Coronavirus is a deadly virus outbreak from Wuhan China. Human coronaviruses are common throughout the world. Seven different coronaviruses, that scientists know of, can infect people and make them sick.
(OAKLAND, Calif.) — A cruise ship with a cluster of coronavirus cases that forced it to idle off the California coast for days arrived Monday at a port in the San Francisco Bay Area as state and U.S. officials prepared to start bringing passengers to military bases for quarantine or get them back to their home countries.
The Grand Princess pulled into the Port of Oakland with more than 3,500 people aboard — 21 of them infected with the new virus. Some people waved from their balconies or left their cabins to go onto the decks.
It’s unclear how many travelers would get off the ship Monday — the captain told passengers that not everyone would.
U.S. passengers will be flown or bused from the port — chosen because of its proximity to an airport and a military base — to bases in California, Texas and Georgia for testing and a 14-day quarantine. The ship is carrying people from 54 countries, and foreigners will be whisked home.
About 1,100 crew members, 19 of whom have tested positive for COVID-19, will be quarantined and treated aboard the ship, which will dock elsewhere, California Gov. Gavin Newsom said.
The ship had been held off the coast since Wednesday amid evidence it was the breeding ground for infections tied to a previous voyage.
Passengers from the previous voyage have tested positive in California and other states. Six Canadians who were on the Grand Princess from Feb. 11 to 21 were confirmed to have the virus.
As it pulled closer to the Bay Area, Grand Princess passenger Karen Schwartz Dever said “everyone was hollering and clapping as we entered the harbor.”
Another passenger, Laurie Miller of San Jose, said they were told that anyone who was getting off Monday had already received a written notice and luggage tags.
“Not us!” she said in a message. “This is an absolute circus.”
The virus has infected 600 people in the U.S., and at least 22 have died, most in Washington state. Cases have topped 111,000 worldwide and over 3,800 people have died, the bulk of them in China. Italy has become the latest country to lock down a region in an attempt to prevent the virus from spreading.
On Wall Street, a combination of coronavirus fears and plunging oil prices sent stocks plummeting Monday.
Dr. Anthony Fauci, the National Institutes of Health’s infectious diseases chief, said widespread closure of a city or region is “possible.”
U.S. Surgeon General Jerome Adams said communities will need to start thinking about canceling large gatherings, closing schools and letting more employees work from home, as many companies have done in the Seattle area amid an outbreak at a care home that has killed 17.
Several universities have begun online-only courses, including the University of Washington, Stanford University and Columbia University. The largest school district in Northern California, with 64,000 students, canceled classes for a week when it was discovered a family in the district was exposed to COVID-19.
The California governor and Oakland mayor sought to reassure people that none of the cruise ship passengers would be exposed to the public before completing the quarantine. Officials also were trying to decide where the ship and its crew would go next.
“That ship will turn around — and they are currently assessing appropriate places to bring that quarantined ship — but it will not be here in the San Francisco Bay,” Gov. Newsom said.
Meanwhile, another cruise ship, the Regal Princess, pulled into a Florida port late Sunday after being held off the state’s coast for hours while awaiting coronavirus test results for two crew members, who did not have symptoms consistent with COVID-19.
The State Department warned against travel on cruise ships because of “increased risk of infection of COVID-19 in a cruise ship environment.”
Another Princess ship, the Diamond Princess, was quarantined for two weeks in Yokohama, Japan, last month because of the virus. Ultimately, about 700 of the 3,700 people aboard became infected in what experts pronounced a public health failure, with the vessel essentially becoming a floating germ factory.
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Rodriguez reported from San Francisco. Associated Press writer Juliet Williams in San Francisco also contributed to this report.
New York State is using prison labor to manufacture its own hand sanitizer amid an outbreak of the novel coronavirus, Governor Andrew Cuomo announced Monday.
Cuomo unveiled the “NYS Clean” hand sanitizer during a press conference, calling it superior to existing products thanks to its scent and alcohol content of 75%. That exceeds the Centers for Disease Control and Prevention (CDC)’s recommendation of 60%.
Cuomo said that New York has the capacity to make 100,000 gallons of NYS Clean a week, at the cost of $6 a gallon. It will be provided to government agencies, the Metropolitan Transportation Authority (MTA), schools, and prisons. It will not be sold to the public, despite shortages and price surges in New York City and other affected areas of the state.
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While introducing NYS Clean, Cuomo denounced those attempting to capitalize on people’s fears of the potentially deadly coronavirus through price gouging. “To Purell and Mr. Amazon and Mr. Ebay, if you continue the price gouging, we will introduce our product which is superior to your product and you don’t even have the floral bouquet,” Cuomo said. “So stop price gouging.”
NYS Clean is being made by Corcraft Products, part of New York’s Division of Correctional Industries. The company uses prison labor to make a variety of products, including floor cleaner, laundry detergent, automotive fluids and more.
It’s unclear how much prisoners are being paid to make NYS Clean. Working inmates in New York are paid between $0.10 to $0.33 an hour and work six hour days, according to the Prison Policy Initiative. Corcraft’s website says the company’s goal is to “prepare offenders for release through skill development, work ethic, respect and responsibility.”
New York has a total of 142 confirmed cases of the coronavirus, Cuomo said Monday. Most of the cases are in Westchester County, where there are 98 known infected people. Another 19 of the known cases are in New York City. Eight people across New York are currently being hospitalized with the illness.
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Two of the most widely felt symptoms of the coronavirus are uncertainty and confusion. Part of this is about jargon. A doctor can make bad news even more alarming by using scientific terms that the patient doesn’t understand. And it doesn’t help the masses trying to get a grasp on just what — and how bad — the situation with this virus is when discussions about it inevitably drift into technical territory.
The news is a whirl of unfamiliar words, and so one place people are turning for a little clarity and comfort is the dictionary. At TIME’s request, Dictionary.com and Merriam-Webster analyzed their website traffic data to see which words users were looking up more than usual, in connection with coverage of the coronavirus. Using those insights, TIME has assembled a glossary for navigating this crisis, along with some context about where these words come from.
The word virus comes from a Latin word meaning venom and describes a tiny, tiny agent that causes infectious disease. Coronavirus is a family of viruses that got its name from its appearance.
The word corona means crown. The scientists who in 1968 came up with the term coronavirus thought that, under a microscope, the virus they were looking at resembled a solar corona: the bright crown-like ring of gasses surrounding the sun that is visible during a solar eclipse. (The beer brand Corona, incidentally, based its logo on the crown atop the Cathedral of Our Lady of Guadalupe in Puerto Vallarta.)
Though the disease currently spreading around the globe — COVID-19 — is often called coronavirus, it’s really a disease caused by one type of coronavirus: SARS-CoV-2. Calling this particular one novel coronavirus is simply a way of making it clear which coronavirus is at issue: the new one.
As Dictionary.com breaks down in a thorough explainer, the name COVID-19 was derived from the year it was first detected (2019) and using letters from CO-rona-VI-rus D-isease. If you’re wondering how to say it, a helpful (if somewhat glib) reminder is that it can be said and read with the same cadence as “Come On, Eileen.”
outbreak / epidemic / pandemic
These are crescendoing terms. Per Merriam-Webster, an outbreak is “a sudden rise in the incidence of a disease,” which is usually confined to one area or group of people. When there are enough outbreaks, in places beyond that initial spot, that amounts to an epidemic. A pandemic is an epidemic that has become a worldwide phenomenon. When does something officially become “worldwide”? There’s no absolute answer.
As of March 9, the World Health Organization was not yet using the word pandemic, though outbreaks have been reported in scores of countries. This decision can hinge on many factors, like whether the disease is spreading in additional places only because travelers had been to the site of the initial outbreak, as well as concerns about terminology causing officials to freak out or lose hope.
The prefix pan- suggests the whole of the universe or mankind. The pan in pandemic is the same one in pandemonium, a description of uproar that originally referred to the place where all demons dwelled; and Pangea, the vast supercontinent, comprising all the land on Earth, that is thought to have once existed.
The word quarantine, explains Merriam-Webster Editor-at-Large Peter Sokolowski, originally referred to a period of 40 days. The word’s earliest known uses were in religious contexts, like describing a 40-day period of fasting that emulated the 40 days Jesus fasted in the desert. It was also used in legal contexts, like describing the period of time that a widow could remain in her deceased husband’s home before she started owing somebody rent.
In the Middle Ages, Italians adopted that word to describe a 40-day period that boats had to wait before docking, to ensure the passengers weren’t sick with the plague before they were allowed to join the population on land. It’s from this use that we eventually got the term that’s all over the news today.
If one is in quarantine, that’s good news in a way. The word typically describes the confinement of people who appear healthy but could have the disease. (When someone is determined to be sick and is kept apart from others, that is known as isolation.)
To self-quarantine suggests that one is voluntarily confining themself by, say, staying at home, versus being legally confined to a military base by the U.S. Marshals Service.
When the Chinese government effectively cut off some 50 million people in Wuhan, the location of the first outbreak, that was most aptly described as a cordon sanitaire. That French term, which came into use following the flu pandemic of 1918, describes roping off a whole community, which might contain sick and healthy people, and preventing anyone from leaving in order to curb the spread of a disease.
symptom / symptomatic / asymptomatic / incubation
Many of the words that are seeing the biggest spikes on Dictionary.com are exotic ones like coronavirus. But senior research editor John Kelly says people are also looking up more familiar fare: words like symptom, a sign or indication that someone has a disease.
Symptomatic cases of COVID-19 include things like fever, cough and shortness of breath. One of the big questions health officials have been racing to answer is whether, and how long, someone might have the novel coronavirus while being asymptomatic: not showing signs that they have the disease.
This is related to a virus’ incubation period, the length of time between when an infection begins and when there are apparent signs of the disease. The the Centers for Disease Control and Prevention (CDC) is operating under the assumption that COVID-19 has a two to 14-day incubation period, based on what officials have seen with other coronaviruses.
spread / community spread / communicable / contagion
Kelly also says Dictionary.com has seen spikes in lookups for words as simple as spread. How the novel coronavirus is passed from one person to another remains of central concern for health officials, as is tracking the way it moves. In late February, the CDC announced that there might have been an instance of community spread in the United States, meaning the “spread of an illness for which the source of infection is unknown.”
This is potentially unsettling. If someone in the U.S. tests positive for the coronavirus after traveling to China, health experts have a good idea of how they got sick. When someone tests positive who has not traveled outside the country or knowingly come in contact without anyone else who has the disease, the picture is less clear. All it suggests is they got it from someone else in their own community.
Kelly says Dictionary.com has also seen spikes for words like communicable (an adjective that describes diseases that can be transmitted; COVID-19 is communicable, cancer isn’t) and contagion. The latter has several meanings but often refers to the spreading of a disease, as in, “The best way to break this cycle of fear and further contagion is to dispense with zero-sum thinking and stitch together a safety net big enough, and strong enough, for everyone.”
morbidity / mortality
Every week, the CDC is issuing a morbidity and mortality report related to COVID-19 in the U.S. The morbidity rate is a measure of how many people have an illness relative to the population; the mortality rate is a measure of how many people have died because of an illness, also relative to the population.
Though the word morbid is frequently used to describe someone who is really gloomy, it originally meant “relating to disease,” per the Oxford English Dictionary. From there it came to describe unhealthy people and then people who had an unhealthy preoccupation with disease or other disturbing subject, like death. From there it is a short jump to brooding. The word mortal comes from roots meaning “subject to death.”
While no amount of vocab-expanding will quell all the uncertainty around COVID-19, understanding the terminology can be helpful. “We need factual information, we crave it,” says Merriam-Webster’s Sokolowski. “The dictionary does serve as a kind of backstop, for some people, for some ideas.”
(WASHINGTON) — Several hundred people are being asked to self-quarantine after potential exposure to the first confirmed case of the new coronavirus in the nation’s capital, identified as the rector of a prominent Episcopal church.
District of Columbia Mayor Muriel Bowser said Monday that anyone who entered Christ Church Georgetown on Feb. 24 or between Feb. 28 and March 3 is requested to self-quarantine for two weeks from the date of their entrance to the church.
Officials on Saturday had announced the district’s first positive test, but identified the victim only as a man in his 50s. A second local positive test involves a man who visited the Washington area from Nigeria, but he was being hospitalized in Maryland.
Rev. Timothy Cole, the church rector, announced Sunday that he was the person whom city officials had been referring to as “patient 1.” He remains hospitalized in stable condition and the church has canceled all activities until further notice.
Dr. Anjali Talwalker of the Washington Health Department said Monday that an exposure risk is defined as coming within six feet of a person with active virus symptoms.
“Several hundred people were potentially impacted,” she said.
A Washington high school linked to the second case was closed Monday, though no new confirmed coronavirus cases have been reported. Three people who stayed at the same house as the Nigerian man who tested positive in Maryland were tested Sunday and all were negative. But one of them works at the School Without Walls High School. Bowser said the school was closed for a deep cleaning and to give time to communicate with staff and parents; she expects the school to re-open Tuesday.
Two charter schools in Washington, D.C., also voluntarily closed on Monday but there have been no reported or suspected virus cases linked to either.
Two Republican members of Congress — Sen. Ted Cruz of Texas and Rep. Paul Gosar of Arizona — have announced that they would self-quarantine after coming in contact with an infected person during the recent Conservative Political Action Conference.
Bowser said she was “evaluating” whether to declare a ”public health emergency” if the virus continues to spread. As both a mayor and the de-facto governor of a quasi-state, Bowser has more powers than the average city mayor. Formally declaring a health emergency would enable her to impose quarantines and closures and also take steps to prevent price gouging on supplies, she said.
“I don’t believe that’s where we are right now,” Bowser said.
On Sunday, Maryland reported two new cases, raising to five the total confirmed cases in the state. Virginia reported its second case.
In Maryland’s new cases, a Harford County resident in her 80s who contracted the virus while traveling overseas was hospitalized, officials said. A Montgomery County resident in his 60s who contracted the virus while traveling overseas was also briefly hospitalized.
Virginia recorded its first case Saturday when a Marine stationed at Quantico was found to have the virus. He was taken to Fort Belvoir for treatment. On Sunday, Virginia officials announced a second case involving a Fairfax man in his 80s who took a Nile River cruise. On Monday, officials announced a third case, involving an Arlington County resident in their 60s.
“All three cases were exposed through international travel,” said a statement Monday from the Virginia Department of Health.
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Associated Press writers Michael Balsamo and Robert Burns in Washington, and Randall Chase in Dover, Delaware contributed to this report.
Ever since the coronavirus began spreading in her home state of Washington, Azia Jenkins has spent hours cleaning her workplace: a 2017 Jeep Patriot. Jenkins, who escorts children for supervised visits on behalf of Child Protective Services, fears that her vehicle is becoming a petri dish, putting herself, the children she supervises, and her own two daughters at risk. Her new cleansing ritual, which she performs before and after dropping off any children, involves wiping down the compact SUV’s handles, seats, and steering wheel with Clorox wipes. She’s also trying to teach her children how important it is to wash their hands as much as they can.
Public health experts are recommending that companies encourage employees to work from home to prevent the potentially deadly coronavirus from spreading around offices, public transit and elsewhere. Many firms, like Apple, Microsoft and Google, are following that advice. But remote work isn’t an option for people like Jenkins, who, like millions of other Americans in fields like retail, dining and other industries, can’t simply log on to software like Outlook, Slack or Google Hangouts to do her job.
“Either I stay home, and I miss out on money, or I continue to work and I get sicker and sicker or I get other people sick,” says Jenkins, 26.
For all the promise of high-speed Internet and other innovations that can make it possible for us to work from anywhere, only about 29% of American employees actually did their jobs remotely as of 2018,according to the Bureau of Labor Statistics. Those who work remotely tend to be both better-educated and wealthier. Among workers ages 25 and older, 47% of workers with a bachelor’s degree or higher worked from home sometimes, according to BLS data, compared to just 3% of workers with only a high school diploma. Of course, some highly educated workers, like medical professionals, also typically have to show up in person for work.
Alex Baptiste, policy counsel for the nonprofit National Partnership for Women and Families, says the remote work gap is just one way the coronavirus outbreak is underscoring inequalities inherent in the American economy.“On the one hand, you want people to have the best benefits that they possibly can, and when you see that kind of progress, we’re excited about it,” Baptiste says. “But it definitely is showing how wide the gap is between who have it and people who don’t.”
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Like Jenkins, Rachel Gorham, 37, also needs to be physically present for her job. But Gorham, a nanny in the Seattle area, isn’t certain that she will be asked to work through the outbreak now that her clients, who work in the tech industry, are working remotely. However, she feels more financially secure because hercontract includes a provision called “guaranteed hours,” which means that she’s paid as long as she’s available to work, even if her clients don’t need her. Like more than half of all Americans, Gorham lives paycheck to paycheck. “Itwould take me about a week and a half to not be able to pay any of my bills,” she says.
Lydia, a 22-year-old bartender in New York City — where the coronavirus is also spreading — says she’s worried about being exposed at work, where she estimates she interacts with 500 to 600 people on busy nights. However, shedoubts that the restaurant where she works will close in the face of an outbreak. She says she’ll likelyhave to keep working not only to make ends meet, but to show her managers that she takes her job seriously.
“The underlying tone with the managers is, ‘if you can’t do this job, I can find someone else who can,'” says Lydia, who asked we use only her first name for fear of employer retribution.“There isn’t a lot of job security in this industry, and illness just makes it 10 times worse.”
Indeed, must-show workers in fields like restaurants and retail, whose schedules tend to be set by their managers, often face pressure from bosses or even colleagues to keep working despite health concerns, says Ellen Kossek, a professor at Purdue University’s Krannert School of Management. “Part of the problem for people with unpredictable schedules is they’re forced to also take whatever hours the employer gives them,” she says. “If you’re viewed as someone that’s unreliable, needs to take off for a chronic health condition, a kid with asthma, or a kid that gets sick, you’re then less likely to get more hours in the future.”
Compounding the problem is that people in must-show kinds of fields often lack access to benefits like paid sick leave that could keep them from coming to work and potentially spreading an illness to customers and colleagues, says Eileen Appelbaum, co-director of the Center for Economic and Policy Research.“If you get the coronavirus and are quarantined, we’re talking about two weeks, we’re not talking about five days,” Appelbaum says. “And for that, we would have to have paid family and medical leave. And we know how rare that is — only about 20% of all workers have it.”
Jenkins, the Seattle CPS worker, argues that denying some workers sick days puts everyone in the community at risk — especially with those who can’t work from home. “We’re all human. We all get sick,” she says. “So for them not to have to give us that option, is kind of unfair. It’s like we’re expected to be superheroes who never get sick, or who never need time off. It’s crazy how some employers don’t offer that, or you have to earn it. What are we supposed to do?”
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Nobody had ever seen the coronavirus that causes the disease known as COVID-19 before the current outbreak began in China in December 2019. So for context, it is often compared to a symptomatically similar disease we know well: the seasonal flu, which infects many people each year but kills only about 0.1% of them on average.
Many people were alarmed, then, when the World Health Organization announced in March that COVID-19 has killed 3.4% of the people who have caught it so far—a mortality rate far higher than not only the seasonal flu, but also higher than earlier COVID-19 mortality estimates, which were around 2%.
That estimate may say more about the inherent uncertainty in making these sorts of calculations during an evolving outbreak than it does about the true deadliness of COVID-19.
Since the COVID-19 outbreak began to pick up steam in China in January, experts have been scrambling to get a handle on the disease and the way it behaves. But they have also warned that estimates are not exact, and that numbers are likely to shift over time. One key reason: people with milder versions of the illness are underrepresented in official case counts, since they may not be sick enough to seek medical attention or realize they have anything more than a cold. Some people, research now suggests, may get infected by SARS-CoV-2, the virus that causes COVID-19, without showing any symptoms at all.
That means the total number of reported cases is very likely an underestimate—and by not counting many mild or asymptomatic cases, we’re likely overestimating the disease’s overall mortality rate. President Donald Trump, for one, told Fox News he has a “hunch” that the actual mortality rate is likely below 1%.
Looking at data from countries with robust testing systems does support the idea that the disease’s mortality rate may be lower than 3.4%. Countries that have tested significant numbers of people are generally reporting lower mortality rates than those, like the U.S., that have tested in far lower numbers and with a stronger focus on severe cases. This suggests that when testing networks are broadened to catch people with less serious illnesses, and case counts then reflect this range of severity, mortality rates go down.
The mortality rate in South Korea, where more than 1,100 tests have been administered per million residents, comes out to just 0.6%, for example. In the U.S., where only seven tests have been administered per million residents, the mortality rate is above 5%.
The chart below is a snapshot of testing and mortality rates on March 5, obtained through records published by, or direct contact with, each country’s department of health. The quality of the data per country range from extremely precise, such as in South Korea and the U.K. to fairly rough, as with Australia, whose department of health offered a rounded number. As for the U.S., the Centers for Disease Control and Prevention told TIME that 1,526 people had been tested as of March 4, but said this number “did not include testing being done at state and local public health laboratories.” We’ve chosen to use the figure of 1,895 that The Atlantic reported on March 6, which includes both the CDC count, and additional testing numbers their reporters discovered through contacting the local health departments of all 50 states and D.C.
Few countries with significant testing capacity are reporting mortality rates above 2%, but Italy has proven an outlier. Even with 638 tests given per million people, the country is still reporting a mortality rate of nearly 4%. While the exact reason for the discrepancy is unclear, it could point to differences in the country’s testing strategy, the specific test it is using or something unique about the actual outbreak there.
Even when taking the current estimated global mortality rate of 3.4% at face value, COVID-19 looks more like influenza than other once-novel coronaviruses. Severe Acute Respiratory Syndrome (SARS) killed about 10% of the people who got it, while Middle East Respiratory Syndrome (MERS) was even deadlier, killing 34% of patients. At least so far, COVID-19 does seem to be more lethal than the seasonal flu, but it’s closer to that end of the spectrum.
A more complete—and, hopefully, less severe—picture of COVID-19 will likely emerge as the outbreak continues, testing capacity increases and data are refined. Until then, stay calm and keep washing your hands.
Additional reporting by Alice Park.
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A total of 248 new coronavirus cases and one new death were registered in the country in the past 24 hours.
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The health ministry has asked AIIMS to designate part of the new emergency wing at its trauma facility, Jai Prakash Narayan Apex Trauma Centre, for setting up of isolation beds for acute management of Covid-19 patients.
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The U.S. Centers for Disease Control and Prevention (CDC) is advising Americans to avoid taking cruises and says older people and others at elevated risk from COVID-19 should avoid crowded places and “non-essential” travel, including long plane rides.
The new guidance, published Sunday to the CDC’s website, is an attempt to minimize exposure to the coronavirus already spreading in some U.S. communities.
The CDC recommends that travelers, “particularly those with underlying health issues, defer all cruise ship travel worldwide.” It adds that that cruise ship passengers are at “increased risk of person-to-person spread” of the coronavirus.
Cruise ships have been at the center of a number of coronavirus scares and outbreaks—the Grand Princess cruise is currently floating off the California coast and passengers confined to their rooms after news that an earlier passenger had died of the coronavirus. The cruise liner said Friday that 21 people on board have tested positive.
Last month, more than 700 people from the Diamond Princess cruise ship, out of around 3,700, were diagnosed with the virus. The cruise, which was docked in Japan, had earlier sailed with a coronavirus patient.
Fears that cruises could carry the virus have also prompted port authorities globally to turn ships away. Over the weekend, the Costa Fortuna sailing in Southeast Asia was barred from docking in Malaysia and Thailand.
Separately, the U.S. Surgeon General urged American businesses to allow employees paid time off if they are ill: “It’s much cheaper than shutting down because everyone else gets sick!”
Americans: if you are sick with fever/cough/ flu symptoms, please don’t go to work!
Employers: PLEASE understand giving your employees flexibility and (paid) sick leave will save you money in the long run- it’s much cheaper than shutting down because everyone else gets sick!
— U.S. Surgeon General (@Surgeon_General) March 8, 2020
There are 554 confirmed coronavirus cases in the U.S. as of Sunday night, according to Johns Hopkins University’s virus tracker. At least 34 states have reported the coronavirus, with more than 100 cases each in Washington, New York and California.
At least nine states have declared emergencies, and an increasing number of schools and public services are shutting down. Twenty-two people have succumbed to the virus.
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Experts have criticized U.S. authorities for their slow response to the growing epidemic. Last Thursday, Vice President Mike Pence, who is spearheading the White House response to the virus, cast doubt that the administration would be able to deliver one million testing kits by the end of the week.
“We don’t have enough tests today to meet what we anticipate the demand going forward,” Pence said.
But in a Sunday evening tweet, President Donald Trump maintained that the White House has a “perfectly coordinated and fine tuned plan” to fight the virus.
We have a perfectly coordinated and fine tuned plan at the White House for our attack on CoronaVirus. We moved VERY early to close borders to certain areas, which was a Godsend. V.P. is doing a great job. The Fake News Media is doing everything possible to make us look bad. Sad!
FDA has directed all manufacturers to regularly submit report of APIs stock available with them and shortage if any.
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The number of Covid-19 cases in India rose to 39 on Sunday, with five people from Kerala – a couple and their son who returned from Italy on February 29 and two of their relatives – testing positive for the novel coronavirus.
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Kevin Connolly says his father-in-law credits the Life Care Center of Kirkland, Washington with “giving him his life back.” It’s where he recovered from hospice care, flirted with nurses and enjoyed eating chicken pot pie. But now, it’s where Connolly worries the 81-year-old will die because of what he says has been a bungled response to thecoronavirus outbreakthat has devastated the nursing home facility, which is linked to at least 10 of the17 coronavirus deathsthat had been reported in the U.S. as of Saturday.
“I can no longer sit around and wait for a phone call to tell me my loved one has died. Our loved ones that live here are already amongst the most vulnerable in the community, and they are being left to be picked off one by one by this disease,” Connolly said Thursday at a press conference held by relatives of Life Care Center residents.
“We have limited resources to battle this disease, and I think somebody somewhere decided that this population of people wasn’t worth wasting resources on. That’s how it feels.”
The arrival of the coronavirus in the United States has intersected with the persistent problems associated with caring for the elderly, one of the country’s most vulnerable populations, especially as long-term care is often understaffed and underfunded.
As health experts urge nursing homes to plan ahead and take precautionary measures to prevent the spread of the virus in their communities, some are cancelling bingo games and family dinners, encouraging relatives to take advantage of the ability to “visit” via Skype, and stocking up on the supplies they would need to combat an outbreak in their facilities.
“The data from China and from Italy seems to suggest that this virus disproportionately affects older adults. We’re looking at mortality rates for people over the age of 80 close to 15%,” says Dr. David Dosa, an associate professor of medicine at Brown University and a geriatrician who has researched nursing home infections, referencinga study of the outbreak in Chinapublished by the Journal of the American Medical Association. (Whilehard to assess, the overall coronavirus fatality rate is far lower — 3.4%,according to the World Health Organizationon March 3.)
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About 1.3 million Americans live in nursing homes, according to the Centers for Disease Control and Prevention (CDC), andmore than halfare over the age of 75.
“They do need to take it very seriously,” Dosa says. “I think that the Washington case is the proverbial canary in the coal mine.”
He said the virus, which causes a disease known as COVID-19, can spread quickly in nursing home settings, where people with existing medical conditions and compromised immune systems live in close proximity and depend on help for daily activities, including bathing, dressing and eating. On Friday, another nursing home and a senior living complex in Seattle each reported a case of coronavirus among their residents, theNew YorkTimesreported.
Brenda Chrystie says she was reassured by an email she received Monday from her father’s memory care facility in King County, the same county where the Life Care Center of Kirkland is located. Leaders at Aegis Living said they are disinfecting “high touch surfaces” daily, preparing a containment plan in case residents or staff members become infected, stocking up on both CDC-approved cleaning agents for the virus and enough food to feed staff and residents “for an extended period of time” if necessary, and canceling events for large groups. The facility has also asked anyone who traveled outside of the U.S. in the past 30 days to postpone their visit.
Karen Ducey—Getty ImagesSu Wilson hands flowers to a staff member (in red uniform) to give to her mother, Chun Liu, who is a patient at the Life Care Center nursing home in Kirkland, Washington, on March 6, 2020.
“For all of us who care for the elderly, the coronavirus is presenting an unprecedented challenge,” Kris Engskov, Aegis Living president, said in a statement on Thursday. “Over the last few days, we’ve put extraordinary protocols in place in all of our communities to ensure we were doing everything possible to protect our residents and staff from infection.”
“They’re having to ratchet it up and take it to another level and just hoping that all of us, the loved ones, don’t freak out and panic too much,” Chrystie says. “But who knows? Who knows how this is going to spread?”
She says she’s trying to protect her 80-year-old father, who has Alzheimer’s, from any of that panic because stress can be harmful to his health. “I’m pretty sure he doesn’t know about the coronavirus,” she says. “And I’ll keep it that way.”
Bethany Retirement Living in Fargo, North Dakota has cancelled group activities, including bingo, music and group exercise as a precautionary measure to prevent the spread of germs.
“A lot of times, bingo is passing around cards. Group exercise might be throwing around the same ball,” says Shawn Stuhaug, president and CEO of Bethany Retirement Living. “We’re just trying to be precautionary until we know more.”
The organization has started directing visitors through certain entrances to guarantee they pass a hand sanitizing station, and asking people not to visit if they have a fever or cough, have been on a cruise or have traveled to a country affected by the outbreak. The facility allows family members to Skype or FaceTime their loved ones if they can’t come in person.
Sandy Sidler, a 67-year-old retired teacher, visits her 91-year-old mother, who has been recovering from the flu, almost every day at Bethany, sitting beside her until she wakes up from her afternoon nap and keeping her company during supper. Sidler says she’s not worried about the spread of coronavirus yet, but she always uses hand sanitizer before entering her mother’s room.
Because there have not yet been any cases of coronavirus identified in North Dakota, Stuhaug says his biggest priority right now is preventing the spread of the seasonal flu, which is more likely to be deadly in an elderly population. “It’s just as important to pay attention to the flu,” he says. “Every year, I wish everybody would get this excited about the flu.”
I can no longer sit around and wait for a phone call to tell me my loved one has died.In Rhode Island — where officials have identified three “presumptive positive” cases of COVID-19 — former state senator Gloria Kennedy Fleck says she has been asking her 90-year-old mother’s nursing home, the West Shore Health Center in Warwick, R.I., for its contingency plan in case the virus spreads there. She has wondered if residents would be temporarily moved or separated if they test positive for the virus, but she hasn’t received a clear answer.
“The biggest concern is that no preparations are being made, and if and when it happens, then what? They’re just going to let them sit there in the petri dish?” she says. “I’m not trying to be an alarmist. We have to take precautions. There has to be a plan.”
On Thursday, she spoke with an administrator who told her plans are underway. Representatives from the West Shore Health Center directed inquiries from TIME to Scott Fraser, president and CEO of the Rhode Island Health Care Association, who said the nursing home was screening visitors, had put up signs asking them not to enter if they’re ill and would be following its existing contingency plans for seasonal flu and norovirus outbreaks, but he could not elaborate on what those plans entail.
“We’re following state guidelines and CDC guidelines, and we’re following them very closely because obviously the residents in all our homes are some of the most vulnerable,” he said.
The Centers for Medicare & Medicaid Servicesreleased guidelineslast week aimed at limiting the spread of COVID-19 in nursing homes, asking facilities to screen visitors for symptoms such as a cough, fever and sore throat and for international travel to restricted countries within 14 days. Any health care workers who develop symptoms on the job should stop work, put on a face mask and self-quarantine at home, the guidelines say.
Richard Mollot, executive director of the Long Term Care Community Coalition, says he’s advising families to ask more questions of the facilities housing their elderly relatives. “We’re telling people, ‘Look to see, is your nursing home implementing better practices, doing more cleaning, ensuring that everyone is on board with hand washing,’” he says. “I would ask the administrator, ‘Are you prepared for what is going to come?’”
Fleck — who brings her mother lemon-filled donuts and Hershey’s kisses each time she visits — says she worries about exactly that. Last month, healthcare workersprotestedat the Rhode Island state house over under-staffed nursing homes in the state, and Fleck worries staffing levels will worsen because of COVID-19.
In Washington state, the leader of the union representing home care and nursing home workers says that’s already happening. Sterling Harders, president of the SEIU 775, says the outbreak is “making the chronic understaffing in nursing homes even worse,” as more workers call in sick.
Sherylon Hughes — a direct caregiver at the North Cascades Health and Rehabilitation Center in Bellingham, Wash., — says at the start of their shift, workers are now required to report to the nurse on duty to have their temperature checked and fill out a short questionnaire about whether they’ve come in contact with anyone who is potentially infected.
“Everyone is just really concerned,” Hughes says. “There’s a lot of frustration among some of the workers. We feel like the people who are in charge haven’t really come up with a plan for what we are supposed to do.”
She and her coworkers have wondered what would happen if someone at her nursing home tests positive for the coronavirus. Will the facility shut down? Will all the workers be tested? Will they have to pay for it themselves?
Chona Kasinger—Bloomberg/Getty ImagesGov. Jay Inslee of Washington address a news conference on the coronavirus in his state as Vice President Mike Pence looks on, in Tacoma on March 5, 2020.
“I’m very concerned about the health care workers, the people who are on the front lines,” says Hughes, who makes about $17 an hour. “The potential loss of livelihood is devastating, especially for caregivers. We do not make very much money at all, and none of us can afford to miss work for any extended period of time, and very few of us have healthcare that’s affordable.”
At a press conference on Friday, Washington Gov. Jay Inslee said the state would cover the cost of the test for anyone who does not have insurance. As officials work to contain the spread of the virus, he said the state would dedicate assistance specifically to long-term care facilities. “We know that the first potential victims of this virus are elderly and those who are medically compromised,” he said. “We are standing up a separate incident command post in the structure to specifically give assistance to long-term care facilities, both to help them prevent infection from entering the facilities and to help them deal ith it in the event that that happens.”
But questions linger for many of the Life Care Center relatives, who on Thursday expressed their frustration with a lack of communication, demanding clear guidance on when their relatives would be tested for the virus and asking to speak with CDC health officials and to relocate healthy residents to a different facility.
King County Executive Dow Constantine said Friday that the Life Care Center has not been shut down or evacuated because the more than 60 residents remaining there require 24-hour medical care, and there were no hospitals or nursing homes with the capacity to take them in. “This is, for many of the residents, the best place that they can be — those who are asymptomatic but have these health conditions that have to be attended to in a 24-hour care facility,” he said.
Connolly’s father-in-law is one of those residents, but he is still seeking more answers. Constantine said all Life Care Center residents and staff members will be tested for COVID-19 now that there is increased testing capacity at the University of Washington.
On Saturday, Connolly said his father-in-law, who has not been showing symptoms for coronavirus, had not yet been tested.
“Still no one has reached out to us,” Connolly said in a text to TIME. “Still we are in the dark.”
Please send any tips, leads, and stories tovirus@time.com.
(SAN FRANCISCO) — A cruise ship hit by the new coronavirus is headed to the port of Oakland, California, the captain told passengers, though they were destined to stay aboard the ship for at least another day.
Grand Princess Capt. John Smith, in a recording provided by passenger Laurie Miller of San Jose, told guests the ship will dock in Oakland. Princess Cruises says it’s expected to arrive on Monday. The ship is carrying more than 3,500 people from 54 countries.
“An agreement has been reached to bring our ship into the port of Oakland,” he told passengers Saturday night. “After docking, we will then begin a disembarkation process specified by federal authorities that will take several days.”
Smith said passengers who need medical treatment or hospitalization will go to health care facilities in California, while state residents who don’t require acute medical care “will go to a federally operated isolation facility within California for testing and isolation.”
U.S. guests from other states will be transported by the federal government to facilities in other states. Crew members will be quarantined and treated aboard the ship.
Smith said the information he was given did not include any details about what would happen to passengers from other countries.
“We are working to obtain more details overnight. … I’m sorry I can’t provide you more details right now,” he said.
The Grand Princess had been forbidden to dock in San Francisco amid evidence that the vessel was the breeding ground for a cluster of nearly 20 cases that resulted in at least one death after a previous voyage.
Meanwhile, the U.S. death toll from the virus climbed to 19, with all but three victims in Washington state. The number of infections swelled to more than 400, scattered across the U.S., as passengers aboard the ship holed up in their rooms.
Steven Smith and his wife, Michele, of Paradise, California, went on the cruise to celebrate their wedding anniversary. The Smiths said they were a bit worried but felt safe in their room, which they had left just once since Thursday to video chat with their children.
Crew members wearing masks and gloves delivered trays with their food in covered plates, delivered outside their door. They’ve occupied themselves by watching TV, reading and looking out the window.
“Thank God, we have a window!” Steven Smith said.
The ship was heading from Hawaii to San Francisco when it was held off the California coast Wednesday so people with symptoms could be tested for the virus. Cruise officials on Saturday disclosed more information about how they think the outbreak occurred.
Grant Tarling, chief medical officer for Carnival Corporation, said it’s believed a 71-year-old Northern California man who later died of the virus was probably sick when he boarded the ship for a Feb. 11 cruise to Mexico.
The passenger visited the medical center the day before disembarking with symptoms of respiratory illness, he said. Others in several states and Canada who were on that voyage also have tested positive.
The passenger likely infected his dining room server, who also tested positive for the virus, Tarling said, as did two people traveling with the man. Two passengers now on the ship who have the virus were not on the previous cruise, he said.
Some passengers who had been on the Mexico trip stayed aboard for the current voyage — increasing crew members’ exposure to the virus.
Another Princess ship, the Diamond Princess, was quarantined for two weeks in Yokohama, Japan, last month because of the virus. Ultimately, about 700 of the 3,700 people aboard became infected in what experts pronounced a public-health failure, with the vessel essentially becoming a floating germ factory.
Hundreds of Americans aboard that ship were flown to military bases in California and other states for two-week quarantines. Some later were hospitalized with symptoms.
An epidemiologist who studies the spread of virus particles said the recirculated air from a cruise ship’s ventilation system, plus the close quarters and communal settings, make passengers and crew vulnerable to infectious diseases.
“They’re not designed as quarantine facilities, to put it mildly,” said Don Milton of the University of Maryland.
Worldwide, the virus has infected more than 100,000 people and killed more than 3,400, the vast majority of them in China. Most cases have been mild, and more than half of those infected have recovered.
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Associated Press writers Olga R. Rodriguez and Juliet Williams in San Francisco; Gene Johnson, Martha Bellisle and Carla K. Johnson in Seattle; Adriana Gomez Licon in Miami; Rachel La Corte in Olympia, Washington; and AP researcher Monika Mathur in Washington, D.C., contributed to this report.
(BEIJING) — Italy’s prime minister announced a sweeping coronavirus quarantine early Sunday, restricting the movements of about a quarter of the country’s population in a bid to limit contagions at the epicenter of Europe’s outbreak.
Shortly after midnight, Prime Minister Giuseppe Conte signed a decree affecting about 16 million people in the country’s prosperous north, including the Lombardy region and at least 14 provinces in neighboring regions. The extraordinary measures will be in place until April 3.
“For Lombardy and for the other northern provinces that I have listed there will be a ban for everybody to move in and out of these territories and also within the same territory,” Conte said. “Exceptions will be allowed only for proven professional needs, exceptional cases and health issues.”
Around the world, more and more countries were bracing for a big increase in virus cases. Western countries have been increasingly imitating China – where the virus first emerged late last year, and which has suffered the vast majority of infections — by imposing travel controls and shutting down public events.
After the city of Venice canceled its cherished Carnival and governments warned citizens against travel to Italy, the country is facing a possible recession. Hotel occupancy rates in the lagoon city are down to 1%-2%.
“The surface of the Grand Canal is like glass because the boats that transport merchandise are not there. On the vaporetti (water buses), there are only five or six people,’’ Stefania Stea, vice president of the Venice hoteliers association, said.
Italy on Saturday saw its biggest daily increase in coronavirus cases since the outbreak began in the north of the country on Feb. 21.
In its daily update, Italy’s civil protection agency said the number of people with the coronavirus rose by 1,247 in the last 24 hours, taking the total to 5,883. Another 36 people also died as a result of the virus, taking the total to 233.
There was chaos and confusion in the northern Italian city of Padua in the Veneto region as word spread late Saturday evening that the government was planning to announce the quarantine.
Packed bars and restaurants quickly emptied out as many people rushed to the train station in Padua. Travelers with suitcases, wearing face masks, gloves and carrying bottles of sanitizing gel shoved their way on to trains.
Before Conte signed the quarantine decree, Stefano Bonaccini, president of the Emilia Romagna region, said parts of the decree were confusing, and he asked the premier for more time to come up with solutions that were more “coherent.”
Around the world, passenger-packed cruise ships confronted their own virus problems.
Officials in California were deciding Saturday where to dock the Grand Princess cruise ship, after 21 tested positive for the virus. There is evidence the ship now idling off San Francisco was the breeding ground for a deadly cluster of almost 20 cases during an earlier voyage.
“Those that will need to be quarantined will be quarantined,” U.S. Vice President Mike Pence said. “Those who will require medical help will receive it.” President Donald Trump said he would have preferred not to let the passengers disembark onto American soil, but would defer to medical experts.
In Egypt, a cruise ship on the Nile with more than 150 aboard was under quarantine in the southern city of Luxor after 12 positive tests.
Also Saturday, the port of Penang in Malaysia turned away the cruise ship Costa Fortuna because 64 of the 2,000 aboard are from Italy. The ship had already been rejected by Thailand, and is now heading to Singapore.
And in Malta, which reported its first case of the virus Saturday, the MSC Opera ship agreed not to enter the Mediterranean country’s port amid local worries — even though there are no infections suspected on board. The ship continued to Messina, Sicily, where passengers were allowed to disembark after officials reviewed medical records.
Transmission of the virus is now going in every direction.
While the global death toll has risen past 3,400, more people have now recovered from the virus than are sickened by it. As of Saturday, nearly 90,000 cases have been reported in Asia; more than 8,000 in Europe; 6,000 in the Mideast; about 450 in North America, Latin America and the Caribbean, and fewer than 50 cases reported so far in Africa.
While many scientists say the world is clearly in the grips of a pandemic — a serious global outbreak – the World Health Organization isn’t calling it that yet, saying the word might spook the world further.
The virus is still much less widespread than annual flu epidemics, which cause up to 5 million severe cases around the world and up to 650,000 deaths annually, according to the WHO.
In Iran, fears over the virus and the government’s waning credibility has become a major challenge to leaders already reeling from American sanctions. More than 1,000 infections were confirmed overnight, bringing the country’s total to 5,823 cases, including 145 deaths.
The government declared a “sacred jihad” against the virus: Wearing gas masks and waterproof fatigues, members of Iran’s Revolutionary Guard sprayed down streets and hospitals with disinfectants.
South Korea, the hardest-hit country outside China, reported 93 new cases on Sunday morning, taking the total to 7,134, with 50 deaths overall.
China on Sunday morning reported 44 new cases over the past 24 hours, the lowest level since it began publishing nationwide figures on Jan 20, and 27 new fatalities. But while infections were increasing more slowly, the country was struck anew by tragedy: A hotel used for medical observation of people who had contact with coronavirus patients collapsed on Saturday, trapping 70 people inside, according to local news reports.
Countries outside Asia stepped up efforts to control the outbreak.
Saudi Arabia banned spectators at any sports competitions starting Saturday. The NBA and British sports teams are considering doing the same.
“I ain’t playing if I ain’t got the fans in the crowd,” Los Angeles Lakers star LeBron James said. “That’s who I play for.”
Spain deployed police to enforce a quarantine. Austria confiscated 21,000 disposable masks that a Turkish company smuggled aboard a tour bus, seeking to profit from soaring demand. Turkish police, meanwhile, threatened legal action against social media accounts accused of spreading false virus information.
The U.S. Centers for Disease Control and Prevention is urging older adults and people with severe medical conditions to “stay home as much as possible” and avoid crowds.
Most people who get the virus have mild cases, though the elderly face greater risks. Among the many new cases in Europe on Saturday was a doctor in Slovenia who was in contact with more than 100 people in a nursing home after a ski trip to neighboring Italy.
Global markets were enjoying a weekend respite from market panic, but the world economy faced mounting damage. China, the world’s biggest trader, reported Saturday its exports tumbled 17.2% from a year earlier in January and February.
A total of 78 million migrant workers have since returned to work in China, and manufacturers are reopening. But they aren’t expected to return to normal production until at least April, and most people in Wuhan still are barred from leaving their homes.
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Charlton reported from Paris. Associated Press writers Colleen Barry in Milan; Tong-hyung Kim in Seoul, South Korea; Eileen Ng in Kuala Lumpur, Malaysia; Samy Magdy in Cairo; Nasser Karimi in Tehran, Iran; Joe Wilson in Barcelona; Dusan Stojanovic in Belgrade; Karel Janicek in Prague; David Rising in Berlin; and researcher Henry Hou in Beijing contributed to this report.
This will be enforced from 0000 hours of March 10, 2020, and is a temporary measure till cases of Covid-19 subside.
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