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.
There’s nothing quite like the behavior of panicky humans—especially when it comes to hoarding. Let a blizzard approach or a hurricane churn toward shore, and we descend on stores, buying up more batteries, bottled water and canned foods than we could use in a lifetime. We’re seeing the same thing again as America hunkers down against the novel coronavirus, and of all of the products that are being snatched up the fastest, there’s one that’s in special demand: toilet paper.
The Washington Post reports a run on the rolls, with both Costco and the Giant supermarket chain stripped all but clean. Even Amazon’s physical stores “appeared to be down to single rolls of novelty toilet paper in some places Friday,” the Post said. The New York Times similarly reports from a Whole Foods supermarket in Somerville, Mass., where shoppers had to be limited to two packages of toilet paper each, lest they strip the store bare.
But why? What is it about toilet paper—specifically the prospect of an inadequate supply of it—that makes us so anxious. Some of the answer is obvious. Toilet paper has primal—even infantile—associations, connected with what is arguably the body’s least agreeable function in a way we’ve been taught from toddlerhood. Few, if any of us, remember a time when we weren’t acquainted with the product.
“There is comfort in knowing that it’s there,” says psychologist Mary Alvord, Associate Professor of Psychiatry and Behavioral Sciences at the George Washington University School of Medicine. “We all eat and we all sleep and we all poop. It’s a basic need to take care of ourselves.”
We are also exceedingly social creatures, and we count on the community for our survival. People seen as unclean or unwell are at risk of being shunned—which in the state of nature could mean death. “We’ve gone beyond using leaves,” says Alvord. “It’s about being clean and presentable and social and not smelling bad.”
The coronavirus panic has only made things worse. We know exactly when hurricane or blizzard season is approaching, and stores and supply chains can prepare. No one foresaw the season of corona.
“We, as a country, responded slowly,” says psychologist Baruch Fischoff, professor in the Department of Engineering and Public Policy at Carnegie Mellon University. “Until very recently, many people heard assurance that this was not a major problem. Then, suddenly, they were told to stock up, for an indeterminate period.”
When it comes to stocking up, different basics offer differing options. “If people did not find the food that they wanted, they could buy other food,” says Fischoff. “For toilet paper, there are no substitutes.”
The need to hoard the one product for which there is no alternative is only exacerbated, he adds, by the fact that it is not clear when the possible shortages will end. America’s late-to-the-party response to the COVID-19 pandemic means shoppers have not been “given assurances that the supply chain issues would be managed in due course.”
They likely will be just as the virus will be brought under control—eventually. Until then, humans will be humans and our eccentricities will be our eccentricities. Our panic buying, Alvord says, represents one thing we can control. In an exceedingly uncertain moment, it’s at least something.
Travel to — and throughout — the United States has rapidly dropped in recent days, driven by concerns about the spread of the novel coronavirus. On Wednesday night, President Donald Trumpannounced a month-long ban on most non-U.S. citizens traveling from Europe in an attempt to slow the spread of the virus — and on Saturday said the ban will extend to the United Kingdom and Ireland— although the move has been criticized as ineffective at stopping a virus that is already in the U.S.
Trump’s orders follow a widely-reported trend of people across and the U.S. (and across the world) canceling or curtailing travel plans in an attempt limit their risk of contracting COVID-19. This practice of self-isolation, known as social distancing, has already had a major impact on many major forms of mass transportation across the U.S. and internationally; here’s how’s how the travel industry is responding — across flights, trains, cruise ships and more — and what it means for the industry’s workforce.
How is the airline industry affected by coronavirus?
The airline industry has already been heavily impacted. According to OAG, a global travel data provider, the number of scheduled flights is globally down by 10% compared to the second week of March in 2019.
Many U.S. and European companies have been hit particularly hard by President Trump’s travel ban on non-U.S. citizens who have visited Europe’s Schengen Area, a collection of 26 countries that do not restrict travel amongst each other including Italy, Spain and France. Per OAG, the ban will affect passengers arriving on nearly 7,000 flights over the next month.
A spokesperson for Airlines for America, a trade association and lobbying group that represents major U.S. airlines, tells TIME in a statement that, “We respect President Trump’s decision to take action to prevent the spread of the virus as our top priority is – and always will be – the safety and well-being of all passengers and crew. However, the government-imposed travel restrictions have triggered rapid and severe damage to the airline industry.”
U.S. airlines directly employ 750,000 workers; the industry as a whole supports 10 million jobs. “The economic impact on U.S. airlines, their employees, travelers and the shipping public is staggering,” the spokesperson continues. New flight bookings for the next 90 days are down by 65-75%.
The flight attendant’s union the Association of Flight Attendants-CWA (AFA-CWA) tells TIME that they’ve seen a general reduction in the availability of flight hours but have not yet been made aware of any involuntary furloughs. However, flight attendants are generally paid by the hour, and that drop could be costly.
Sara Nelson, the International President of the Association of Flight Attendants-CWA — which represents 50,000 flight attendants at 20 airlines — explains to TIME that 80% of flight attendants in the industry are organized, and that their contracts provide pay protections that help mitigate schedule loss. However, most flight attendants work more hours than such pay protections account for, and depend on the income from those extra hours.
Nelson also tells TIME that the AFA-CWA has worked with airlines to secure contractual pay protection in the current months’ schedule and has worked with management of multiple airlines to determine how much voluntary, unpaid leave they’ll offer. Nelson says that flight attendants will still have their health insurance while on leave, “which is critically important as we’re facing this pandemic.” Flight attendants on leave will also maintain their seniority.
The Air Line Pilots Association, a union that represents over 63,000 pilots, tweeted on March 11, “ALPA’s Air Safety Organization is closely monitoring the 2019 novel#coronavirus(COVID-19) outbreak and will continue to meet regularly and provide timely information to our pilot groups as the situation progresses.”
Delta Airlines
The airline most affected by the the U.S.-Schengen area travel ban will be Delta Airlines, which was scheduled to fly 17% of flights affected by Trump’s ban, per OAG. On Friday, Delta announced it would reduce an unprecedented 40% of its overall capacity over the next few months — parking up to 300 aircrafts. This will be the largest reduction in the company’s history, including 9/11, per Reuters.
Delta also said it would immediately offer voluntary short-term unpaid leave and institute a company-wide hiring freeze, per Reuters. It also will reportedly reduce its use of consultants and contractors.
Delta did not immediately respond to TIME’s request for comment on what plans it has for workers affected by route suspensions. The AFA-CWA’s Nelson tells TIME that Delta is the only major airline whose flight attendants are not unionized, and she’s concerned what this could mean for workers.
United Airlines
United Airlines is the second-most affected by the ban; it was scheduled to operate 14% of affected flights, per OAG. The airline was also one of the first to take drastic action because of the spread of the virus. On March 4, United announced it would reportedly offer voluntary, unpaid leave for U.S. based employees, would institute a hiring freeze and postpone salary increases.
On Tuesday, United announced that it would cut 20 percent of its flights indefinitely until demand increases, according to The Washington Post. Its CEO and president will also reportedly forgo their base salaries through June. United President Scott Kirby said that airline’s domestic net books are down 70% as of Tuesday, per ABC News.
“We are reviewing our flight and crew schedules to comply with the administration’s travel restrictions,” United tells TIME in a statement sent on Thursday, March 12. “As always, we will continue to provide our customers and employees with the very latest information as it develops.”
American Airlines is the fourth most affected by the U.S.-Schengen ban, per OAG, and announced on Thursday that it would suspend multiple routes to Europe and South America through May. When asked for comment, American Airlines referred TIME to a letter sent to all its team members on Thursday night, which announced that the company would suspend all hiring and leadership moves, postpone pay increases, and offer extended unpaid, voluntary leaves of absence. The letter also said that American Airlines is extending a two-week paid sick policy for all team members who have been diagnosed with COVID-19 or are quarantined.
Many other U.S. and European airline companies have been hurt by the threat of COVID-19. The German company Lufthansa is the third most affected by the U.S.-Schengen Area travel ban, for example. But even before Trump’s announcement, the airline had already canceled 23,000 flights between March 29 and April 24.
“Our primary goal is to keep as many of our employees on board as possible,” a Lufthansa spokesperson told TIME in an emailed statement. “The extremely urgent decisions on reduced working hours are an important milestone in this regard… The Lufthansa Group has launched an extensive savings program. This includes an immediate hiring freeze, as well as cost reductions in personnel, material and project costs. We are using all available means to secure our liquidity.”
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How is the rail industry affected?
On Saturday, Amtrak announced its Northeast Corridor — which runs between Boston and Virginia — would run its Saturday schedule beginning March 16 through March 29. The Keystone Service in Pennsylvania will also be operating on a Saturday schedule with no service to the Ardmore Station.
On Wednesday, Amtrak announced it had temporarily suspended three trains that run between New York and Washington “due to lower demand.” It added that “additional changes to our schedule are under consideration.”
John Feltz, director of the Transport Workers Union Train Division, tells TIME there’s a possibility that onboard service workers on Amtrak he represents — such as cafe car workers — may have to prepare for a “furlough or a layoff situation.” He says the the union is “still trying to work that out with Amtrak right now” and “they are cooperating and they are working hand-in-hand.”
Feltz says that, if furloughed, workers would be able to collect unemployment under the Railroad Retirement Board, but their health insurance would be only last three months from their time they first left work.
Amtrak told TIME on Friday night that they are “working closely with the unions right now as we adjust our schedules as a result of reduced demand that has cut hundreds of millions of dollars from our revenue estimates.”
“We will soon be rolling out a voluntary unpaid leave program where non-essential employees can volunteer to take unpaid leave in order to contribute to reducing our expenses,” the spokesperson continued. She added they’ve taken other cost cutting measures “as we work hard to offset the revenue loss while minimizing the impact on our employees.” These measures include: ending all non-safety critical hiring; cutting discretionary travel, cutting professional fees, cutting consultant spending, cutting advertising spending, and cutting deferred non-priority capital projects.
Anthony Simon, general chairman of the transportation division of the International Association of Sheet Metal, Air, Rail and Transportation workers, who represents workers on the Long Island Railroad, writes TIME in an email that they have “been in constant contact with management and local officials. We have the full support of our international Union as well, and our work is secure moving forward as decisions and conditions are constantly changing.”
“Our first priority is for everyone’s safety and to prepare for whatever is necessary to restore normal. While there have been no threats to cut service as of yet, we will be prepared for whatever comes our way,” he writes.
How is the cruise industry affected?
Joe Raedle—Getty ImagesRoyal Caribbean Symphony of the Seas Cruise ship is seen docked at Port Miami after returning from an Eastern Caribbean cruise as the world deals with the coronavirus outbreak on March 14, 2020 in Miami, Florida.
The spread of COVID-19 has been devastating for the cruise industry. In a tweet on Friday, President Donald Trump announced that four major cruise lines — Carnival, Royal Caribbean, Norwegian, and MSC — have agreed to not sail from U.S. ports for thirty days. This comes after ports around the world have begun to temporarily ban cruise ship arrivals out of fear about the spread of coronavirus.
Cruise Lines International Association, a trade organization that includes over 50 cruise lines,announcedon Friday that all CLIA ocean-going cruise lines will be temporarily suspending cruise ship operations from U.S. ports of call for 30 days.
At my request, effective midnight tonight, Carnival, Royal Caribbean, Norwegian, and MSC have all agreed to suspend outbound cruises for thirty days. It is a great and important industry – it will be kept that way!
Multiple cruise ships have suffered high profile outbreaks of the virus. The Diamond Princess was quarantined for weeks off the coast of Japan and at least 700 people on board ended up contracting coronavirus. Another cruise ship, the Grand Princess, was prevented from docking off the coast of California for days out concerns about spreading the virus, and 21 people on board ended up testing positive by the time they disembarked in Oakland on March 9.
Princess Cruises
On Thursday, Princess Cruises — which is owned by Carnival Corp. — announcedit was suspending all its global operations through early May, meaning18 ships will cancel trips that were scheduled to begin between March 12 and May 10.
When asked what would happen to the employees scheduled to work these voyages, a spokesperson for Princess Cruises told TIME on Thursday, “Shoreside employees may temporarily take on new duties to support this change and the refund process. Most shipboard teammates will return home until service resumes in 60 days.”
“Our teammates are our Princess family and we are committed to the care of our team. This is an unprecedented action in the history of our company, so we do not know how everything will play out. We ask for understanding as we work through the specifics regarding compensation and other details,” the spokesperson continued.
On Friday, Carnival Corp. announced four more cruise lines would suspend their activity for a month: Carnival Cruise Line, Cunard North America, Holland America Line and Seabourn. Carnival Corp. did not immediately respond to TIME’s request for comment about what would happen to its workers.
Disney Cruises
On Friday, Disney Cruise Lines announced that it would suspend all new departures of Disney cruise ships beginning March 14 through the end of the month. “While we know this decision may be disappointing, the health and wellbeing of our guests is of the greatest importance,” Disney Cruise Line said in a statement.
“We are equally committed to the wellbeing of our incredible crew members who live and work aboard our ships and on Castaway Cay. During the suspended operations, Disney Cruise Line will continue to compensate our Crew Members and shoreside Cast Members,” the statement continued.
Viking Cruises also announced that it would suspend all ocean and river cruises until May 1.
Viking directed TIME’s request for comment to a message sent to all employees on March 11: “Viking’s guests and our crew always come first; we stand by you. The Company is financially strong, and we have experience in handling adversity. We have no plans to reduce our crew levels as they currently are and will use the next weeks to improve our procedures to handle future challenges presented with the new coronavirus.”
How is the shipping and delivery industry affected?
In late February, Shippers Transport Express alerted 145 drivers who work at the port of Los Angeles that they would be reducing hours beginning on Feb. 28, because of the decreased volumes of cargo moving through the port.
Ron Herrera, the director of the Teamster’s Union Port Division of the Western Region, tells TIME that roughly 30% of those drivers have been allowed to keep driving. He says the decreased hours are driven by the low volume of cargo coming from Asia. ABC 7 reports that Phillip Sanfield, spokesperson for the Port of LA, said that they saw a roughly 25% decline in volume in February 2020 compared to February 2019.
A spokesperson for Shippers Transport Express told TIME in an email Friday night, “We have in good faith worked to alert our workers to the reduced volume situation facing our industry as a result of the [coronavirus].”
“We’ve informed [drivers] that we will be providing hours as volume arrives and we have more work. Hopefully, volume returns to normal shortly and we will have volume and hours for all our drivers. This will be done on a seniority basis, as hours materialize, which is the Teamster’s process,” he continued.
One of those workers is 35-year-old Wendy Cruz, who has driven for Shippers Transport Express for four years. She tells TIME that she’s “definitely” worried about job security going forward. “We don’t know what’s going to happen,” she explains. “And I recently just purchased a home.”
Herrera tells TIME that the Teamster’s Union anticipates more layoffs because of low manufacturing rates in China. “I don’t think we’ve seen the bottom of this yet,” he says. As NBC News reports, some economists say the coronavirus could have a bigger effect on U.S.-China trade than the Trump-era trade war did.
How is the ride-sharing industry affected?
Uber and Lyft have also taken a hit from the spread of COVID-19.
Uber has announced that if any driver or delivery person contracts coronavirus or is asked to self-isolate the company will provide financial assistance for up to 14 days. Uber has also announced that it’s working to provide drivers with disinfectants to help clean their cars. Similarly, Lyft has announced that it plans to deliver cleaning supplies to its drivers and will “provide funds to drivers” with COVID-19 or in quarantine “based on the rides they provided on the Lyft platform over the last four weeks.”
But many U.S.-based Uber and Lyft drivers have expressed frustration that their companies have no done enough to protect them from the virus or from severe economic losses.
Steve Gregg, who has been driving for Uber and Lyft in California’s Bay Area for a little over three years, tells TIME that he’s “not in a position” where he can stop driving. Even though he says his fear over the coronavirus has caused him to have mild panic attacks, he’s had to keep driving because he depends on the income to support his children. Gregg adds that the two-weeks compensation he would receive if he got sick would be “a little too late.”
Yash — an Uber and Lyft driver whose full name TIME is withholding to protect his job — says his income went down last week by 30%. He adds that as his income has gone down, his costs have gone up; he now takes his car to get washed every day.
“We are at the front line of this epidemic. On a daily basis we deal with 20-30 people,” he says. He says he’s been suffering from insomnia since the crisis began, but he can’t stop driving because he can’t afford to.
When asked for comment on Thursday about the impact the spread of the virus has had on drivers, Uber directed TIME to a speech the company’s CEO Dara Khosrowshahi gave at Morgan Stanley last week, where he said, “As far as the impact to date, first of all, we are completely focused on the operational side of the business, making sure that our riders are safe, our drivers are safe, they understand what are best practices to make sure you stay safe.Our employees are taken care of. Our partners are taken care of.”
When asked for comment on Thursday about the virus’ impact on drivers, a Lyft spokesperson told TIME in a statement, “We are monitoring the coronavirus situation closely, and taking action based on guidance from the Centers for Disease Control. Our focus is on keeping our riders, drivers and team members safe. We have an internal task force dedicated solely to this issue, and are prepared to take action as needed.”
Responding to the concerns raised by the drivers TIME spoke with, a spokesperson for Uber said on Saturday in a statement, “The mounting fear and uncertainty caused by the coronavirus is being felt by everyone around the world. We know it’s especially concerning for people who drive and deliver with Uber. In these difficult times, their well-being is at the top of our minds, and we have a dedicated team working around the clock to support them the very best we can.”
Lyft did not return a Friday request for comment on the drivers’ comments.
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During a press conference on Saturday, President Donald Trump said he was tested for the novel coronavirus, officially known as COVID-19, on Friday night and has not yet learned the results. He said he took the test because the press repeatedly asked if he had been tested during a press conference on Friday.
“I also took the test last night,” he told reporters.“I decided I should based on the press conference yesterday. People were asking, ‘did I take the test?’” When asked how long until the public learned the results, he said,“I don’t know, whatever it takes, a day or two days.”
The White House also announced on Saturday that it is conducting temperature check on anyone who has come in close contact with the President or Vice President Mike Pence, according to the Associated Press.
On Friday, the White House announced that at the President’s Mar-a-Lago club, Trump came into contact with two individuals later confirmed to have COVID-19, one of whom he shook hands with and one of whom sat at his dinner table. The White House said the CDC categorized the interactions as having a low risk for transmission and did not require quarantine. The President’s doctor also reportedly said in a memo Friday night that Trump did not need to be tested or self-quarantine.
The president’s doctor says that despite interactions with two people with COVID-19 last weekend, Trump does not need a test or to self-quarantine at this time. pic.twitter.com/8T9x2pfmhA
At Saturday’s press conference, Vice President Mike Pence said the U.S. would suspend all travel to the United Kingdom and Ireland affective midnight Monday night, Eastern Time.
The White House announced on Wednesday that non-U.S. citizens who had traveled to European countries in the Schengen Area — 26 countries that typically don’t restrict movement amongst each other including Italy, Spain and France — would be banned from entering the U.S. for 30 days.
The President also said that he is “working with the states” and is considering other travel restrictions domestically, “specifically from certain areas.”
According to a tracker by John’s Hopkins University on Saturday afternoon Eastern Time, 2,177 cases of coronavirus have been confirmed the the U.S., and at least 47 people have died. On Friday, the President declared a state of emergency as schools and businesses across the country close in an attempt to stem the spread of the virus.
The Indian Drug Manufacturers Association (IDMA) has assured that its members have enough stocks of APIs and formulations," Minister for Chemicals & Fertilizers DV Sadananda Gowda said in a reply.
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Europe is now the "epicentre" of the global coronavirus pandemic, Tedros Adhanom Ghebreyesus, Director General of the World Health Organization said on Friday.
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New Delhi, Mar 13 () India reported its second casualty due to coronavirus on Friday with the Health Ministry saying a 68-year-old woman, whose son with a travel history abroad had tested positive, died in Delhi.
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(WASHINGTON) — President Donald Trump said Friday he will likely be tested for the novel coronavirus “fairly soon,” as questions swirled about why the president, his top aides and his family weren’t doing more to protect themselves and others against COVID-19.
Trump spent time last weekend with a top Brazilian official who tested positive for the virus after returning from a weekend at the president’s private club in Florida. And late Friday, news broke that a second person who was at Mar-a-Lago over the weekend had tested positive, according to a Republican official who spoke on condition of anonymity in order to discuss private health matters.
The second person had attended a Trump fundraiser at the president’s Florida resort on Sunday.
In the face of repeat direct and indirect exposures, Trump was defensive, insisting he didn’t need to isolate himself because he wasn’t exhibiting symptoms. But he conceded he would “most likely” submit to testing after a top Brazilian official who spent time with him last weekend in Florida tested positive for the virus.
At the same time, Trump continued to flout public health officials’ advice by publicly and repeatedly shaking hands during a Rose Garden address on efforts to combat the pandemic. At the same event, he allowed that “anyone can be a carrier of the virus” and risk infecting older Americans and others at higher risk.
The president, according to two people close to the White House, has resisted taking the test for fear it would project weakness or worry. Trump has wanted to appear in full control during the crisis, especially as he tries to calm stock markets amid historic drops, and has expressed concerns that taking personal steps could undermine that.
Trump continued to stress Friday that he is not exhibiting any symptoms of infection, but he skirted questions about whether he was being selfish by refusing to isolate himself when others who have had similar exposure have chosen to do to avoid potentially infecting others. Asked whose advice people with similar exposure should listen to in the face of the contradictory messages, Trump said, “I think they have to listen to their doctors.”
Trump has also had repeated contact with lawmakers who were themselves exposed to people who later tested positive and chose to self-isolate out of an abundance of caution.
As White House officials worked to determine the level of exposure by the president and senior aides, Trump held an afternoon news conference and announced he was declaring a national emergency — something he had been reluctant to do for fear it would further rattle the markets — and unveiled a new public-private partnership to expand coronavirus testing capabilities.
Still, he said that, “We don’t want everyone taking this test,” adding: “It’s totally unnecessary. This will pass.”
The president had up until Friday declined to be tested for the virus or to limit his contact with others, professing no concern about potential exposure as his White House insisted they were following Centers for Disease Control and Prevention guidelines. He told reporters Thursday that he was “not concerned,” adding Friday that, “we have no symptoms whatsoever.”
And even as he refused to modify his own behavior — including continuing to shake hands — Trump told the nation that, “We must take all precautions” and be “responsible for the actions” that we take and see others take.
Trump spent time last weekend with Brazilian President Jair Bolsonaro’s communications director, Fábio Wajngarten, who tested positive just days later. Wajngarten posed for a photo with Trump at his Mar-a-Lago club and attended a birthday party for Kimberly Guilfoyle, who is dating the president’s eldest son, Donald Trump Jr. The president attended the party as well. There were also fears that Bolsonaro himself might have the virus, but he said Friday he’d tested negative.
The White House stressed that Trump and Vice President Mike Pence “had almost no interactions with the individual who tested positive and do not require being tested at this time.”
In addition to the Brazilian official, top administration officials — including Attorney General William Barr and Trump’s daughter and senior adviser Ivanka — met last week with an Australian Cabinet minister who on Friday tested positive for the virus.
Minister for Home Affairs Peter Dutton, said he woke up with a temperature and sore throat on Friday, one week after his meeting with the Americans.
White House spokesman Judd Deere said Ivanka Trump worked from home Friday “out of an abundance of caution,” but said Dutton had been asymptomatic during their interaction and the White House Medical Unit determined she was “exhibiting no symptoms and does not need to self-quarantine.”
The CDC advises those who have been in “close contact with a person with symptomatic laboratory-confirmed COVID-19” to remain home and practice social distancing.
People don’t show symptoms immediately after exposure to the virus; there is an incubation period of anywhere from two to 14 days. However, not all exposures automatically put people at risk of infection: the CDC doesn’t consider it risky to walk past someone with the virus or to be briefly in the same room with them. The CDC is most concerned with close contact, which it defines as being coughed on by a patient or being within about 6 feet for a prolonged period of time such as while living with, visiting or sharing a room.
Trump has also had repeated contact with others who were exposed to the virus and quarantined themselves out of an abundance of caution. That included Florida Rep. Matt Gaetz, who traveled aboard Air Force One with the president on Monday and found out mid-flight that he was among a handful of GOP lawmakers who were exposed to a person who tested positive for the virus after last month’s Conservative Political Action Conference.
Also staying home: Texas Sen. Ted Cruz, who announced Friday he would be extending his CPAC-related self-quarantine after coming into contact with another person who later tested positive, and South Carolina Sen. Lindsey Graham, who announced Thursday he was self-quarantining after spending time in Mar-a-Lago and his own meeting with Dutton. Florida Sen. Rick Scott was also isolating himself following his interactions with the Brazilian delegation.
Many doctors across the country have been advising those who have been exposed to someone with the virus to isolate themselves. And Trump, who is 73, is considered to be at higher risk of developing serious complications because of his age.
The president should get tested, even if he is not exhibiting symptoms, said Stephen Morse, a Columbia University expert on the spread of diseases. “If I were in that position I’d certainly want to be tested, rather than waiting until something happened,”said Morse. Beyond Trump’s own health, he said, he could pose a risk to others if he is infected and keeps meeting other political leaders.
”Anyone who’s infected is a risk of spreading it to other people,” and that can be true of people who are infected but don’t have symptoms, Morse said.
Trump’s new conference came amid intense criticism over his mixed messages on the severity of the outbreak and over the administration’s scattershot response. His prime time address earlier this week only added to the public confusion, and Trump has grown increasingly frustrated that his words to the nation so far have done little to calm the public or the financial markets.
The president’s mood was “as black as it has ever been” on Thursday, according to one confidant. He has called around to allies while watching cable news coverage of the Wall Street plummet, furious that his efforts to bolster markets did the exact opposite, according to three White House officials and Republicans close to the White House who spoke on condition of anonymity because they were not authorized to publicly discuss private conversations.
And he has been lashing out at those around him for failing to do more, at times criticizing former President Barack Obama and a familiar target, the chairman of the Federal Reserve.
___
Lemire reported from New York. Associated Press writers Lauran Neergaard in Washington and Michael Stobbe in New York contributed to this report.
President Donald Trump’s declaration of a national emergency is designed to speed federal support to parts of America that are struggling to prepare for a coming surge of COVID-19 cases, unlocking $50 billion in aid, giving hospitals and doctors more freedom to handle a potential tsunami of sick patients and scrambling to make tests available. In a Rose Garden press conference Friday, Trump presented the emergency measures as proof that, “No nation is more prepared or more equipped to face down this crisis.”
But for epidemiologists, medical experts and current and former U.S. public health officials, the need for such extraordinary and hastily organized steps is a tacit admission of failure, not just by Trump’s White House but by the U.S. government over multiple administrations.
The warning signs that America was unprepared for a pandemic have been blinking red for more than a decade, as Congressional hearings, table-top exercises and think-tank studies showed that the U.S. healthcare system was unprepared. But too little was done to fix it and now that COVID-19 is here, the Trump administration is rushing to identify who is vulnerable, how can they be helped, and how costly it will be to save as many lives possible.
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Few dispute the crisis has already arrived. Even before Trump’s declaration, 33 U.S. governors had declared their own states of emergency. At the same time, hospitals across the country are preparing for surge capacity and instructing their staff not to leave the area. On March 10, Massachusetts’ urgent request was granted from the federal government for equipment including face masks, gowns and gloves. Short of available hospital space, health officials in Washington state on March 6 purchased an Econo Lodge motel, 20 miles south of Seattle, to house up to 80 patients. Over the last five weeks, the Centers for Disease Control and Prevention distributed hundreds of faulty diagnostic test kits.
Some federal officials are openly admitting they missed the signs. “We did not consider a situation like this today,” Dr. Robert Kadlec, Department of Health and Human Services (HHS) assistant secretary for preparedness and response, told Congress this week. “We thought about vaccines. We thought about therapeutics. We never thought about respirators being our first and only line of defense for health care workers.” He said about 35 million respirator masks are used by the healthcare industry in a typical year. This year up to 1 billion will be used over a six-month period. The Strategic National Stockpile, a federally managed emergency stash that can be accessed in crises, holds only a fraction of that number. The situation with testing is equally bad. Dr. Anthony Fauci and other officials admitted during Trump’s Friday press conference that the testing system in place in the U.S. was adequate for small outbreaks, not for the kind that COVID-19 presents, even though experts have long warned such of the dangers of a global coronavirus epidemic.
The failing is not limited to the Trump White House. Over multiple administrations, the U.S. government hasn’t prioritized pandemic preparedness, experts say, and typically the flow of funding only has come after a crisis has started. In that sense, Trump’s emergency declaration follows the same pattern of previous health crises—SARS, MERS, H1N1, Ebola, Zika—unlocking billions in federal dollars, only to dry up once it’s over. The boom-and-bust cycles is a recurring problem, experts say. “We see this cycle of panic and neglect,” says Dr. Tom Frieden, former director of the U.S. Centers for Disease Control (CDC) and president and CEO of Resolve to Save Lives. “When something like COVID-19 happens, people are willing to do a lot to avoid health harm. When it’s out of the headlines, it’s out of sight, out of mind.”
The compounded problems of lack of preparation will also hamper the effectiveness of Trump’s emergency measures. With limited testing around the country, experts say, it’s hard to know where best to target some aid. “If anyone says they know with confidence what will be happening over the next few months, they don’t know enough about this virus,” Frieden says. “We’re learning more every day and the more we learn the better we can protect people. One thing is for sure, however, it is going to get worse before it gets better.”
One month before the first COVID-19 cases emerged in China, the Washington think tank Center for Strategic and International Studies published the results of a two-year study conducted by a blue-ribbon panel of former members of Congress, public health experts, and former U.S. and military officials. The conclusions weren’t pretty. “The American people are far from safe,” they wrote. “The United States must either pay now and gain protection and security or wait for the next epidemic and pay a much greater price in human and economic costs.”
Now everyone is scrambling to mitigate those costs. The first order of business, experts say, is to realize that the fast-growing crisis can be slowed, but not stopped. Flight cancellations, school closures and public event postponements will fundamentally reshape American life in the near-term, but they will also reduce the scale of the outbreak. The hope is to shrink the chance of transmission, and therefore minimize the number of people who get infected, something public health officials describe as, “flattening” the epidemic curve.
“If you look at the curves of outbreaks, they go up in big peaks, and then come down. What we need to do is flatten that down,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters Tuesday at the White House. “That would have less people infected. That would, ultimately, have less deaths.” It remains unclear how bad the COVID-19 crisis will get in the United States, according to Fauci. “If we are complacent and don’t do really aggressive containment and mitigation, the number could go way up and be involved in many, many millions. If we contain, we could flatten it,” he said.
Trump’s Mar. 13 emergency declaration could help. By waiving regulations, Trump said more patients would be able to consult doctors remotely over the internet, rather than flock to hospitals. He also gave hospitals the power to waive certain federal licensing requirements so doctors in one state can interact with patients in another. He eliminated restrictions on where doctors can care for patients within a hospital. “We’ll remove or eliminate every obstacle necessary to deliver our people the care that they need and that they’re entitled to,” Trump said. “No resource will be spared, nothing whatsoever.”
Emergency funding will be provided to state and local governments through the Stafford Act, the federal law that governs disaster-relief efforts. But natural disasters tend to strike a single region and pandemics are everywhere at once. Even the best hospitals will unexpectedly run out of beds and mechanical ventilators if they are inundated with coronavirus cases. Italy, which has seen its healthcare system overrun in recent weeks, has the worst outbreak of COVID-19 outside of China. On Wednesday, Italian government officials said nearly 400 people died over a 48-hour period. A total of 1,016 COVID-19 related deaths have been reported in Italy thus far.
As far as space for patients goes, Italy was better prepared than the United States. Italy has 3.2. hospital beds per 1,000 people, according to the Organisation for Economic Co-operation and Development. The U.S. has even less: 2.8 beds per 1,000 people. “This is going to be a significant challenge for any hospital in the U.S. to mount a response against the surge of demands that will come through its doors,” says Dr. David Marcozzi, an associate professor at the University of Maryland School of Medicine and former director of a federal health care preparedness program. “I, personally, have concerns about the United States’ ability to respond to an event like what we’re seeing from COVID-19.”
One of the central criticisms of the Trump Administration’s response is that it is missing a key ingredient of a solution: data from test kits. Testing in the U.S. remains far behind other nations. The U.S. has conducted 13,624 tests for COVID-19, according to the CDC. South Korea, on the other hand, has said it has carried out more than 230,000 tests. Part of the disparity is that South Korea has set up dozens of mobile testing sites around the country that people can drive-through like McDonald’s, though a few states have set up services on their own. Trump authorized establishing mobile testing sites on Friday at big box retailers, including Walmart and Target, after days of criticism. It remains unclear when such tests will be available.
CDC Director Dr. Robert Redfield had told a House panel earlier in the week that the U.S. had no plans for the sites. “We’re trying to maintain the relationship between individuals and their healthcare providers,” he said. The issue, which was raised to Redfield, is that most Americans don’t really have a doctor and rather show up at a hospital emergency room when they need help, which underscores the potential crisis if officials can’t limit the number of cases flooding into hospitals in the coming days. Hospitals are already inundated daily with people with gunshot wounds, congestive heart failure or suffering from influenza, considering it’s still flu season, COVID-19 will push the hospital system to the breaking point. “If you look at hospital capacity right now, much of it is full, up to 95, 96, 97%,” Redfield said Tuesday. “So we really don’t have a lot of resilience in the capacity of our health system.”
Another variable in the fight against COVID-19 is who will need to be hospitalized. Most Americans who get the virus won’t. But the elderly and those affected with underlying conditions could require intensive care. Unfortunately, that doesn’t limit the number of potential patients as much as one might hope. “That’s a lot of people who will need hospital care. And that’s the real risk,” says Dr. Eric Toner, a senior scientist at Johns Hopkins Center for Health Security. “If we don’t handle things well—and even if we do—we may not have capacity for everyone that’s sick.”
Last October, Toner oversaw a table-top exercise with a group of public-health experts from the CDC, China and industry gathered in New York City. The simulation aimed to see how international government organizations, healthcare companies and other institutions would answer to a theoretical “pandemic with potentially catastrophic consequences.” The simulated virus, which took place two months before COVID-19 broke out in central China, was dubbed Coronavirus Associated Pulmonary Syndrome (CAPS). After 18 months, the disease swept the globe and killed 65 million people.
The U.S. does have a national strategy for pandemics, and there have been welcome steps taken since the bioterrorism fears that followed 9/11. The CDC has a so-called “playbook” for dealing with pandemic influenza as a starting point. But the playbook doesn’t include dollars. Which means it is no substitute for sustained preparedness funding that extends out for years. That support would ensure a steady supply of doctors and nurses trained to deal with pandemics at home and support U.S. efforts to build defenses abroad.
Some have tried. The top White House official charged with leading the U.S. response to a global pandemic, Rear Adm. Timothy Ziemer, abruptly left the administration in May 2018, when then-national security advisor John Bolton reorganized the National Security Council. The global health security team he led, created in 2016 to address the issues revealed by the slow, uncoordinated U.S. response to the Ebola crisis, was also disbanded. White House homeland security adviser Tom Bossert, who had been a vocal advocate for a comprehensive biodefense strategy against deadly pandemics, had left a few months earlier. According to current and former officials, those positions were not reinstated and the unit was downgraded. However, the National Biodefense Strategy which had been spearheaded by Bossert and his colleagues, remains a roadmap that is playing a crucial role in the current U.S. response to the coronavirus.
Experts stress that public health capacity is something that needs to be built and sustained over time. Dr. J. Nadine Gracia, vice president and chief operating officer at Trust for America’s Health, says without steady pandemic preparedness funding it’s difficult to hire individuals within the public health departments for the long-term. Pandemic planning also makes community hospitals and government officials more interconnected. “What we’ve been seeing is an increase in the number of—and severity of—these types of public health emergencies,” she says.
Ultimately, how bad COVID-19 will get in the United States depends on a range of factors, including how fast the disease transmits, whether Americans heed government advice to avoid crowds and the performance of healthcare providers. If everything goes just right, the U.S. may be able to minimize deaths and limit the costs to lives and livelihoods. But even in the best case, says Gracia, it’s critical to take note of what works, not just now as the nation struggles through this pandemic, but down the road when the world has the chance to prepare for another, potentially even more deadly, crisis.
Businesses, basketball games, Broadway shows, baby showers—every area of life has been disrupted by the COVID-19 pandemic. It’s impossible to go an hour without hearing of another cancellation or closure. Like many others, I’ve spent the past weeks stressing over which key supplies and shelf-stable foods to stock up on, whether we should keep our kids home from school, how we’ll manage if we’re asked to shelter in place for weeks or even months. But the most gut-wrenching decision I’ve faced, by far, is whether I should travel to see my sick and immunocompromised mom, potentially exposing her to a virus from which she might not recover.
I live on the East Coast; my mother lives on the West. Sometime in the next couple of weeks, I have to decide whether I will visit her in April, as planned—and, if I do, whether I’ll bring my kids along. It takes two planes and anywhere from 12 to 18 hours, depending on layovers and travel mishaps, to make the trip. During the years when my father was sick and on dialysis, neither my parents nor I could afford frequent cross-country journeys. I’ll always regret not being able to spend more time with my dad in the last years of his life.
My mom was diagnosed with cancer in late 2018, months after my dad’s death. She was in remission for a short time, but then it came roaring back, Stage IV, and within a few months her doctors stopped saying optimistic things. I knew that whatever happened, I didn’t want to have the same regrets I had when my father died—I’m grateful that my financial situation has improved to the point where I’ve been able to visit her more often and send money when she needs it. For months we’ve gotten nothing but terrible news—the cancer has metastasized; it’s everywhere; it’s not responding well to chemotherapy—but at least, I’ve been able to tell myself, we can see each other. We can spend time together, the time my dad and I never got.
Then came COVID-19. I was worried, but I assumed it wouldn’t affect my travel plans. When I first spoke to my doctor, she said I’d probably be fine, despite my asthma, as long as I practiced good handwashing. There were only a handful of cases in our area.
Now community transmission has begun, and every day brings what feels like a month’s worth of bad news. Given the Administration’s weak response and the subsequent test shortages, we can’t know how widespread the virus is in the U.S., but many believe the actual number is well beyond our ability to test for. Nursing homes are on lockdown; schools and churches are closing. Most people I know are working from home as much as possible. While there are still no domestic travel restrictions, Trump has indicated they’re not off the table, and it seems everything else that can shut down has already done so.
I don’t assume this will remain the case, as it seems COVID-19 will soon be everywhere, but for now I would guess my mother’s risk of exposure is relatively low. She lives with her sister in a town of about 5,000 people, hours from the closest major outbreak. She has regular visitors, but she doesn’t go out much. And while we now know that she won’t get better, she is in a “stable period,” according to her care team. If I travel to see her, carrying germs—no matter how careful I try to be, how many times I wash my hands—I might be the one to compromise her fragile, hard-won stability.
My kids ask me every day if we’re going to see Grandma soon, and all I can tell them is, “I hope so.” But even if I go, bringing them with me seems foolhardy. While children don’t appear to be in great danger from COVID-19, have you ever tried to keep two kids from touching various public surfaces for an hour, let alone a full day of travel? It’s been impossible for me to stop touching my face, and I am an adult who spends approximately a quarter of her waking time thinking: Don’t touch your face!!! If we pick something up while airborne, or in any one of the three airports we’ll have to travel through—or if we contract the virus but are asymptomatic before we even leave—there’s a chance we could pass it to my mom
The situation is changing daily, but almost every article I’ve read about air travel within the U.S. has laid out both sides, noting that many people are still flying while urging readers to reconsider travel plans if they are older, have medical conditions that make them vulnerable, or know they will come into contact with those at greater risk. If my mother didn’t have a terminal diagnosis, I wouldn’t even consider traveling; I know staying home could help suppress the spread of the virus. But I don’t know how many more chances I’ll have to see my mom, and no one knows how long the pandemic will last.
Friends, including those who work in public health, now seem torn when I poll them on what they would do in my place. If I’m leaning one way or the other, whoever I’m talking with will say, “That’s definitely the right decision,” and I might agree—until I start second-guessing myself again. Maybe everyone is just being kind, telling me what they imagine I want to hear, even though we all know that my mother and I have absolutely no good options at the moment. And I know so many other people who are facing the same terrible choice, trying to figure out if they should visit sick or aging loved ones; what the incalculable danger might be if they do; how they will live with whatever decision they’re forced to make. How do you weigh such an enormous health risk, one that isn’t solely or even primarily your own?
I try to keep the worst of my anxiety from my mother, because God knows she has enough to deal with, but she’s aware that I’m wrestling with this. As of last week, she still wanted me to come out soon and bring the kids. But she’s also following the news, if not quite as obsessively as I am, and when I talk to her now, she sounds less certain. A typical mom, she’s worried for me, too—and her grandkids—even though we aren’t terribly at risk. She says she’ll understand whether we travel soon or try to wait it out, and it is a relief to know she won’t blame me either way. But I know from bitter experience what it is to blame myself for distance, for time missed, for painful separation from my family, no matter how unwanted or unplanned.
It seems we’re all afraid in this moment; it’s hard not to be. I’m afraid of so many things, especially the suffering of people I love and a world without my mom. Even after my father died, I assumed my mother would live to see my hair turn gray, my kids grow up. It’s devastating to know that this is happening to her, that I will lose her far earlier than I’d ever imagined. Now, as this virus sweeps through our country and the world, it feels as though my need to see her is in direct conflict with my wish for her to stay comfortable, stay alive for as long as possible. I can’t predict with confidence the next time we will see each other, nor can I guess how many more memories my kids will make with her. Of all the sudden and drastic changes the new coronavirus has wrought in our lives, this is the hardest for me to accept.
The World Health Organization (WHO) has launched a first-of-its-kind fundraising drive for companies, philanthropies and individuals to contribute to as it continues to fight the growing coronavirus pandemic.
The United Nations Foundation and the Swiss Philanthropy Foundation will manage the COVID-19 Solidarity Response Fund to address the need for money to prepare for and respond to the spread of the coronavirus.
WHO Director-General Dr. Tedros Adhanom Ghebreyesus announced the new fund on Friday. The organization anticipates a need of $675 million through April to address the worldwide outbreak, and said funding needs will likely increase as the crisis evolves.
“We hope it will become the foremost way for businesses, individuals and philanthropies to get involved in this fight against this virus on a global scale, which is exactly what we need at this moment,” a UN Foundation representative told reporters Thursday.
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The money will be used to support efforts in tracking and understanding the spread of COVID-19, ensuring that patients can access the care they need and that frontline workers can get supplies and information, and accelerating the development of vaccines, tests and treatments, according to UN Foundation representatives.
Scott Pendergast, director for strategic planning at WHO’s emergency preparedness and response program, told reporters donations to the fund will be used to provide medical equipment, such as ventilators and oxygen, along with personal protective supplies to countries, particularly those with weaker healthcare systems, in an effort to ramp up their responses to COVID-19.
“One of the major actions is making sure that countries are prepared for and can respond to COVID-19, and this includes putting in place coordination mechanisms at the country level,” Pendergast said.
Businesses, philanthropies and individuals from all over the world are encouraged to donate to the fund by visiting www.COVID19Fund.org or contact COVID19Fund@unfoundation.org to send a check or wire money.
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(RIO DE JANEIRO) — Brazil’s President Jair Bolsonaro has tested negative for the new coronavirus, according to a post Friday on his official Facebook profile.
He traveled to Florida last weekend and dined with his U.S. counterpart, President Donald Trump, and a member of the delegation that accompanied him had tested positive after meeting Trump. Bolsonaro, 64, received the test on Thursday after his communications director was confirmed to have the virus.
There had been a swirl of confusing information earlier Friday, with a some media reporting Bolsonaro had received an initial positive test result. But the president’s official social media account later said tests were negative, and also posted a photo of Bolsonaro making an offensive arm gesture to reporters earlier this year.
“Don’t believe the fake news media!” he wrote in a subsequent post.
Bolsonaro’s Mar-a-Lago meeting also included Trump’s daughter Ivanka Trump, son-in-law Jared Kushner, Brazil’s foreign minister Ernesto Araujo and Bolsonaro’s son Eduardo, who is a federal lawmaker, among others. Vice President Mike Pence and Trump’s personal lawyer Rudy Giuliani also went to Mar-a-Lago that evening.
This week, Bolsonaro told a group in Florida that he believed mainstream media was exaggerating the virus’ severity. He reversed course Thursday, wearing a face mask on a live transmission on Facebook. On a televised address later, he said the World Health Organization “responsibly” characterized the virus as a pandemic, and tried to dissuade supporters from turning out for mass demonstrations scheduled for March 15.
The rallies “demonstrate the maturity of our presidential democracy and are evident expressions of our liberty. They need, however, to be rethought in the face of these facts. Our health and that of our families must be preserved,” Bolsonaro said.
Bolsonaro’s health has been a focus since a 2018 stabbing on the campaign trail. Since the assassination attempt, he has already undergone four surgeries with a fifth one upcoming. In December, he was taken to the hospital after slipping in the bathroom of the presidential residence and banging his head.
For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.
The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover. In mainland China, where the virus first exploded, more than 80,000 people have been diagnosed and about 60,000 have so far recovered.
As more cases of COVID-19 are reported around the world, medical advice about who should be tested for the coronavirus infection is constantly changing to reflect changing levels of risk for infection. Here’s how doctors are deciding who to test, and when.
I have a fever and a cough. Can I get tested for COVID-19?
Not necessarily. COVID-19 symptoms include fever, cough and difficulty breathing. But those are also symptoms of the seasonal flu, so doctors will first make sure you don’t have the flu or other common respiratory illnesses. Most hospitals and some urgent care centers can run a test for those and for some types of pneumonia. In most cases, results take a couple of hours. (Doctors’ offices can order these tests, in which case it may take a few days.) If those results are negative, then doctors might consider ordering a COVID-19 test. But before doing that, they will ask you more questions to determine how likely it is that you were exposed to the virus.
“All folks who come to the hospital with symptoms go through risk stratification per the Centers for Disease Control [guidance],” says Dr. Dan Varga, chief physician executive at Hackensack Meridian Health. This includes asking about whether you traveled in the past 14 days to places with high numbers of cases, or if you had close contact with someone who tested positive. At the University of California Los Angeles Medical Center, doctors are following California department of health guidelines that limit testing only to people with symptoms who need hospitalization and have traveled to affected countries or been in contact with people who tested positive. Columbia University Medical Center in New York is also only testing those who are sick enough to need hospitalization.
The U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) have, however, loosened these criteria and currently allow doctors to use their own discretion about other circumstances that might warrant testing for people with symptoms. These might include being in a public location where infected people had been. Another example might be a health care worker who cared for a person diagnosed with COVID-19. According to Dr. David Buchholz, senior founding medical director of primary care at Columbia, it’s important to know if health care workers are infected, so they can be isolated and not spread the infection to others in the hospital.
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I have symptoms and my doctor wants to order a test, but the state or local health department won’t test me.
This is a direct result of the limited number of testing kits that have been available to date. When state and local public health departments had the only test kits that were available, health officials there made the decision about who to test. “Essentially up to now the test was being rationed to people where it might make a difference,” says Buccholz.
But that is quickly changing, as commercial testing labs are rolling out thousands of tests a day. And any physician can order tests through these companies, although many are still following certain criteria in deciding which people need them. (See below)
I don’t have any symptoms but I use public transportation where people are coughing and sneezing. Can I get tested?
At the moment, probably not. “Certainly nobody who has no symptoms at all and has not had contact with anybody who is known to have COVID-19, should be running out and getting tested,” says Dr. Daniel Kuritzkes, chief of the division of infectious diseases at Brigham and Women’s Hospital.“
While doctors have discretion on ordering tests, most depend on some type of risk assessment, based on CDC guidance, to decide how likely it is that people asking for the test were exposed to the virus.
It’s worth noting that different doctors may assess risk in different ways, however, so some providers may be more willing to order tests than others. The number of tests available also factors into their decision. “We’re still not ready to test people just because they want to know because we don’t have even tests,” says Buchholz. Until recently, testing kits have been limited, so doctors have been reserving tests for those who were most likely exposed and would test positive. (That should change this week, as more commercial testing labs produce tests that doctors can order.)
Doctors are also keeping in mind that people who couldn’t be tested but have been asked to self-isolate just in case, will need to be tested in order to clear them to return to work. (The CDC says people should have two negative tests to confirm they aren’t contagious.)
Buccholz also notes that testing people who don’t have symptoms isn’t necessarily helpful, since it’s possible that if people who are infected get tested very soon after their infection, they might be negative.
Testing people without symptoms in the general population falls into the category of public health screening, and the goal there is to get a better handle for how widespread an infection is in the community. While this is important to know, it’s not as critical at this point in the pandemic as finding people who need treatment immediately.
I don’t have symptoms but I might have come into contact with someone who tested positive at work. Can I get tested?
As capacity for COVID-19 testing grows, this is likely the next group that would be eligible.
Right now, however, these people would most likely be turned away. For example, most of Massachusetts’ nearly 100 cases came from a company meeting held in Boston that was attended by several people who had recently traveled to Italy and became infected. At the time, meeting attendees who didn’t have symptoms but wanted to be tested at emergency rooms were turned away because they weren’t sick.
“Even in those cases, we would not recommend that people go to the emergency room for testing,” says Dr. Aimee Moulin, associate professor of emergency medicine at University of California Davis. “At the emergency room, we are trying to focus on patients who are symptomatic.” They simply don’t have a testing capacity for an entire community, she says.
If I have symptoms, where should I go to get tested?
Because COVID-19 seems to be highly contagious, doctors are urging people with fevers and cough to not walk into emergency rooms or make appointments at their doctor’s office. Call first, describe your symptoms and then follow your doctor’s advice about whether you need to be tested.
If you need testing, you may be directed to special COVID-19 testing facilities, including drive-through units or tents outside emergency rooms where you would minimize your contact with others.
These practices may change as the outbreak evolves, say experts, and it’s likely that in coming weeks as more tests are available, more groups of people would be eligible for testing, including those with respiratory symptoms that can’t be linked to flu. Broader testing of people without symptoms may also be possible, as public health officials try to learn important information about how deeply the virus has penetrated a community, and how many people can be infected with no symptoms or only mild ones. “But we’re still days or weeks away from having that kind of testing capacity,” says Kuritzkes.
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We can’t all be Wesley Autrey—and most of us wouldn’t even try. Autrey is the man who became celebrated in 2007 as the “Subway Samaritan” after he was standing on a New York subway platform and a man next to him had a seizure and fell onto the tracks. Autrey leapt down and lay atop the stranger in a trench between the rails, allowing the oncoming train to pass safely over both of them.
“I don’t feel like I did something spectacular,” Autrey told The New York Times. “I just saw someone who needed help.”
In the era of coronavirus, there are a lot of Autreys out there: the doctors and other caregivers plunging unbidden into infection zones to diagnose and tend the sick, aware that they are exposing themselves to the virus. Then there are others, who are being asked to sacrifice less—and the results have been inconsistent. Tongues clucked and fingers wagged earlier this week when word got out that a Missouri father had broken a required coronavirus quarantine and attended a father-daughter school dance after the man’s other daughter tested positive for the coronavirus. The school was closed the following Monday for a hospital-grade cleaning.
A coronavirus quarantine is not easy. It amounts to two weeks of house arrest for a disease you may not have. Your fortnight of confinement is done entirely in the service of others, protecting them from possible infection. A situation like that causes two of our more primal and conflicting impulses, selfishness and altruism, to bump up hard against each other.
“I think these quarantine issues are going to put many people in a moral conundrum,” says Jonathan Haidt, Professor of Ethical Leadership at New York University’s Stern School of Business.
Haidt can speak with particular authority. When he talked with TIME, he was in the sixth day of his own 14-day quarantine (so-far symptom-free), having been exposed to the coronavirus by an infected individual during a talk he gave about his new book, The Coddling of the American Mind. He plans to honor every day of his viral sentence. But why?
For one thing, Haidt, like all of us, wants to be thought well of—by himself and by others. “As someone who studies moral psychology, I can say we all do care about the welfare of other people—although inconsistently,” he says. “We also all care about our reputations—very consistently. I would truly feel guilty if I passed the virus onto anybody else. I would feel great shame that people knew that it was me who broke the quarantine.”
“Shame is huge,” agrees Steven Pinker, professor of psychology at Harvard University and author, most recently, of Enlightenment Now. “We carry around in our heads the expectation that anything we do might leak out. It’s that public opprobrium for misbehavior that keeps us in line.”
But shame can be overcome, and if you’re secretive about things, no one even has to know you misbehaved. Yes, you’re under quarantine but you’re not under surveillance. If you slip out for dinner or to shop for a few things, who’s going to spot you? Acting altruistically takes some moral muscle.
Haidt identifies three sets of circumstances that tend to drive people and nations toward either selfish or altruistic behavior. The first is some kind of danger from outside—an attack by a common enemy. “That makes people band together,” he says. “Pearl Harbor was the perfect way of doing that and September 11 was a good example too.”
Consider the lines at enlistment centers the morning after Pearl Harbor and the rationing people tolerated during the long span of a four-year war. Consider the similar lines that spontaneously formed at blood donor centers in New York City on 9/11, before it was clear that there would be few survivors to receive the donations. “There is altruism for the public good, and it does pay dividends,” says Pinker. Any time we step forward to give without expectation of reward, there is a corresponding party who benefits without a requirement to pay. But for the giver, the dividends can include an element of selfishness even when they look selfless. “If you do something that’s civic-minded your reputation goes up.”
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Things get a little more complicated when the attack comes not from a human enemy, but from a virus or other pathogen. In this case, moral stress-cracks form in the community because other people are the source of menace. “Diseases do not bring us together,” Haidt says. “They can push us apart because of the nature of contagion.”
Worse than pushing us apart, they can bring out the sublimely ugly. Think of the shaming and shunning of lepers, of the homophobic hatred that was given full voice—and even imagined moral license—during the early years of the AIDS epidemic.
Third on the list of social stressors is any kind of deprivation—especially in the case of famine or shortage of other basics. “Scarcity and starvation activate the mindset of hoarding and deception and dishonesty,” Haidt says. “So when masks are in short supply many people feel a need to get some.”
It’s not just masks: whether in the face of a creeping pandemic or an approaching blizzard, store shelves are quickly stripped of bottled water, canned foods, flashlights, batteries, and ever and always toilet paper, far more than the circumstances call for in most cases. Since all such resources are finite, the marginal sense of greater security the hoarder achieves by buying out, say, the band-aid shelf leaves the next shopper with nothing at all.
The novel coronavirus, of course, ticks both the contagion and scarcity boxes, which is one reason people are behaving badly. And when they do behave badly—like breaking quarantine—there’s a social reason too for the tongue-clucking and finger-wagging that follow. “There is a certain amount of social glory that comes from being the punisher,” says Pinker.
That, of course, is not always fair—much as it might seem to be warranted. Haidt is honoring his quarantine, but he is cognizant that he has it comparatively easy, with a job that allows him to telecommute.
“I don’t think I’m a good example because for me the cost is minimal,” he says. “I think a lot about single parents who have a job and no alternative arrangements. This is going to be hard for them.”
The U.S. government is rising—slowly—to the need, debating offering paid leave and other forms of job security for people working paycheck to paycheck at jobs that require their physical presence. A system that doesn’t force people to choose between honoring a quarantine and feeding their families will make it easier for more people to make the moral choice.
“I did what I thought was right,” is how Autrey put it back in 2007. When the coronavirus epidemic at last passes into history, it will be to the credit of both individuals and policymakers if we can echo his words.
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