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When an Epidemic Looms, Gagging Scientists Is a Terrible Idea When an Epidemic Looms, Gagging Scientists Is a Terrible Idea
(8 days later)
Many times in many countries, political leaders have tried to censor health officials and play down the risks of infection just as epidemics approached.Many times in many countries, political leaders have tried to censor health officials and play down the risks of infection just as epidemics approached.
This strategy has almost never worked, historians and former health officials said. And ultimately, if there are more deaths than leaders blithely predict, it destroys the reputations of the leaders themselves.This strategy has almost never worked, historians and former health officials said. And ultimately, if there are more deaths than leaders blithely predict, it destroys the reputations of the leaders themselves.
This week’s efforts to reorganize the Trump administration’s chaotic response to the coronavirus outbreak risk falling into that pattern. The White House will coordinate all messaging, the public was told, and scientists in government employ will not be popping up on television talk shows, saying whatever they think.This week’s efforts to reorganize the Trump administration’s chaotic response to the coronavirus outbreak risk falling into that pattern. The White House will coordinate all messaging, the public was told, and scientists in government employ will not be popping up on television talk shows, saying whatever they think.
That may not be a winning strategy, experts warned. The stock market reacts to rumors, and the Federal Reserve Bank may succumb to political pressure. But pathogens, like hurricanes and tsunamis, are immune to spin.That may not be a winning strategy, experts warned. The stock market reacts to rumors, and the Federal Reserve Bank may succumb to political pressure. But pathogens, like hurricanes and tsunamis, are immune to spin.
As they bore into communities, how many people in their path survive usually depends on whether a country’s leaders can correctly read early warning signs, muster an intelligent response and adroitly adjust their tactics if the threat changes.As they bore into communities, how many people in their path survive usually depends on whether a country’s leaders can correctly read early warning signs, muster an intelligent response and adroitly adjust their tactics if the threat changes.
For that to happen, medical expertise must outweigh campaign messaging. China has already experienced the consequences.For that to happen, medical expertise must outweigh campaign messaging. China has already experienced the consequences.
Initially, officials in Wuhan — the city at the epicenter of the coronavirus epidemic — claimed that the new lethal pneumonia associated with a seafood market there was not jumping from person to person.Initially, officials in Wuhan — the city at the epicenter of the coronavirus epidemic — claimed that the new lethal pneumonia associated with a seafood market there was not jumping from person to person.
When that was exposed as a lie, local officials arrested and threatened the first doctors to expose it. As hospitals were mobbed, large numbers of Wuhanese began dying, and cases began cropping up in other cities.When that was exposed as a lie, local officials arrested and threatened the first doctors to expose it. As hospitals were mobbed, large numbers of Wuhanese began dying, and cases began cropping up in other cities.
Beijing tried to play down negative news in state-controlled media. As a result, a population that normally does not dare criticize its leaders began doing so — loudly.Beijing tried to play down negative news in state-controlled media. As a result, a population that normally does not dare criticize its leaders began doing so — loudly.
Finally, stung by the outcry, President Xi Jinping asserted that he had been in charge all along, although critics noted that the initial response was inept.Finally, stung by the outcry, President Xi Jinping asserted that he had been in charge all along, although critics noted that the initial response was inept.
Something similar may happen in the United States, now that the virus has reached these shores.Something similar may happen in the United States, now that the virus has reached these shores.
Fighting epidemics is often likened to war. It is best led by generals with combat experience and deep understandings of military history. During crises, when the public seeks trustworthy leadership, the leader’s bearing and credibility matter.Fighting epidemics is often likened to war. It is best led by generals with combat experience and deep understandings of military history. During crises, when the public seeks trustworthy leadership, the leader’s bearing and credibility matter.
The awkward bickering over who was in charge that ended Mr. Trump’s first news conference on the coronavirus was the exact opposite of what was needed, experts said.The awkward bickering over who was in charge that ended Mr. Trump’s first news conference on the coronavirus was the exact opposite of what was needed, experts said.
So is the confusion about whether the vice president’s office will filter messages, or to what extent Dr. Deborah L. Birx, who was until recently the country’s global AIDS coordinator, will be allowed to lead.So is the confusion about whether the vice president’s office will filter messages, or to what extent Dr. Deborah L. Birx, who was until recently the country’s global AIDS coordinator, will be allowed to lead.
Dr. Birx has long experience as a clinician in Africa, and directs the President’s Emergency Plan for AIDS Relief, which dispenses billions of dollars.Dr. Birx has long experience as a clinician in Africa, and directs the President’s Emergency Plan for AIDS Relief, which dispenses billions of dollars.
But she is not a familiar public figure and has no history of working with the hundreds of state and local health departments that will provide the front-line troops for the fight.But she is not a familiar public figure and has no history of working with the hundreds of state and local health departments that will provide the front-line troops for the fight.
“It’s crucially important that experts tell the public what they know and when they know it,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention.“It’s crucially important that experts tell the public what they know and when they know it,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention.
“That’s the only way to earn and maintain the public trust that is essential to work together as a society and fight an epidemic.”“That’s the only way to earn and maintain the public trust that is essential to work together as a society and fight an epidemic.”
On Friday, the president of the Service Employees International Union, which represents two million health care workers, accused Mr. Trump of jeopardizing its members’ health by playing down the epidemic’s severity.On Friday, the president of the Service Employees International Union, which represents two million health care workers, accused Mr. Trump of jeopardizing its members’ health by playing down the epidemic’s severity.
The administration “must immediately reverse course and allow public health experts to lead a nationally coordinated response,” said the S.E.I.U. president, Mary Kay Henry.The administration “must immediately reverse course and allow public health experts to lead a nationally coordinated response,” said the S.E.I.U. president, Mary Kay Henry.
Medical groups decried the idea of muzzling or sidelining scientists.Medical groups decried the idea of muzzling or sidelining scientists.
“Introducing a political sieve between the scientists and the public undermines the public’s right to know the truth about the health threats they face,” said Dr. Keith Martin, executive director of the Consortium of Universities for Global Health.“Introducing a political sieve between the scientists and the public undermines the public’s right to know the truth about the health threats they face,” said Dr. Keith Martin, executive director of the Consortium of Universities for Global Health.
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.
Previous American presidents have tried, unsuccessfully, to suppress bad news about disease.Previous American presidents have tried, unsuccessfully, to suppress bad news about disease.
In early 1918, said Dr. Howard Markel, a medical historian at the University of Michigan medical school, President Woodrow Wilson told his own staff to keep silent about the devastating flu then striking the American military.In early 1918, said Dr. Howard Markel, a medical historian at the University of Michigan medical school, President Woodrow Wilson told his own staff to keep silent about the devastating flu then striking the American military.
“They were taking precautions like wearing masks, but he ordered them not to talk about it,” Dr. Markel said. “But it was spreading so fast that attempts to cover it up were just silly.”“They were taking precautions like wearing masks, but he ordered them not to talk about it,” Dr. Markel said. “But it was spreading so fast that attempts to cover it up were just silly.”
That pandemic became known as the Spanish flu — even though it first hit the American, English, French and German armies in Europe — because war correspondents were subject to military censorship. Reports of widespread deaths of young soldiers were considered bad for morale.That pandemic became known as the Spanish flu — even though it first hit the American, English, French and German armies in Europe — because war correspondents were subject to military censorship. Reports of widespread deaths of young soldiers were considered bad for morale.
In neutral Spain, newspapers were free to report deaths on the front pages.In neutral Spain, newspapers were free to report deaths on the front pages.
Message control also failed in Hamburg, Germany, in 1892, Dr. Markel noted. The city’s business and civic leaders conspired to suppress news of its cholera epidemic.Message control also failed in Hamburg, Germany, in 1892, Dr. Markel noted. The city’s business and civic leaders conspired to suppress news of its cholera epidemic.
But word leaked out, and ships from Hamburg, a major port, became suspect and were refused entry when they tried to dock in the United States.But word leaked out, and ships from Hamburg, a major port, became suspect and were refused entry when they tried to dock in the United States.
During the early 1980s, a mysterious illness appeared: Its victims slowly wasted away and died despite all attempts to save them. No one knew the cause, how it was transmitted or who, if anyone, was safe.During the early 1980s, a mysterious illness appeared: Its victims slowly wasted away and died despite all attempts to save them. No one knew the cause, how it was transmitted or who, if anyone, was safe.
Because it struck hardest at groups who initially had no political power, including gay men, hemophiliacs, heroin users and Haitians, President Ronald Reagan for years did not even acknowledge the outbreak of what was first called Gay-Related Immune Disease and ultimately Acquired Immune Deficiency Syndrome, or AIDS.Because it struck hardest at groups who initially had no political power, including gay men, hemophiliacs, heroin users and Haitians, President Ronald Reagan for years did not even acknowledge the outbreak of what was first called Gay-Related Immune Disease and ultimately Acquired Immune Deficiency Syndrome, or AIDS.
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But public health officials in cities like San Francisco were forced to confront it — and they realized that they had to institute policies that would mean asking victims extremely intrusive questions, including their sexual orientation and the names of all their sexual partners.But public health officials in cities like San Francisco were forced to confront it — and they realized that they had to institute policies that would mean asking victims extremely intrusive questions, including their sexual orientation and the names of all their sexual partners.
“Can you imagine what would have happened if people thought that everything I was saying was first politically vetted?” said Dr. Dean Echenberg, who was then director of disease control for the city’s health department, and held almost daily news conferences.“Can you imagine what would have happened if people thought that everything I was saying was first politically vetted?” said Dr. Dean Echenberg, who was then director of disease control for the city’s health department, and held almost daily news conferences.
“It was very difficult to be trusted as it was,” he said. “Providing information about the disease was as important a tool in control for us as testing and contact tracing.”“It was very difficult to be trusted as it was,” he said. “Providing information about the disease was as important a tool in control for us as testing and contact tracing.”
Asked if he had ever been asked to suppress or tailor a health message, Dr. Frieden, who was New York City health commissioner under Mayor Michael R. Bloomberg before running the C.D.C., replied: “Never. Never when I worked for Mike. Never on Ebola. Never on the flu pandemic. And never over the stock market.”Asked if he had ever been asked to suppress or tailor a health message, Dr. Frieden, who was New York City health commissioner under Mayor Michael R. Bloomberg before running the C.D.C., replied: “Never. Never when I worked for Mike. Never on Ebola. Never on the flu pandemic. And never over the stock market.”