Coronavirus Update

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Coronavirus Update 5-19

“I’m taking hydroxychloroquine and I’m still here.” 

President Trump

“As far as the president is concerned, I would rather he not be taking something that has not been approved by the scientists, especially in his age group and in his, shall we say, weight group — morbidly obese they say.”  

Nancy Pelosi, Speaker of the US House of Representatives

Today’s Features

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A. Recent Developments and Headlines

B. Numbers & Trends

Note: All changes noted in this Update are since the 5/17 Update

Sources: Worldometers

1. Confirmed Total Cases, New Cases and Tests

  • Worldwide:  
    • Total Cases = 4,891,330 (+1.9%)
    • New Cases = 92,064 (+11.9%) (+9,804)
    • New Cases (5 day avg) = 93,135 (+0.9%) (+802)
  • US: 
    • Total Cases = 1,550,294 (+1.5%)
    • New Cases = 22,630 (+13.8%) (+2,739)
    • New Cases (5 day avg) = 23,989 (+0.8%) (+184)
    • Number of Tests = 12,300,744 (+425,164)

2. Deaths

  • Worldwide Deaths = 320,134 (+1.1%) 
    • New Deaths = 3,614 (-0.1%) (-4)
    • New Deaths (5 day avg) = 4,474 (-7.1%) (-340)
  • US Deaths = 91,981 (+1.1%) 
    • New Deaths = 1,003 (+16.0%) (+138)
    • New Deaths (5 day avg) = 1,357 (-10.2%) (-154)
  • 5 Countries with Largest Number of Confirmed Deaths: 
CountryTotal DeathsDeaths per 1M Population
US91,981 (+1,003)278 (+3) 
UK34,769 (+160)513 (+2)
Italy32,007 (+99)529 (+1)
France28,239 (+131)433 (+2)
Spain27,709 (+59)593 (+2)
Worldwide319,965 (+3,445)41.0
  • 5 Countries = 67.1% of Worldwide Total Confirmed Deaths (-0.3%)
  • US = 28.8% of Worldwide Total Confirmed Deaths 
  • 5 States with Largest Number of Confirmed Deaths: 
StateTotal DeathsNew Deaths
(5-day avg)		Deaths per 1M Population
New York28,480 (+155)238 (+8)1,464 (+8)
New Jersey10,488 (+82)144 (-21)1,176 (+9)
Massachusetts5,862 (+65)109 (-22)850  (+9)
Michigan4,915 (+24)40 (-3)492 (+2)
Pennsylvania4,668 (+165)104 (-13)365 (+13)
US91,981 (+1,003) 278 (+3)
  • 5 States = 61.9% 59.2% of US Total Confirmed Deaths (-2.7%)
  • NY = 31.0% of US Total Confirmed Deaths (-0.6%)

3. Countries/States To Watch

  • Sweden [Note: The World Health Organization has cited the Swedish approach as a model for reopening economies]
    • Total Cases = 30,143 (+466)
    • Deaths = 3,679 (+5)
    • New Deaths (5 day avg) = 73 (-12.4%) (-10)
    • Deaths per 1M population = 365 
  • Below are 5 of the States moving quickly to reopen their economies (OK never locked down).   
StateTotal CasesTotal DeathsNew Deaths (5-day avg)Deaths per 1M Pop
Georgia38,283 (+582)1,649 (+40)26 (+3)155 (+3)
Florida46,442 (+854)1,997 (+24)34 (-5)93 (+1)
Texas49,684 (+1,007)1,369 (+9)30 (-6)47 (+0)
Ohio28,484 (+556)1,628 (+14)35 (-3)142 (+3)
Oklahoma5,398 (+88)288 (+0)2 (+0)73 (+0)
US1,550,294 (+22,630)91,981 (+1,003) 278 (+3)
  • 5 States = 10.9% of US Total Confirmed Cases (+0.1%)
  • 5 States = 7.5% of US Total Confirmed Deaths (+0%)

C. Vaccines

1. Moderna Says Initial Vaccine Results Are Positive  

  • Drugmaker Moderna Inc. reported early results Monday from the first human study of its experimental coronavirus vaccine that gave a positive signal about the shot’s ability to protect people [a “Phase I clinical trial”], raising hopes that a weapon to slow or halt the pandemic could be on the horizon.
  • The company said the vaccine induced immune responses in some of the healthy volunteers who were vaccinated, and the shots were generally safe and well-tolerated.
  • The results offered a preliminary but promising sign about one of the most advanced coronavirus vaccines in development, and suggested Moderna was on track to meet its ambitious timetable for producing it for possible emergency use in the fall.
  • The vaccine still has much to prove. The results don’t show whether it actually protects people who are exposed to the new coronavirus, a key proof point. Many vaccines fail to pass muster even after showing positive signs in early testing.
  • Moderna’s vaccine is among several front-runners that have emerged from the more than 100 coronavirus vaccines in development world-wide. At least seven other vaccines have started human testing, and several companies including Johnson & Johnson, Pfizer Inc. and AstraZeneca PLC are bulking up manufacturing capacity to make doses to meet global demand if vaccines they or their partners are developing prove successful.
  • The early data suggest Moderna’s vaccine, code-named mRNA-1273, “has a very good chance to provide protection” from C19, the disease caused by the coronavirus, Moderna Chief Executive Stephane Bancel said in an interview.
  • The company’s vaccine could be ready for emergency use as early as the fall, if it proves to work safely in the subsequent testing. The U.S. Food and Drug Administration recently gave Moderna permission to begin the second stage of testing, and the company aims to enter the final stage in July.
  • The progress is relatively quick for any experimental vaccine, let alone one like Moderna’s based on a new and unproven technology.
  • Moderna, of Cambridge, Mass., codesigned its vaccine with the National Institute of Allergy and Infectious Diseases in January and rushed to manufacture doses for testing.
  • NIAID is leading the clinical trial that began in March, starting at a site in Seattle and now expanded to Atlanta and Maryland. The trial is ongoing and aims to enroll up to 105 people, each receiving two shots about four weeks apart.
  • The participants aren’t tested for their body’s ability to fight off the virus compared with a group that wasn’t vaccinated; such testing will come in a later stage.
  • Moderna’s vaccine doesn’t contain the virus itself but rather genetic material called messenger RNA, which upon injection delivers instructions to the body’s cells to produce proteins resembling those on the surface of the coronavirus.
  • The proteins in turn trigger an immune response that is supposed to subsequently protect a person against any exposure to the actual virus.
  • Researchers can design and manufacture these types of gene-based vaccines quickly, but they have never been approved for widespread use against diseases in humans. Older vaccine technologies, such as those using a weakened virus or proteins, have a more proven record but generally take longer to develop.
  • For some participants in the Moderna vaccine study ages 18 to 55, varying doses of the vaccine increased immune responses, including boosting certain antibodies to levels at or above those seen in blood samples from people who have recovered from C19, Moderna said.
  • The responses included both binding antibodies, which attach to viruses but don’t necessarily prevent them from infecting cells, as well as neutralizing antibodies, which do block infection.
  • “If you get to the level of people who have had disease, that should be enough,” to be protective, Moderna Chief Medical Officer Tal Zaks said on a conference call with analysts Monday.
  • The phase 1 study data reported Monday came from among the 45 people ages 18 to 55 who received three different dose levels of the vaccine. An additional 60 people over age 55 are being enrolled in the study.

Source: Moderna Says Initial Vaccine Results Are Positive

D. New Scientific Findings & Research  

1. 17-year-old blood sample yields promising antibodies 

  • The search for C19 therapies has turned to an antibody that was first identified back in 2003, in a blood sample from a patient who recovered from a similar coronavirus-based disease.
  • In a paper published today by the journal Nature, a team including researchers from the University of Washington reports that the antibody, known as S309, can neutralize the virus that causes C19 in lab experiments. “We still need to show that this antibody is protective in living systems, which has not yet been done,” David Veesler, a biochemist at the UW School of Medicine who’s one of the paper’s senior authors, said in a news release. [Note: Read the Nature paper here]
  • S309 was one of several promising monoclonal antibodies identified in the memory B cells of a patient who survived Severe Acute Respiratory Syndrome. No cases of SARS have been reported since 2004. Like C19, SARS was caused by a type of coronavirus, which led researchers to check for therapeutic crossover effects.
  • Combining the S309 antibody with other antibodies identified in the SARS patient’s blood sample enhanced the neutralization effect on the coronavirus. Medications that make use of the antibodies are now on a fast-track development and testing path at California-based Vir Biotechnology in collaboration with GlaxoSmithKline, in preparation for clinical trials.

Source: 17-year-old sample yields promising antibodies for COVID-19

2. CDC plans sweeping antibody study in 25 metropolitan areas  

  • The CDC plans a nationwide study of up to 325,000 people to track how the new coronavirus is spreading across the country into next year and beyond, a CDC spokeswoman and researchers conducting the effort told Reuters.
  • The CDC study, expected to launch in June or July, will test samples from blood donors in 25 metropolitan areas for antibodies created when the immune system fights the coronavirus, said Dr. Michael Busch, director of the nonprofit Vitalant Research Institute.
  • Busch is leading a preliminary version of the study – funded by the National Heart, Lung and Blood Institute and the National Institute of Allergy and Infectious Diseases – that is testing the first 36,000 samples.
  • The CDC-funded portion, to be formally announced this week, will expand the scope and time frame, taking samples over 18 months to see how antibodies evolve over time, said CDC spokeswoman Kristen Nordlund.
  • Vitalant, a nonprofit that runs blood donation centers and tests samples, will lead the broader effort as well.
  • Researchers aim to publish results on a rolling basis, Nordlund said.
  • Antibody studies, also known as seroprevalence research, are considered critical to understanding where an outbreak is spreading and can help guide decisions on restrictions needed to contain it.
  • The CDC study should also help scientists better understand whether the immune response to COVID wanes over time.
  • The CDC study will test blood from 1,000 donors in each of the 25 metro areas monthly, for 12 months. Researchers will then test blood from another 25,000 donors at the 18-month mark. Samples will come from “regular, altruistic people” who come in to donate blood, Busch said.
  • Some public health officials have complained that the CDC has lagged on research and guidance for local governments trying to cope with the pandemic. “We’re feeling exposed at the local level, in terms of not seeing that kind of organized plan from CDC,” Dr. Matt Willis, public health officer for Marin County, California, said in an interview last week. 
  • News of the study brought Willis some reassurance. “Partial answers and preliminary results are better than nothing when you have a decision to make” that could affect lives, he said, like when to reopen parks and businesses.
  • The CDC’s Nordlund said the study “is indicative of how leaders across the federal government are working collaboratively with partners in academia and in blood donation and testing industries” to monitor C19.
  • She added that blood donor results can be used by CDC to form estimates about the broader population through statistical methods. “This has been done with West Nile virus, Zika, and other emerging infectious diseases,” she said.
  • The 6 metropolitan areas being surveyed in the precursor study are New York, Seattle, the San Francisco Bay Area, Los Angeles, Boston and Minneapolis, said Dr. Graham Simmons, another Vitalant researcher involved in the project. “In all likelihood” the next phase will add Miami, Atlanta, New Orleans, Dallas, St. Louis, Chicago, Denver and others, Simmons said.
  • “We have selected sites to give a broad geographical distribution throughout the country,” Simmons said, including sites with high infection rates or places where rates may increase.
  • Researchers at John Hopkins University, in a 2019 paper, found blood donors, who are disproportionately healthy, are not always ideal populations for research. (bit.ly/2LDtz910)
  • The CDC study may not “generate results that are generalizable to the population,” Thomas McDade, a researcher at Northwestern University, said in an interview. [NOTE: As noted earlier, samples will be taken from voluntary blood donors]
  • Still, it could “substantially add to our understanding of (C19) infections,” said Dr. Susan Philip, deputy health officer at the San Francisco Department of Public Health.
  • “It will be a large sample size, geographically diverse … and quick to set up,” Philip added.     
  • Some local governments have done their own seroprevalence research. New York in April found antibodies in more than 20% of some 3,000 test subjects, suggesting the number of residents exposed to the virus in the hardest-hit state is much higher than the 355,000 who have tested positive. 
  • Last week, an antibody study by the city of Boston and Massachusetts General Hospital found 10% of the population had C19 antibodies. The Spanish government ran a study showing exposure in 5% of people – suggesting 10 times the number of confirmed positive cases. 

Source: Exclusive: CDC plans sweeping COVID-19 antibody study in 25 metropolitan areas

E. The Cost of Lockdowns

1. State Lockdowns Are Creating A Mental Health Disaster  

  • State lockdowns have led to a host of unintended consequences, including the emergence of a new health crisis – a dangerously sharp rise in mental illness. Though states are gradually wading out of lockdown, the damage has already been done and is here to stay.
Distress and Disorder
  • The science is clear that having meaningful human interactions is an inherent, biological need that all people share. But in the name of “public health,” people are prohibited from freely and peaceably congregating. There’s no church, no “nonessential” shopping, no going into work (for many), no girls’ nights out, no going to the gym, no visiting friends, no family get-togethers. Nothing. No sacrifice can be too great in the age of COVID per the “experts.” And that’s taken a harsh psychological toll on the nation.
  • Extensive study has, for years, correlated social isolation with poor mental health. The need for connection is as real now as it’s ever been. Since the US had already long suffered from a loneliness crisis, the stark and sudden crop up of stay-at-home orders made this immediately much worse. As Drs. Betty Pfefferbaum and Carol North found:
    • A recent review of psychological sequelae in samples of quarantined people and of health care providers…revealed numerous emotional outcomes, including stress, depression, irritability, insomnia, fear, confusion, anger, frustration, boredom, and stigma associated with quarantine, some of which persisted after the quarantine was lifted.
  • Being whisked from normal life into the repressive conditions of lockdowns is understandably damaging. The anguish people are feeling is at astronomical levels.  Schoolchilden recently surveyed in Wuhan and Huangshi during stay-at-home orders reported symptoms of depression and anxiety at a rate far higher than normal. 
  • The same seems to be holding true for the general US population. The Crisis Text Line—a free service providing crisis counseling over SMS—has reported a 40% increase in recent volume, averaging over 100,000 text conversations each month. In a Kaiser Family Foundation (KFF) poll from the end of March, 47% of respondents under stay-at-home orders reported that COVID-related stress had negatively impacted their mental health, compared to 37% of respondents not facing such orders. Twenty-one percent of stay-at-homers described that impact as “major,” compared to 13 percent those not locked down. Statistically speaking, that’s quite a significant gap, especially when scaled to a population of 330 million. Though there has been no reliable polling data since then, it’s easy to imagine how much worse the situation has become as the weeks have worn on. 
  • Combine that with the financial aspect of the lockdowns, and there’s a recipe for absolute disaster. Under mandatory closure, an untold number of “nonessential” businesses—particularly small businesses—have gone insolvent or are on the brink thereof.  That’s led to tens of millions of new jobless claims in just the past two months—amounting to the worst employment crisis in American history. 
  • A vast literature connects economic downturns to a number of psychological issues, including anxiety, stress, and depression, which often spur on various high-risk behaviors. Although recessions are inherently stressful, mental health challenges usually emerge within the personal context of income and employment insecurity. With the economy in free fall, many millions of Americans have become worried about their ability to continue paying bills and putting food on the table going forward. The psychological impact that recessions have is capable of lasting for years, even after economic difficulties themselves have disappeared. With entire states having been locked down for weeks and months on end, public activity is only reemerging under the scourge of intense mental disturbance.
Self-Harm and Suicide
  • Although everyone is potentially at risk of developing symptoms of mental illness, those already struggling may be the most vulnerable. One user in a depression support group on Reddit recently posted, “I am going absolutely insane battling with my mind and being locked up in my house.” Another said, “Lockdown is making my depression the worst it’s ever been….I’d rather be dead than stuck in my house alone with my thoughts.” Rock-bottom feelings such as these are very often accompanied by a number of different maladaptive coping strategies, among them nonfatal self-harm.
  • For individuals already overloaded with anxiety and desperation, economic hardship is often the “final straw” leading to self-harm behaviors. An Irish study found the self-harm rate to have increased across the population following the Great Recession, with men between the ages of 25 and 44 impacted the most. Although this is far outside the usual age and sex demographic for self-harm, it may be explained by the heightened that stress working-aged men felt in their roles as primary breadwinners. A study in Britain after the crash also noted a spike in self-harm, associated particularly with areas seeing greater amounts of job loss. In an economy with people out of work more than ever before, that’s of considerable alarm.
  • Even without financial trouble, many may turn to hitting and cutting themselves just out of sheer loneliness. With face-to-face interaction hard to come by, there are few support systems for people to rely on. Despite serving a vital role in many capacities, Zoom calls clearly aren’t a cure for people’s woes, usually leaving users more exhausted than connected. 
  • And although many health providers are providing patients with over-the-phone coverage, that sort of help may be much less effective for self-harmers. A 2013 Taiwanese study on the etiology of self-harm reasoned that “the structural conditions and quantity of support” may help alleviate the urge to self-harm more than “the quality of support received through specific networks.” Sheltered away from friends, many sufferers are left feeling that there is no escape, and telehealth services can do little to change that.
  • In all the lockdown mess, many have even reached the brink of suicide. The 2003 SARS outbreak led to an significant uptick in the suicide rate in Hong Kong—up to 18.6 suicides per 100,000 residents. The elderly population there was hit the worst, likely as a consequence of increased social isolation. Now, with community activities interrupted, many have become isolated from the gatherings that give their lives meaning—such as church, whose regular attendees face a suicide rate of one-fifth that of the rest of the population. “Living” means more than mere biological life—it involves a complex array of relationships, activities, and goals. But under lockdown, the world has been sapped of any semblance of true living.
  • Financial struggles are another common theme in suicide etiology. During the Great Recession, suicides spiked across the globe. Across just the US, the European Union, and Canada, research revealed more than ten thousand suicides connected to the downturn—again, particularly among men. Some fear that worse numbers could arise from the current economic crisis. 
  • The Meadows Mental Health Policy Institute recently estimated that for every percentage point that the unemployment rate rises, the overall suicide rate rises 1.6%. Considering that last month the real unemployment rate rose to 22.8% (and possibly even higher), the US probably had nearly one thousand additional suicides in April stemming just from the economic shutdown. As job loss continues this month, more people are bound to take their lives—not to mention the untold effect that social isolation is having. Although national data isn’t yet available, many local suicide prevention centers have been reporting significant increases in hotline usage—around 20–30% on most days and as high as 100% on others.  
Substance Abuse and Addiction
  • To manage lockdown stress, many have found themselves self-medicating and kicking back on old habits, which is exactly what prior research suggests. When the economy falls, the use of alcohol and other drugs tends to spike—especially among those who lose their jobs. Along with many financial stressors, spending more time at home intensifies the propensity for use, which stay-at-home orders and social distancing guidelines have only helped worsen. 
  • People also seek out many addictive substances to find relief from social disconnection—which the brain can interpret as physical pain. That’s why it’s no surprise that the lockdowns have helped spell doom for those already suffering with addiction. Alone, it’s more difficult to resist relapse and misuse.
  • For the week ending April 25, year-over-year total off-trade alcohol sales were up 26.4%, down from a high of 55% in March when the lockdowns began. Online sales of alcohol have exploded—recently growing in excess of 500%. But that’s not all because of people stocking up. The data has shown that more people have been buying more alcohol, of a higher proof and at a more frequent pace. That means that both consumption and sales have faced a significant uptick. Even as the rate of sales growth has slowly decreased in mid-April, year-over-year increases have remained quite high.
  • Alcoholics Anonymous and other nonemergency addiction resources have not been deemed “essential,” leaving those recovering to find help online or over the phone. Activity on internet support groups has shot through the roof, as have calls to addiction helplines. Many former addicts have fallen into relapse after years of sobriety, sending them back into the mire of struggles that they long thought they’d escaped.
  • Hard drug use is also on the rise—which is frightening, as the opioid crisis had already been wreaking havoc across the country. Call volume at the Substance Abuse and Mental Health Services Administration (SAMHSA) National Hotline was five times higher at the end of March than it had been at the beginning of the month, and harm reduction centers are operating at limited capacity. That’s left addicts with little recourse besides continued use.
  • Research indicates that even in periods of decreased income, drug use remains constant. Throughout the present crisis, addicts have remained addicts and still need their fix, despite recent disruptions in the meth and heroin supply chains. To avoid withdrawal symptoms, many switch to different substances, dealers, and means of ingestion—making use more imprecise and risky. There’s also the fear that addicts who have stockpiled substances are using them at a quicker pace. As with suicides, national data has yet to emerge, but some municipal and county offices have already reported a substantial jump in overdoses since the lockdown began. Although lockdowns are temporary, their effects can be irreversible. 
  • Other addictive behaviors also seem to be on the rise. Tobacco sales, for one, have absolutely boomed. Industry giant Altria reported that in Q1 (quarter 1), shipments of its smokeable tobacco products rose 6.2% and oral tobacco shipments rose 2.8%. Although it’s unclear how much of that is due to people stocking up, both convenience stores and online sellers have recently noticed a significant uptick in demand as well. And an increase in use would follow the same pattern as what happened during the Great Recession.
  • Stressed and stuck at home, people have also ramped up their porn consumption. Since the lockdowns began, PornHub traffic has consistently been above average—with a high of 23.2% at the end of March, when the company offered all users free premium access. When used frequently, porn can rope users into a powerfully addictive cycle, engendering psychosexual difficulties such as low libido, sexual dissatisfaction, and erectile dysfunction—even in young men. 
  • Online, many have also begun to try their luck at gambling. Global Poker—a popular online poker room—saw a 43% spike in use following lockdown orders, with a remarkable 255% increase in first-time players. Much of that may be new traffic from gamblers who had frequented brick-and-mortar casinos—a mere shifting of activity from one channel to another. But it comes at a cost: online gambling is associated with a number of increased risks for becoming addicted. The fallout from that could take decades to move past. 
Conclusion
  • The politicians and medical experts basking in the COVID spotlight have traded the façade of an effective public health response for the hidden realities of mental illness. As talking heads repeatedly prattled the “flatten the curve” mantra, the curves for stress, suicide, and addiction all steepened. A study by the Well Being Trust concluded that “deaths of despair”—which include all suicide and substance-related fatalities resulting from fear, unemployment, and isolation—may total seventy-five thousand by the end of the COVID crisis. Their death knells rang out the moment governors committed their states to shutting down. 
  • And among those who live, the residual psychological and behavioral effects will remain long after the lockdowns are over—possibly for the rest of their lives. Indeed, by overstepping individual judgment, the government imposed a one-size-fits-none solution so debilitating and unprecedented that the country will never truly recover. In the long run—aside from the blips and bumps of infection and disease—the state remains the true risk to the health of the nation.

Source:  State Lockdowns Are Creating A Mental Health Disaster

2. Unintended, Long-Term and Devastating Consequences of Shutting Down Economies  

By Christopher Dembik, Head of Macro Economics
  • The coronavirus is a pure negative externality. It initially caused a negative supply shock that was rapidly offset by a negative global aggregate demand shock. The fact that global commodity prices are plunging also speaks to the fact that we are dealing with a demand shock.
  • The only short-term solution to limit the spread of the virus was to favor social distancing and to implement strict lockdown where it was needed, which contributed to depress aggregate demand. Households were called upon to stay at home and avoid social interactions, which forced them to spend less. If consumers buy less, companies are inclined to produce less. In other words, if some companies can continue to produce despite these unusual circumstances, they do not necessarily have the incentive to do so. This will also have a negative impact on production and will cause massive layoffs. This is the phase in which we currently are.
Phase 1: Temporary massive layoffs
  • In the United States, the economy destroyed more than 20,000,000 jobs in April due to the lockdown, which pushed the unemployment rate to 14.7% from 4.4% a month earlier. According to several members of the Federal Reserve, the unemployment rate might quickly climb to 20%, eventually reaching a peak close to 30%. 
  • But a better indicator of what is actually happening is probably the ratio unemployment as share of population (16 years and over) which dropped to 51.3%. Said differently, only half of the population has a job. The service sector has been the most affected by the coronavirus: more than 7 million jobs have been lost in leisure and hotels, almost 2.5 million in education and health and another 2 million in retail trade. The below charts shows the impact on unemployment rate by education level. We see that every unemployment rate quadrupled so far during the lockdown period but, as it is the case with every “normal” recession, the size of the shock is much greater for lower education level than for higher ones. The only major difference is the amplitude of the shock in such a short period of time.
Phase 2: Hysteresis effect and solvency issues 
  • A large chunks of layoffs are considered as temporary (up to 70% in the United States according to the April nonfarm payrolls report). It is assumed that, after lockdown measures are lifted, the economy will restart as normal and companies will hire back those who were laid off during the crisis. 
  • I disagree with this assumption. 
  • If China leads the rest of the world in the ongoing process, then there is no V-shape recovery in perspective. In China, it took one month to one month and half for productive capacities to get back to 100%, but consumption remains sluggish. Retail sales fell 15.8% year-on-year in March and restaurant spending plunged nearly 50% over the same period. Many shops are still desperately empty, even in Beijing. 
  • This phenomenon is called the hysteresis effect. Although the pandemic has disappeared, it continues to have a noticeable effect on consumption and savings behavior. 
  • Due to the uncertain economic outlook and fears of rising unemployment, consumers are strongly inclined to save, which is a huge negative for aggregate demand, and will amplify the economic downturn. 
  • As a result, companies are facing increasing solvency issues topping sometimes preexisting decrease in industrial profit (as it is the case in China where industrial profit was down minus 37% in Q1 2020) and will have no other choice but to focus on restoring cash flows and to cut costs, including jobs. The vicious circle of sluggish aggregate demand and solvency issues is just about to start and will lead to a strong and lasting jump in unemployment which will be more important in countries with insufficient automatic stabilizers.
Winners and losers in the post-COVID world
  • Coronavirus scars will weaken the economy for years to come. Policymakers, with a massive inflow of liquidity into the economy, have delayed and postponed a lot of pain but they have not eliminated it. 
  • The second economic wave is coming and will be characterized by weak demand, an unprecedented number of bankruptcies and much higher unemployment. Before the outbreak, the global economy was already in a very weak position, with a high level of public and private debt, elevated market valuation and low growth momentum. 
  • Historical precedent tend to indicate that, contrary to wars, there is no strong recovery after pandemics and depressive effects, such as depressed investment opportunities and increase in precautionary saving, can persist up to 40 years (see Longer-run Economic Consequences of Pandemics).
  • Another characteristic of pandemics is that they leave the poor even farther behind. One of the latest IMF blogposts (see How Pandemics Leave the Poor Even Farther Behind) using the net Gini coefficient concludes that pandemics progressively widen gap between rich and poor and hurt employment prospects of those with only a basic education while scarcely affecting employment of people with advanced degrees. The most striking finding is certainly that inequality tends to increase in the long run (the net Gini increased by nearly 1.5% after five years), confirming that pandemics scars have a very long-term impact on the broad economy.14_CDK_1
  • The risk is that the gap between rich and poor will widen further. There have been plenty of research from the IMF and the Bank of England over the past years demonstrating that quantitative easing induces a lasting jump in wealth inequalities due to the increase in the price of financial assets. 
  • Given the amount of liquidity injected by central banks all around the world and the initial effect on the stock market, the winners of the ongoing crisis might likely be the 1%. On the contrary, the losers will be the rest of the population, especially the less educated, that will need to cope with higher unemployment and lower purchasing power. 
  • Coronavirus unemployment is putting at risk the social contract made between citizens and the state and may pave the way to populism. Governments will certainly try to address the issues of unemployment and inequality by implementing more redistributive policy and letting the fiscal deficit widen. Will it be enough? I don’t have the answer yet, but I know that policymakers cannot let down the 99% one more time.

Source: The real killer is coronavirus unemployment | Saxo Group

3. Coronavirus devastating small businesses  

  • Of small and medium-sized businesses that have been forced to shut down during the coronavirus pandemic, more than half of owners surveyed by Facebook said they won’t rehire the same workers they had before the crisis. 
  • In a report released Monday, Facebook said it surveyed 86,000 small and medium-sized business owners, managers and employees for an ongoing data initiative with the World Bank and Organization for Economic Cooperation and Development. The report highlights the lasting economic impact of the coronavirus and the especially dire effect it’s having on smaller businesses without the same level of access to capital that larger corporations often have.
  • According to the report, only 45% of owners and managers of small and medium-sized businesses surveyed by Facebook said they would rehire the same workers they were forced to let go or furlough once they reopen. If that estimate holds true for similar businesses across the country, it could devastate predictions for a swift economic recovery from the crisis. 
  • About a third of closed businesses surveyed said they do not expect to reopen, with many citing an inability to pay bills or rent.
  • The report also revealed the large gap in paid sick leave and time off for employees of small and medium-sized businesses. Of employees surveyed, 74% reported not having access to paid sick leave and 70% said they did not have paid time off. Those numbers were over 90% for hotel, cafe and restaurant employees surveyed.
  • Facebook, which counts small and medium-sized business owners as a significant cohort for its digital advertising business, said more than half of those surveyed are increasingly interacting with customers online. More than a third of businesses surveyed said they are now conducting all of their sales online.

Source: Coronavirus devastating small businesses

F. Projections & Our (Possible) Future

1. US Counties Most At Risk  

  • As the new coronavirus continues to spread over the next months, and maybe even years, it could exact a heavy new toll in areas of the United States that have not yet seen major outbreaks but have high rates of diabetes, obesity, high blood pressure and other chronic health conditions.
  • Large parts of the South and Appalachia are especially vulnerable, according to a health-risk index created for The New York Times by PolicyMap, a company that analyzes local health data. The index for the first time identifies counties with high rates of the underlying conditions that increase residents’ risk of becoming severely ill if they are infected with the coronavirus.
  • Even in lower-risk counties, a significant proportion of the population is living with these conditions.
  • Public health experts warn that these areas may not be adequately prepared for new waves of infection, even as some have lifted restrictions meant to curb the spread of the virus.
  • “Places that have not seen a lot of infection yet should be thinking about what infection is going to mean once they have an outbreak there,” said Micaela E. Martinez, a professor at Columbia University’s Mailman School of Public Health.
  • “This infection is highly contagious and we have no vaccine, so it will inevitably sweep through our populations unless we have very tight measures in place to prevent that from happening,” Dr. Martinez said. Once it does, the overall health of a community will matter, she added.
https://static01.nyt.com/newsgraphics/2020/05/05/underlying-conidtions-maps/90e0020ed2d5b9a799fb9f92b4f485342a3910ac/riskblurb-1200.png
  • The map above shows where U.S residents are at increased risk for severe C19 illness, compared with the national average (darker areas are at greater risk). It is based on the estimated proportion of adults in each county who have one or more of these conditions: diabetes, high blood pressure, obesity, heart disease and chronic lung disease, using survey data from the CDC.
  • A majority of patients hospitalized with C19 in the New York City area, an early epicenter of the nation’s outbreak, had one or more underlying health conditions. Studies from the C.D.C. and others suggest that, once infected with the coronavirus, people with such conditions are at particular risk for severe illness, including hospitalization and death. The conditions do not on their own increase a person’s chance of catching the disease.
  • Public health experts warn that these areas may not be adequately prepared for new waves of infection, even as some have lifted restrictions meant to curb the spread of the virus.
  • “Places that have not seen a lot of infection yet should be thinking about what infection is going to mean once they have an outbreak there,” said Micaela E. Martinez, a professor at Columbia University’s Mailman School of Public Health.
  • “This infection is highly contagious and we have no vaccine, so it will inevitably sweep through our populations unless we have very tight measures in place to prevent that from happening,” Dr. Martinez said. Once it does, the overall health of a community will matter, she added.
  • The map does not include age as a separate risk factor, though several of these conditions are more common in older people. The new coronavirus has been particularly brutal for seniors, who are hospitalized and die at higher rates than younger people. But underlying health conditions appear to increase the risk of serious illness across age groups.
  • In all, more than half of Americans have at least one condition that increases their risk of becoming seriously ill if infected.
  • “It’s important to recognize that it’s not some ‘other people’ that are vulnerable,” said Caitlin M. Rivers, an assistant professor at Johns Hopkins Center for Health Security. “The kinds of conditions that put people at higher risk are extremely common.”
  • But while many people have these conditions, there are important disparities by age, race and income.
  • Heart disease and hypertension are more common among older people. Obesity rates are similar across age groups in America, but higher among black and Hispanic people than among white people.
  • Lower-income groups and communities of color face significant health disparities, including higher rates of chronic health conditions, as well as lower health insurance rates and more limited access to health care.
  • Such disparities reflect historical and current inequalities, said Nancy Krieger, a professor of social epidemiology at the Harvard T.H. Chan School of Public Health, including a long-term lack of resources and opportunity.
  • And these same groups may also be at higher risk for catching the virus. Black and Hispanic workers more frequently have jobs classified as critical or otherwise lack the ability to stay home, and they more often live in multigenerational and crowded homes where it is harder to isolate if infected with the coronavirus. “It’s a compounding of risk,” Dr. Krieger said.
  • In New York City, the impact of coronavirus — both in cases and deaths — has been disproportionately concentrated in lower-income neighborhoods and communities of color. Similar racial and socioeconomic inequalities have been seen in outbreaks across the country.
  • Identifying high-risk communities could help policymakers better anticipate future outbreaks.
  • “If you’re an official or city planner or hospital administrator, you want to know what to expect when the disease hits,” said Dr. Leora Horwitz, a co-author of a study that evaluated underlying conditions among coronavirus patients hospitalized in the NYU Langone Health System. Or, she added, if it hits again.
  • Dr. Krieger of Harvard said data on health risk should inform targeted interventions and public health messaging. “Can we pinpoint where more testing needs to be done or made accessible and affordable?” she said. “Where is the greatest need for community outreach, for contact tracing?”
  • In the end, keeping new coronavirus infection and death rates low for people at high health risk requires keeping them low over all, Dr. Horwitz said. “The more disease is in the community, the more disease among people at high risk, period.”

Source: Where Chronic Health Conditions and Coronavirus Could Collide

2. The Pandemic’s Geopolitical Aftershocks Are Coming  

  • With most European countries confident that they are past the worst of the coronavirus pandemic, their attention is turning to the chance of its resurgence once society returns to some semblance of normal. But beyond the epidemiological challenges lies a slowly amassing threat that is not pathological in nature, but economic, political, and military. This is the geopolitical second wave, and its power is already starting to concern Western leaders.
  • Imagine a scenario: Just as Europe and the United States begin to feel as if they have the coronavirus under control, it takes hold in the developing world. Exhausted, indebted, and desperate for their own economies to get back up to speed, richer countries are too slow to help. Panic ensues. Migrants mass in southern Europe, which is still struggling to pull itself out of a coronavirus-induced depression. Somewhere, a state defaults on debt held largely by Western financial institutions. In the chaos, an autocrat eyes an opportunity for a land grab. A United States already unwilling to take the lead leaves China to step into the void.
  • This is just one (invented) scenario of a number that are raising concerns in Western capitals and that were laid out to me in conversations with more than half a dozen leading security experts, academics, and government advisers in recent weeks. Of those I spoke with, few doubted that a second wave was coming. The real concern was where it would land.
  • History, as Barack Obama said of American progress, zigs and zags. Great changes set off chain reactions: The Wall Street Crash of 1929 ushered in the New Deal era; Allied victory in 1945 created the conditions for the Cold War. Each event creates political aftershocks and trends that we can see clearly only afterward. The decade that followed the 2008 financial crisis saw the euro zone teeter on the brink of collapse, Britain vote to leave the European Union, and Donald Trump elected president. Today, the global economy has suffered another sudden seizure, shifting geopolitics as U.S.-China tensions have risen, trade has slowed markedly, and structural divisions between northern and southern Europe have widened. The question, then, is what might happen in the decade after this crisis?
  • “Historians love chapter breaks,” said Robert Kaplan, an American foreign-policy expert and former member of the U.S. Defense Policy Board, who this month briefed officials at 10 Downing Street on the potential second-order effects of the coronavirus crisis. “C19 will come to be seen as a chapter break.”
  • Among Kaplan’s concerns is how Russia and its leader, Vladimir Putin, will act, a fear echoed by some of the most influential voices in British foreign policy, who worry that the geopolitical second wave of C19 will hit Europe the hardest. Michael Clarke, a defense-studies professor at King’s College London and former special adviser to Britain’s national committee on security strategy, who remains plugged in to the country’s foreign-policy establishment, told me that an economically weakened Russia, hit by the recent collapse in oil prices, poses a greater danger to Western security interests. “Putin’s aggressive opportunism will probably get worse,” Clarke said. “The nature of Putin’s leadership is that he can’t stand still; he has to keep pushing forward. This makes him more volatile.” What happens if the Russian leader, spooked by the country’s collapsing economy, eyes an opportunity to test NATO’s resolve? 
  • Others, such as Bruno Maçães, Portugal’s former Europe minister, told me that the crisis might not embolden Russia, but cripple it, leaving it more dependent on China and bringing Beijing’s sphere of influence to the borders of continental Europe. “Crises,” Kaplan noted, “put history on fast-forward.”
  • The array of possible second-wave consequences is dizzying: the prospect of the disease taking hold in a developing G20 country—think India—which could see the virus quickly doubling back to Europe and the U.S.; the uncertain impact of technological advances in fields such as artificial intelligence as they are used to help combat the disease’s spread; a recession pulling at the ties between the European Union’s poor south and wealthy north. Clarke is particularly concerned about an arc of instability from West Africa through the Middle East to Asia, where conflict and instability have in recent years forced people to flee. 
  • Karin von Hippel, the director general of the Royal United Services Institute, an influential British defense and international-affairs think tank, told me that “some kind of reckoning with China” is likely as well. “Some countries will emerge from this trying to cling to China … but most others are likely to try to decouple,” she said. For Britain, Germany, France, and other major European economies reliant on the American security umbrella but wanting to maintain strong economic ties with China, the difficulty of managing the fallout from the Trump administration’s anti-China rhetoric may now only increase.
  • This is the world in which countries such as Britain are having to think about their strategic vision. Some of the challenges might be entirely new but many others are likely to be ones already at play that have been accelerated by the pandemic, such as worsening relations between Washington and Beijing.
  • More than anything, though, for Western governments there is a simple underlying reality to the geopolitical second wave: cash, or a lack of it. “You’ve got more problems but less money to deal with them,” one senior adviser to the British government, who asked for anonymity to speak candidly about internal deliberations, told me.
  • After more than a decade of public-spending cuts, for example, Britain’s military—capable of helping the United States invade both Iraq and Afghanistan less than 20 years ago—has morphed into a “one shot” force that is unable to sustain itself for longer than six months outside Europe, according to Clarke. What will its capacity look like after another set of cuts? Britain and France required American support to intervene in Libya in 2011. Could a joint European force do so again anywhere along its exposed underbelly on the North African shore? Could it even be used in a purely medical capacity, as it was during the Ebola outbreak in 2014?
  • A major British government review of the country’s foreign-affairs, defense, and intelligence strategy was due to be published this year, but it has since been pushed back indefinitely because of the pandemic. The immediate consequence is that the review, when it happens, will be less strategic and more tactical—driven by financial considerations rather than any grand vision the government wanted to set out for post-Brexit Britain. Officials in London will have to focus more on “What can we afford?” and less on “What do we want to do?,” an approach that is short-term, ad hoc, and defensive.
  • Inside Downing Street, concern about C19’s geopolitical second wave is real, with work under way to understand the potential threats and prepare for them. The British government expects protectionism to increase, supply chains to be brought back under national control, nation-states to be strengthened, and the U.S.-China relationship to become more antagonistic—changes that could be seen as simply the “firming up of some fundamentals,” in the words of the government adviser I spoke with.
  • Whether the pandemic brings about revolutionary change or simply accelerates the currents already working under the surface, the fact is that the epidemiological second wave isn’t the only one we need worry about.

Source: The Pandemic’s Geopolitical Aftershocks Are Coming

G. The Road Back?

1. 70 cases of C19 at French schools days after re-opening  

  • Just one week after a third of French schoolchildren went back to school in an easing of the coronavirus lockdown, there’s been a worrying flareup of about 70 C19 cases linked to schools.
  • Some lower grades in schools were opened last week and a further 150,000 junior high students went back to the classroom Monday as further restrictions were loosened by the government. The move initially spelled relief: the end of homeschooling for hundreds of thousands of exhausted French parents, many of whom were also working from home.
  • But French Education minister Jean-Michel Blanquer sounded the alarm Monday, telling French radio RTL that the return has put some children in new danger of contamination. He said the affected schools are being closed immediately. French media reported that seven schools in northern France were closed.
  • The situation highlights the precarious situation the French government is finding itself in as it seeks both to reassure the public that the country is moving forward past coronavirus and to react prudently to safeguard public health.
  • Blanquer did not specify if the 70 cases of C19 were among students or teachers.
  • Given that the incubation period for the virus is several days, people are “likely” to have been infected before the reopening of the schools, he said.
  • France reopened about 40,000 preschools and primary schools last week, with classes capped at 15 students.
  • About 30% of children went back to school, Blanquer said. The government has allowed parents to keep children at home.
  • This week France is reopening junior high schools in “green” regions less affected by the virus, which do not include Paris.
  • Although the idea of children being silent “super-spreaders” has been largely debunked in recent analyses, last week France recorded its first death of a child linked to Kawasaki disease, a mysterious inflammatory syndrome that some doctors say could be triggered by C19.
  • In neighboring Germany, schools have been slowly opening to various degrees for about two weeks now, subject to precautions.
  • No major outbreaks related to the reopenings have been reported, though there have been many individual cases. In Berlin’s Spandau neighborhood, one school was ordered temporarily closed on the weekend after it emerged that a teacher with C19 had contact with two elementary classes, an after-school care program and other teachers.
  • A teacher from another school in the area also tested positive, but only had contact with a small number of children. Those individuals were ordered into quarantine but the school has remained open, the BZ newspaper reported on Monday. In the surrounding state of Brandenburg two kindergartens were closed and a fifth-grade class at an elementary school were quarantined.

Source: 70 cases of COVID-19 at French schools days after reopening 

2. The New Airline Travel: Fewer Flights, More Layovers, Rules for Bathrooms  

A new age of air travel is taking shape
  • Airports and airlines are rolling out temperature checks for crew and, increasingly, passengers, as well as thermal scans to spot people with elevated body temperatures. Face masks are now de rigueur for travelers across the U.S. Passengers on Europe’s biggest budget carrier must raise their hands to use the toilet.
  • Forget about the perks of priority boarding at Air France. The carrier is one of several boarding passengers seated at the back of the aircraft first, to limit traffic jams in the aisle. Many airlines are removing in-flight magazines, scrapping meal services on shorter routes, and parking the duty-free cart.
  • Getting off the plane at the end of the flight could take even longer than usual as airlines try to control the typical crush, with some saying flight attendants will cue small groups when it’s their turn to stand up.
  • As lockdowns loosen, airlines are plotting a path out of hibernation, reformulating routes and services, and balancing safety protocols with the challenge of convincing passengers to board the enclosed space of an aircraft in the midst of a pandemic.
  • The Trump Administration is preparing to begin temperature checks conducted by the Transportation Security Administration at some airports, The Wall Street Journal reported Friday. The TSA said no decision has been made.
  • Some of the biggest changes airlines envision are the result of what executives expect will be months, maybe years, of lower demand: They see fewer direct flights, for instance, which means more dreaded stopovers.
  • Some airlines are considering requiring passengers to sign health certifications, or to eventually carry “immunity passports”—documentation that a passenger has had, and recovered from, the virus.
  • All of this presents a threat to many of the practices that helped drive a record-long streak of airline profits in the U.S.
  • Carriers boosted revenue by squeezing more people into coach cabins in recent years—shrinking seats and space between rows. They had started charging for more room and for extras that were once free, like choosing seats in advance. Fees for flight changes and checked bags brought in billions of dollars each year.
  • Now carriers are being encouraged to keep seats empty, making it harder to turn a profit on each flight. At the same time, the corporate customers that were willing to pay high fares for seats in premium cabins could be slow to return as long as international travel restrictions remain in place, and may stay grounded longer if video conferencing becomes the norm or if companies remain cautious about business travel.
  • For now, airlines have suspended flight change fees and may have a hard time reinstating them as they seek to restore confidence and keep sick people from flying.
  • “It’s going to be socially less acceptable for someone to get on an airplane who clearly isn’t well,” JetBlue Airways Corp. Chief Executive Robin Hayes says. “Airlines have to figure out how they’re going to respond to that in a way that still allows them to be profitable, but also recognize that you don’t want people on the airplane that are ill.”
  • Air France has rolled out mandatory temperature checks before each departure, with passengers showing a temperature above 38 degrees Celsius, or about 100 degrees Fahrenheit, prevented from boarding. So far, no passenger has been denied boarding as a result, according to an airline spokesman. Carrier KLM in the Netherlands is requiring passengers from areas designated high-risk by the European Union to fill out a health declaration. The areas include major airports in 20 U.S. states.
  • The airport in Canberra, Australia’s capital, is already using thermal cameras to take the temperature of passengers as they pass through security. London’s Heathrow Airport plans to test thermal imaging to screen arrivals at one of its terminals for fever.
  • Korean Air has started scanning passengers for high temperatures flying out of Seoul. Air Canada takes passenger temperatures with a no-contact infrared thermometer; and Frontier Airlines plans to do the same at boarding.
  • Some critics say temperature checks could give passengers false confidence, as they won’t identify infected people who are not symptomatic. European air-safety regulators aren’t expected to embrace temperature checks. A draft document of the European Union Aviation Safety Agency’s recommendations circulated to national authorities, according to industry and government officials, indicates such checks aren’t effective in delaying or mitigating the C19 contagion.
  • Low cost Ryanair Holdings PLC, Europe’s biggest carrier by passengers, has done away with lines for the toilets. Passengers are now required to raise their hand to request permission from a cabin crew member before using them.
  • U.S. carriers are beginning to require passengers to wear masks for the entirety of their flights, but it’s not clear how such a policy can be enforced. Some airlines said they’re advising flight attendants to de-escalate difficult situations if passengers refuse to wear masks while planes are in the air.
  • The CEO of Frontier Airlines, based in Denver, said “if someone is uncompliant, we will eventually divert an airplane.”
  • One of the biggest challenges revolves around the viability of social distancing at airports and onboard aircraft. Many industry executives say it isn’t feasible. There’s little agreement on standards. Industry leaders are insisting on consistency around the world so passengers aren’t confused.
  • “It’s impossible to socially distance in an airport,” says John Holland-Kaye, chief executive of London Heathrow Airport. The hub is in the process of rolling out Plexiglas screens at check-in desks, encouraging the use of face masks, and deploying more automation to limit the interaction between staff and passengers.
  • Mr. Holland-Kaye is working with his counterparts at airports in Los Angeles, Hong Kong and Sydney to implement standardized procedures. “If we wait until some global organization has agreed it for 172 countries, it’ll never happen,” he said.
  • Some carriers have promised to keep the middle seat open, to preserve some sense of social distancing aboard. That hasn’t been too onerous, since there are so few fliers these days.
  • Executives say that’s not viable for the long haul. They question its effectiveness, and say carriers can’t afford the cost of leaving those seats empty. Air New Zealand Ltd., the country’s flag carrier, said that to comply with social distancing, just under 50% of seats on a turboprop and only 65% of seats on an A320 narrowbody can be filled. Flights need to be 77% full on average for airlines to break even, according to the International Air Transport Association, which estimates that fares would have to climb 50% to offset the cost of leaving so much empty space on an A320.
  • With airlines having cut down on the frequency of flights, some planes have started filling up.
  • United Airlines Holdings Inc. earlier this month said it would start giving passengers advance notice if they’re scheduled to fly on a full flight, allowing them to make other plans. The airline shifted its policy after images on social media of a packed flight earlier this month sparked outrage.
  • Rep. Peter DeFazio (D. Ore.), chairman of the House Transportation and Infrastructure Committee wrote to major U.S. airline trade groups last week, urging them to do more to space passengers out. Airline executives say they can’t keep that up forever.
  • “I would hope that we don’t have unnecessary regulations,” Southwest Airlines Co. Chief Executive Gary Kelly says. “It’s really not a viable intermediate or long-term solution to cap a flight at 60%.”
  • For now, however, Southwest is limiting the number of seats it will fill on any given flight. When it sees bookings start to approach that threshold—something that has started to happen several times a week for some routes—it will add another flight if there’s enough demand to cover operating costs like fuel, Mr. Kelly said. “We at least want the revenue,” he said.
Ready to Fly?
  • As flights increase, passengers are in for some big changes. Here are some things airlines and airports are doing differently amid the pandemic.
  • Temperature checks
    • The Trump administration is preparing to roll out temperature checks conducted by the TSA at some airports. Some airlines are taking passengers’ temperatures and airports are using thermal scanning to check crowds.
  • Health declarations
    • Dutch carrier KLM asks passengers from high-risk areas to affirm their health before flying. The carrier reserves the right to keep passengers it deems ill off the plane.
  • Boarding
    • Air France is boarding the back of the plane first, making business class and other higher fare passengers wait.
  • On board
    • China Southern and other carriers are not seating passengers in the middle seat, or spacing them out through the cabin. Xiamen Air keeps the last three rows free for ill passengers.
  • The lavatory
    • Ryanair, Europe’s budget carrier, is requiring passengers to raise their hand and seek permission to use the bathroom.
  • Earlier this month, Frontier Airlines, thought it hit on a solution. Chief Executive Barry Biffle says he believes keeping middle seats empty does little for safety if passengers wear masks. To give passengers peace of mind, though, while not forcing the airline to operate money-losing flights, the airline created a new offering: for a $39 fee, a passenger could ensure being seated next to an empty middle seat.
  • Lawmakers wrote to Frontier to object. Sen. Amy Klobuchar (D., Minn.) suggested federal guidelines might be necessary to ensure distancing on planes during a subcommittee hearing, broadcast online.
  • Nick Calio, chief of Airlines for America, an airline lobbying group, protested that a rule wouldn’t be necessary.
  • “Hopefully the market will take care of that,” he said.
  • “Well, it didn’t with Frontier,” Ms. Klobuchar responded. That evening, Frontier rescinded its plan.
  • The carrier isn’t the only one that has encouraged passengers to spend more to secure their peace of mind. Ryanair last week asked passengers to purchase fast-track access through airport security and priority boarding to help avoid crowding.
  • In China, where domestic flights have resumed in significant numbers, aviation authorities haven’t publicly announced social-distancing measures. Most airports and airlines require passengers to wear masks, and to have their temperature checked. Some airlines, including China Southern Airlines Co., are preventing passengers from sitting next to one another.
  • Demand in China lags far behind capacity, despite airlines offering discounts of up to 90% on many routes. China’s civil aviation authority said last week that passenger numbers in April were down 69% from a year ago at 16.7 million. A five-day holiday at the start of May provided a boost, but not the dramatic spike in travel demand that usually characterizes China’s national vacations.
  • Airlines have started cleaning planes more thoroughly and more often, using equipment to mist cabins with disinfectant and wiping down all surfaces between every flight, not just when jets are parked overnight.
  • Delta Air Lines Inc. has started building in extra time between flights for cleaning, and says it plans to keep the procedures in place indefinitely.
  • “We’ll take delays if we have to,” said Bill Lentsch, Delta’s chief customer experience officer.
  • Analysts at airline data firm OAG estimated that with new cleaning procedures, carriers might need to leave two hours for connections, up from 45 minutes for domestic flights and 90 for international connections.
  • Another big change: Where you can fly. Widebody planes that flew lucrative long haul international routes are being parked in droves, many permanently. Delta said it will retire its 18 Boeing 777 jets, which it used to launch ambitious global routes like Los Angeles to Sydney, this year.
  • Last year, global airlines competed to offer flights so long they tested human endurance, like Qantas’s experiments with direct service from New York and London to Sydney—a 19-hour journey. Now Project Sunrise, as the effort was dubbed, is on indefinite hold.
  • U.S. airlines like Delta, United and American Airlines Group Inc. had assembled global networks, securing lucrative airport slots and signing joint venture deals with global partners. Executives now believe international travel will be some of the last to recover.
  • American has slashed international flying for the summer and has delayed the launch of new international routes it planned for this year. Flights from Philadelphia to Casablanca, Morocco, Chicago to Krakow, Poland, and Seattle to Bangalore, India, are being pushed back to 2021.
  • “We’re not going to be flying the same airplanes to the same places that we flew in the past,” American Chief Executive Doug Parker told pilots during a town hall earlier this month.

Source: The New Airline Travel: Fewer Flights, More Layovers, Rules for Bathrooms

3. NFL testing new protective facemasks with surgical or N95 material  

  • NFL engineers and sports equipment company Oakley are testing prototypes of modified facemasks that may contain surgical or N95 material, the NFLPA’s medical director said Monday.
  • Speaking on Monday’s The Adam Schefter Podcast, Thom Mayer said “there will probably be a recommendation” that the NFL will use such masks to protect players from the coronavirus when the league returns to play.
  • “Back in early March, I had suggested that we should consider novel and emerging ways to handle the helmets and the facemasks and the spread of the virus,” Mayer said. “And these guys, the bioengineers that we use and that the league uses — Oakley, as you may or may not know, does all the face visors for the league under contract — these guys got the bit between their teeth.”
  • Mayer said he wasn’t sure exactly how the modifications would look, but he acknowledged that it is realistic to think that the new designs could cover a player’s entire facemask, and that the engineers were working on all such a design might entail.
  • “They’ve got some prototypes; they’re doing really good work,” he said. “Some of them, when you first look at them, you think, ‘Gosh, no’ — ’cause you’re not used to seeing it; you’re just not used to seeing it. But they’re looking at every issue you can imagine, including when it fogs up. What do we do with that? But these guys are used to dealing with this stuff.”
  • Oakley has experience designing durable eyeglasses that won’t fog up for use by the military, Mayer said.
  • Mayer also advised players who may have elevated risk factors to be constantly aware of doing everything possible to prevent exposure to the coronavirus.
  • “For a player like that, getting the helmet off, putting a mask on right afterwards, maintaining social distancing when not in the field as much as possible, using single-use hydration, whether water, Gatorade, whatever it might be — I mean, just every little detail,” he said.
  • “Anybody who’s got a risk, I would advise them to be zealous, religious and frankly, almost maniacally committed to minimizing the chance of spreading the virus.”

Source: NFL testing new protective facemasks with surgical or N95 material 

H. Practical Tips & Other Useful Information

1. Staying Ahead Of The Shortages: What To Stock Up On For The Coming Year  

By Samantha Biggers  

[Note: While no one can be certain what the future holds, we can protect ourselves against reasonably foreseeable risks.  And disruptions to foreign supply chains are a definite risk, especially if a trade war breaks out with China, the odds of which seem to be increasing.  Several months ago, who would have thought we’d be experiencing shortages of toilet paper, paper towels, hand cleaners, meat, etc.?  Disruptions in supply chains are not only more foreseeable now, they are much more likely.]

Overview:
  • Items to Stock Up On:
    • Sheets and Bedding
    • Small and Large Appliances
    • Clothing
    • Shoes
    • Some Fertilizers
    • Tires
    • Electronics
    • Cat and Dog Food
    • Small Hand and Power Tools
    • Nail, screws, and other fasteners
    • Even more of the over the counter and basic medical supplies we are used to having
    • Any Imported Items that you would miss if unavailable
  • While a lot of people are concerned about food shortages, one should not forget that there are a lot of items that make life easier or at least more enjoyable that come from abroad. A lot of these items specifically come from China and India. I am going to mention a few other things that are mostly made in the USA but that may potentially be in short supply as a result of the pandemic.
  • Food and water are primary concerns as they should be but what about these other things. I have compiled this list of things that you may want to consider acquiring if you don’t think you have enough to get through the next 6 months to a year.
  • Do what you can with what financial resources and ingenuity you have. You don’t have to jump on buying everything I talk about all at once. Sometimes people get caught up thinking that they have to do it all at once and that is not true. I presented this information so you can use it over the coming months to determine your preparedness needs and plan accordingly. I think this winter is going to be a difficult one and that the sooner you start planning the better.
  • That being said, I cannot predict what is going to happen but I can tell you that if you put back things you know you are going to need sooner rather than later than in the worst case you are prepared and in the best case you are ahead of the game and won’t have to buy those things later and may have some extra funds to put towards things later.
  • I am not trying to encourage you to buy things that there is no way that you are going to need. The intent of this post is really to make you think about what you do need considering the situation we are all in due to the pandemic and what things you have that are close to the end of their useful life and might need replaced soon.
Just because something is available later on doesn’t mean it will be affordable
  • While as a country we may not run out of coffee grinders or coffee pots, they may get a lot more expensive. Buying now is one way to avoid potentially higher prices later on.
  • It is easy to take some of the basics for granted. The old saying “you don’t know what you got until it is gone” is accurate.
  • I remember going from years of having easy hot water and reliable heating and cooling in our living space to not having any of those things while we were living in a camper and building our house. To put this on a perspective for the average person in America, what if you couldn’t buy socks at an affordable price? What if you couldn’t get a broom or vacuum to clean your home? These are just a few examples.
  • When manufacturing starts coming back to the USA or we start contracting with other countries for some manufacturing, the price is going to go up and it may go up a lot.
  • People cannot live in the USA on a wage equal to that of a Chinese or Indian laborer. Also given that there are minimum wage laws, we technically wouldn’t be allowed to work for that low of a wage if we wanted to. Americans will work but they are not going to work for wages that require them to live under the conditions that a lot of people in China and India live in.
The Items 
  • Sheets and Bedding
    • Have you ever priced a hand-sewn quilt? They are really expensive because they take a lot of time and they are usually made of fabric that is at least of moderate quality. I have made them and they last for years. I no longer have the time to make blankets that are that fancy and artistic so I buy them like everyone else. Regardless of how fancy or cheap you like to buy your sheets, those are made overseas. India produces a lot of the quality cotton blankets and sheets that are sold in the United States.
    • You may be thinking that we grow a lot of cotton in the United States. We sure do and it often that same cotton that goes into making the blankets and sheets that we get from India and China. The manufacturing facilities and inexpensive labor are not available here at the moment.
    • The other day I was thankful that I had bought a set of sheets ahead for everyone because all of a sudden I started noticing holes appearing in the ones I bought years ago. It is easy to not buy until you realize that things are getting threadbare.  Sometimes they are a little less but they are still a very good deal for the quality you get.
    • Right now you can still get some inexpensive blankets but I am not sure how long that is going to last. I just know that there is only so much stuff in the country at the moment and it is pretty hard to say how much consumer goods are actually coming in. Just going by total container volume, it is not much.
  • Small and Large Appliances
    • How many of you have went to buy a small to medium chest freezer only to find that you might be able to get one in June if you are lucky? We were in the position of having two sheep that we had to butcher but not enough freezer space. We were concerned about not being able to get a smaller freezer so we went ahead and got a small one from Wal-Mart.
    • For some reason I thought that more freezers and other large appliances were made in the USA but I was sure wrong about that one. Freezers sold out much faster than I thought they would. I have seen a few really big freezers for sale but they are so big that most people are just not going to have the space and they cost twice as much as what most of us are used to paying when we want to go get a freezer.
    • Freezers are just the beginning. If you are noticing that your microwave, toaster, coffee pot, etc. are starting to act up or not run so well, you may want to get your replacement now and throw it in the garage or closet. I can imagine that if demand is much greater than supply, a seller that does an auction on eBay may be shocked to see what some are willing to pay for items that they don’t want to do without. People like you or me that cannot outbid someone with a lot of money will be out of luck.
  • Clothing
    • There is a lot of clothing in the country but a lot of it is used clothing. Items like blue jeans that you wear out more often are made in Asia with the majority being made in China. I am going to make an effort to buy American made after we wear out what I bought up. My husband works outside a lot and goes through some pants and t-shirts. Some of you may wear an odd size or a size that you find is not as available at stores.
    • If this is you then you need to be especially aware of what you have on hand. As I have stated many times in the past, buying out of season can save a lot of money. I routinely pick items at 50%-70% off by purchasing winter items in the spring or summer or summer items at the beginning of winter. This also means I can get better quality which in turn saves money because I don’t have to buy the same thing as often.
  • Shoes
    • People love shoes. In fact a lot of people have way more pairs than they really need but those that do often don’t choose to buy the most practical footwear. During the year ahead you may find that you need different footwear even if you have a lot of shoes overall. The majority of footwear is made in China or other Asian countries. Some companies do have a USA made line that costs more but that is the exception, not the norm. Shoes made in the USA and Italy, both known for quality footwear, cost a lot more to buy and the selection is rather limited.
    • Right now you can still find some exceptional deals on footwear. My husband and I live on a mountain and farm. We deal with a lot of rough terrain and do a good deal of manual labor so we have to have good work boots. Other footwear will just get destroyed. Consider what your footwear needs are going to be over the next year and start buying what you need as you can afford it. Keep an eye out for good deals.
    • I love to shop at Amazon Warehouse for shoes because since I can wear a men’s size and I am not picky about the color, I can find exceptional deals. You have to shop around a bit but I picked up 4 pairs of boots for us for maybe $160? A single pair had a retail value that high. These types of deals will not be around forever because a lot of those companies have severely cut back on production or are not operating at all.
    • Another good place to find boots is through a military surplus store.  
  • Some Fertilizers 
    • A lot of people are gardening and that has led to a big run on fertilizers. While a lot is still available, that might not always be the case. It takes quite a bit of energy and people to make a lot of the commercial fertilizers on the market. A lot of folks are also stocking up on the organic varieties. The smaller organic fertilizer companies are not used to this type of demand and they could struggle to meet it in the near future. I know that some products like Garden Tone in larger bags have become a little more scarce here lately.
  • Tires
    • I have been trying to make an effort to be more on top of it when it comes to vehicle and machinery maintenance. For example, when this pandemic situation started, we ordered some tire patch kits and a gallon of tire slime in case we have to make some repairs at home.
    • Months ago, Matt and I were talking about when the tires would need to be replaced on the Kawasaki Mule. We agreed that we could get through the summer but before winter hit we absolutely had to get a new set. Then the pandemic happened. We set aside a little here and there and I went ahead and bought a set.
    • We use the Mule for everything around the farm and to go down to see my Dad at the other property and take him things. The truck is more vehicle than we need around the farm most of the time and it costs more to maintain and operate. A lot of our roads are not for trucks either. It would cause us an enormous amount of extra work that we honestly don’t have time for with just the two of us working the farm if we could not use our Mule.
    • A lot of tires are made in China and Korea. Yes there are US manufacturers but not as many as you might think. Only certain sizes will work with certain vehicles and some people need heavy duty 4×4 tires for things not street tires. My point is that even if your tires are looking worn, you might consider buying a set now and setting them aside for when you need them. Take a look at your tractors and other small machinery. I know that tires are not cheap but they could get a lot more expensive, especially if you need something that is specialized.
  • Electronics
    • I am not one to have a fancy cell phone. I buy $50 and under smartphones and then barely ever keep it on. In fact some months I don’t even bother with it. At the same time, I realize that others depend on their phones for a lot of things. If you can pick up a cheap throwaway phone as a back up then it is something to consider. It may be difficult to find one that is not overpriced.
    • A lot of people are also choosing to keep the computer or Chromebook they have going rather than upgrading it for a different model. That being said, if you depend on your computer for work and entertainment and don’t already have a backup, now might be the time to pick up a cheap backup. Remember that nowadays cheap doesn’t mean it is not highly functional. I bought an open box Samsung Chromebook a few years back for $110 and used it for all my writing and for watching shows for over a year. It is still what we use for our TV but we hook it up to a big monitor.
    • Computer parts and internet equipment are mostly made overseas too. Network and technology needs vary by the person but there is nothing wrong with having an extra wireless router or network card. I bought a USB wireless adapter when all this started because my computer stopped going online. It seemed like some of the better adapters were already more expensive or harder to find. Not sure what it looks like out there now.
  • Cat and Dog Food
    • A lot of meat processors are shut down due to the pandemic. Some have stated that they are shut down indefinitely. When meat processors shut down that means that there are not byproducts and leftovers to be used in dog and cat foods. Maybe if some animals are put down they will go for pet foods but that is not a guaranteed thing.
    • It may also come to pass that the more affordable pet foods sell out while the more expensive ones are still somewhat available but out of reach for a lot of people due to cost. If your dog or cat requires a special diet then you need to be even more concerned. Here are a few links to posts on pet food storage and calorie needs that may be helpful with your planning.
  • Small Hand and Power Tools 
    • Almost all the hand tools and power tools that we use often are made in China. There are a few companies that manufacture in the USA. Bully Tools and Eastwing both come to mind for hand tools. Milwaukee and Dewalt make some items in the USA. Remember that a lot of tool companies have products made in many different countries. You cannot assume that because they have a few USA made products that everything you get with their logo on it is made in the USA.
    • Tools make it possible to be more self-sufficient. I would never want to give up our tools. If you don’t have a basic household toolkit or the garden tools you need then try to buy them as you can. You will not regret having a few basic tools around.
  • Nail, screws, and other fasteners
    • I just put in an order to Lowes and it was amazing what they were out of. Most of the screws, nails, and fasteners are made in China or similar. If I wanted a screw under 2 inches, my only choice as the star bit variety. A standard Phillips head was not available in that size. Just for the record, I have never seen Lowes out of such a basic size and variety in over a decade of helping build houses, barns, etc.
  • Even more of the over the counter and basic medical supplies we are used to having.
    • Some medical and personal protective gear have been in short supply for quite some time. Since a lot of the ingredients that are necessary to produce many medications are made in foreign lands, it seems like we would be bound to see more medications in short supply the longer the pandemic continues and especially if there is a devastating second wave.
    • Besides medications, there are a lot of other medical supplies made overseas as well. Those without a good medical kit should start putting one together so that they can deal with basic needs at home.
  • Other Items
    • Soap
    • Batteries
    • Laundry products
    • Coffee
    • Herbs and spices that are usually foreign grown. Black peppercorns are an example. A lot of black pepper is grown in India.
    • Sewing supplies
    • Anything imported that you would really miss.

Source: Staying Ahead Of The Shortages: What To Stock Up On For The Coming Year

2. Copper masks are the latest craze. Should you buy one?  

  • If you’ve been on the hunt for a mask lately, you might have stumbled across one that contains copper. And if you’re not dialed into the latest on microbial surfaces, this might raise some questions. Why copper? And is it worth spending the extra money?
  • The answer is complicated. “I have great hopes for copper masks,” says Michael Schmidt, a professor of microbiology and immunology at the Medical University of South Carolina, who has studied the use of copper in medical products. “But there is a lot of research that still needs to be done about [their] effectiveness. If you’re just throwing copper layers onto a mask, we don’t [know] if they work.” Here are some things to consider the next time you see a pop-up ad for a copper mask.
Why Copper?
  • Copper can destroy bacteria and viruses, as my colleague Mark Wilson recently reported. It contains positively charged ions that trap viruses that are negatively charged. Then the copper ions penetrate the viruses, stopping them from replicating. A recent study found that copper is effective at inactivating the novel coronavirus within four hours.
  • Historically, copper has been used in hospital door knobs and IV stands to curb the spread of illness. It has also been used in fabric. Schmidt points to an innovator in this space, Virginia-based Cupron, which invented a copper-infused fabric more than a decade ago. These fabrics have been made into bedsheets and pillowcases in hospitals. Microbiologist Phyllis Kuhn was another early advocate of using copper in hospitals. She developed a mask made from 99.95% copper mesh, which she sells on her website for $25. [Note: You can order here: https://kuhncoppersolutions.org/]
  • Now, as coronavirus has swept across the planet and forced more people to wear masks, more companies are thinking about incorporating copper into masks. Companies like shoe startup Atoms, The Futon Shop, and an Israeli tech company called Argaman have all started selling copper masks, which cost between $10 and $70 a pop. “These fabrics have been around for some time—it’s just COVID that makes it new again,” Schmidt says.
  • Cupron, for instance, has started making cloth masks that contain a mix of cotton fibers and polyester blended with cotton, although they’re not available for individual purchase. Last week, the University Hospitals of Cleveland Medical Center bought 25,000 for employees. Daniel Simon, the chief clinical and scientific officer of UHCMC, says that N95 and surgical masks are being reserved for workers caring for confirmed COVID-19 patients. Meanwhile, the copper masks will be worn by all other employees. “We believe copper masks are more effective at protecting our workers than a simple cloth mask because the copper in them kills germs,” Simon says.
How is a copper mask better?
  • Right now, most copper masks on the market aren’t respirators, like the N95 mask, which creates a perfect seal around the wearer’s face. Instead, they’re looser-fitting cloth masks, which allow particles to enter through gaps in the side. These masks aren’t designed for people who are at high risk of being exposed to those with COVID-19.
  • Instead, they’re designed to be an improvement on the cloth masks that the CDC recommends people wear in public to curb the spread of the coronavirus. If a wearer is infected, virus-laden droplets that come out of their mouth or nose and land on the mask will be killed off in a matter of hours. On a cloth mask, they could live on the material for several days. In other words, these masks are designed to be more hygienic. “As the viral particles go out of you through the copper mask into the environment, they will die,” says Schmidt.
  • There are some benefits for the wearer as well. For instance, Cupron’s chief medical scientist says one way the virus could be transmitted is if someone touches an infected surface—like a doorknob—then touches their mask to adjust it. In this situation, the copper in the mask would kill these viruses, whereas they would linger on a traditional cloth mask, potentially contaminating the wearer. “The outside of a mask can pick up the virus,” Schmidt says. “You can pick it up with your fingers, rub your eye, pick your nose, lick your finger, and voila, you’re contaminated.”
  • However, the effectiveness of a mask depends on how much copper is in it, Schmidt says. Virus particles are very small, so they would need to actually encounter the copper to be deactivated. The best copper masks would have copper incorporated into every fiber, rather than just on one single layer embedded inside the mask.
Can they be washed? 
  • One benefit of copper masks is that many are washable. While the specific details of washability vary, many copper masks—including Cupron’s and Phyllis Kuhn’s—can be washed repeatedly without reducing their efficacy. This is one reason that some hospitals, like UHCMC, are so eager to get their hands on them. “It’s hard procuring new PPE at a time when there is a global shortage,” says Simon. “With these copper masks, our workers can keep them for years and they will be just as effective.”
  • Schmidt says that copper is unlikely to interact with other chemicals, like cleaning solutions. He points out that copper is found in many everyday objects, including nickels and dimes. Most people aren’t allergic to these objects when they touch them, nor do they create adverse reactions with chemicals.
Buyer Beware
  • So should you buy a copper mask? Schmidt says that if a copper textile has been scientifically evaluated, it could be an improvement on the average cloth mask. The problem is that most copper masks on the market haven’t been studied.
  • Cupron’s copper masks—which are currently only available for institutions to purchase—have been studied and registered by the EPA, so Schmidt believes they’re trustworthy. But most other copper masks popping up haven’t been put to the test. “Many companies selling copper masks have not gone through the rigorous approach of getting their products registered or done studies to evaluate their masks,” says Schmidt. “They could just be bad copycats of Cupron’s mask.”
  • If you’re interested in purchasing a copper mask, Schmidt urges caution. “You need to know what you’re buying and how to properly use it,” he says. “Do your homework. Don’t buy the first mask you stumble across.”

Source: Copper masks are the latest craze. Should you buy one?

Annex I. John Hopkins Daily COVID-19 Updates

May 18, 2020

EPI UPDATE The WHO COVID-19 Situation Report for May 17 reports 4.53 million confirmed cases (100,012 new; 277,108 since Friday’s briefing) and 307,395 deaths (5,336 new; 15,349 since Friday’s briefing).

Brazil is now #4 in the world in terms of total incidence, with 241,080 confirmed cases. Brazil reported its 2 highest daily incidence totals on May 15 and 16—15,305 and 14,919 new cases, respectively—and it will likely surpass the United Kingdom (246,406 cases) with the next update. Additionally, Peru surpassed China over the weekend to reach #12 in the world in terms of total incidence, with 92,273 cases. Chile (46,059 cases) and Ecuador (33,182) are currently #18 and #22 in the world, respectively. 

Many of the countries with the highest per capita incidence have passed their peak already, including those in Western Europe. Among those with total incidence greater than 2,000 cases per million population, several appear to still be accelerating. Notably, the per capita incidence in Qatar (11,317 cases per million) is more than double every other country and still accelerating. Also in the Eastern Mediterranean region, Bahrain, Kuwait, and the United Arab Emirates are exhibiting concerning accelerating trends. In Central and South America, Chile, Panama, and Peru are all accelerating as well, as are Belarus and Maldives. The epidemics in Canada, Singapore, Sweden, and the United States appear to be slowing.

Russia reported 27,835 new cases since Friday’s briefing, continuing its recent trend of elevated incidence. India reported 14,199 new cases since Friday’s briefing, averaging more than 4,700 new cases per day over the weekend. India reported its 2 highest daily totals and exceeded 5,000 new cases per day for the first time. India surpassed China in terms of total incidence and is now #11 in the world, behind Iran. Tamil Nadu state, where a large outbreak has been linked to one of Asia’s largest markets, reported 1,550 new cases since Friday’s briefing, averaging more than 500 new cases per day. In response to the increased incidence, India extended its national “lockdown” policy through the end of May, although areas of lower risk have fewer restrictions.

Singapore reported 1,452 new cases since Friday’s briefing, including 1,433 (98.7%) among residents of migrant worker dormitories. Outbreaks in migrant worker dormitories continue to drive Singapore’s growing COVID-19 epidemic. Singapore estimates that the cases confirmed so far represent 8.1% of the total population across all migrant worker dormitories, compared to only 0.03% of the general public population. Of the 28,343 total COVID-19 cases reported in Singapore, 26,090 (92.1%) are among residents of migrant worker dormitories.

UNITED STATES

The US CDC reported 1.47 million total cases (31,967 new; 82,135 since Friday’s briefing) and 88,709 deaths (1,394 new; 4,762 since Friday’s briefing). The United States will likely reach 1.5 million cases by tomorrow’s update. The 31,967 new cases is the United States’ highest daily total since April 25. In total, 9 states (no change) reported more than 40,000 cases, including New York with more than 350,000; New Jersey with more than 125,000; and California, Illinois, and Massachusetts with more than 75,000. Additionally, 36 states (no change), plus Guam, are reporting widespread community transmission.

The New York Times continues to track state-level COVID-19 incidence, with a focus on state policies regarding social distancing. This tracker is updated to differentiate between states that have relaxed social distancing measures statewide and those that have updated their policies on a regional basis.

The Johns Hopkins CSSE dashboard is reporting 1.49 million US cases and 89,874 deaths as of 12:30pm on May 18.

LANCET EDITORIAL As we have noted previously, a number of experts around the world—including from health care, public health, and other fields—have lamented that the US CDC appears to be “sidelined” during the US COVID-19 response. An unsigned editorial published in The Lancet continued this conversation, noting the scaled-back US CDC presence in China prior to the emergence of SARS-CoV-2, partisan conflict over CDC funding, and waning trust in CDC experts, particularly among senior US government officials. The piece describes the CDC’s current role as “an ineffective and nominal adviser,” and calls for an expanded role for the CDC, commensurate with its considerable expertise and a return to political independence. Former CDC Director, Dr. Tom Frieden, commented that “it’s not clear that the CDC’s expertise is feeding into the decisions that are being made.”

VACCINE DEVELOPMENT Last week, US President Donald Trump provided additional details on Operation Warp Speed, the US plan to rapidly develop, test, and manufacture a SARS-CoV-2 vaccine. The program will involve senior experts and leadership from both the US Department of Health and Human Services and the Department of Defense, and it aims to develop, test, and scale up production for a SARS-CoV-2 vaccine in order to make millions of doses available by early 2021. This would be a monumental effort and would considerably accelerate the process for any previous vaccine by months or years. One of the project leaders, Dr. Moncef Slaoui, commented that he had recently seen encouraging preliminary data from early clinical trials of a vaccine candidate. This morning, Moderna, Inc., issued a press release describing encouraging preliminary results from its Phase 1 vaccine trial. While Phase 1 trials are designed to evaluate safety of the vaccine in humans, Moderna noted that early data (based on only 8 participants) are promising that the vaccine could induce the development of protective antibodies. More data is required to better characterize the body’s immune response, particularly with respect to the effect on conferring immunity to SARS-CoV-2.

President Trump committed to collaborating with other countries to ensure wide availability of any successful vaccine, regardless of where it is developed, including distributing production around the world. The WHO is reportedly considering the development of a voluntary global repository for relevant data, patent rights, intellectual property, and other technical and regulatory information to support the worldwide availability of the vaccine as soon as possible. The United States has previously declined to participate in the WHO-led international consortium to support SARS-CoV-2 vaccine development, and it is unclear whether it would participate in the voluntary repository.

Yesterday, Jerome Powell, Chairman of the US Federal Reserve, commented that the full recovery of the US economy may be contingent on the availability of a vaccine. Without a vaccine to mitigate transmission risk, experts are concerned that any increased social contact resulting from states loosening social distancing restrictions could result in increased transmission. Chairman Powell stated that he expects the economy to steadily recover over the coming months, but it will depend on individuals’ confidence in their health and safety. And full confidence may not be feasible without a vaccine.

US SOCIAL DISTANCING US states continue to announce and implement plans to ease social distancing measures. Last week, New York, New Jersey, Connecticut, and Delaware laid out plans to begin resuming some aspects of society. Notably, the 4 states will begin opening some beaches in time for the Memorial Day holiday weekend. The plan will apply to state beaches, which will be limited to 50% capacity. Some group activities, such as sports like volleyball, will be prohibited, and concession stands, picnic areas, and pavilions will be closed in an effort to promote social distancing. Local beaches may reopen as well, if they follow the state guidance, at a minimum.

Massachusetts Governor Charlie Baker is expected to announce the initial steps to relax statewide social distancing measures. Massachusetts is among the hardest-hit states after an early outbreak linked to a biotechnology conference. Massachusetts will use a 4-phase plan, which will incrementally relax social distancing until the point at which the availability of a vaccine or treatment will permit “the resumption of a ‘new normal.’”

Kentucky is scheduled to lift its “travel ban” and reopen most state parks this week ahead of Memorial Day weekend. Several state parks are being used to house “low acuity patients,” so those will remain closed to the public. Minnesota is also set to begin resuming operations at non-essential businesses and state parks this week. As businesses, parks, and other facilities reopen, they will be required to implement various social distancing, hygiene, and other protective measures.

WORLD HEALTH ASSEMBLY The 73rd World Health Assembly (WHA 73) commenced today, conducted virtually for the first time in history. While a number of health issues are on the agenda—including polio eradication, neglected tropical diseases, and International Health Regulations implementation—the discussion is expected to focus heavily on the COVID-19 pandemic and the mechanisms and capabilities necessary bring it under control. A group of 41 individual countries as well as the Africa Group Member States and the European Union submitted a proposal that calls, in part, for a systematic and independent review of the WHO’s COVID-19 pandemic response in order to inform best practices for future responses. Additionally, the proposal directs the WHO to continue collaboration with the World Organisation for Animal Health, including on determining the zoonotic origin of the pandemic.

In an opening address at WHA 73, Chinese President Xi Jinping announced that China will commit approximately US$2 billion in aid over the next 2 years to combat the COVID-19 pandemic, particularly in Africa. President Xi also indicated that China supports a review of the COVID-19 response. After recent increases by several countries, including the United States, in their support for Taiwan’s inclusion in WHA 73, particularly in light of Taiwan’s successful COVID-19 response, Taiwan did not receive an invitation. Taiwan announced that it would not pursue further efforts to participate in the meeting.

COVID-19 ANIMAL MODEL The search for a suitable animal model for SARS-CoV-2 continues. Numerous scientists are currently researching animal species that can mimic COVID-19 in humans in order to develop animal models for research purposes; an animal model would more easily allow for challenge studies for investigational vaccines and therapeutics. The WHO instituted a working group to study prospective animal models in mid-April, and initial studies are beginning to publish results. Researchers have demonstrated that non-human primates, including the African green monkey and multiple species of macaques, and rodents, including Syrian hamsters, can be infected with SARS-CoV-2 and exhibit COVID-19-like clinical manifestation. Additional research is necessary to better characterize the limitations of these models; however, these are promising initial steps that could provide critical data necessary for future pharmaceutical research. 

NIGERIA Reports are emerging of a COVID-19 hotspot in Kano, Nigeria. Nigeria has reported 5,959 confirmed cases and 182 deaths, including 825 cases and 36 deaths in Kano, but reports indicate that COVID-19 incidence and deaths in Kano are being underreported and that the outbreak could be much worse than the data indicate. Nigeria began easing restrictions in select areas on May 4, including the cities of Lagos and Abuja, but government officials are struggling to enforce the restrictions in areas that have not yet lifted them. In response to the increased incidence, Nigeria reportedly announced today that it will implement “precision” lockdown in 9 areas reporting high incidence, including Kano, and strengthen efforts to enforce those measures. Nigeria is expected to continue its national plan to relax social distancing measures in other areas, but the first phase will be prolonged by 2 weeks.

ITALY SCHEDULED TO LIFT TRAVEL RESTRICTIONS Italy is allowing most businesses to reopen, with social distancing measures in place, including higher-risk settings such as bars, hairdressers, and churches. Movement restrictions for travel within regions have been lifted, but inter-region travel is still largely restricted, except for work or health reasons, until June 2. Italy may permit international travel to resume as well starting June 3, although international travel may be limited to certain countries, depending on COVID-19 risk assessments. Italy has reported 66,553 confirmed cases, including 32,007 deaths, but the national incidence has been declining for several weeks.COVID-19 IN RURAL AMERICA Over the past several weeks, the expansion of the US COVID-19 epidemic beyond major cities and into rural parts of the country has garnered considerable attention. The epidemic spread rapidly in urban areas where high population density and other factors facilitate transmission; however, rural areas face their own challenges. Low population density could slow the spread of the disease, but rural populations do not necessarily have access to the same health care capacity as urban or suburban populations. As we have covered previously, rural areas are struggling to maintain health care capacity, and a large number of hospitals and other medical facilities have been forced to close over the past several years, including some recently affected by decreased demand stemming from social distancing and concern about SARS-CoV-2 transmission. Rural populations are also disproportionately affected by underlying medical conditions, which could translate into more severe outcomes. Some outbreaks reported in rural communities center around particularly high-risk populations, including nursing homes, meat packing facilities, or correctional facilities, but these events may not remain limited to those institutions. As states continue to relax social distancing measures, it will be important to monitor COVID-19’s spread further into rural populations that were not affected early in the epidemic.

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