'U.S. Health Experts Say Stricter Measures Are Required to Limit Coronavirus’s Spread' diff viewer (8/9)

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U.S. Health Experts Say Stricter Measures Are Required to Limit Coronavirus’s Spread	U.S. Health Experts Say Stricter Measures Are Required to Limit Coronavirus’s Spread
2020-06-09 23:39:41 UTC	2020-06-10 00:11:14 UTC (32 minutes later)
As the coronavirus gained a foothold in the United States, thousands of employees from Seattle to Silicon Valley were told to work from home. Public school districts in several states have shut down, universities are moving classes to online only, and even churches are limiting services or prayer meetings. A global health conference in Orlando, Fla., planned for Monday, which President Trump was supposed to address, will no longer happen.	As the coronavirus gained a foothold in the United States, thousands of employees from Seattle to Silicon Valley were told to work from home. Public school districts in several states have shut down, universities are moving classes to online only, and even churches are limiting services or prayer meetings. A global health conference in Orlando, Fla., planned for Monday, which President Trump was supposed to address, will no longer happen.
Off the California coast, another cruise ship with infected passengers is waiting for a place to dock. The State Department on Sunday advised Americans, especially those with underlying health conditions, not to travel on cruise ships.	Off the California coast, another cruise ship with infected passengers is waiting for a place to dock. The State Department on Sunday advised Americans, especially those with underlying health conditions, not to travel on cruise ships.
As the coronavirus spread to two-thirds of the states, Americans began to grasp the magnitude of the threat facing them. The weekend’s case tally ballooned, veering toward nearly 600 cases and close to 20 deaths.	As the coronavirus spread to two-thirds of the states, Americans began to grasp the magnitude of the threat facing them. The weekend’s case tally ballooned, veering toward nearly 600 cases and close to 20 deaths.
In Washington State, with the epicenter in the Seattle area, Gov. Jay Inslee said on Sunday that he was considering mandatory measures to help keep people apart. Federal public health officials also signaled that the degree of community spread — new cases popping up with no known link to foreign travel — indicated that the virus was beyond so-called containment in some areas and that new, stricter measures should be considered.	In Washington State, with the epicenter in the Seattle area, Gov. Jay Inslee said on Sunday that he was considering mandatory measures to help keep people apart. Federal public health officials also signaled that the degree of community spread — new cases popping up with no known link to foreign travel — indicated that the virus was beyond so-called containment in some areas and that new, stricter measures should be considered.
It’s a concept in public health known as shifting from containment of an outbreak to “mitigation,” which means acknowledging that the tried-and-true public health measures of isolating the sick and quarantining their contacts are no longer enough. So steps must be taken to minimize deaths from the disease and to slow its spread so that hospitals are not overwhelmed.	It’s a concept in public health known as shifting from containment of an outbreak to “mitigation,” which means acknowledging that the tried-and-true public health measures of isolating the sick and quarantining their contacts are no longer enough. So steps must be taken to minimize deaths from the disease and to slow its spread so that hospitals are not overwhelmed.
“You don’t want to alarm people, but given the spread we see, you know, anything is possible,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Fox News on Sunday. “And that’s the reason why we’ve got to be prepared to take whatever action is appropriate to contain and mitigate the outbreak.”	“You don’t want to alarm people, but given the spread we see, you know, anything is possible,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Fox News on Sunday. “And that’s the reason why we’ve got to be prepared to take whatever action is appropriate to contain and mitigate the outbreak.”
No one in the United States wants to use the word “lockdown,” in the manner of what Italy is doing in its northern regions to try to control the spread of the disease.	No one in the United States wants to use the word “lockdown,” in the manner of what Italy is doing in its northern regions to try to control the spread of the disease.
But the specter of isolation — of telling people in affected areas not to go out — is hovering in big cities where the infection has taken hold.	But the specter of isolation — of telling people in affected areas not to go out — is hovering in big cities where the infection has taken hold.
In an interview, Dr. Fauci said, “I don’t think you want to have folks shutting down cities like in northern Italy. We are not at that level. That is a hot spot. Social distancing like in Seattle is the way to go. I’m not talking about locking down anything. There’s a big difference between voluntary social distancing and locking anything down.”	In an interview, Dr. Fauci said, “I don’t think you want to have folks shutting down cities like in northern Italy. We are not at that level. That is a hot spot. Social distancing like in Seattle is the way to go. I’m not talking about locking down anything. There’s a big difference between voluntary social distancing and locking anything down.”
If community spread is being detected now, that means it began, unseen, weeks ago. The greatest concern is for older people, particularly those who have underlying conditions like diabetes, heart disease, lung problems and weakened immunity.	If community spread is being detected now, that means it began, unseen, weeks ago. The greatest concern is for older people, particularly those who have underlying conditions like diabetes, heart disease, lung problems and weakened immunity.
“Don’t go to crowded places, think twice before a long plane trip, and for goodness sake don’t go on any cruises,” Dr. Fauci said.	“Don’t go to crowded places, think twice before a long plane trip, and for goodness sake don’t go on any cruises,” Dr. Fauci said.
For people who are particularly vulnerable, he said: “Don’t wait for community spread. Now is the time to do social distancing, whether there is spread in your community or not.”	For people who are particularly vulnerable, he said: “Don’t wait for community spread. Now is the time to do social distancing, whether there is spread in your community or not.”
If community spread has already started, as in Seattle, he said, everyone should practice social distancing.	If community spread has already started, as in Seattle, he said, everyone should practice social distancing.
“Everybody is going to be thinking about this, and trying to adapt it to their own circumstances,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “‘Maybe I can attend this meeting virtually.’ A family that’s religious will think about being reverent at home rather than attending services with the rest of the congregation. Maybe we don’t go to the movies.”	“Everybody is going to be thinking about this, and trying to adapt it to their own circumstances,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “‘Maybe I can attend this meeting virtually.’ A family that’s religious will think about being reverent at home rather than attending services with the rest of the congregation. Maybe we don’t go to the movies.”
One goal of mitigation is at least to slow down an epidemic, he said, adding, “If you can stretch things out long enough, you buy more time for the development of the vaccine and the research to be done for treatments.”	One goal of mitigation is at least to slow down an epidemic, he said, adding, “If you can stretch things out long enough, you buy more time for the development of the vaccine and the research to be done for treatments.”
The cruise ship stranded off the coast of California will be allowed to dock on Monday in the port of Oakland at an as-yet-undecided time, the state’s governor, Gavin Newsom, said at a news briefing on Sunday.	The cruise ship stranded off the coast of California will be allowed to dock on Monday in the port of Oakland at an as-yet-undecided time, the state’s governor, Gavin Newsom, said at a news briefing on Sunday.
The site was chosen in part because of the ability to cordon off an 11-acre containment area at the port where the ship’s 2,421 passengers will disembark.	The site was chosen in part because of the ability to cordon off an 11-acre containment area at the port where the ship’s 2,421 passengers will disembark.
California residents, who make up around 40 percent of the passengers, will be transferred for a 14-day quarantine at military bases across the state, including the nearby Travis Air Force Base, where evacuees from China were quarantined last month. Passengers who are not from California will be flown to military bases in Texas and Georgia, the governor said.	California residents, who make up around 40 percent of the passengers, will be transferred for a 14-day quarantine at military bases across the state, including the nearby Travis Air Force Base, where evacuees from China were quarantined last month. Passengers who are not from California will be flown to military bases in Texas and Georgia, the governor said.
Last week, 45 people were tested for coronavirus on the ship and 21 tested positive, 19 of them crew members.	Last week, 45 people were tested for coronavirus on the ship and 21 tested positive, 19 of them crew members.
Testing of the remaining passengers will be done in their quarantine areas, where they will remain for two weeks, officials said.	Testing of the remaining passengers will be done in their quarantine areas, where they will remain for two weeks, officials said.
Foreign passengers will be sent home on charter flights from a section of Oakland International Airport where they can avoid contact with the general public, officials said at the briefing.	Foreign passengers will be sent home on charter flights from a section of Oakland International Airport where they can avoid contact with the general public, officials said at the briefing.
On Sunday afternoon advance medical teams were boarding the ship, Grand Princess, which is about 10 miles offshore, to assess the general health of passengers.	On Sunday afternoon advance medical teams were boarding the ship, Grand Princess, which is about 10 miles offshore, to assess the general health of passengers.
Most of the more than 1,000 crew members will remain onboard the cruise ship, which will leave the San Francisco Bay within about three days, Mr. Newsom said.	Most of the more than 1,000 crew members will remain onboard the cruise ship, which will leave the San Francisco Bay within about three days, Mr. Newsom said.
Oakland’s mayor, Libby Schaaf, said she had sought assurances that the ship would leave quickly and that there would be no local spread of the virus as a result of the ship’s docking at the Oakland port.	Oakland’s mayor, Libby Schaaf, said she had sought assurances that the ship would leave quickly and that there would be no local spread of the virus as a result of the ship’s docking at the Oakland port.
“This is a community that has suffered decades of environmental racism and injustice,” Ms. Schaaf said. “No one will be quarantined in Oakland or released to our community.”	“This is a community that has suffered decades of environmental racism and injustice,” Ms. Schaaf said. “No one will be quarantined in Oakland or released to our community.”
Updated June 5, 2020	Updated June 5, 2020
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.
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.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
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.
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.	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.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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.