New story in Health from Time: Millennials Aren’t Taking Coronavirus Seriously, a Top WHO Official Warns

One of the World Health Organization’s top officials in charge of fighting the coronavirus pandemic has a stark warning for millennials and other young people about the threat of COVID-19 amid reports that some are shrugging off pleas from health officials to stay home.

“This is one of the most serious diseases you will face in your lifetime, and recognize that and respect it,” Dr. Bruce Aylward, senior adviser to the Director-General of the World Health Organization (WHO), told TIME via telephone on Thursday from his office in Geneva.

While the risks of severe complications or death are much higher for older people and those with underlying health conditions, Aylward says COVID-19 is more dangerous for young people than many realize.

“One of the things that terrifies me now is, as this is spread in the west is, there’s this sense of invulnerability among millennials,” he says.

(The age range of the millennial generation varies, with some sources defining it as 1981 to 1996, though the U.S. Census has said it includes those born between 1982 and 2000.)

“We don’t understand why some young healthy people progress to severe disease and even die, and others don’t,” he says. “Never, never underestimate a new disease, there’s just too much unknown.”

Aylward’s warning comes on the heels of the release of a preliminary analysis on Wednesday by the Centers for Disease Control and Prevention (CDC) that suggests 38% of coronavirus patients in the U.S. who were sick enough to be hospitalized were under the age of 55.

“Ten percent of the people who are in ICUs in Italy are in their 20s, 30s or 40s, these are young, healthy people with no co-morbidities, no other diseases,” he says.

The doctor, who lead a joint WHO-China mission into China in February to study the effectiveness of the coronavirus response in the country, says frontline doctors there couldn’t pinpoint what factors were leading the virus to kill some young people. “They said, ‘We simply don’t know.'”

Earlier this week, French health ministry official Jérome Salomon said half of the 300 to 400 coronavirus patients treated in ICUs in Paris were younger than 65. And half of the ICU patients in the Netherlands were younger than 50, according to a study of hospital admissions presented at a conference of intensive care specialists

“There are concerning reports coming out of France and Italy about some young people getting seriously ill, and very seriously ill in the ICUs,” Dr. Deborah Birx, the response coordinator of the U.S. coronavirus task force, warned at a White House news conference on Wednesday.

President Donald Trump reinforced her warning during the press conference. “We don’t want them gathering, and I see they do gather, including on beaches and in restaurants, young people. They don’t realize, and they’re feeling invincible,” he said.

The president’s comments came as some have ignored health officials calls for people to avoid crowds and stay at home. Some young people are capitalizing on cheap airline tickets to travel, despite a CDC warning that “crowded travel settings, like airports, may increase chances of getting COVID-19. Police vehicles had to be deployed to clear partiers from New Orleans’ famed Bourbon Street. And Florida beaches were packed with spring breakers this week.

“If I get corona, I get corona,” one spring breaker in Miami told Reuters. “At the end of the day, I’m not going to let it stop me from partying…We’ve been waiting for Miami spring break for a while.”

Jason Lee—The Sun News/APDespite warnings from government officials take caution and self distance because of coronavirus, many college students, some from Coastal Carolina University, hang out on the beach at 65th Avenue North in Myrtle Beach, S.C. on March 19, 2020.

But Alyward cautions that even if the virus causes only mild symptoms in a majority of people who become infected, the long-term health implications may be serious. According to one recent study by the Hong Kong’s Hospital Authority on released patients, some of those who recover from the virus are left with 20 to 30% reduced lung function and suffer from shortness of breath from just walking quickly.

He also urges young people to consider the role they play in stopping the virus, which spreads by close contact and through respiratory droplets produced when an infected person coughs or sneezes.

“You are not an island in this, you are part of a broader community, you are part of transmission chains, if you get infected you are making this much more complicated and you are putting people in danger, not just yourself,” he says.

And while there remain many unknowns about COVID-19, Aylward says that there is one thing that’s for certain: “What we do know is it will kill young people, it will make young people sick in large numbers. You’ve gotta respect this.”

New story in Health from Time: Hong Kong Records Its Biggest Rise in Coronavirus Cases as New Wave of Infections Crashes Into Asia

Hong Kong recorded what is by far its biggest daily jump in coronavirus cases on Friday—the latest in a new phase of infected travelers, many of whom are returning to the city from Europe, the United States and Southeast Asia.

The city is not alone in facing the increasing threat of imported cases. Taiwan, which also saw a daily record increase in the number of new cases, reported 27 additional infections on Friday—most of which are travel-related. In Singapore, 24 out of 32 newly infected patients had a history of travel to Southeast Asia, Europe and North America.

All three places managed to fend off the first wave of the coronavirus outbreak, when it was spreading across mainland China—despite having close economic ties and a large number of travelers from the mainland.

The new wave is crashing across the region as the number of officially reported new cases in the mainland has dropped to just a handful. On Thursday, Chinese officials reported zero new domestic coronavirus infections.

Read more: What We Can Learn From Singapore, Taiwan and Hong Kong About Handling Coronavirus

In Hong Kong, 36 of the 48 COVID-19 cases reported Friday had overseas travel records, Dr. Chuang Shuk-kwan, head of the communicable disease branch of Hong Kong’s Centre for Health Protection, said during an afternoon press conference. The cases involve travel to over a dozen countries, including Singapore, the Philippines, Austria, Portugal, United Kingdom, Canada and the United States. The newly confirmed cases brings the total in Hong Kong to 256.

Among the infected is a four-year-old girl whose father is believed to have contracted the virus during a trip to London. A taxi driver who did not travel abroad recently, but takes one or two trips to and from the airport daily, has also been diagnosed with the coronavirus.

Experts are concerned that the wave of sick travelers returning to Asia could mean a surge in local infections and the risk of a community outbreak.

Read more: A Silent Epidemic? Experts Fear the Coronavirus Is Spreading Undetected in Southeast Asia

“We’re moving into a new phase,” Ben Cowling, a professor of infectious disease epidemiology at the University of Hong Kong, tells TIME.

“In one or two weeks time, we could see outbreaks where we don’t really know where people got [the virus]. Maybe someone who came in with the infection wasn’t identified, spreads it to a family member, who spreads it to the community. That’s going to happen in Hong Kong, and in other parts of Asia,” Cowling adds.

In Hong Kong, over 90% of the new cases in the past two weeks had links to overseas travel, according to the South China Morning Post.

Globally, almost 245,000 cases of the novel coronavirus have been confirmed, according to John Hopkins University’s virus tracker. Earlier this week, the total number of infections outside mainland China surpassed the number in the country. On Thursday, the death toll in Italy, which has more than 41,000 cases, exceeded the number of fatalities in China. Worldwide, the virus has killed more than 10,000 people.

Coronavirus impact: Will life sciences industry turn to digital platforms for growth?

As companies adopt social distancing globally, how will digital tools and health information platforms be a lucrative opportunity for Indian pharma companies to drive their growth.

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New story in Health from Time: Mexico’s President Is Resisting Coronavirus Restrictions as the Rest of the World Shuts Down

(MEXICO CITY) — Many countries in Latin America have taken aggressive measures to deal with the coronavirus such as closing their borders, dock and airports to foreigners, declaring states of emergencies and ordering business shutdowns.

Mexico, by contrast, has so far taken a “business as usual” attitude. People still crowd street markets picking through piles of fruit and vegetables. Cars and trucks continue to fill the streets and commuters throng subway trains, though the volume of traffic is noticeably lower.

President Andrés Manuel López Obrador and his government have said a shutdown of the country would disproportionately hurt poor people and also be a psychological weight on all Mexicans. They say there is no reason to impose major restrictions before health officials deem them necessary — a moment they are expecting in late March, based on the virus’ pattern elsewhere and the Feb. 27 date of Mexico’s first confirmed case.

The approach is worrying many experts.

But it is the president’s personal attitude that has Mexicans puzzled. He continues to attend mass public rallies, shaking hands and kissing babies. Asked how he was protecting Mexico, López Obrador removed two religious amulets from his wallet and proudly showed them off.

“The protective shield is the ‘Get thee behind me, Satan,’” López Obrador said, reading off the inscription on the amulet, “Stop, enemy, for the Heart of Jesus is with me.”

López Obrador, often described as a leftist, is in fact a nationalist with deep religious feelings.

“I think President López Obrador is trying to project confidence and minimize the risk,” said Jesus Silva-Herzog, a political commentator and professor at the Tecnológico de Monterrey University.

But, Silva-Herzog added, “I think that what he has wound up doing is minimizing the risks associated with the emergency, and sending messages that contradict what is being said almost everywhere else.”

Mexico reported its first death from the virus Wednesday — a 41-year-old man said to have been obese and suffering from diabetes. As of late Thursday, the country has 164 confirmed cases of coronavirus, up from just over 40 a week ago.

Still, Hugo López-Gatell, deputy secretary in the Health Ministry and the administration’s public face of López Obrador’s coronavirus response team, said the country remains in what it calls phase 1 of the epidemic, with all cases related to importation from other countries and no community transmission.

Federal officials have suspended classes for about a month beginning after Friday’s school sessions and are encouraging things like social distancing, working from home and following hygienic measures recommended by international and domestic health experts.

Some large events have been called off, yet others such as a multi-day music festival attended by tens of thousands in Mexico City were allowed to proceed. Federal officials recommend that “non-essential” gatherings should not be larger than 5,000 people, while local authorities in the capital have said events topping 1,000 people should be canceled.

Mexico has only 5,000 emergency beds, and about 1,500 intensive care or sealed rooms, for a population of over 125 million, but officials still exude a sense of calm at their daily briefings on the virus. And some observers say they are chilled by remarks like López Obrador’s.

“I think this has shown a lack of respect by the president,” said Carlos Padilla, a Mexico City business administrator. “I think he should be doing a better job of protecting the public, in every sense.”

Once community transmission begins — and Mexican officials make no secret that they know it is coming, sooner rather than later — the country is likely to see more aggressive measures.

“We are prepared. We have enough budget. All the resources we need,” López Obrador said Thursday.

Some, however, are beginning to be nervous about the lack of response now, including among the president’s political opposition. The conservative National Action Party sent a letter to the Pan American Health Organization on Thursday expressing its “deep concern about the government’s actions in the face of the COVID-19 pandemic.”

Former diplomat Enrique Berruga Filloy said in a column for the newspaper El Universal on Thursday that Mexico’s geographic advantages gave it more leeway to plan for the virus and take timely actions, but that the administration has squandered the chance.

“The tsunami is coming and we, instead of seeking safety, are playing on the beach,” Berruga Filloy wrote.

Like in other countries, Mexico’s stock market has been hit hard by coronavirus concerns. The peso has slid precipitously, trading over 24 to the dollar at times this week for the first time in history.

Alfredo Coutiño of Moody’s Analytics said Mexico’s markets “are now realizing that the country is facing a higher risk of contamination by the coronavirus” with the Mexican economy already weak.

Despite assurances from officials, Mexico and its health system are showing “real vulnerability,” Coutiño said.

He said investors particularly don’t like the lack of government measures to protect the economy and the people. “Fiscal and monetary policies are running far behind the curve,” he said.

National Action senators proposed a package of measures this week that would include measures such as lowering interest rates, stimulating home construction and infrastructure, reactivating private investment in the energy sector and transferring money to the Health Department. But López Obrador is known for a visceral dislike of spending and deficits.

López-Gatell displayed the administration’s attitude Thursday when he said everything is going according to plan.

“All of the scenarios that we foresaw for what was going to happen, are happening,” he said. “This will allow us to keep to a well-planned, well-calculated technical plan of action.”

López Obrador, who enjoys approval ratings that would be the envy of many a world leader, said Thursday that military medical workers and installations would be part of the pandemic response. But he ruled out any curfew or troop deployments, saying he wanted nothing to do with tough measures that could be seen as authoritarian.

Virus whistleblower doctor punished 'inappropriately': Chinese probe

Li Wenliang, one of a group of doctors in Wuhan who shared posts on social media warning of a SARS-like virus spreading in the city in December, was reprimanded by police for sharing the information and made to sign a statement agreeing not to commit any more "law-breaking actions."

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Coronavirus: Govt bans export of face masks, ventilators

Following a meeting of the group of ministers on Thursday, the ban was notified by the directorate general of foreign trade, sources told TOI. While India had banned the export of masks soon after the outbreak due to a surge in exports to China, it later on withdrew the curbs.

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New story in Health from Time: California Announces Statewide ‘Stay at Home’ Order to Stop Coronavirus. Here’s What That Means

California’s governor has issued a statewide stay at home order in an attempt to stop the spread of COVID-19 in the state after warning that 56% of the population is at risk of getting the coronavirus.

Gov. Gavin Newsom called on all Californians to stay at home, except for essential reasons like buying groceries or seeking medical care.

“We need to bend the curve in the state of California, and in order to do that, we need to recognize the reality, the fact is, the experience we’re having on the ground throughout the state of California… require us to adjust our thinking and to adjust our activities,” Newsom said.

There are 675 confirmed cases of COVID-19 in California and there have been 24 deaths—not counting the Americans who touched down in California on U.S. repatriation flights from abroad. In a letter sent on Wednesday, Newsom warned President Donald Trump that 56% of the population—more than 25 million people—could be infected over the next eight weeks.

Governor Gavin Newsom makes a major announcement on California’s response to the COVID-19 outbreak. https://t.co/VlQM38OkYK

— Office of the Governor of California (@CAgovernor) March 20, 2020

The latest measures follow a “safer at home” order by the city of Los Angeles on Thursday and a ‘“shelter in place” order for the San Francisco Bay area on Tuesday.

Here’s what to know about California’s new stay at home order.

When does the ‘stay at home’ order go into effect?

The new measures go into effect on Thursday evening.

Where does this apply?

Residents across the entire state are being asked to stay at home, except for essential purposes.

Some who work in essential state and local government jobs will continue working, including police officers.

How long will it last?

The measures are in force until further notice.

Newsom said at a news conference on Thursday night that the next eight weeks are critical, but didn’t give a timeline for when it would end.

“We could not give you a deadline that we could really believe in,” Newsom said in a press conference. “This is a dynamic situation.”

What’s still open?

Essential services such as gas stations, pharmacies, food stores, banks and laundromats will remain open.

Bars, gyms and other entertainment venues will be closed. Restaurants are closed to dine-in customers.

What can I do?

State officials are asking people to stay home except to get food, care for a relative or friend, get necessary medical care or to go to an essential job.

“I can assure you home isolation is not my preferred choice, I know it’s not yours, but it’s a necessary one,” Newsom said.

Authorities are urging residents to avoid large gatherings, and to stay at least six feet away from other people if they need to leave their homes.

How will California enforce the order?

Newsom said in his press conference that he doesn’t believe that law enforcement actions are required to convince Californians to follow the order.

“People will self-regulate their behavior, they’ll begin to adjust and adapt,” he said. “We will have social pressure that will encourage people to do the right thing.”

New story in Health from Time: The Best Way to Love Your Neighbor Right Now Is to Stay Home

In the aftermath of murdering his brother Abel, Cain is posed a simple question by God. “Where is your brother Abel?” God asks. Cain–we imagine him here as a sullen teenager, which perhaps he was–responds with a question of his own. “I do not know,” he says. “Am I my brother’s keeper?” It’s an insubordinate question, a trick of a young man trying to shirk responsibility and hide a dark secret.

I live in San Francisco, where we were recently ordered to “shelter in place” for at least the next three weeks. “Sheltering in place” means not leaving the house except for essential errands, like picking up groceries or medication or getting medical attention. My family and I recently moved into a new neighborhood, and I’ve been eager to meet our neighbors, but the sheltering order has put a stop to our plans to knock on their doors with cookies and greetings.

Similar orders are likely to be enacted across the country as the coronavirus continues to infect and kill patients and overwhelm our healthcare system. Since the virus can be transmitted by people who feel entirely well, staying home may be the best defense we have against spreading it. Staying home is an act of care for our neighbors. To stay home these days is to say “yes” to the question, “Am I my brother’s keeper?”

Many of us have seen people posting on social media that they’re frustrated about having to stay at home. We’ve seen photos of restaurants in which people are clearly not six feet apart, videos of spring breakers refusing to let a pandemic ruin their party. When I see these images, I think of my 88-year-old grandmother who lives in Los Angeles. Under normal circumstances, she and her best friend–who is 93 and lives, independently, in the same condominium complex–go out to eat a couple of times a week, usually to Olive Garden or In-N-Out or, for a nice occasion, The Cheesecake Factory. They attend church together. My grandmother goes to the library regularly, plays cards with friends, gets her hair done every few weeks by the same woman who has been doing it for decades.

This past week, my grandmother and her best friend both stayed home from church. They ate all their meals at home. My grandmother drove by the library to return the five novels she read last week. They were closed, which, I told her, was for the best. “You never know who touched those books last,” I said. She agreed, although I knew she was sad that she couldn’t get anything new to read. She lives alone and already spends a lot of her time feeling lonely.

My grandmother is one of the millions of people who are especially susceptible to the coronavirus, and more likely to die from it if they contract it. You probably know someone in that group as well–someone with a compromised immune system, or an underlying condition, or someone over 65. When you’re a healthy 34-year-old, as I am, the threat of the coronavirus can seem distant, just like the threat of death (though recent research suggests young people may be at higher risk than previously understood). And when you live in a culture that values individualism and productivity, as ours does, it can be disorienting to be told that you can no longer get things done the way you used to. But if I want to love my neighbors, it is my responsibility to do whatever I can–even the things that inconvenience me–to prolong the lives of others.

After Cain asks God about being his brother’s keeper, God responds with thunder. “Listen; your brother’s blood is crying out to me from the ground!” Thousands of people have already died from this virus; scientists predict that millions more may still die. If I were to do anything to add to that number, the blood of those who died would cry out from the ground. By sacrificing our own routines and maybe even briefly our senses of identity, we keep our brothers and sisters safe.

Italy overtakes China’s coronavirus death toll

Records 3,405 deaths; in China, 3,249 have died so far

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New story in Health from Time: Actor Daniel Dae Kim Shares His Coronavirus Diagnosis and Calls for an End to ‘Cowardly’ Anti-Asian Racism

American actor Daniel Dae Kim announced on Thursday that he has tested positive for COVID-19, the disease caused by the novel coronavirus.

Kim — who is known for his roles on Hawaii Five-0 and Lost — shared the news in a 10-minute video posted to his Instagram. He had been filming the series New Amsterdam in New York City for the past several weeks before the show halted production because of the threat of the virus. In a darkly ironic twist, he was playing a doctor working to respond to a flu pandemic.

Kim, 51, said he began feeling ill while returning home on a flight to Hawaii, and later began to experience chest tightness, body aches and a fever. He said he self-isolated since returning, leaving only to go to a drive-through coronavirus testing facility in Honolulu.

The actor explained that while he was diagnosed with COVID-19 and has experienced symptoms, he has not needed to go to the hospital and has started to feel better. His family has all tested negative for the virus.

View this post on Instagram

Hi everyone- yesterday I was diagnosed with COVID-19, the disease caused by the coronavirus. Looks like I’ll be ok, but I wanted share my journey with you in the hopes that you find it informative or helpful. Hope you all stay safe, calm, and above all, healthy.

A post shared by Daniel Dae Kim (@danieldaekim) on Mar 19, 2020 at 10:34am PDT

In the video, Kim also spoke out against the xenophobia and anti-Asian racism that’s risen since the coronavirus crisis began.

“Please, please stop the prejudice and senseless violence against Asian people,” he said. “Randomly beating elderly, sometimes homeless Asian Americans is cowardly, heartbreaking and it’s inexcusable.” Racist attacks against Asian people have been reported in Los Angeles, New York and other cities around the world.

Kim, who was born in South Korea but raised in the U.S., also subtly addressed President Donald Trump‘s decision to refer to COVID-19 as “the Chinese virus,” which many have decried as racist. An image of the President’s prepared remarks on Thursday show the word “corona” crossed out and replaced with “Chinese.”

Jabin Botsford—The Washington Post/Getty ImagesA close-up of President Trump’s notes shows where the word “Corona” was crossed out and replaced with “Chinese” during a briefing at the White House on March 19, 2020.

“Yes, I’m Asian. And yes, I have coronavirus. But I did not get it from China, I got it in America. In New York City,” Kim said in the Instagram video. “Despite what certain political leaders want to call it, I don’t consider the place where it’s from as important as the people who are sick and dying.”

“If I did, I would call this thing the ‘New York virus,’ but that would be silly, right?” he continued.

Stars including Tom Hanks and Idris Elba have also announced they contracted the virus. As of Thursday evening ET, there are at least 242,191 confirmed cases and at least 9,843 deaths from the virus around the world, according to a tracker from Johns Hopkins University.

“I’m grateful to be alive and healthy,” Kim said, thanking his friends, family and fans for their support. “It gives me hope that through our collective efforts we can beat this thing and flatten the curve.”

New story in Health from Time: Total Cost of Her COVID-19 Treatment: $34,927.43

When Danni Askini started feeling chest pain, shortness of breath and a migraine all at once on a Saturday in late February, she called the oncologist who had been treating her lymphoma. Her doctor thought she might be reacting poorly to a new medication, so she sent Askini to a Boston-area emergency room. There, doctors told her it was likely pneumonia and sent her home.

Over the next several days, Askini saw her temperature spike and drop dangerously, and she developed a cough that gurgled because of all the liquid in her lungs. After two more trips to the ER that week, Askini was given a final test on the seventh day of her illness, and once doctors helped manage her flu and pneumonia symptoms, they again sent her home to recover. She waited another three days for a lab to process her test, and at last she had a diagnosis: COVID-19.

A few days later, Askini got the bills for her testing and treatment: $34,927.43. “I was pretty sticker-shocked,” she says. “I personally don’t know anybody who has that kind of money.”

Like 27 million other Americans, Askini was uninsured when she first entered the hospital. She and her husband had been planning to move to Washington, D.C. this month so she could take a new job, but she hadn’t started yet. Now that those plans are on hold, Askini applied for Medicaid and is hoping the program will retroactively cover her bills. If not, she’ll be on the hook.

Keep up to date with our daily coronavirus newsletter by clicking here.

She’ll be in good company. Public health experts predict that tens of thousands and possibly millions of people across the United States will likely need to be hospitalized for COVID-19 in the foreseeable future. And Congress has yet to address the problem. On March 18, it passed the Families First Coronavirus Response Act, which covers testing costs going forward, but it doesn’t do anything to address the cost of treatment.

While most people infected with COVID-19 will not need to be hospitalized and can recover at home, according to the World Health Organization, those who do need to go to the ICU can likely expect big bills, regardless of what insurance they have. As the U.S. government works on another stimulus package, future relief is likely to help ease some economic problems caused by the coronavirus pandemic, but gaps remain.

Here is everything you need to know about what getting treated for COVID-19 could cost you.

How much does it cost to be hospitalized for COVID-19?

Because of our fragmented health care system, it depends on what kind of insurance you have, what your plan’s benefits are, and how much of your deductible you’ve already paid down.

A new analysis from the Kaiser Family Foundation estimates that the average cost of COVID-19 treatment for someone with employer insurance—and without complications—would be about $9,763. Someone whose treatment has complications may see bills about double that: $20,292. (The researchers came up with those numbers by examining average costs of hospital admissions for people with pneumonia.)

How much of that do I have to pay?

Most private health insurance plans are likely to cover most services needed to treat coronavirus complications, but that doesn’t include your deductible—the cost you pay out-of-pocket before your insurance kicks in. More than 80% of people with employer health insurance have deductibles, and last year, the average annual deductible for a single person in that category was $1,655. For individual plans, the costs are often higher. The average deductible for an individual bronze plan in 2019 was $5,861, according to Health Pocket.

In both complicated and uncomplicated cases, patients with employer-based insurance can expect out-of-pocket costs of more than $1,300, the Kaiser researchers found. The costs were similar regardless of complications because many people who are hospitalized reach their deductible and out-of-pocket maximum.

Many health insurance plans also require co-pays or co-insurance, too. Those costs are often 15-20% for an in-network doctor, meaning you would pay that portion of the cost, and can be much more for out-of-network doctors.

Medicare and Medicaid will also likely cover the services needed for coronavirus treatment, but the details on deductibles (for Medicare) and potential co-pays will again depend on your plan, and which state you’re in for Medicaid.

What if I’m uninsured?

It’s not pretty. Some hospitals offer charity care programs and some states are making moves to help residents pay for COVID-19 costs beyond testing. Several states, including Maryland, Massachusetts, Nevada, New York, Rhode Island and Washington, have created “special enrollment periods” to allow more people to sign up for insurance mid-year.

Other states are requiring coverage of future vaccines or changing rules about prescription medication refills to help people stock up on essential medicines. So far, Maine, Maryland, Massachusetts, Nevada, New Mexico, New York and Oregon have required insurers to waive costs for a COVID-19 vaccine once one is ready, and the states that have loosened rules to help people fill prescriptions include Alaska, Colorado, Delaware, Florida, Maine, Maryland, New Hampshire, North Carolina and Washington.

The Commonwealth Fund, a healthcare think tank, has a coronavirus tracker that’s keeping a list of the moves each state has made so far.

There’s no way I could afford to pay out-of-pocket for care. What can I do?

The U.S. health care system doesn’t have a good answer for you, and it’s a problem. But there are a few things to keep in mind that could help minimize costs.

If you think you may have the virus, the first step is to call your doctor or emergency department before showing up, the CDC says. This will let them prepare the office and give you instructions ahead of time, but it could also save you money. Getting treated in a hospital will generally start off more expensive than a visit to a doctor’s office. Another cost comes from the “facilities fee,” which many hospitals charge anytime a patient comes through their doors. For Danni Askini’s first trip to the hospital in Boston on Feb. 29, for example, she was charged $1,804 for her emergency room visit and another $3,841.07 for “hospital services.”

Other costs to watch out for include lab tests, which can be “out-of-network” even if the doctor treating you is in your insurance network. It’s always best to ask for information in writing so that you can appeal the bills if necessary, says Caitlin Donovan of the National Patient Advocate Foundation. And appealing is worth it. Often, providers and insurers have reversed or lowered bills when patients go public or are covered by the media.

These problems aren’t coming out of the blue. Even when we’re not weathering a global pandemic, Americans face uniquely high health care costs, compared to the rest of the world, and millions of us already put off medical care because of concerns about how much it’ll cost. But with COVID-19 sweeping across the country, an old problem becomes increasingly urgent: many Americans could still face massive treatment bills, or seek to prevent those by avoiding testing and treatment—worsening the outbreak further.

“If you’re sick, you need fewer barriers,” Donovan says. “But also, it doesn’t help society to have people still crawling around going to their job and getting other people sick.”

New story in Health from Time: ‘They Didn’t Deserve This.’ Coronavirus Kills 3 Members of Same New Jersey Family

(FREEHOLD, N.J.) — A New Jersey family is mourning the loss of three of its members to COVID-19, and several others remain ill.

Freehold resident Grace Fusco died Wednesday night, shortly after son Carmine Fusco died in Pennsylvania. Several days earlier, Grace Fusco’s daughter, Rita Fusco-Jackson, also died. The New York Times confirmed Grace Fusco’s death Wednesday through a relative.

In her final hours, Grace Fusco wasn’t aware her two children had died, the relative, Roseann Paradiso Fodera, told the newspaper. Carmine Fusco died Wednesday night hours before his mother at a hospital in northeastern Pennsylvania, where he lived. A relative confirmed his death, which was the first in Pennsylvania caused by the virus, to the Morning Call of Allentown.

Carmine Fusco and Rita Fusco-Jackson, who were both in their 50s, were “the most wonderful brother and sister that anybody can have,” their sister, Andriana Fusco, told the newspaper. ““They were good people. I don’t know why this is happening. They didn’t deserve this, they’re too young.”

Carmine Fusco trained horses that competed at harness racing tracks in the area. Andriana Fusco told The Morning Call that she disputed reports that the virus may have been spread through a family gathering attended by a person who’d had contact with 69-year-old John Brennan, a former harness racing trainer who worked for years at New York’s Yonkers Raceway.

Brennan, who lived in northern New Jersey, was the first person in the state to die because of the virus, on March 10.

Andriana Fusco told the newspaper her brother hadn’t been in New Jersey in the past two weeks and that she hadn’t seen him since last month. She also said other members of her family had been sickened by the virus.

New story in Health from Time: How Much Does COVID-19 Affect Millennials? New CDC Data Offer a Clue

Despite the fact that older adults are most at risk, Millennials have taken on an outsized role in the COVID-19 pandemic. During press briefings, the Trump Administration has zeroed in on young adults, calling on them, specifically, to stay home and practice social distancing to slow the transmission of the virus. Stories about healthy young people who contracted serious cases of COVID-19 have gone viral on social media.

Now, new data out of the U.S. Centers for Disease Control and Prevention (CDC) have thrust younger adults into an even brighter spotlight: it suggests adults ages 20 to 44 have accounted for nearly 30% of U.S. COVID-19 cases, and 20% of related hospitalizations. After adding adults ages 45 to 54, the percentages swelled to nearly 50% and 40%, respectively.

That’s a somewhat surprising finding, given the refrain that elderly adults are at by far the highest risk for serious illness and complications. It’s also a conclusion that should be taken with a grain of salt.

“For younger adults, the bottom line is there is still a small percentage that can get severe disease,” says Dr. George Anesi, director of the Medical Critical Care Bioresponse team at Penn Medicine. “In the overwhelming majority of cases, they do okay.”

On the whole, the report affirmed data out of China showing that older adults, who are likely to have underlying conditions and poorer overall health, are at the highest risk of dying or suffering very severe disease, while children are largely unaffected. Despite the relatively high number of young adults included in the new CDC report, it still backs up that conclusion. Younger adults may be getting sick, but not many of them are progressing to the ICU or death, the report shows. Meanwhile, about a third of confirmed U.S. hospitalizations were among people 65 and older—but more than half of patients admitted to the intensive care unit were in this age range, as was the vast majority of the (very small) pool of people confirmed to have died from COVID-19.

Only 5% of total U.S. cases were among people 19 or younger.

There are also caveats to all of the report’s numbers. It was based on the approximately 4,200 COVID-19 cases reported to the CDC by March 16. Given domestic testing shortages, that’s likely a gross underestimate of the total number in the U.S.

“We are prioritizing testing for more symptomatic and sicker patients, rather than testing everyone. We’re almost certainly missing less-sick patients,” Anesi says. Once we include them, “these numbers might look a little bit better, in that a lower proportion of patients [would get severe disease].”

Even within the report, a lot was unknown. The CDC could only confirm the patient’s age in about 2,500 cases. Only about 500 people were known to have been hospitalized, while 120 had been sent to the ICU and about 40 had died. That’s not to say the report is flawed, only that it’s preliminary. In this outbreak, as is always the case, numbers are shifting constantly. It’s important to get an early read on the situation, but that early read is likely to evolve considerably as time goes on.

To be sure, people of all age groups need to take coronavirus seriously. The CDC has urged everyone—young or old, sick or healthy—to stay home as much as they are able. The new data is a good reminder that no one is immune to COVID-19, and that everyone has a role to play in slowing its transmission.

Older adults need to be most vigilant of all, but “any adult of any age is certainly at risk,” Anesi says. “We need a full societal commitment to this. Life is going to look different for a while, and that’s important to be able to turn the tide on this.”

New story in Health from Time: My Husband Is West Virginia’s First COVID-19 Patient. The State Almost Lost His Test Results

On March 17, Carolyn Vigil’s husband, James, became the first person in West Virginia to be diagnosed with COVID-19, meaning every U.S. state now has at least one confirmed case. Carolyn, who is 55 and now experiencing symptoms herself, spoke with TIME about the long road to getting James, 53, tested—and the even more circuitous path to getting his results.

Their story began on March 12, when James awoke with what seemed like a bad cold. By the next day, his symptoms had worsened, and seemed consistent with what the couple had read about COVID-19, despite James having no clear link to a confirmed patient or a high-risk travel history. Carolyn now believes he contracted the virus during a weekend trip the couple took to Washington, D.C. the prior weekend. Here’s what happened next, according to Carolyn (what follows has been edited and condensed for clarity):

We went to the ER, and I left James in the car. He was really sick: his fever had been as high as 104°F; he had a cough, terrible headaches, body aches. He has asthma, which can lead to more serious disease. I had no symptoms at that point, but I was trying to keep my distance from people at the hospital, because I thought I could be a carrier. A staff member met me at the door. She was very kind, but she said, ‘I don’t think we’re equipped to do this.’ A nurse came out to the car with a sticky note and the number for a hotline—which I had already tried to call, only to find that the number didn’t work—and told me I had to leave and just call that number, or drive to Morgantown, two and a half hours away. I told her, ‘I’m going to remain calm, but I’m not leaving unless he is at least screened.’ The head nurse came out and saw James, and she could tell he was sick. James and I waited in the car until they took him to a room where they could do the exam without risking others in the hospital. Once he got back there, they were very compassionate. They gave him very good care.

They first tried to rule out all other respiratory illnesses. Those tests came back negative, so they decided to go ahead and do the COVID-19 test. But we had to wait until Tuesday to get the result back. Then Tuesday came and nobody contacted us. We called the ER. The ER told us to call the state health lab. The state health lab told James to call the county health department. The county health department said, ‘We have no record of you ever being tested.’ It was bizarre.

The ER doc called James back and said, ‘Listen, they’ve lost your tests. I’m not sure what to do because we’re not supposed to take any more people into the ER for testing.’ Then a different doctor called back and said, ‘Your tests were found, but they were sitting at the lab and they have not been tested. Now they’re not viable because it’s been five days, so you have to go get tested again—but we don’t know where.’

I called the governor’s office. They tried to help, but they didn’t have much information. A friend who’s very politically connected knew Senator Joe Manchin and offered to help. One of Manchin’s staffers called and said, ‘We’re going to have someone call you back within the hour.’ Dr. Catherine Slemp, West Virginia’s state health officer, called me back, personally on my cell phone, within an hour. She said, ‘Let me cut to the chase: I have your husband’s results in my hand. I don’t know why you were told they were lost, I don’t know why you were told they’re not viable, but they’re in my hand right now.’ Then she said, ‘Are you sitting down?’ I sat down, and she told me James was positive—the first case in West Virginia. If I wasn’t so persistent, and if some angel that knows Senator Manchin did not help, I think we’d be without test results, and I don’t know that we would have ever gotten them.

Now I have symptoms. I was tested on March 18 at a drive-through testing center, and it was much easier this time around. I was in and out in about 10 minutes, and I should have results in a couple days.

We’re hunkered down. We have an adult son with autism who’s not symptomatic at all, but I think he should be tested too. He’s been super, super anxious because he has a lot of questions and I can’t answer them. It needs to be black or white answers, and everything’s gray.

We’ve been told to make a list of everyone we’ve been in contact with over the past three weeks. The health department will call them, but I wanted my close friends to hear the news from me first. Most people have been 100% supportive, but a few people were like, ‘Wow, you did this to me?’ I had no idea I was doing that. It was before everything got crazy.

Hopefully, now that there is a case and we’re giving them feedback and other people are getting more involved, maybe we can get some of this fixed so we can get the health care that West Virginians need. I just want this community to feel protected and safe.

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Sen. Joe Manchin’s office encourages West Virginians who need help securing testing or test results to email Common_sense@manchin.senate.gov or call 304-342-5855.

Coronavirus outbreak: Delhi hospitals cancel elective surgeries

All routine or non-emergency surgeries scheduled to take place at Safadrjung hospital and a Delhi government-run Guru Nanak Eye Centre from Thursday onwards have been cancelled in view of the Covid-19 outbreak.

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