Category: Corona Virus

A woman mourns during a funeral held at Beheshte Masoumeh Cemetery for the victims of the new coronavirus in Qom, Iran, on March 17, 2020.

Photo: Fatemah Bahrami/Anadolu Agency via Getty Images

The U.S. government is run by sociopaths.

How else to explain the Trump administrations callous disregard for the lives of ordinary Iranians in the midst of this global coronavirus crisis? How else to make sense of U.S. officials doubling down in their support for crippling economic sanctions on the Islamic Republic, despite the sheer scale of the suffering?

The spread of Covid-19 has been nothing less than a catastrophe for the people of Iran. On Monday, Iranian officials reported another 129 fatalities, the largest one-day rise in deaths since it began battling the Middle Easts worst outbreak. Dozens of Iranian government officials, parliamentarians, and religious leaders have lost their lives to the disease. The death toll now stands at 988, and the total number of cases has crossed 16,000 roughly, nine out of every 10 cases in the Middle East! Globally, only China and South Korea have had more confirmed cases and yet, as the AP notes, the real number in Iran may be even higher.

To be clear: A lot of the responsibility for the death and suffering in Iran has to lie with the Iranian government, which has been grotesquely incompetent and deeply dishonest. The official response was glaring denial of the magnitude of the crisis, wrote Iranian doctors (and exiles) Kamiar and Arash Alaei in the New York Times earlier this month. The countrys supreme leader, Ayatollah Ali Khamenei, they noted, even accused the countrys enemies of exaggerating the threat of the coronavirus.

Nevertheless, U.S. sanctions on Iran, which have had a devastating impact on the economy, have made things much worse. The government has been forced to request an emergency $5 billion loan from the International Monetary Fund while Iranian President Hassan Rouhani has written to several world leaders to tell them how his countrys fight against the coronavirus has been severely hampered by US sanctions. His foreign minister Javad Zarif accused the U.S. government of medical terrorism.

The Trump administration in the form of Treasury Secretary Steve Mnuchin continues to insist that sanctions do not prevent humanitarian aid. This is, technically, correct. Yet as Human Rights Watch pointed out in October 2019, months before the novel coronavirus outbreak in Iran, while the US government has built exemptions for humanitarian imports into its sanctions regime in practice these exemptions have failed to offset the strong reluctance of US and European companies and banks to risk incurring sanctions and legal action by exporting or financing exempted humanitarian goods. The result, concluded the human rights group, has been to deny Iranians access to essential medicines and to impair their right to health.

Imagine being both so cruel and so unreasonable that you make George W. Bush and Dick Cheney look compassionate and reasonable in comparison.

In fact, as the Atlantic Council noted in May 2019, despite the fact that sanctions exempted humanitarian goods, the US Treasury Department had previously prosecuted medical companies for selling small amounts of medical supplies to Iran, which in turn, has had a deterring effect on other companies doing business with Tehran.

So it is any surprise, then, that Iranian suppliers of respiratory masks, surgical gowns, and ventilators are now saying they are out of stock? Or that the Iranian government is struggling to import the raw materials that it needs to manufacture antiviral drugs?

In late February, the Trump administration made a minor adjustment to the sanctions regime and allowed some humanitarian aid to arrive in Iran in coordination with the Swiss government. Sanctions relief, however, needs to go much further and much faster. As Rep. Ilhan Omar, one of the few progressive foreign policy voices on Capitol Hill, tweeted last week: We need to suspend these sanctions before more lives are lost.

Shes right. And there is precedent here: When a massive earthquake killed 26,000 people in the city of Bam, in southeastern Iran, in December 2003, the Bush administration allowed for a temporary suspension of sanctions. As journalist Negar Mortazavi has recounted, multiple U.S. military planes landed in Iran for the first time since the 1979 revolution and transferred over 150,000 pounds of medical supplies and more than 200 civilian personnel from Boston, Los Angeles, and Fairfax County in Virginia, to assist Iran in search and rescue, emergency surgery, and disaster response coordination.

Yet the Trump administration has refused to budge. Imagine being both so cruel and so unreasonable that you make George W. Bush and Dick Cheney look compassionate and reasonable in comparison.

On Monday, the Chinese and Russian governments demanded the U.S. suspend sanctions on Iran as a result of the pandemic. The Chinese foreign ministry called on the U.S. to immediately lift unilateral sanctions on the Islamic Republic, which it described as undermining the delivery of humanitarian aid by the UN and other organizations. Referring to illegal and anti-human U.S. sanctions, the Russian government accused Washington of purposefully cutting off millions of Iranian citizens from the possibility of purchasing necessary medical supplies.

Yet, again, the Trump administration has refused to budge. Imagine being both so cruel and so out of step with the international community that the Chinese and Russian governments have the moral high ground over you.

The unilateral reimposition of U.S. sanctions on Iran in 2018 was a clear violation of international law, according to the International Court of Justice. It was not mandated by the U.N. Security Council, and the U.N. Special Rapporteur on the effect of sanctions on human rights has since slammed the Trump administrations illegal and immoral forms of coercion, calling it an economic attack on the Iranian people.

Of course, an attack on the Islamic Republic is what the hawks in Washington have always craved. On Sunday, Trumps former national security adviser John Bolton was once again agitating for a new war with Iran. Meanwhile, Boltons former colleagues over at theneoconservative pressure group United Against Nuclear Iran, as Eli Clifton revealed, have been urging major pharmaceutical companies to end their Iran business, focusing on companies with special licenses most often under a broadly defined humanitarian exemption to conduct trade with Iran.

There is only one word to describe such behavior: sociopathic. Millions of Iranians, remember, could lose their lives from the virus.

But we have been here before. Brutal U.S. sanctions on Iraq in the 1990s caused the deaths of hundreds of thousands of innocent Iraqi children. Multiple senior U.N. humanitarian officials quit in protest of the policy, with one of them denouncing it as genocide.

And the U.S. governments response? We think the price is worth it, declared then Secretary of State Madeleine Albright.

As ordinary Americans line up at grocery stores and pharmacies across the United States to stock up on prescription medications, do they have any clue that their Iranian counterparts are being denied medicines and basic goods because of U.S. government policy? And as the number of deaths in Iran from Covid-19 continues to soar, exacerbated by a horrific U.S. economic embargo, do ordinary Americans think the price is worth it?

Read more:

Coronavirus Is Killing Iranians. So Are Trump's Brutal Sanctions. - The Intercept

In the race to develop a treatment for the rapidly spreading illness Covid-19, dozens of drugs are being tested around the world. Its an urgent mission because the latest data suggests that some 20 percent of people infected have serious illness, and around 1 percent may die.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Congress on Wednesday that Covid-19 is 10 times more lethal than the seasonal flu.

The danger stems from the pathogen itself: a virus called SARS-CoV-2.

Teeny tiny viruses are one of the biggest threats that humanity has ever faced. They are behind some of the most devastating pandemics ever known. Even with all of modern medicine, we have only eradicated one virus, smallpox, which required a decades-long global mass vaccination effort.

SARS-CoV-2, the brand new foe, is spreading fast even as entire countries, like Italy, are locking down to prevent its transmission. Estimates of its potential impact vary, but Brian Monahan, the attending physician of the US Congress, told lawmakers Wednesday he expects between 70 million and 150 million people in the US to get infected with the virus over time.

Right now, doctors are using general treatment measures to control the symptoms of Covid-19, but theres not yet a specific vaccine or cure.

Several factors make viruses like SARS-CoV-2 a particularly pernicious threat to humans. The good news is scientists have learned more about how they attack. Theyve also come up with ways to keep some of the deadliest of these tiny germs in check and are slowly inching toward cures. The question now is whether that research will bear fruit in time to blunt the blow of the Covid-19 pandemic and help us get ahead of the next outbreak.

Viruses are the most bizarre germs. Using just a handful of molecules, they assemble into all kinds of tiny shapes, and with just a small set of instructions, they can wreak havoc across entire ecosystems and threaten crop harvests. They can travel between hosts through the air, water, soil, and droplets. They mutate rapidly. And they are truly everywhere, from the oceans to the skies.

Compared to infectious agents like bacteria and fungi, viruses are much smaller and simpler. In fact, viruses can even make other germs sick. Yet theyre so simple that most scientists dont even consider them to be living organisms.

For instance, the poliovirus is just 30 nanometers wide. The SARS-CoV-2 virus behind Covid-19 is about 120 nanometers. Meanwhile, the E. coli bacterium is more than 16 times larger than SARS-CoV-2, and the human red blood cell is 64 times larger. A human cell uses 20,000 different types of proteins. HIV uses just 15. SARS-CoV-2 uses 33.

With all that extra space, larger pathogens like bacteria store the molecular tools they need to make copies of themselves and to fight off infections of their own. These tools are also what make bacteria vulnerable to antibiotics, drugs that interfere with molecular mechanisms in bacteria but not those of human cells, so they have a targeted effect.

But antibiotics dont work on viruses. Thats because viruses dont reproduce on their own. Rather, they invade cells and hijack their hosts machinery to make copies of themselves.

Bacteria are very different from us, so theres a lot of different targets for drugs. Viruses replicate in cells, so they use a lot of the same mechanisms that our cells do, said Diane Griffin, a professor of microbiology and immunology at the Bloomberg School of Public Health at Johns Hopkins University. So its been harder to find drugs that target the virus but dont damage the cell as well.

Theres also a huge variety of viruses, and they mutate quickly, so tailored treatments and vaccines against a virus can lose effectiveness over time.

Another factor that makes viruses so difficult to treat is how our bodies respond to them. Once the immune system detects a virus, it makes antibodies. These are proteins that attach to a virus or a virus-infected cell, marking it for destruction or preventing it from infecting new cells.

The problem is that a virus can cause a lot of damage and infect other people before the immune system readies its defenses. When those defenses kick in, they can cause other problems like fever and inflammation. And by the time these symptoms show up, the virus may already be in decline, or it may be too late to act.

Often at the time that virus diseases present themselves, its fairly far into the replication of that virus in that person, Griffin said. Many symptoms of the virus disease are actually manifestations of the immune response to the disease, so often things are sort of starting to get better at the time that you actually even figure out somebody has a virus infection.

Researchers use two broad strategies to combat viral infections: slowing down the damage from the virus, and speeding up and strengthening the bodys countermeasures.

Antiviral drugs are one approach to slowing down viruses. Like antibiotics, these are drugs that hamper the virus without causing much collateral damage. The majority of antivirals are targeting the viruses [themselves]. That means the components of the viruses, the viral enzymes, the surface proteins, said Pei-Yong Shi, a biochemistry and molecular biology professor at the University of Texas Medical Branch. By attacking different parts of the virus, antiviral compounds can prevent a virus from entering cells or they can interfere with its reproduction.

For example, remdesivir, under development by Gilead Sciences, is being studied as a way to treat Covid-19. It works by blocking the SARS-CoV-2 virus from copying its genetic material, RNA, the instructions the virus uses to replicate itself. Remdesivir resembles a component of RNA, but when its taken up by the virus, it causes the copying process to stop. Crucially, remdesivir fools the virus, but not human cells.

Protease inhibitors are another class of antiviral drugs, like lopinavir and ritonavir used to treat HIV (the -vir suffix is used to denote an antiviral drug, similar to how -cillin denotes an antibiotic). These compounds block an enzyme in the virus that normally trims proteins down, allowing the virus to infect other cells. When the enzyme is blocked, the virus doesnt mature properly, rendering it inert.

Researchers are also studying how to use antibodies to a given virus collected from engineered animals or from people previously infected with the same virus. By administering antibodies as a treatment, the recipients immune system can get a head start on identifying and eliminating the viral threat rather than waiting to build up its own antibodies.

There are also drugs like interferons that trigger a general immune response. These are a series of signaling molecules that make cells in the body more resistant to infection, inhibiting the spread of a virus while the rest of the immune system catches up. Its mainly used to control persistent infections like hepatitis B.

But interferons can have severe side effects like inflammation, so it requires fine-tuning to treat a virus without doing more harm than good. Doctors have used interferon with other antiviral drugs to treat Covid-19 in China and researchers are investigating this approach as another potential therapy.

Doctors can also use a number of different therapies to limit the immune systems response to viruses, like fever and inflammation, which can sometimes cause more damage to a patient than the virus itself. Anti-inflammatory drugs like corticosteroids and chloroquine are often used to lessen these symptoms.

And there are also vaccines for some viruses and efforts to develop new ones. These are treatments that coach the immune system to detect and fight off a virus before an infection takes place. These are powerful tools for controlling viruses across an entire population, but theyre tricky to optimize for a rapidly changing pathogen, and they require extensive, time-consuming testing to ensure they are safe for a wide segment of the population.

However, even if effective treatments enter the market, the virus will likely remain a threat. As weve learned with influenza (another respiratory disease caused by viruses), despite updated vaccines, new treatments, and a long history of public health responses, there are still between 12,000 and 60,000 flu deaths each year in the US. Covid-19 could remain a persistent threat, too.

To be clear, the best way to fight a virus is to prevent infections in the first place. And that depends on public health measures during an outbreak, like quarantines and social distancing, as well as personal tactics like robust, 20-second hand-washing with soap.

While there is a large and growing body of research on drugs to control viruses, they are still few and far between. We dont have that many antiviral drugs for acute infections, Griffin said. You often dont have any choice except to let it run its course.

Developing new drugs can take years of testing, and by then, an outbreak may have faded, or another more threatening pathogen may have emerged. Even viruses for which we do have antiviral drugs, like influenza, the illness often isnt detected in time to make it worth the treatment.

Other viruses like HIV can be controlled with drugs, but not eliminated, as hidden reservoirs of the virus remain in the body.

And within a population, there are always people who are more susceptible to infections, like people with depressed immune systems. For them, treatments and vaccines may not work, so they depend on the people around them to be immunized and to take proper infection control procedures.

All of which brings us back to prevention as the most effective way to combat viruses within a population. That means global coordinated action can be one of the best strategies to control the smallest pathogens. And simple tools like soap and water can be more effective at fighting a pandemic than the best drugs.

Go here to see the original:

Is there a cure for coronavirus? Why Covid-19 is so hard to treat - Vox.com

A medical officer prepares to take samples from a visitor at a drive-throughtesting center atYeungnam University Medical Center.

By Dennis NormileMar. 17, 2020 , 8:00 AM

Europe is now the epicenter of the COVID-19 pandemic. Case counts and deaths are soaring in Italy, Spain, France, and Germany, and many countries have imposed lockdowns and closed borders. Meanwhile, the United States, hampered by a fiasco with delayed and faulty test kits, is just guessing at its COVID-19 burden, though experts believe it is on the same trajectory as countries in Europe.

Amid these dire trends, South Korea has emerged as a sign of hope and a model to emulate. The country of 50 million appears to have greatly slowed its epidemic; it reported only 74 new cases today, down from 909 at its peak on 29 February. And it has done so without locking down entire cities or taking some of the other authoritarian measures that helped China bring its epidemic under control. South Korea is a democratic republic, we feel a lockdown is not a reasonable choice, says Kim Woo-Joo, an infectious disease specialist at Korea University. South Koreas success may hold lessons for other countriesand also a warning: Even after driving case numbers down, the country is braced for a resurgence.

Behind its success so far has been the most expansive and well-organized testing program in the world, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. South Korea has tested more than 270,000 people, which amounts to more than 5200 tests per million inhabitantsmore than any other country except tiny Bahrain, according to the Worldometer website. The United States has so far carried out 74 tests per 1 million inhabitants, data from the U.S. Centers for Disease Control and Prevention show.

South Koreas experience shows that diagnostic capacity at scale is key to epidemic control, says Raina MacIntyre, an emerging infectious disease scholar at the University of New South Wales, Sydney. Contact tracing is also very influential in epidemic control, as is case isolation, she says.

Yet whether the success will hold is unclear. New case numbers are declining largely because the herculean effort to investigate a massive cluster of more than 5000 cases60% of the nations totallinked to the Shincheonji Church of Jesus, a secretive, messianic megachurch, is winding down. But because of that effort, We have not looked hard in other parts of Korea, says Oh Myoung-Don, an infectious disease specialist at Seoul National University.

New clusters are now appearing. Since last week, authorities have reported 129 new infections, most linked to a Seoul call center. This could be the initiation of community spread, through Seoul and its surrounding Gyeonggi province, Kim says. The region is home to 23 million people.

South Korea learned the importance of preparedness the hard way. In 2015, a South Korean businessman came down with Middle East respiratory syndrome (MERS) after returning from a visit to three Middle Eastern countries. He was treated at three South Korean health facilities before he was diagnosed with MERS and isolated. By then, he had set off a chain of transmission that infected 186 and killed 36, including many patients hospitalized for other ailments, visitors, and hospital staff. Tracing, testing, and quarantining nearly 17,000 people quashed the outbreak after 2 months. The specter of a runaway epidemic alarmed the nation and dented the economy.

That experience showed that laboratory testing is essential to control an emerging infectious disease, Kim says. In addition, Oh says, The MERS experience certainly helped us to improve hospital infection prevention and control. So far, there are no reports of infections of COVID-19 among South Korean health care workers, he says.

Legislation enacted since then gave the government authority to collect mobile phone, credit card, and other data from those who test positive to reconstruct their recent whereabouts. That information, stripped of personal identifiers, is shared on social media apps that allow others to determine whether they may have crossed paths with an infected person.

After the novel coronavirus emerged in China, Korea Centers for Disease Control and Prevention (KCDC) raced to develop its tests and cooperated with diagnostic manufacturers to develop commercial test kits. The first test was approved on 7 February, when the country had just a few cases, and distributed to regional health centers. Just 11 days later, a 61-year-old woman, known as Case 31, tested positive. She had attended 9 and 16 February services at the Shincheonji megachurch in Daegu, about 240 kilometers southeast of Seoul, already feeling slightly ill. Upward of 500 attendees sit shoulder to shoulder on the floor of thechurch during 2-hour services, according to local news reports.

The country identified more than 2900 new cases just in the next 12 days, the vast majority Shincheonji members. On 29 February alone, KCDC reported more than 900 new cases, bringing the cumulative total to 3150 and making the outbreak the largest by far outside mainland China. The surge initially overwhelmed testing capabilities and KCDCs 130 disease detectives couldnt keep up, Kim says. Contact tracing efforts were concentrated on the Shincheonji cluster, in which 80% of those reporting respiratory symptoms proved positive, compared with only 10% in other clusters.

High-risk patients with underlying illnesses get priority for hospitalization, Chun says. Those with moderate symptoms are sent to repurposed corporate training facilities and spaces provided by public institutions, where they get basic medical support and observation. Those who recover and test negative twice are released. Close contacts and those with minimal symptoms whose family members are free of chronic diseases and who can measure their own temperatures are ordered to self-quarantine for 2 weeks. A local monitoring team calls twice daily to make sure the quarantined stay put and to ask about symptoms. Quarantine violators face up to 3 million won ($2500) fines. If a recent bill becomes law, the fine will go up to 10 million won and as much as a year in jail.

In spite of the efforts, the Daegu-Gyeongbuk region ran out of space for the seriously ill. Four people isolated at home, waiting for hospital beds, were rushed to emergency rooms when their conditions deteriorated, only to die there, according to local media.

Still, the numbers of new cases have dropped the past 2 weeks, aided by voluntary social distancing, both in the Daegu-Gyeongbuk region and nationwide. The government advised people to wear masks, wash their hands, avoid crowds and meetings, work remotely, and to join online religious services instead of going to churches. Those with fevers or respiratory illnesses are urged to stay home and watch their symptoms for 3 to 4 days. People were shocked by the Shincheonji cluster, Chun says, which boosted compliance. Less than 1 month after Case 31 emerged, The cluster is coming under control, Oh says.

Yet new clusters are emerging, and for 20% of confirmed cases, its unclear how they became infected, suggesting there is still undetected community spread. As long as this uncertainty remains, we cannot say that the outbreak has peaked, Chun says.

The government hopes to control new clusters in the same way it confronted the one in Shincheonji. The national testing capacity has reached a staggering 15,000 tests per day. There are 43 drive-through testing stations nationwide, a concept now copied in the United States, Canada, and the United Kingdom. In the first week of March, the Ministry of the Interior also rolled out a smartphone app that can track the quarantined and collect data on symptoms.

Chun Byung-Chul, an epidemiologist at Korea University, says scientists are eager to see more epidemiological data. We are literally stamping our feet, Chun says. KCDC releases the basic counts of patients, their age and gender, and how many are linked to clusters. That is not enough, Chun says. He and others would like to study detailed individual patient data, which would enable epidemiologists to model the outbreak and determine the number of new infections triggered by each case, also known as the basic reproductive number or R0; the time from infection to the onset of symptoms; and whether early diagnosis improved patients outcomes. (South Korea has had 75 deaths so far, an unusually low mortality rate, although the fact that Shincheonji church members are mostly young may have contributed.) Chun says a group of epidemiologists and scientists has proposed partnering with KCDC to gather and share such information, and we are waiting for their response.

Kim says medical doctors are also planning to share details of the clinical features of COVID-19 cases in the country in forthcoming publications. We hope our experience will help other countries control this COVID-19 outbreak.

With reporting by Ahn Mi-Young in Seoul.

See original here:

Coronavirus cases have dropped sharply in South Korea. What's the secret to its success? - Science Magazine

SINGAPORE Two hours. Thats all the time medical teams in Singapore are given to uncover the first details of how patients contracted the coronavirus and which people they might infect.

Did they travel abroad? Do they have a link to one of the five clusters of contagion identified across the city-state? Did they cough on someone in the street? Who are their friends and family, their drinking buddies and partners in prayer?

As Western nations struggle with the wildfire spread of the coronavirus, Singapores strategy, of moving rapidly to track down and test suspected cases, provides a model for keeping the epidemic at bay, even if it cant completely stamp out infections.

With detailed detective work, the governments contact tracers found, among others, a group of avid singers who warbled and expelled respiratory droplets together, spreading the virus to their families and then to a gym and a church forming the largest concentration of cases in Singapore.

We want to stay one or two steps ahead of the virus, said Vernon Lee, the director of the communicable diseases division at Singapores Ministry of Health. If you chase the virus, you will always be behind the curve.

Singapore, along with Taiwan and Hong Kong, offers successful approaches, at least so far, in battling a pandemic that has infected more than 182,000 people and killed at least 7,300 worldwide. Despite being hit months ago by the virus, these three Asian societies have recorded only a handful of deaths and relatively few cases, although they continue to face risks as people from emerging hot spots in the United States, Europe and elsewhere carry the virus with them.

Early intervention is key. So are painstaking tracking, enforced quarantines and meticulous social distancing all coordinated by a leadership willing to act fast and be transparent.

In Singapore, the details of where patients live, work and play are released quickly online, allowing others to protect themselves. Close contacts of patients are quarantined to limit the spread. The government further strengthened its borders this week to protect against a new wave of imported infections.

Some of these lessons are too late for the United States and Europe, where contagion is raging as some governments delay and debate their response.

And the vigilant monitoring systems in Singapore, Taiwan and Hong Kong were built over years, after their failures to stop another dangerous outbreak SARS 17 years ago. The United States disbanded its pandemic response unit in 2018.

There is also the question of how replicable this model from smaller Asian centers is in large Western countries where people might chafe at the harnessing of C.C.T.V. cameras or immigration records for the health of the nation. Disease control infringes on individual liberties, and places like Singapore, where chewing gum was once banned, are more willing to accept government orders.

Maybe its because of our Asian context, but our community is sort of primed for this, said Lalitha Kurupatham, the deputy director of the communicable diseases division in Singapore. We will keep fighting, because isolation and quarantine work.

Rich and orderly, Singapore has spent years building a public health system that includes designated clinics for epidemics and official messaging urging the public to wash their hands or sneeze into tissues during flu season. The Infectious Diseases Act gives the city-state wide latitude in prioritizing the common good over privacy concerns.

During peacetime, we plan for epidemics like this, Ms. Kurupatham said.

As the leader of Singapores contact tracing program, she has been working 16-hour days for two months, and her depiction of a war against disease is a function of its vulnerability to contagion. A tiny red dot on a world map, Singapore is a densely populated island where every flight is international.

In the early days of the outbreak, Singapore was highly susceptible to a large population of mainland Chinese people arriving during the Lunar New Year holiday.

The dozens of confirmed cases in Singapore in January reflect widespread and freely available testing. Many were mild cases that would otherwise have gone undiagnosed. Nevertheless Singapore was sprinting to stem the possibility of runaway local transmission.

Until Italy, Korea and Iran happened, Singapore was the worst outside China, said Linfa Wang, the director of the emerging infectious diseases program at the Duke-National University of Singapore Medical School. Why didnt we feel that way? Because the government is very transparent and because that number means we are so effective in tracing and isolating every case.

For all the panic erupting elsewhere, most Singaporeans do not wear masks out, because the government has told them its not needed for their safety. Most schools are still running, albeit with staggered lunchtimes to avoid big crowds. There is plenty of toilet paper.

As of Tuesday evening, Singapore had 266 confirmed cases. Only a fraction are mysteries, unlinked to recent foreign travel or previously identified local clusters, which include churches and a private dinner.

Nearly 115 patients have been discharged from the hospital. Singapore has recorded no deaths from the coronavirus.

When rumors of a mysterious respiratory virus began circulating in China at the beginning of the year, Singapore moved quickly. It was one of the first countries to ban all travelers from mainland China, starting in late January. Thermal scanners measured the temperatures of all who came into the country.

In a nation of 5.7 million residents, Singapore rapidly developed the capacity to test more than 2,000 people a day for the coronavirus. In Washington State, one of the hardest hit places in the United States, public labs are aiming to process 400 samples a day.

Testing is free in Singapore, as is medical treatment for all locals. Singapore has 140 contact tracers outlining each patients case history, along with the police and security services doing the shoe-leather work.

After weeks of investigation and the use of a new antibody test that can detect people who have recovered, health officials were able to tie two church clusters of 33 people to a Lunar New Year dinner attended by members of both congregations. The people who transmitted the disease between the two churches had never shown serious symptoms.

Close contacts of patients are put into mandatory quarantine to stop further contagion. Nearly 5,000 have been isolated. Those who dodge quarantine orders can face criminal charges.

All pneumonia patients in Singapore are tested for coronavirus. So are people who are seriously ill. Positive cases have been identified at the airport, at government clinics and, most frequently, through contact tracing.

Singapores epidemic regimen was shaped by the 2003 SARS outbreak, when 33 people died out of 238 confirmed cases. As in Hong Kong, medical workers were among the casualties in Singapore.

Hong Kongs heavy death toll from SARS, nearly 300 people, has spurred residents in the semiautonomous Chinese territory to exercise vestigial muscles of disease prevention this time around, even as the local authorities initially dithered on whether to close the border with mainland China. Nearly everyone, it seemed, began squirting hand sanitizer. Malls and offices set up thermal scanners.

The most important thing is that Hong Kong people have deep memories of the SARS outbreak, said Kwok Ka-ki, a lawmaker in Hong Kong who is also a doctor. Every citizen did their part, including wearing masks and washing their hands and taking necessary precautions, such as avoiding crowded places and gatherings.

The Hong Kong government eventually caught up to the publics caution. Borders were tightened. Civil servants were ordered to work from home, prompting more companies to follow suit. Schools were closed in January, until at least the end of April.

Taiwan acted even faster. Like Hong Kong and Singapore, Taiwan was linked by direct flights to Wuhan, the Chinese city where the virus is believed to have originated. Taiwans national health command center, which was set up after SARS killed 37 people, began ordering screenings of passengers from Wuhan in late December even before Beijing admitted that the coronavirus was spreading between humans.

Having learned our lesson before from SARS, as soon as the outbreak began, we adopted a whole-of-government approach, said Joseph Wu, Taiwans foreign minister.

By the end of January, Taiwan had suspended flights from China, despite the World Health Organizations advising against it. The government also embraced big data, integrating its national health insurance database with its immigration and customs information to trace potential cases, said Jason Wang, the director of the Center for Policy, Outcomes and Prevention at Stanford University. When coronavirus cases were discovered on the Diamond Princess cruise ship after a stop in Taiwan, text messages were sent to every mobile phone on the island, listing each restaurant, tourist site and destination that the ships passengers had visited during their shore leave.

As of Tuesday, Taiwan had recorded 77 cases of the coronavirus, although critics worry that testing is not widespread enough. Students returned to school in late February.

With new waves of the virus surging across the world, public health officials in the three locales are gearing up for a longer fight.

On Tuesday, the government of Hong Kong, where only 157 cases have been confirmed, announced a mandatory 14-day quarantine for all travelers from abroad beginning later this week.

Taiwan will require self-quarantine for arrivals from 20 countries and three American states.

Prime Minister Lee Hsien Loong of Singapore warned last week that the countrys caseload would increase sharply. Singapore announced 23 new coronavirus patients on Tuesday, the highest single-day tally, with 17 imported cases.

The city-state has restricted its borders further. Arrivals from Southeast Asia and parts of Europe must now undergo a 14-day self-quarantine.

The world is only as good as the weakest link, said Dr. Lee, the head of Singapores communicable diseases division. Diseases do not respect borders.

Chris Horton contributed reporting from Taipei, Taiwan, and Elaine Yu from Hong Kong.

Read the rest here:

Tracking the Coronavirus: How Crowded Asian Cities Tackled an Epidemic - The New York Times

Working at a breakneck pace, a team of hundreds of scientists has identified 50 drugs that may be effective treatments for people infected with the coronavirus.

Many scientists are seeking drugs that attack the virus itself. But the Quantitative Biosciences Institute Coronavirus Research Group, based at the University of California, San Francisco, is testing an unusual new approach.

The researchers are looking for drugs that shield proteins in our own cells that the coronavirus depends on to thrive and reproduce.

Many of the candidate drugs are already approved to treat diseases, such as cancer, that would seem to have nothing to do with Covid-19, the illness caused by the coronavirus.

Scientists at Mount Sinai Hospital in New York and at the Pasteur Institute in Paris have already begun to test the drugs against the coronavirus growing in their labs. The far-flung research group is preparing to release its findings at the end of the week.

There is no antiviral drug proven to be effective against the virus. When people get infected, the best that doctors can offer is supportive care the patient is getting enough oxygen, managing fever and using a ventilator to push air into the lungs, if needed to give the immune system time to fight the infection.

If the research effort succeeds, it will be a significant scientific achievement: an antiviral identified in just months to treat a virus that no one knew existed until January.

Im really impressed at the speed and the scale at which theyre moving, said John Young, the global head of infectious diseases at Roche Pharma Research and Early Development, which is collaborating on some of the work.

We think this approach has real potential, he said.

Some researchers at the Q.B.I. began studying the coronavirus in January. But last month, the threat became more imminent: A woman in California was found to be infected although she had not recently traveled outside the country.

That finding suggested that the virus was already circulating in the community.

I got to the lab and said weve got to drop everything else, recalled Nevan Krogan, director of the Quantitative Biosciences Institute. Everybody has got to work around the clock on this.

Dr. Krogan and his colleagues set about finding proteins in our cells that the coronavirus uses to grow. Normally, such a project might take two years. But the working group, which includes 22 laboratories, completed it in a few weeks.

You have 30 scientists on a Zoom call its the most exhausting, amazing thing, Dr. Krogan said, referring to a teleconferencing service.

Viruses reproduce by injecting their genes inside a human cell. The cells own gene-reading machinery then manufactures viral proteins, which latch onto cellular proteins to create new viruses. They eventually escape the cell and infect others.

In 2011, Dr. Krogan and his colleagues developed a way to find all the human proteins that viruses use to manipulate our cells a map, as Dr. Krogan calls it. They created their first map for H.I.V.

That virus has 18 genes, each of which encodes a protein. The scientists eventually found that H.I.V. interacts, in one way or another, with 435 proteins in a human cell.

Dr. Krogan and his colleagues went on to make similar maps for viruses such as Ebola and dengue. Each pathogen hijacks its host cell by manipulating a different combination of proteins. Once scientists have a map, they can use it to search for new treatments.

In February, the research group synthesized genes from the coronavirus and injected them into cells. They uncovered over 400 human proteins that the virus seems to rely on.

The flulike symptoms observed in infected people are the result of the coronavirus attacking cells in the respiratory tract. The new map shows that the viruss proteins travel throughout the human cell, engaging even with proteins that do not seem to have anything to do with making new viruses.

One of the viral proteins, for example, latches onto BRD2, a human protein that tends to our DNA, switching genes on and off. Experts on proteins are now using the map to figure out why the coronavirus needs these molecules.

Kevan Shokat, a chemist at U.C.S.F., is poring through 20,000 drugs approved by the Food and Drug Administration for signs that they may interact with the proteins on the map created by Dr. Krogans lab.

Dr. Shokat and his colleagues have found 50 promising candidates. The protein BRD2, for example, can be targeted by a drug called JQ1. Researchers originally discovered JQ1 as a potential treatment for several types of cancer.

On Thursday, Dr. Shokat and his colleagues filled a box with the first 10 drugs on the list and shipped them overnight to New York to be tested against the living coronavirus.

The drugs arrived at the lab of Adolfo Garcia-Sastre, director of the Global Health and Emerging Pathogens Institute at Mount Sinai Hospital. Dr. Garcia-Sastre recently began growing the coronavirus in monkey cells.

Over the weekend, the team at the institute began treating infected cells with the drugs to see if any stop the viruses. We have started experiments, but it will take us a week to get the first data here, Dr. Garcia-Sastre said on Tuesday.

The researchers in San Francisco also sent the batch of drugs to the Pasteur Institute in Paris, where investigators also have begun testing them against coronaviruses.

If promising drugs are found, investigators plan to try them in an animal infected with the coronavirus perhaps ferrets, because theyre known to get SARS, an illness closely related to Covid-19.

Even if some of these drugs are effective treatments, scientists will still need to make sure they are safe for treating Covid-19. It may turn out, for example, that the dose needed to clear the virus from the body might also lead to dangerous side effects.

In February, a team of researchers found that remdesivir could eliminate the coronavirus from infected cells. Since then, five clinical trials have begun to see if the drug will be safe and effective against Covid-19 in people.

Other researchers have taken startling new approaches. On Saturday, Stanford University researchers reported using the gene-editing technology Crispr to destroy coronavirus genes in infected cells.

As the Bay Area went into lockdown on Monday, Dr. Krogan and his colleagues were finishing their map. They are now preparing a report to post online by the end of the week, while also submitting it to a journal for publication.

Their paper will include a list of drugs that the researchers consider prime candidates to treat people ill with the coronavirus.

Whoever is capable of trying them, please try them, Dr. Krogan said.

Read this article:

Coronavirus Treatment: Hundreds of Scientists Scramble to Find One - The New York Times

Weve all seen the scenes of anxious customers tearing through grocery aisles, loading toilet paper, hand sanitizer, and canned goods into piled-high shopping carts. The mania comes after thousands of work-from-home orders, vast state-wide lockdowns, a declared National Emergency, and an unnerving sense of ambiguity about how much the coronavirus will alter American life. The survivalist instinct is to stockpile goods and hope that a decade-worth of toilet paper might spare you from whats to come. Unfortunately, people like Chris, a 67-year-old woman who works at a grocery store in Seattle, is caught in the crossfire of the panic. Chris is one of 70+ people who have shared their experience working in the service industry with us.

Chris is employed by QFC, a Pacific Northwest supermarket chain that she describes as having three floors and a dense supply of goods. Despite that, she tells me that the store can barely keep up with demand. Bottles of hand sanitizer last 20 minutes, the chicken gets cleared out immediately, dry goods disappear within hours. All of this has left Chris feeling vulnerable. Seattle is one of the epicenters of the domestic Covid-19 outbreak. She understands that at her age, she falls into the bracket of people most vulnerable to a serious illness if she contracts the virus. States like New York and Ohio have closed down museums, movie theaters, bars, and restaurants in the wake of the pandemic, but core community infrastructure like grocery stores and pharmacies remain open. Chriss work schedule isnt going anywhere. Shes expected to be on the linoleum floor, surrounded by a swarm of nervy patrons, each of whom could potentially pass her the disease.

Right now, Chris is self-isolating at home. She informed her employer last Wednesday that she will be taking a temporary leave of absence after deciding that the chances of contracting coronavirus at her job were too great to risk it. Right now, there is no social safety net for people like Chris. She is no longer generating an income, and rent is bearing down in two weeks (though a moratorium on evictions in Washington state has been signed). The Trump administration fast-tracked a sick-leave bill to keep infectious workers at home, but thus far, the same guarantee does not exist for elderly or immunocompromised people who are staffing the few private institutions that will, in all likelihood, remain open for the remainder of the pandemic. Chris says she feels caught between two bad options: She needs to make money in order to live, but her current means of employment might kill her. We spoke about that, as well as about how the panic buying has affected her grocery stores bottom line, and the shreds of optimism she finds in the attitude of the Seattle community.

So when did the panic buying start to pick up at your store?

It was when Governor Inslee declared a state of emergency [on Feb. 29]. We were just swamped. They were all over the place. They cleared the shelves. And this isnt a small store. Weve got three levels, and its practically a full city block. They cleared out the non-perishables, toilet paper was gone, anything that had to do with antiseptic sprays or wipes was gone. They went to the Clorox, never mind the hand sanitizer. We hadnt ordered in anticipation of this, so we ran out. Ever since that Saturday they have been there every single day, buying everything. We put hand sanitizer on the shelf and its gone in 20 minutes.

Has this been high stress for you?

Back in September I fell and broke my elbow, and my main job is to go up to people who look confused and find out if theyre looking for something and to help them find that. Basically, I was thrown right into the middle of all these people. Ive seen whats been going on. Ive seen all the rice and beans disappear, be it dry goods or canned. They cleared out the chicken. We cant keep chicken in. At this point were over-ordering, and the staff of the store is working really hard. Its been something else. They keep buying water. Why do you need water?

So a number of states have moved to shut down everything except for grocery stores and pharmacies. What does it feel like knowing that for as long as were under quarantine, youll still be going to work and be out and about when everyone else is shut in?

Heres the thing. Ive been taking this in stride. But last Sunday, when I saw that the crowds were not going down, and while I was keeping up on all the medical news and whats going on, it hit me that, you know, Im not in a good situation here. On Wednesday I called in and said I needed to take a leave of absence to the end of the month. So right now Im negotiating to find a way to have an income while preemptively quarantining. Because Im in that vulnerable group.

I have a realistic outlook. I do not expect to get through this horrible pandemic without getting sick at some point. I absolutely expect for that to happen. But I dont want to get sick before were past the peak of infections. If I do get it and I get it seriously, I dont want to be stuck out in the streets because theres no room in the hospital. Im reading Twitter reports from doctors in Italy about how they have to make this gut-wrenching decision about who they treat. Theyre having to let people die. I dont want to be stuck in that, and I dont want to contribute to that.

The problem is I also need to have an income and health insurance, and I dont know how to do that while self-quarantining. Its an awful decision: Go to work and put your life at risk, or lose your job, lose your income, and lose your insurance. I havent committed either way at this point. Im trying to find a way to stay home.

Trump came out a week ago and announced a national sick-leave plan. Are you holding out hope for some sort of legislation that will allow people like you, in that vulnerable group, to stay home while keeping an income?

It seems to me like its an oversight that they didnt specify that some way for the elderly or compromised to stay home. I applaud Inslee for taking the initiative and being the first state to call an emergency and open up all sorts of federal help. He has been able to get some leniency in unemployment. But right now, the requirement is that you have to be sick in order to be able to get that. Its an oversight that they didnt take that further, to offer that to vulnerable people before they get sick. Ive got my fingers crossed. Ive been making as much noise as I can about this. I hope that at some point it will occur to the people in power that they need to open this up more.

When youre at the store, surrounded by all these people, do you feel vulnerable?

Absolutely. Im pretty much concentrated on giving the best service I can to people. If they are looking for a product we dont have, Ill pull out my phone and find where they can get it. I give them new information. I really do try to do my best. But when Im in the break room or before I go into work or after I get off, I have concerns. And thats whats made me stay home with no income coming in, looking at the bills coming at the end of the month. I dont have savings, at this point all my credit is approaching max, and Ive got rent coming up in a week or two. I dont know what Im going to do. Do I worry about that, or do I just go ahead and go to work? At this point I dont think its safe. The virus has spread too much in Seattle. I think what finally started to get to me was two days before I made this decision, Amazon cleared up all their offices after an employee got sick. That building was right near my dentists office where I was getting dental care. Its too close. A reasonable person would worry.

I dont want to be glib about a serious situation, but I am curious: Do you have an idea how profitable all this panic buying has been for the stores bottom line?

I know that its doing good business. Ordinarily, we do in the mid-single-digit thousands, and last week we did, I think, $200,000. Its been really good for them financially, but on the other hand, people are being worked to death. You have all these people coming in, and a lot of them are pissed off that they cant find what they need to get, theyre pissed off that they have to wait in line for so long, but no matter what store you go to you run into those issues. Were ordering huge amounts of stuff to try to keep up with the demand.

Are customers still polite despite all of that?

On any given day, over the last four years, you have a few assholes. They feel privileged and entitled, and no matter what you do they take it as an opportunity to mistreat you in some way. But Im finding that because of the panic, everyones a little bit in shock. So theyre very tolerant. Theres a hashtag called #WeGotThisSeattle. If you look on there, its a very reassuring bunch of tweets. Theres a fine dining restaurant thats changing from being a sit-down restaurant to a takeout burger place. Youve got people offering to do grocery runs for each other. Since nobody is coming to concerts, the symphony is doing these live streams on the internet, so you can sit back and watch that. Its amazing to see how people are stepping up. By and large, everybody is trying to help everybody else out, because were all in this together.

Were looking to hear from people who work in the service industry in the US about their experiences related to the coronavirus. Share your story in the form below, and we might use it in an upcoming video, article, or podcast episode. (You can also access the Google form here.)

Excerpt from:

Coronavirus panic is clearing out grocery stores; heres how workers are handling it - Vox.com

This is my career this is not my side job, she said. If I only have experience in restaurants, how do I branch out?

Across the East River in Queens, Quy Tran, a 55-year-old waiter and delivery man for a Vietnamese restaurant in Jackson Heights, said he had two or three weeks of cash in the bank. I feel nervous, scared, he said, not about the sickness but about money.

And in a restaurant on Columbus Avenue, as the owners sat around a table trying to figure out how to convert to takeout and delivery, a dishwasher swept the floor nearby. He said he still owed $5,000 to the person who helped him cross the border from Mexico last year.

Im not scared to come into work, the dishwasher said. I need the job.

At Bar Tabac, a longtime bistro in Carroll Gardens, Brooklyn, Roman Kologov, a waiter, set up water glasses on empty tables as if in a trance. Basically serve whoever wants to still eat, he said when asked about the last day before closing. Would you want to eat out?

Its a question that could linger beyond the shutdown. Once the crisis passes, chefs and restaurateurs do not expect business to immediately return. After what might be months of time away, diners might be initially wary of public gatherings or might still be out of the habit of dining out.

Everyone is going to have to make an effort, Mr. Ripert, the co-owner of Le Bernadin, said. We are going to see some drastic changes in the restaurant industry. Whatever was yesterday will be difficult to recreate.

Mr. Boulud agreed. We are going to work on zero margins for a long time, Im sure, he said. We need to be able to make the guests feel more comfortable to go out.

Visit link:

New Yorks Nightlife Shuttered to Curb Coronavirus - The New York Times

The fight against Covid-19 is a full-on war. China seems to have won the first battle. Hong Kong, Taiwan, Singapore and Japan have also chalked up visible successes in mitigating the outbreak, no doubt owing to their experiences in dealing with the 2003 Sars epidemic. Europe and the US, on the other hand, are only just awakening from their illusions of invulnerability. As a result, the epidemic is now raging across the west.

The hardest-hit western country so far is Italy, which has particularly strong economic ties to China. Northern Italy is the new Wuhan (the Chinese megacity where the coronavirus first emerged). With its health system overwhelmed, the Italian government has slammed on the brakes, shutting down the retail economy and quarantining the entire country. All shops except pharmacies and grocery stores are closed. People have been instructed to stay at home and may enter public places only for necessary shopping or commuting to work. Many public and private debt obligations (such as housing rents and interest payments) have been suspended. Italy is attempting to slow down the economic clock until the coronavirus dies out.

Meanwhile, although Germany has had very few coronavirus deaths so far, the number of infections is now skyrocketing as quickly as anywhere else. In response to the crisis, the German government has introduced a short-time work allowance and granted generous credit assistance, guarantees or tax deferrals for distressed companies. Public events across the country have been cancelledand schoolchildren have been told to stay at home. And Austria, for its part, has long since closed its border with Italy. Austrian schools, universities and most shops have also been closed. Initially, France pursued a more relaxed approach, but it has now also shuttered its schools, restaurants and shops, as has Spain. Denmark, Poland and the Czech Republic have closed their borders with Germany.

The US president, Donald Trump, has declared a national state of emergency. Congress has approved an $8.3bn (6.7bn) emergency programme to fund efforts to contain the epidemic. Even larger sums are awaiting passage through the Senate. The federal government has also barred foreign travellers, first from China and Iran, and now from Europe.

Globally, not all responses to the crisis have been well targeted, and others have not been strong enough. Most worryingly, some governments have convinced themselves that they can merely slow down the spread of the virus, rather than taking the steps needed to halt it entirely. The predictable overcrowding of hospitals in many heavily affected areas has already exposed the folly of such complacency.

On the economic front, a severe recession can no longer be avoided, and some economists are already calling for governments to introduce measures to shore up aggregate demand. But that recommendation is inadequate, given that the global economy is suffering from an unprecedented supply shock. People are not at work because they are sick or quarantined. In such a situation, demand stimulus will merely boost inflation, potentially leading to stagflation (weak or falling GDP growth alongside rising prices), as happened during the 1970s oil crisis, when another important production input was in short supply.

Worse, measures targeting the demand side could even be counterproductive, because they would encourage interpersonal contact, thus undermining the effort to limit transmission of the virus. What good would it do to give Italians money for shopping trips, when the government closes the shops and forces everyone to stay at home?

The same arguments apply to liquidity support. The world is already awash in liquidity, with nominal interest rates close to or below zero nearly everywhere. More interest-rate cuts into deep-red territory might help stock markets, but they also could trigger a run on cash.

The brutal decline in economic activities that epidemiologists say is required make crashing stock markets inevitable, given that central banks policy of excessively cheap money and pooled liabilities caused an unsustainable bubble. Because they used up their ammunition at inopportune moments, central banks bear responsibility for the bubble that has now burst.

What is really needed are fiscal measures to save companies and banks from bankruptcy, so that they can recover quickly once the pandemic is over. Policymakers should be considering various forms of tax relief and public guarantees to help firms borrow if necessary. But the most promising option is a short-time work allowance. This approach, which has been tried and tested in Germany, compensates for the underemployment of the workforce through the same channels that are already used for unemployment insurance. Better yet, it costs hardly anything, because it prevents the losses that would follow from increased real unemployment. All countries should be replicating this part of Germanys policy to prevent job losses.

But, most important, all governments need to follow China in taking direct action against Covid-19. Nobody on the frontlines should be constrained by a lack of funds. Hospital intensive-care units must be expanded; temporary hospitals must be built; and respirators, protective gear and masks must be mass-produced and made available to all who need them. Beyond that, public health authorities must be given the resources and funds they need to disinfect factories and other public spaces. Hygiene is the order of the day. Large-scale testing of the population is particularly important. The identification of each case can save multiple lives. Surrendering to the pandemic simply is not an option.

Hans-Werner Sinn is professor of economics at Munich University. He was president of the Ifo Institute for Economic Research and serves on the German economy ministrys dvisory ouncil.

Project Syndicate

More here:

How best to fight the economic impact of the coronavirus pandemic - The Guardian

Nearly everyone in the US will be affected in some way by the COVID-19 pandemic, the illness caused by the novel coronavirus by stress and anxiety, event closures, or the illness itself. Theres cause for concern: the disease can be deadly, and the outbreak in the US is likely to continue to get worse.

Theres still a lot that scientists and doctors dont know about the new coronavirus and the illness it causes. With three months of data, though, it appears that around 80 percent of people who are infected have a mild or moderate illness, around 15 percent have severe disease (which requires hospitalization), and around 5 percent are critical (and go into respiratory or organ failure). Around 3 percent of people with confirmed cases of the infection in China died, according to the World Health Organization (WHO).

Different groups of people, though, are more likely to fall into the severe or critical categories than others:

The elderly: People who are over the age of 60 are at a higher risk of developing a severe case of COVID-19, according to data collected by the WHO. The highest death rate is in people above the age of 80. Around 15 percent of people in that age group died from the disease in one set of Chinese patients. The Centers for Disease Control and Prevention (CDC) recommends that people who are older stay away from crowds and avoid nonessential travel.

Children: Children, on the other hand, dont appear to get as sick. Very few develop the disease in the first place, and if they do, only a small group develop severe or critical disease. No young children have died from the virus in China.

Researchers are still trying to figure out why thats the case. It may be that childrens lungs are less susceptible to infection or that their immune systems are stronger. Children might carry the virus around, though, and pass it between each other and then to their parents and caregivers. Thats why kids should still wash their hands as much as adults. Its also one of the reasons why areas where the virus is spreading are closing down schools.

People with chronic conditions: People who have underlying health conditions like high blood pressure, kidney disease, cancer, or diabetes are also more likely to get very sick or die from COVID-19. Around 9 percent of people with diabetes who contracted the virus died, for example, as did around 8 percent of people with high blood pressure. The CDC also recommends that people in this group avoid crowds, stick close to home, and stock up on medication for their condition if theyre able to.

Everyone else: Most people who are young or healthy and who contract the virus dont get severely ill. But if you have the virus, even if you dont get that sick, you might come into contact with people who are more at risk and pass the virus to them. Thats why its so important to stay home if youre not feeling well. Minimizing the number of people each sick person infects is low-tech, but its the best way to slow the spread of a disease like COVID-19. Its the goal of policies like school closures and event cancellations and why people who might have been exposed to the illness are asked to isolate themselves.

Not everyone can work from home, stop taking public transportation, or skip large gatherings, though. If you can do those things even though they may seem silly and even if there have not been many cases identified in your area you can help blunt the impact of the pandemic.

Follow this link:

Heres whos most at risk from the novel coronavirus - The Verge

[Want to get New York Today by email? Heres the sign-up.]

Its Monday. Because of the coronavirus outbreak, officials are urging a reduction in gatherings. As such, we are temporarily suspending our event listings.

Weather: Bright in the morning, then building clouds; high in the mid-40s.

Alternate-side parking: In effect until April 9 (Holy Thursday).

New York Citys public schools will begin shutting down this week, Governor Cuomo announced yesterday afternoon, in an effort to slow the spread of the coronavirus. Hours later, Mayor de Blasio announced that he would soon order all bars and restaurants to close, limiting them to takeout and delivery.

Mr. de Blasio said that the schools would be closed today for all students and staff, but that teachers would be asked to report to work later in the week for training on remote learning. By March 23, the city will move to remote learning, and the school system will be closed except for several dozen buildings that will be used as learning centers to support the children of essential city workers like health care employees.

Schools will be closed until at least April 20, but could stay closed for longer, Mr. de Blasio said.

City school buildings will remain open this week for children to pick up food, and then the city will find alternative sites for students who need food to receive it. Students who do not have computers at home will be lent laptops, and the city will work on helping students who do not have internet access get online.

[Read more on the decision to close the citys schools, and find the latest coverage on nytimes.com.]

Around 10 p.m., Mr. de Blasio issued a statement saying that he was closing restaurants and bars, effective Tuesday at 9 a.m. He said his executive order would limit restaurants, bars and cafes to takeout and delivery. Nightclubs, movie theaters, small theater houses and concert venues must all close.

This is not a decision I make lightly, he said. These places are part of the heart and soul of our city. They are part of what it means to be a New Yorker. But our city is facing an unprecedented threat, and we must respond with a wartime mentality.

[Everything is a black hole: Mounting dread in the age of coronavirus.]

Mr. Cuomo called yesterday for private businesses to voluntarily close and have their employees work from home. And Mr. de Blasio ordered hospitals in the city to cancel all elective surgery, postponed an election for the Queens borough president and closed city senior centers.

The states presidential primary election could be moved from April 28 to June 23, the date of another scheduled statewide vote, officials said yesterday.

State courts will postpone many criminal cases indefinitely and stop performing all but the most essential functions to help stop the spread of the coronavirus, officials said.

In addition, all eviction proceedings and pending eviction orders have been suspended statewide until further notice.

New York State had 732 confirmed coronavirus cases officials said. The largest concentration of cases was in New York City, where 329 people had tested positive. Of the six deaths in the state from the virus, five were in the city.

College in the Coronavirus Era: Wistful Goodbyes and a Sense of Loss

Stirring Sermons About Coronavirus, in Empty Cathedrals

Two Boys Jumped Into the Hudson River. They Havent Been Seen Since.

At the Library, Last Call for Beauty and Books

Want more news? Check out our full coverage.

The Mini Crossword: Here is todays puzzle.

Orders to marijuana delivery services have reportedly seen a sharp increase since the coronavirus outbreak. [Complex]

Amazon is buying the former Lord & Taylor flagship building in Midtown for $1.15 billion. [The Street]

A Brooklyn man was reunited with two police officers who saved his life as an infant nearly 30 years ago. [New York Post]

The Timess Rebecca Halleck writes:

In the 17th century, Brooklyn was Breuckelen. Harlem was Haarlem. And Wall Street was an actual wall to keep the English from marching south on the Dutch colony of New Netherland.

Before the Treaty of Westminster in 1674, Britain and the Netherlands had spent two decades locked in a global game of capture the colony. As part of the pacts terms, the Dutch surrendered Manhattan to the English and in exchange legitimized their control of several islands and other territories around the world, including the sugar-rich Suriname.

Several readers recently asked The Times what inspired the Dutch to trade Manhattan for Suriname and if there were remnants of Dutch history remaining in New York City today. Their questions are part of a project from The Times that invites readers to join in our reporting process.

Though it may seem like there was a simple swap of land, that would be an oversimplification, according to Charles Gehring, the director of the New Netherland Research Center in Albany.

The English had controlled Manhattan for nine years, and mostly left alone a Dutch settlement on the southern tip of the island, before the summer of 1673. Then, 600 Dutch marines sailed into New York Harbor, emboldening Dutch settlers to take up arms against English troops.

The Dutch emerged victorious, renaming the whole island New Netherland. They signed it away 14 months later.

The Dutch probably saw the writing on the wall, Mr. Gehring said. They were basically surrounded by the English colonies in the North and the tobacco farms in the South.

But there were also economic factors at play: The supply of beaver fur that initially brought the Dutch to the Hudson Valley was dwindling, while the demand for sugar, a crop grown in tropical climates like Surinames, had skyrocketed.

Centuries later, here are four places you can see traces of New Netherland:

The Lovelace Tavern on Pearl Street: It was accidentally discovered by excavators searching for Stadt Huys, New Netherlands City Hall, which was built in 1641.

The Schenck Houses at the Brooklyn Museum: The older of the pair was built by Jan Martense Schenck around 1675, and it survived in its original location for 275 years before being disassembled and reconstructed inside the museum in 1952.

Wyckoff House in Brooklyn: The one-room house was constructed in 1652 and is thought to be the oldest building in the city. It has a packed-dirt floor and was the home of Pieter and Grietje Claesen and their 11 children.

The Dyckman farmhouse: The house was built in 1784, after the original farmstead was destroyed during the Revolutionary War. The site was once the centerpiece of a farm covering 250 acres of Upper Manhattan.

Its Monday know your history.

Dear Diary:

I was on my way to meet some friends for lunch. I was wearing my green dress with white polka dots. A young woman stopped me as I left the subway station.

That is a great dress, she said.

I was out to dinner one night at a local restaurant. I was wearing the polka dot dress again. When the waitress brought the check, there was a note at the bottom.

Best dress of the day, it said.

Another time, two men complimented me on my polka dots as I was leaving church one Sunday.

I bought a new red dress with white polka dots. I was wearing it one night while waiting for the light to change on West End Avenue. A car that was turning slowed down, and the window rolled down.

Love the dress, the woman who was driving shouted as she passed by.

That was when I realized that polka dots rule.

Catherine Henihan

New York Today is published weekdays around 6 a.m. Sign up here to get it by email. You can also find it at nytoday.com.

Were experimenting with the format of New York Today. What would you like to see more (or less) of? Post a comment or email us: nytoday@nytimes.com.

See more here:

Closing Down the Schools Over Coronavirus - The New York Times