'As a Federal Coronavirus Expert Frets, the Capital Moves to Reopen' diff viewer (10/11)

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As a Federal Coronavirus Expert Frets, the Capital Moves to Reopen	As a Federal Coronavirus Expert Frets, the Capital Moves to Reopen
2020-06-17 17:06:40 UTC	2020-06-24 12:46:40 UTC (7 days later)
WASHINGTON — The leaders around the nation’s capital are pushing forward with plans to reopen the region, hoping they are close enough to their public health goals to move toward normalcy despite coronavirus infection rates that have alarmed federal officials.	WASHINGTON — The leaders around the nation’s capital are pushing forward with plans to reopen the region, hoping they are close enough to their public health goals to move toward normalcy despite coronavirus infection rates that have alarmed federal officials.
“I want to make sure we all understand that moving into Phase 1 means that more people can get infected,” Muriel E. Bowser, Washington’s mayor, said on Wednesday as she announced that parts of the city would begin to reopen on Friday. “It cannot be said enough: Every single one of us has a role to play.”	“I want to make sure we all understand that moving into Phase 1 means that more people can get infected,” Muriel E. Bowser, Washington’s mayor, said on Wednesday as she announced that parts of the city would begin to reopen on Friday. “It cannot be said enough: Every single one of us has a role to play.”
The northern suburbs of Virginia will also begin limited reopenings on Friday, while suburban counties in Maryland remain shuttered, underscoring the challenges that the region faces with boundaries that its residents crisscross daily.	The northern suburbs of Virginia will also begin limited reopenings on Friday, while suburban counties in Maryland remain shuttered, underscoring the challenges that the region faces with boundaries that its residents crisscross daily.
The Washington metropolitan area, home to 6.2 million people, is among the most interconnected regions in the nation, with a shared public transportation system and entwined economies. The region’s unusual symbiosis is further complicated by the movements of congressional lawmakers in and out of town and a mercurial White House, all posing difficulties for the governors of Maryland and Virginia and the mayor of the District of Columbia — a city that lacks the autonomy of states with the same or smaller populations — as they move to bring their economies back to life.	The Washington metropolitan area, home to 6.2 million people, is among the most interconnected regions in the nation, with a shared public transportation system and entwined economies. The region’s unusual symbiosis is further complicated by the movements of congressional lawmakers in and out of town and a mercurial White House, all posing difficulties for the governors of Maryland and Virginia and the mayor of the District of Columbia — a city that lacks the autonomy of states with the same or smaller populations — as they move to bring their economies back to life.
On Tuesday, in a private call with the nation’s governors, Dr. Deborah L. Birx, the White House coronavirus response coordinator, singled out the Washington region as among a handful of metropolitan areas where positive coronavirus test rates remain above 10 percent. In the call, a recording of which was obtained by The New York Times, Dr. Birx also mentioned Baltimore and Richmond, the largest nearby cities.	On Tuesday, in a private call with the nation’s governors, Dr. Deborah L. Birx, the White House coronavirus response coordinator, singled out the Washington region as among a handful of metropolitan areas where positive coronavirus test rates remain above 10 percent. In the call, a recording of which was obtained by The New York Times, Dr. Birx also mentioned Baltimore and Richmond, the largest nearby cities.
On Wednesday, Virginia reported 45 new deaths, the third day in a row of record increases. A majority of them were in the Washington suburbs, where the overall number of infections remains far higher than in the rest of the commonwealth.	On Wednesday, Virginia reported 45 new deaths, the third day in a row of record increases. A majority of them were in the Washington suburbs, where the overall number of infections remains far higher than in the rest of the commonwealth.
Nonetheless, Gov. Ralph Northam, a Democrat, has said that because Northern Virginia health officials judged that the region had met four of the six metrics for reopening, the area would begin to do so on Friday, joining the less-affected parts of the commonwealth. That day, Virginia will also begin a statewide mask requirement for indoor businesses.	Nonetheless, Gov. Ralph Northam, a Democrat, has said that because Northern Virginia health officials judged that the region had met four of the six metrics for reopening, the area would begin to do so on Friday, joining the less-affected parts of the commonwealth. That day, Virginia will also begin a statewide mask requirement for indoor businesses.
The growth rates of new cases and deaths in the District of Columbia have mostly held steady at a time when rates have mostly fallen elsewhere in the country, underscoring the city’s difficulty in fully reversing the course of the virus, as Dr. Birx would like to see.	The growth rates of new cases and deaths in the District of Columbia have mostly held steady at a time when rates have mostly fallen elsewhere in the country, underscoring the city’s difficulty in fully reversing the course of the virus, as Dr. Birx would like to see.
In Maryland, the two counties bordering Washington have opted to maintain stay-at-home orders as Gov. Larry Hogan, a Republican, has moved to slowly open the state while leaving counties to decide their own path.	In Maryland, the two counties bordering Washington have opted to maintain stay-at-home orders as Gov. Larry Hogan, a Republican, has moved to slowly open the state while leaving counties to decide their own path.
On Wednesday, Marc Elrich, the county executive in Montgomery County, a sprawling and diverse suburb across the district line where the most Maryland deaths have occurred, said it would begin restricted reopenings in “a matter of days.”	On Wednesday, Marc Elrich, the county executive in Montgomery County, a sprawling and diverse suburb across the district line where the most Maryland deaths have occurred, said it would begin restricted reopenings in “a matter of days.”
Another close-in suburb, Prince George’s County — which has nearly 30 percent of Maryland’s cases even though it holds only 15 percent of the state’s population — is expected to take similar measures soon.	Another close-in suburb, Prince George’s County — which has nearly 30 percent of Maryland’s cases even though it holds only 15 percent of the state’s population — is expected to take similar measures soon.
A much-celebrated tranche of tests that Mr. Hogan procured from South Korea has not really made its way into the Maryland counties as many local leaders expected, and the counties closest to the nation’s capital — areas with the highest rates of infection and death — have scrambled to obtain their own tests.	A much-celebrated tranche of tests that Mr. Hogan procured from South Korea has not really made its way into the Maryland counties as many local leaders expected, and the counties closest to the nation’s capital — areas with the highest rates of infection and death — have scrambled to obtain their own tests.
“Maryland’s high positive infection rate, one of the highest in the country, shows just how limited our state’s testing capacity is,” said Representative Anthony G. Brown, a Democrat. “We are not testing beyond our sickest residents, leaving us mostly blind to the broader community spread that is likely occurring.”	“Maryland’s high positive infection rate, one of the highest in the country, shows just how limited our state’s testing capacity is,” said Representative Anthony G. Brown, a Democrat. “We are not testing beyond our sickest residents, leaving us mostly blind to the broader community spread that is likely occurring.”
“Local jurisdictions,” he said, “have been left to fend for themselves to get adequate testing and medical supplies in place. This is a threat to public health.”	“Local jurisdictions,” he said, “have been left to fend for themselves to get adequate testing and medical supplies in place. This is a threat to public health.”
Mike Ricci, a spokesman for Mr. Hogan, noted that the governor had said that some components were still needed for the tests, which he got through a contact of his wife, to be used widely around the state. “We have consistently directed much of the state’s response to hardest-hit areas, with Montgomery and Prince George’s receiving the most testing, the most hospitals,” he said.	Mike Ricci, a spokesman for Mr. Hogan, noted that the governor had said that some components were still needed for the tests, which he got through a contact of his wife, to be used widely around the state. “We have consistently directed much of the state’s response to hardest-hit areas, with Montgomery and Prince George’s receiving the most testing, the most hospitals,” he said.
In Washington, the racial disparities in death rates have been stark.	In Washington, the racial disparities in death rates have been stark.
For instance, Ward 4, a neighborhood with a mix of poor, middle-class and wealthy residents, has more infections — 1,771 total — than any other, largely attributed to workers in so-called essential jobs who take public transportation and often live in dense environments. But there have been only 63 deaths in that area.	For instance, Ward 4, a neighborhood with a mix of poor, middle-class and wealthy residents, has more infections — 1,771 total — than any other, largely attributed to workers in so-called essential jobs who take public transportation and often live in dense environments. But there have been only 63 deaths in that area.
In Ward 8, one of the city’s poorest areas, the 1,174 cases are in the middle of infection rates for the city’s eight wards, but the number of deaths, 92, is the highest in the city. The difference, local health care experts said, most likely stems from the fact that Ward 4 is 47 percent black, while Ward 8 is 92 percent black.	In Ward 8, one of the city’s poorest areas, the 1,174 cases are in the middle of infection rates for the city’s eight wards, but the number of deaths, 92, is the highest in the city. The difference, local health care experts said, most likely stems from the fact that Ward 4 is 47 percent black, while Ward 8 is 92 percent black.
~~Updated June ~~16,~~ 2020~~	Updated June 22, 2020
	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.
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.
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.
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.
The city’s black residents are more likely to be obese and have diabetes, high blood pressure and heart disease, all major risk factors for death with the coronavirus.	The city’s black residents are more likely to be obese and have diabetes, high blood pressure and heart disease, all major risk factors for death with the coronavirus.
“I would add to the resource issue the black population’s historically complex relationship with health care,” said Yesim Sayin Taylor, the executive director of the D.C. Policy Center, a research organization. Ward 8 has far fewer health care resources than the rest of the city, and many residents may be getting tested for the coronavirus at a far later stage than other city residents.	“I would add to the resource issue the black population’s historically complex relationship with health care,” said Yesim Sayin Taylor, the executive director of the D.C. Policy Center, a research organization. Ward 8 has far fewer health care resources than the rest of the city, and many residents may be getting tested for the coronavirus at a far later stage than other city residents.
Poverty among black residents in Ward 8 may help explain why their death rates are higher than those of black residents in Prince George’s County, where infection rates are high but deaths lag Montgomery County. Black residents make up about 62 percent of the Prince George’s population, but income levels are higher.	Poverty among black residents in Ward 8 may help explain why their death rates are higher than those of black residents in Prince George’s County, where infection rates are high but deaths lag Montgomery County. Black residents make up about 62 percent of the Prince George’s population, but income levels are higher.
“Wealth allows families to weather an unexpected emergency like Covid-19,” said Danyelle Solomon, the vice president for race and ethnicity policy at the Center for American Progress, a liberal research organization. She noted that in Washington, black residents were 4.5 times more likely to experience poverty than their white counterparts, while in Maryland they were two times more likely.	“Wealth allows families to weather an unexpected emergency like Covid-19,” said Danyelle Solomon, the vice president for race and ethnicity policy at the Center for American Progress, a liberal research organization. She noted that in Washington, black residents were 4.5 times more likely to experience poverty than their white counterparts, while in Maryland they were two times more likely.