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| How Bubonic Plague Has Helped Russia Fight the Coronavirus | How Bubonic Plague Has Helped Russia Fight the Coronavirus |
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| MOSCOW — In a remote alpine meadow in Kyrgyzstan a few years ago, a teenage boy killed and skinned a marmot. Five days later, his parents carried the sweating, delirious boy to a village hospital where he died of bubonic plague. | MOSCOW — In a remote alpine meadow in Kyrgyzstan a few years ago, a teenage boy killed and skinned a marmot. Five days later, his parents carried the sweating, delirious boy to a village hospital where he died of bubonic plague. |
| Like a ghost from the medieval past, the plague still makes occasional, unwelcome appearances in remote regions of the former Soviet Union, where it survives today in wild rodents. | Like a ghost from the medieval past, the plague still makes occasional, unwelcome appearances in remote regions of the former Soviet Union, where it survives today in wild rodents. |
| Over the centuries, with improved public hygiene, the plague declined as a threat. Today, as a bacterial infection, it is treatable with antibiotics, if caught in time. | Over the centuries, with improved public hygiene, the plague declined as a threat. Today, as a bacterial infection, it is treatable with antibiotics, if caught in time. |
| But the plague was still a lethal menace in the 1920s and also an embarrassment for the Soviet Union, which established a specialized state agency to track and contain it. | But the plague was still a lethal menace in the 1920s and also an embarrassment for the Soviet Union, which established a specialized state agency to track and contain it. |
| Successors to that agency still exist in Russia and in half a dozen other countries that were once Soviet republics, and, with their ready quarantine plans and trained personnel, they have become a mainstay of the regional response to the coronavirus. | Successors to that agency still exist in Russia and in half a dozen other countries that were once Soviet republics, and, with their ready quarantine plans and trained personnel, they have become a mainstay of the regional response to the coronavirus. |
| It is too early to tell if the former Soviet antiplague centers, as the sites were called, have made any difference in the coronavirus outbreak, which so far has infected more than 21,000 Russians, killing 170. | It is too early to tell if the former Soviet antiplague centers, as the sites were called, have made any difference in the coronavirus outbreak, which so far has infected more than 21,000 Russians, killing 170. |
| At most, the legacy Soviet system helped delay the spread, and it is just one data point in assessing why the coronavirus moved more slowly in Russia, Ukraine and other former Soviet countries than in Western Europe and the United States. Luck, border closures or officials covering up the true numbers of deaths could also explain the low numbers. | At most, the legacy Soviet system helped delay the spread, and it is just one data point in assessing why the coronavirus moved more slowly in Russia, Ukraine and other former Soviet countries than in Western Europe and the United States. Luck, border closures or officials covering up the true numbers of deaths could also explain the low numbers. |
| Infections are in any case now shooting up, and those countries seem to be headed the way of the rest of the world toward bulging hospitals and morgues. But employees of the antiplague centers say their early work helped, becoming a silver lining to the region’s long-lingering plague problem. | Infections are in any case now shooting up, and those countries seem to be headed the way of the rest of the world toward bulging hospitals and morgues. But employees of the antiplague centers say their early work helped, becoming a silver lining to the region’s long-lingering plague problem. |
| “Of course, it helped” early on, said Ravshan Maimulov, director of a regional antiplague service in Kyrgyzstan who examined the teenage plague victim when he died in 2013. He used the same quarantine plan that he had instituted after the boy’s death to respond to the coronavirus in March. | “Of course, it helped” early on, said Ravshan Maimulov, director of a regional antiplague service in Kyrgyzstan who examined the teenage plague victim when he died in 2013. He used the same quarantine plan that he had instituted after the boy’s death to respond to the coronavirus in March. |
| When the 15-year-old had arrived at the village hospital, “the body was still damp from sweat and I felt swelling under the armpits and chin,” Mr. Maimulov said. But the boy was too far gone to save, and he died within hours. | When the 15-year-old had arrived at the village hospital, “the body was still damp from sweat and I felt swelling under the armpits and chin,” Mr. Maimulov said. But the boy was too far gone to save, and he died within hours. |
| Mr. Maimulov, 57, trained at a Russian antiplague institute called Microbe. After the boy’s death, he had the authority to immediately put in motion plans for a lockdown, even though at that point they had only a partial diagnosis. | Mr. Maimulov, 57, trained at a Russian antiplague institute called Microbe. After the boy’s death, he had the authority to immediately put in motion plans for a lockdown, even though at that point they had only a partial diagnosis. |
| He relayed the news to a regional governor in code — they would need to implement “Formula 100” — lest word leak and inhabitants of the village, Ichke-Zhergez, should try to flee before the door slammed shut. | He relayed the news to a regional governor in code — they would need to implement “Formula 100” — lest word leak and inhabitants of the village, Ichke-Zhergez, should try to flee before the door slammed shut. |
| “We needed to prevent them all from running away,” he said. By the next morning, police checkpoints were in place and the village was sealed. | “We needed to prevent them all from running away,” he said. By the next morning, police checkpoints were in place and the village was sealed. |
| On his recommendation, the authorities in the surrounding Issyk-Kul region used the same approach in March in introducing coronavirus lockdowns. “We worked under the operative plan for the plague,” Mr. Maimulov said in a telephone interview. The region of about half a million people has reported three coronavirus cases, he said. Kyrgyzstan has reported five deaths. | On his recommendation, the authorities in the surrounding Issyk-Kul region used the same approach in March in introducing coronavirus lockdowns. “We worked under the operative plan for the plague,” Mr. Maimulov said in a telephone interview. The region of about half a million people has reported three coronavirus cases, he said. Kyrgyzstan has reported five deaths. |
| Russia maintains 13 antiplague centers, from the Far East to the Caucasus Mountains, five plague research institutes and multiple field stations. In March, the authorities moved new laboratory equipment into the antiplague center in Moscow to expand its ability to test for coronavirus. | Russia maintains 13 antiplague centers, from the Far East to the Caucasus Mountains, five plague research institutes and multiple field stations. In March, the authorities moved new laboratory equipment into the antiplague center in Moscow to expand its ability to test for coronavirus. |
| The Microbe institute, originally dedicated wholly to bubonic plague but later expanded to tackle other infections such as cholera, yellow fever, anthrax and tularemia, models the spread of the coronavirus. | The Microbe institute, originally dedicated wholly to bubonic plague but later expanded to tackle other infections such as cholera, yellow fever, anthrax and tularemia, models the spread of the coronavirus. |
| Updated June 24, 2020 | |
| 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. | 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. |
| Starting in January, directors of antiplague centers in the Eurasian Economic Union, the Moscow-led trade alliance of Armenia, Belarus, Kazakhstan, Kyrgyzstan and Russia, held conference calls about the coronavirus. And a plague institute in Odessa, Ukraine, is among agencies responding to the coronavirus there, officials said. | Starting in January, directors of antiplague centers in the Eurasian Economic Union, the Moscow-led trade alliance of Armenia, Belarus, Kazakhstan, Kyrgyzstan and Russia, held conference calls about the coronavirus. And a plague institute in Odessa, Ukraine, is among agencies responding to the coronavirus there, officials said. |
| “The very fact that Russia and the other former Soviet states are, exactly, former Soviet states means a common legacy,” in health care, said Dmitri Trenin, director of the Carnegie Moscow Center. A legacy of focus on epidemics helped, he said. Soviet health care had haphazard success at treating individuals but “could respond like the military to epidemics,” he noted. | “The very fact that Russia and the other former Soviet states are, exactly, former Soviet states means a common legacy,” in health care, said Dmitri Trenin, director of the Carnegie Moscow Center. A legacy of focus on epidemics helped, he said. Soviet health care had haphazard success at treating individuals but “could respond like the military to epidemics,” he noted. |
| Other analysts of former Soviet medical services say that, in the longer term, the Soviet legacy will prove no gift. The capacity to counter epidemics had degraded while little was done to improve an ability to treat patients, according to Yevgeny S. Gontmakher, a professor at the Higher School of Economics and an authority on Russian health care. | Other analysts of former Soviet medical services say that, in the longer term, the Soviet legacy will prove no gift. The capacity to counter epidemics had degraded while little was done to improve an ability to treat patients, according to Yevgeny S. Gontmakher, a professor at the Higher School of Economics and an authority on Russian health care. |
| “The plague doctors were the elite of a hundred years ago, not today,” he said. | “The plague doctors were the elite of a hundred years ago, not today,” he said. |
| In Kyrgyzstan, Mr. Maimulov works in a wooden laboratory in what had been, until a few weeks ago, the medical backwater of plague control. Most years, he plans for campaigns of spraying insecticide into rodent burrows, to kill fleas and slow the spread in animals. | In Kyrgyzstan, Mr. Maimulov works in a wooden laboratory in what had been, until a few weeks ago, the medical backwater of plague control. Most years, he plans for campaigns of spraying insecticide into rodent burrows, to kill fleas and slow the spread in animals. |
| The disease cannot be fully stamped out. “They are rodents, they reproduce quickly,” he said. “It’s not worthwhile to kill them.” | The disease cannot be fully stamped out. “They are rodents, they reproduce quickly,” he said. “It’s not worthwhile to kill them.” |
| The family of the 15-year-old boy were herding sheep in the mountains and trapping marmots for fur as a sideline. The boy skinned the marmot with a razor blade. Though the Black Death typically spreads by flea bite, in this instance the boy caught it simply by nicking his finger. | The family of the 15-year-old boy were herding sheep in the mountains and trapping marmots for fur as a sideline. The boy skinned the marmot with a razor blade. Though the Black Death typically spreads by flea bite, in this instance the boy caught it simply by nicking his finger. |
| Eventually, 32 villages were put under quarantine while about 700 nurses went door to door looking for infection. Marmot hides were collected and burned. But the antiplague team had acted quickly enough. The boy was the only confirmed case. | Eventually, 32 villages were put under quarantine while about 700 nurses went door to door looking for infection. Marmot hides were collected and burned. But the antiplague team had acted quickly enough. The boy was the only confirmed case. |
| Oleg Matsnev contributed reporting. | Oleg Matsnev contributed reporting. |