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Behind the Virus Report That Jarred the U.S. and the U.K. to Action Behind the Virus Report That Jarred the U.S. and the U.K. to Action
(about 11 hours later)
LONDON — When Boris Johnson was campaigning for Britain to leave the European Union in 2016 — a path that many experts warned would end in disaster for the country — one of his close allies, Michael Gove, famously declared that “people in this country have had enough of experts.”LONDON — When Boris Johnson was campaigning for Britain to leave the European Union in 2016 — a path that many experts warned would end in disaster for the country — one of his close allies, Michael Gove, famously declared that “people in this country have had enough of experts.”
Now, Mr. Gove and Mr. Johnson are leading the British government as it confronts the calamity of the coronavirus, and Mr. Johnson, now the prime minister, insists the process is being guided by experts. The trouble is, those experts can often disagree with each other or change their minds about the right course of action.Now, Mr. Gove and Mr. Johnson are leading the British government as it confronts the calamity of the coronavirus, and Mr. Johnson, now the prime minister, insists the process is being guided by experts. The trouble is, those experts can often disagree with each other or change their minds about the right course of action.
That messy back-and-forth has been on vivid display this week with the publication of a startling new report on the virus from a team at Imperial College in London. The report, which warned that an uncontrolled spread of the disease could cause as many as 510,000 deaths in Britain, triggered a sudden shift in the government’s comparatively relaxed response to the virus.That messy back-and-forth has been on vivid display this week with the publication of a startling new report on the virus from a team at Imperial College in London. The report, which warned that an uncontrolled spread of the disease could cause as many as 510,000 deaths in Britain, triggered a sudden shift in the government’s comparatively relaxed response to the virus.
American officials said the report, which projected up to 2.2 million deaths in the United States from such a spread, also influenced the White House to strengthen its measures to isolate members of the public.American officials said the report, which projected up to 2.2 million deaths in the United States from such a spread, also influenced the White House to strengthen its measures to isolate members of the public.
Imperial College has advised the government on its response to previous epidemics, including SARS, avian flu and swine flu. With ties to the World Health Organization and a team of 50 scientists, led by a prominent epidemiologist, Neil Ferguson, Imperial is treated as a sort of gold standard, its mathematical models feeding directly into government policies.Imperial College has advised the government on its response to previous epidemics, including SARS, avian flu and swine flu. With ties to the World Health Organization and a team of 50 scientists, led by a prominent epidemiologist, Neil Ferguson, Imperial is treated as a sort of gold standard, its mathematical models feeding directly into government policies.
But outside experts pointed out that the report’s alarming conclusions — that the virus would overwhelm hospitals and that governments had no choice but to impose radical lockdown policies — had been made in previous reports on coronavirus or on social media sites devoted to the outbreak.But outside experts pointed out that the report’s alarming conclusions — that the virus would overwhelm hospitals and that governments had no choice but to impose radical lockdown policies — had been made in previous reports on coronavirus or on social media sites devoted to the outbreak.
“A lot of it is not what they say, but who says it,” said Devi Sridhar, director of the global health governance program at Edinburgh University. “Neil Ferguson has a huge amount of influence.”“A lot of it is not what they say, but who says it,” said Devi Sridhar, director of the global health governance program at Edinburgh University. “Neil Ferguson has a huge amount of influence.”
Imperial College, experts noted, was part of the advisory group for the government’s now-abandoned strategy, which played down radical social distancing and accepted that the infection would spread through the population. The theory is that this would build up so-called “herd immunity,” so that the public would be more resistant in the face of a second wave of infections next winter.Imperial College, experts noted, was part of the advisory group for the government’s now-abandoned strategy, which played down radical social distancing and accepted that the infection would spread through the population. The theory is that this would build up so-called “herd immunity,” so that the public would be more resistant in the face of a second wave of infections next winter.
But such a strategy, the report noted, would lead to a flood of critically ill patients in a country without enough beds. Instead, it said, Britain needs to pursue “suppression,” which involves far stricter lockdowns, like the closing of schools and the quarantine of infected people and their families. That would drive down the number of cases and spread out the flow of patients over a longer period, allowing hospitals to cope.But such a strategy, the report noted, would lead to a flood of critically ill patients in a country without enough beds. Instead, it said, Britain needs to pursue “suppression,” which involves far stricter lockdowns, like the closing of schools and the quarantine of infected people and their families. That would drive down the number of cases and spread out the flow of patients over a longer period, allowing hospitals to cope.
Dr. Ferguson has been candid that the report reached new conclusions because of the latest data from Italy, which has seen a spiraling rate of infections, swamping hospitals and forcing doctors to make agonizing decisions about who to treat.Dr. Ferguson has been candid that the report reached new conclusions because of the latest data from Italy, which has seen a spiraling rate of infections, swamping hospitals and forcing doctors to make agonizing decisions about who to treat.
“The U.K. has struggled in the past few weeks in thinking about how to handle this outbreak long term,” Dr. Ferguson said in an interview on Monday, just after the report was released. “Based on our estimates and other teams’, there’s really no option but follow in China’s footsteps and suppress.”“The U.K. has struggled in the past few weeks in thinking about how to handle this outbreak long term,” Dr. Ferguson said in an interview on Monday, just after the report was released. “Based on our estimates and other teams’, there’s really no option but follow in China’s footsteps and suppress.”
The report added, “this conclusion has only been reached in the last few days, with the refinement of estimates of likely ICU demand due to COVID-19 based on experience in Italy and the UK.”The report added, “this conclusion has only been reached in the last few days, with the refinement of estimates of likely ICU demand due to COVID-19 based on experience in Italy and the UK.”
But other experts said the burden on hospitals was clear as far back as the original outbreak in Wuhan, China. Lancet, the British medical journal, published an article in January, based on studying a small group of patients, which found that a third of people had to be admitted to intensive care units.But other experts said the burden on hospitals was clear as far back as the original outbreak in Wuhan, China. Lancet, the British medical journal, published an article in January, based on studying a small group of patients, which found that a third of people had to be admitted to intensive care units.
“I can’t help but feel angry that it has taken almost two months for politicians and even ‘experts’ to understand the scale of the danger from SARS-CoV-2,” said Richard Horton, the editor-in-chief of Lancet, on Twitter. “Those dangers were clear from the very beginning.”“I can’t help but feel angry that it has taken almost two months for politicians and even ‘experts’ to understand the scale of the danger from SARS-CoV-2,” said Richard Horton, the editor-in-chief of Lancet, on Twitter. “Those dangers were clear from the very beginning.”
Some said governments should treat the report’s projections about suppression policies with the same caution. It says social distancing measures might have to be imposed for 18 months or more, at least intermittently, until a vaccine is developed and tested. But the report acknowledges this is uncertain, given the possibility of drug treatments and the mystery of how the virus is transmitted.Some said governments should treat the report’s projections about suppression policies with the same caution. It says social distancing measures might have to be imposed for 18 months or more, at least intermittently, until a vaccine is developed and tested. But the report acknowledges this is uncertain, given the possibility of drug treatments and the mystery of how the virus is transmitted.
“We’re all using the 1918 pandemic flu handbook,” Dr. Sridhar said. “But we’re in a different position than in 1918. We’re in 2020.”“We’re all using the 1918 pandemic flu handbook,” Dr. Sridhar said. “But we’re in a different position than in 1918. We’re in 2020.”
After days of confusion about the wisdom of encouraging “herd immunity,” the government sought to play down the dispute, arguing that this was not a deliberate part of its strategy but a byproduct of it. But it shifted to a policy of urging people not to go to pubs, restaurants, theaters or museums.After days of confusion about the wisdom of encouraging “herd immunity,” the government sought to play down the dispute, arguing that this was not a deliberate part of its strategy but a byproduct of it. But it shifted to a policy of urging people not to go to pubs, restaurants, theaters or museums.
On Tuesday, the government’s chief scientific adviser, Sir Patrick Vallance, said he expected these new, more stringent restrictions to last for months — and that the authorities would have to monitor very carefully what would happen when they are eventually lifted.On Tuesday, the government’s chief scientific adviser, Sir Patrick Vallance, said he expected these new, more stringent restrictions to last for months — and that the authorities would have to monitor very carefully what would happen when they are eventually lifted.
Updated June 12, 2020Updated June 12, 2020
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.
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.
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.
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.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
British officials recognize that their health service faces a moment of truth. All non-urgent operations in England will be postponed for at least three months, starting April 15, to free up 30,000 beds to help tackle the coronavirus.British officials recognize that their health service faces a moment of truth. All non-urgent operations in England will be postponed for at least three months, starting April 15, to free up 30,000 beds to help tackle the coronavirus.
Britain lags behind other European nations in its supply of ventilators. Plans are underway to ramp up their numbers from over 8,000 to 12,000, though officials are reluctant to promise that even this is sufficient.Britain lags behind other European nations in its supply of ventilators. Plans are underway to ramp up their numbers from over 8,000 to 12,000, though officials are reluctant to promise that even this is sufficient.
Underscoring the change in tone, Britain’s finance chief, Rishi Sunak, announced a gargantuan fiscal stimulus to salvage reeling British businesses and to try to stem job losses. The package, worth £330 billion, or $422 billion, will include government-backed loans and tax breaks for companies and a three-month break in mortgage repayments for strapped homeowners.Underscoring the change in tone, Britain’s finance chief, Rishi Sunak, announced a gargantuan fiscal stimulus to salvage reeling British businesses and to try to stem job losses. The package, worth £330 billion, or $422 billion, will include government-backed loans and tax breaks for companies and a three-month break in mortgage repayments for strapped homeowners.
“We have never in peacetime faced an economic fight like this,” said Mr. Sunak, who also promised support for airports and airlines in the coming days, after Britons were advised against all non-essential travel.“We have never in peacetime faced an economic fight like this,” said Mr. Sunak, who also promised support for airports and airlines in the coming days, after Britons were advised against all non-essential travel.
Mr. Johnson hinted on Tuesday that schools could be closed soon. But he still faces criticism for a lack of clarity, including his decision to urge people to avoid pubs and restaurants but not to order their closing. In fact, the government now intends to relax laws to allow pubs to stay open and produce takeout food.Mr. Johnson hinted on Tuesday that schools could be closed soon. But he still faces criticism for a lack of clarity, including his decision to urge people to avoid pubs and restaurants but not to order their closing. In fact, the government now intends to relax laws to allow pubs to stay open and produce takeout food.
To Mr. Johnson’s embarrassment, one of those promising to visit his local pub was his own father, Stanley Johnson.To Mr. Johnson’s embarrassment, one of those promising to visit his local pub was his own father, Stanley Johnson.
Sheri Fink contributed to this report from New York.Sheri Fink contributed to this report from New York.