'As Coronavirus Explodes in China, Countries Struggle to Control Its Spread' diff viewer (20/21)

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As Coronavirus Explodes in China, Countries Struggle to Control Its Spread	As Coronavirus Explodes in China, Countries Struggle to Control Its Spread
2020-06-24 17:56:50 UTC	2020-07-02 22:44:51 UTC (8 days later)
Australians flown home from Wuhan, China, will be quarantined on an island for two weeks. Americans, also evacuated from Wuhan, will be “temporarily housed” on an air base in California. And in South Korea, the police have been empowered to detain people who refuse to be quarantined.	Australians flown home from Wuhan, China, will be quarantined on an island for two weeks. Americans, also evacuated from Wuhan, will be “temporarily housed” on an air base in California. And in South Korea, the police have been empowered to detain people who refuse to be quarantined.
For countries outside China, the time to prevent an epidemic is now, when cases are few and can be isolated. They are trying to seize the moment to protect themselves against the coronavirus outbreak, which has reached every province in China, sickening more than 7,700 people and killing 170.	For countries outside China, the time to prevent an epidemic is now, when cases are few and can be isolated. They are trying to seize the moment to protect themselves against the coronavirus outbreak, which has reached every province in China, sickening more than 7,700 people and killing 170.
More than a dozen nations with a handful of cases — including the United States — are isolating patients and monitoring their contacts, as well as screening travelers from China and urging people to postpone trips there.	More than a dozen nations with a handful of cases — including the United States — are isolating patients and monitoring their contacts, as well as screening travelers from China and urging people to postpone trips there.
But whether this virus can be contained depends on factors still unknown, like just how contagious it is and when in the course of the infection the virus starts to spread.	But whether this virus can be contained depends on factors still unknown, like just how contagious it is and when in the course of the infection the virus starts to spread.
China, with nearly 1.4 billion people, is the most populous nation on Earth, and it has taken extreme measures to try to stop the disease, first reported in December in Wuhan, a city of 11 million. The government has stopped travel in and out of that city and surrounding ones, effectively locking down tens of millions of people.	China, with nearly 1.4 billion people, is the most populous nation on Earth, and it has taken extreme measures to try to stop the disease, first reported in December in Wuhan, a city of 11 million. The government has stopped travel in and out of that city and surrounding ones, effectively locking down tens of millions of people.
“The fact that to date we have only seen 68 cases outside China and no deaths is due in no small part to the extraordinary steps the government has taken to prevent the export of cases,” Dr. Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, said at a news briefing on Wednesday.	“The fact that to date we have only seen 68 cases outside China and no deaths is due in no small part to the extraordinary steps the government has taken to prevent the export of cases,” Dr. Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, said at a news briefing on Wednesday.
But the disease has spread far and wide inside China and, with extensive worldwide travel by its citizens, especially during the celebration of the Lunar New Year, countries everywhere are bracing for the arrival of more new cases.	But the disease has spread far and wide inside China and, with extensive worldwide travel by its citizens, especially during the celebration of the Lunar New Year, countries everywhere are bracing for the arrival of more new cases.
Person-to-person transmission is occurring, and cases have turned up in several countries with people who have not visited China. Mentioning those cases, Dr. Tedros said the potential for further global spread was one of the reasons he had called on the W.H.O.’s emergency committee to meet again on Thursday to decide whether to declare the epidemic a public health emergency of international concern. The committee met twice last week but was split about whether to declare an emergency, saying it did not have enough information to decide.	Person-to-person transmission is occurring, and cases have turned up in several countries with people who have not visited China. Mentioning those cases, Dr. Tedros said the potential for further global spread was one of the reasons he had called on the W.H.O.’s emergency committee to meet again on Thursday to decide whether to declare the epidemic a public health emergency of international concern. The committee met twice last week but was split about whether to declare an emergency, saying it did not have enough information to decide.
“I think things are going to get worse before they get better,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the United States, said in a podcast posted on Tuesday by the medical journal JAMA.	“I think things are going to get worse before they get better,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the United States, said in a podcast posted on Tuesday by the medical journal JAMA.
If China can somehow contain its outbreak, and if other countries with cases can prevent sustained transmission, Dr. Fauci said that it might be possible to end the outbreak, just as the coronavirus that caused the SARS epidemic in 2003 was stamped out.	If China can somehow contain its outbreak, and if other countries with cases can prevent sustained transmission, Dr. Fauci said that it might be possible to end the outbreak, just as the coronavirus that caused the SARS epidemic in 2003 was stamped out.
“But it’s going to be a real kind of tightrope walk, because if it gets so expansive then it’s not going to just disappear the way SARS did,” he said. “I think the next four to five weeks are going to be critical. It’s either going to start peaking and go into a downturn, or it’s going to explode into a global outbreak.”	“But it’s going to be a real kind of tightrope walk, because if it gets so expansive then it’s not going to just disappear the way SARS did,” he said. “I think the next four to five weeks are going to be critical. It’s either going to start peaking and go into a downturn, or it’s going to explode into a global outbreak.”
Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention, said in an interview that he thought it would become clear in a few days whether the outbreak could be contained.	Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention, said in an interview that he thought it would become clear in a few days whether the outbreak could be contained.
“If we’re seeing widespread transmission, thousands or tens of thousands of infections in the community, I don’t see how this gets controlled,” Dr. Frieden said. “On the other hand, if we see a SARS-like situation, where with incredible effort they were able to isolate people, tamp down the spread, then we’re in a containment situation.”	“If we’re seeing widespread transmission, thousands or tens of thousands of infections in the community, I don’t see how this gets controlled,” Dr. Frieden said. “On the other hand, if we see a SARS-like situation, where with incredible effort they were able to isolate people, tamp down the spread, then we’re in a containment situation.”
A particular concern is the possibility that the virus could wreak havoc in Africa, where possible cases are being investigated.	A particular concern is the possibility that the virus could wreak havoc in Africa, where possible cases are being investigated.
“We are very concerned about Africa because some of the least prepared countries for outbreaks are in Africa,” Dr. Frieden said, adding, “We know the systems there to find it and stop it are weaker there than elsewhere.”	“We are very concerned about Africa because some of the least prepared countries for outbreaks are in Africa,” Dr. Frieden said, adding, “We know the systems there to find it and stop it are weaker there than elsewhere.”
If efforts to contain an outbreak fail, public health authorities will focus on “mitigation”— dealing with the disease and trying to minimize the harm it does to people and communities.	If efforts to contain an outbreak fail, public health authorities will focus on “mitigation”— dealing with the disease and trying to minimize the harm it does to people and communities.
“It’s a worrisome situation in China,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said in an interview on Wednesday. “It seems like more of a mitigation strategy than a control strategy that China has moved to.”	“It’s a worrisome situation in China,” Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said in an interview on Wednesday. “It seems like more of a mitigation strategy than a control strategy that China has moved to.”
The United States still has a chance to avoid China’s fate, she said.	The United States still has a chance to avoid China’s fate, she said.
“We still only have five cases, and we can really do aggressive measures around those cases,” Dr. Messonnier said. “We’re trying to contain the disease, and by being aggressive we’re hoping to learn more about what it takes to contain it.”	“We still only have five cases, and we can really do aggressive measures around those cases,” Dr. Messonnier said. “We’re trying to contain the disease, and by being aggressive we’re hoping to learn more about what it takes to contain it.”
The five patients have hundreds of contacts. Some are being tested for the virus, and the results may help researchers understand how the disease is transmitted. The C.D.C. is also monitoring more than 100 “patients under investigation” — some with cough or fever who have been to Wuhan, or have had contact with a patient.	The five patients have hundreds of contacts. Some are being tested for the virus, and the results may help researchers understand how the disease is transmitted. The C.D.C. is also monitoring more than 100 “patients under investigation” — some with cough or fever who have been to Wuhan, or have had contact with a patient.
But if the case count were to increase exponentially, Dr. Messonnier said, it would be hard to continue the concerted containment efforts. The C.D.C. is already gearing up should the approach need to evolve to mitigation strategies like closing schools, preventing public gatherings and helping hospitals prepare for a surge of cases.	But if the case count were to increase exponentially, Dr. Messonnier said, it would be hard to continue the concerted containment efforts. The C.D.C. is already gearing up should the approach need to evolve to mitigation strategies like closing schools, preventing public gatherings and helping hospitals prepare for a surge of cases.
One troubling question is whether infected people can start spreading the virus before they themselves get sick. Chinese health officials have said they believe such transmission has taken place. If it happened often, it could make stopping an outbreak much harder.	One troubling question is whether infected people can start spreading the virus before they themselves get sick. Chinese health officials have said they believe such transmission has taken place. If it happened often, it could make stopping an outbreak much harder.
~~Updated June ~~24,~~ 2020~~	Updated June 30, 2020
	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.	Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.	A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.	The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.	The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
The reason is that the first step in halting outbreaks has traditionally been to identify people who are ill and then stop them from infecting others, usually by isolating them. But that approach will not work as well if people without any symptoms are already transmitting the disease.	The reason is that the first step in halting outbreaks has traditionally been to identify people who are ill and then stop them from infecting others, usually by isolating them. But that approach will not work as well if people without any symptoms are already transmitting the disease.
Health officials in the United States said they had not seen data from China to support that claim, nor any evidence that people without symptoms had spread the disease in the United States. The five patients in the United States had all visited Wuhan, and so far none of their contacts have become ill or tested positive for the virus.	Health officials in the United States said they had not seen data from China to support that claim, nor any evidence that people without symptoms had spread the disease in the United States. The five patients in the United States had all visited Wuhan, and so far none of their contacts have become ill or tested positive for the virus.
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