'Pittsburgh Seemed Like a Virus Success Story. Now Cases Are Surging.' diff viewer (1/2)

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Pittsburgh Seemed Like a Virus Success Story. Now Cases Are Surging.	Pittsburgh Seemed Like a Virus Success Story. Now Cases Are Surging.
2020-07-15 08:42:25 UTC	2020-07-15 17:09:05 UTC (about 8 hours later)
PITTSBURGH — A little more than three weeks ago, officials in Pittsburgh announced a milestone enviable for almost any major city in America: A day had gone by without a single new confirmed case of the coronavirus. It was good news for a city that had seen only a modest outbreak all along, even as the virus raged through places like Philadelphia and New York.	PITTSBURGH — A little more than three weeks ago, officials in Pittsburgh announced a milestone enviable for almost any major city in America: A day had gone by without a single new confirmed case of the coronavirus. It was good news for a city that had seen only a modest outbreak all along, even as the virus raged through places like Philadelphia and New York.
That was then.	That was then.
Western Pennsylvania is suddenly experiencing an alarming surge of infections. Allegheny County, which includes Pittsburgh, reported more than 100 new cases for the first time on June 30; two days later, the daily case count surpassed 200. Over two weeks in late June and early July, the county recorded more new cases than in the previous two months combined, and on some recent days has accounted for nearly half of all new known cases in Pennsylvania.	Western Pennsylvania is suddenly experiencing an alarming surge of infections. Allegheny County, which includes Pittsburgh, reported more than 100 new cases for the first time on June 30; two days later, the daily case count surpassed 200. Over two weeks in late June and early July, the county recorded more new cases than in the previous two months combined, and on some recent days has accounted for nearly half of all new known cases in Pennsylvania.
“Allegheny County is the big area of concern at this point,” Gov. Tom Wolf said at a news conference last week. “There have been others more modest,” he said, “but right now Allegheny County is the area.”	“Allegheny County is the big area of concern at this point,” Gov. Tom Wolf said at a news conference last week. “There have been others more modest,” he said, “but right now Allegheny County is the area.”
The spike in the Pittsburgh area offers a cautionary tale: Even after months of vigilance, an outbreak can flare up all of a sudden. While the nation’s current flood of new cases is being driven primarily by the spread of the coronavirus in the South and the West, experts fear that other parts of the country — including places like Cleveland, Milwaukee, and Kansas City, Mo., which are all seeing new growth — could be close behind.	The spike in the Pittsburgh area offers a cautionary tale: Even after months of vigilance, an outbreak can flare up all of a sudden. While the nation’s current flood of new cases is being driven primarily by the spread of the coronavirus in the South and the West, experts fear that other parts of the country — including places like Cleveland, Milwaukee, and Kansas City, Mo., which are all seeing new growth — could be close behind.
“You are seeing what could be the beginning of what we’ve been seeing in Texas and Arizona,” said Dr. Bill Miller, a professor of epidemiology at the Ohio State University. He described upswings in urban counties in Ohio, a state that saw weeks of steady or declining cases but is now averaging more than 1,000 new confirmed cases a day, the worst so far of the pandemic.	“You are seeing what could be the beginning of what we’ve been seeing in Texas and Arizona,” said Dr. Bill Miller, a professor of epidemiology at the Ohio State University. He described upswings in urban counties in Ohio, a state that saw weeks of steady or declining cases but is now averaging more than 1,000 new confirmed cases a day, the worst so far of the pandemic.
“We can’t let our guard down,” he said.	“We can’t let our guard down,” he said.
For months, Pittsburgh had been both diligent and lucky.	For months, Pittsburgh had been both diligent and lucky.
The virus began spreading here later than in some early centers of the nation’s crisis, like New York City or Detroit. That gave Pittsburgh time to prepare. At the same time, Pennsylvania, which began facing skyrocketing rates in the eastern half of the state, took a more aggressive approach to shutting down public life than states like Florida and Texas, which closed later and reopened earlier.	The virus began spreading here later than in some early centers of the nation’s crisis, like New York City or Detroit. That gave Pittsburgh time to prepare. At the same time, Pennsylvania, which began facing skyrocketing rates in the eastern half of the state, took a more aggressive approach to shutting down public life than states like Florida and Texas, which closed later and reopened earlier.
Pittsburgh, which has an economy driven by the health care industry and is a sister city to Wuhan, China, where the coronavirus first emerged, took the threat seriously. Its 300,000 residents largely abided by the new way of life, ordering their pizzas from Mineo’s to go, drinking their Yuenglings on the porch at home and wearing masks for grocery trips to Giant Eagle, even as the case numbers remained relatively low.	Pittsburgh, which has an economy driven by the health care industry and is a sister city to Wuhan, China, where the coronavirus first emerged, took the threat seriously. Its 300,000 residents largely abided by the new way of life, ordering their pizzas from Mineo’s to go, drinking their Yuenglings on the porch at home and wearing masks for grocery trips to Giant Eagle, even as the case numbers remained relatively low.
From March 23, when the governor ordered everyone to stay at home, until June 5, when Allegheny County was allowed to lift the more stringent restrictions, the city had hunkered down. But it was not long after that limited reopening in June, as people flocked to bars for the first time in months, that the seeds of the current surge were planted.	From March 23, when the governor ordered everyone to stay at home, until June 5, when Allegheny County was allowed to lift the more stringent restrictions, the city had hunkered down. But it was not long after that limited reopening in June, as people flocked to bars for the first time in months, that the seeds of the current surge were planted.
“You have to realize: The virus isn’t going to go anywhere until there is a vaccine,” said Dr. Amesh Adalja, a Pittsburgh-based physician and a senior scholar at the Johns Hopkins University Center for Health Security. “You are going to see these flare-ups in any city, because wherever there are people, there is this virus.”	“You have to realize: The virus isn’t going to go anywhere until there is a vaccine,” said Dr. Amesh Adalja, a Pittsburgh-based physician and a senior scholar at the Johns Hopkins University Center for Health Security. “You are going to see these flare-ups in any city, because wherever there are people, there is this virus.”
Two weeks ago, Mr. Wolf, a Democrat, issued a statewide mask order in response to the mounting cases, a move that was swiftly followed by the governors of West Virginia, where the order applies to indoor public spaces, and of Ohio, where the order applies to hard-hit spots including Cleveland, Cincinnati, Columbus and Dayton. On Thursday afternoon, the governor of Kentucky announced a statewide mask order as well.	Two weeks ago, Mr. Wolf, a Democrat, issued a statewide mask order in response to the mounting cases, a move that was swiftly followed by the governors of West Virginia, where the order applies to indoor public spaces, and of Ohio, where the order applies to hard-hit spots including Cleveland, Cincinnati, Columbus and Dayton. On Thursday afternoon, the governor of Kentucky announced a statewide mask order as well.
On Wednesday, health officials in Allegheny County banned indoor dining for two more weeks.	On Wednesday, health officials in Allegheny County banned indoor dining for two more weeks.
The next few weeks could prove pivotal for Pittsburgh. There has been a modest if notable rise in hospitalizations, but so far very few Covid-19 patients at the major hospitals are in need of ventilators, hospital officials say. On several recent days, the median age of people testing positive for the virus has been 29, far lower than it was several months ago. Many of them have not had symptoms, officials say, and were prompted to get a test only after learning from a friend or a contact tracer that they had been around someone who tested positive.	The next few weeks could prove pivotal for Pittsburgh. There has been a modest if notable rise in hospitalizations, but so far very few Covid-19 patients at the major hospitals are in need of ventilators, hospital officials say. On several recent days, the median age of people testing positive for the virus has been 29, far lower than it was several months ago. Many of them have not had symptoms, officials say, and were prompted to get a test only after learning from a friend or a contact tracer that they had been around someone who tested positive.
“I wasn’t necessarily scared,” said Christian Glikes of Pittsburgh, who learned that he may have been exposed at an outdoor game of cards this month. He drove more than an hour to get a test at a CVS store in St. Clairsville, Ohio, the closest he could find on short notice.	“I wasn’t necessarily scared,” said Christian Glikes of Pittsburgh, who learned that he may have been exposed at an outdoor game of cards this month. He drove more than an hour to get a test at a CVS store in St. Clairsville, Ohio, the closest he could find on short notice.
“I’m healthy, I’m 24 years old,” Mr. Glikes said while at home waiting for his results. “My only concern is giving it to people who aren’t so healthy.”	“I’m healthy, I’m 24 years old,” Mr. Glikes said while at home waiting for his results. “My only concern is giving it to people who aren’t so healthy.”
Some rise in case numbers is inevitable when lockdown orders are lifted and cities enter less restrictive stages of the pandemic response — what the Pennsylvania government has deemed “the green phase.” When Allegheny County entered the green phase in early June, hair salons and gyms opened for the first time in months, though under strict rules, and bars and restaurants allowed some indoor dining. At the same time, large anti-racism protests were taking place across the city and some Pittsburghers were taking vacations to places like Miami and Myrtle Beach, S.C.	Some rise in case numbers is inevitable when lockdown orders are lifted and cities enter less restrictive stages of the pandemic response — what the Pennsylvania government has deemed “the green phase.” When Allegheny County entered the green phase in early June, hair salons and gyms opened for the first time in months, though under strict rules, and bars and restaurants allowed some indoor dining. At the same time, large anti-racism protests were taking place across the city and some Pittsburghers were taking vacations to places like Miami and Myrtle Beach, S.C.
“I knew we would have a bump,” said Mayor Bill Peduto, a Democrat. “The question is whether or not it would exceed the numbers that we had seen earlier. It not only exceeded them it doubled and I think tripled them. It wasn’t supposed to do that.”	“I knew we would have a bump,” said Mayor Bill Peduto, a Democrat. “The question is whether or not it would exceed the numbers that we had seen earlier. It not only exceeded them it doubled and I think tripled them. It wasn’t supposed to do that.”
The main source of the current outbreak is largely undisputed. People who had been cooped up for months flocked to the city’s bars and clubs, crowding shoulder-to-shoulder like old times on East Carson Street. Complaints poured into the health department about bars ignoring the pandemic rules. “It was almost like the entire city turned 21,” said Dr. Adalja, who said that he took walks past crowded bars that he suspected would turn into hot spots.	The main source of the current outbreak is largely undisputed. People who had been cooped up for months flocked to the city’s bars and clubs, crowding shoulder-to-shoulder like old times on East Carson Street. Complaints poured into the health department about bars ignoring the pandemic rules. “It was almost like the entire city turned 21,” said Dr. Adalja, who said that he took walks past crowded bars that he suspected would turn into hot spots.
Kyle Majerick, a 29-year-old insurance salesman whose evenings before the virus were typically filled with intramural soccer games, happy hours and charity and networking events, was more than ready to have a few beers with friends when the bars reopened. He said he took care to avoid the most crowded spots.	Kyle Majerick, a 29-year-old insurance salesman whose evenings before the virus were typically filled with intramural soccer games, happy hours and charity and networking events, was more than ready to have a few beers with friends when the bars reopened. He said he took care to avoid the most crowded spots.
“You go from having something to do every single night to, ‘OK, where am I going to order takeout from and sit at my condo by myself,’” he said. Sitting at a half-empty outdoor bar patio and ordering from a list of options on his phone, instead of a touchable table menu, he said, felt safe.	“You go from having something to do every single night to, ‘OK, where am I going to order takeout from and sit at my condo by myself,’” he said. Sitting at a half-empty outdoor bar patio and ordering from a list of options on his phone, instead of a touchable table menu, he said, felt safe.
“It was a change of scenery, which was a breath of fresh air,” Mr. Majerick, who has not had symptoms, said.	“It was a change of scenery, which was a breath of fresh air,” Mr. Majerick, who has not had symptoms, said.
Through contact tracing, county officials found that bars and restaurants were the most common denominator of new cases and once again shut down indoor dining. For business owners, the new rules have been dizzying and disheartening.	Through contact tracing, county officials found that bars and restaurants were the most common denominator of new cases and once again shut down indoor dining. For business owners, the new rules have been dizzying and disheartening.
Even after the city’s reopening, Jamie Patten kept customers out of her quiet neighborhood wine bar, the Allegheny Wine Mixer, so she could ensure that it was safe. She set up a reservation system for the first time, bought outdoor furniture and installed plexiglass along the bar itself. On Jun 27, the bar opened and regulars returned. A day later, under countywide orders banning the on-site consumption of alcohol, it closed again.	Even after the city’s reopening, Jamie Patten kept customers out of her quiet neighborhood wine bar, the Allegheny Wine Mixer, so she could ensure that it was safe. She set up a reservation system for the first time, bought outdoor furniture and installed plexiglass along the bar itself. On Jun 27, the bar opened and regulars returned. A day later, under countywide orders banning the on-site consumption of alcohol, it closed again.
“We did all this work, we did everything we were supposed to do and we were seeing results,” Ms. Patten said. “Now it’s all just kind of swept away.”	“We did all this work, we did everything we were supposed to do and we were seeing results,” Ms. Patten said. “Now it’s all just kind of swept away.”
~~Updated July 7, 2020~~	Updated July 15, 2020
The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.	The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
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.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.	Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.	A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.	The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.	The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
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.