbreak, they say that there are more likely explanations for a positive diagnostic test coming after a negative test.

For one: The tests used to diagnose Covid-19 look for snippets of the virus genome, its RNA. But what they cant tell you is if what theyre finding is evidence of live virus, meaning infectious virus. Once a person fights off a virus, viral particles tend to linger for some time. These cannot cause infections, but they can trigger a positive test. The levels of these particles can fluctuate, which explains how a test could come back positive after a negative test. But it does not mean the virus has become active, or infectious, again.

And two: the diagnostic tests typically rely on patient samples pulled from way back in their nasal passages. Collecting that specimen is not foolproof. Testing a sample that was improperly collected could lead to a negative test even if the person has the virus. If that patient then gets another test, it might accurately show they have the virus.

As Jana Broadhurst, the director of the Nebraska Biocontainment Units clinical laboratory, said, garbage in, garbage out.

Sharon Begley contributed reporting.

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Everything we know about coronavirus immunity, and plenty we still don't - STAT