New Orleans Faces Another Disaster
The coronavirus is exploding in New Orleans, forcing residents to adapt yet again.
by Jason Berry,
POLITICS
, March 26, 2020
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The French Quarter on Wednesday.
Jonathan Bachman/Reuters
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POLITICS, MARCH 26, 2020 -
As massive coronavirus shutdowns took hold in California and New York, down in Louisiana this past Sunday Gov. John Bel Edwards
announced
that the state had the world’s fastest growth rate of confirmed cases and ordered home sheltering until April 13.
Three days later, with 1,795 positive cases and 65 deaths in the state attributed to COVID-19, the Times-Picayune/New Orleans Advocate reported that Orleans Parish (which encompasses the city) had the sixth-highest rate among U.S. counties, all the rest being in New York. After public officials protested that the state had not been included in President Donald Trump’s disaster declarations that covered New York, California, and Washington state, the White House added Louisiana to its declaration on Wednesday, clearing the way for federal assistance.
As Louisiana fluctuates in the top ranks of per capita cases, New Orleans is the epicenter of the Gulf South with 827 confirmed cases and 38 deaths attributed to COVID-19 as of Thursday morning, according to the state health department.
Edwards hammered home a bleak message. “I’m going to say that again so people can understand what I just said,” the governor emphasized, citing the state’s skyrocketing coronavirus cases. “What happened in Italy is, they started too late. People didn’t socially distance. … And the world learned that you have to act fast and in places that may not look like they have a problem yet.”
The major New Orleans COVID-19 cluster is at Lambeth House, an affluent retirement high-rise that also has a nursing wing; the building overlooks a bend of the Mississippi River levee with terraces and balconies affording scenic views. Forty-two residents have tested positive for COVID-19, according to health officials.
Three of the 11 deaths attributed to the virus at Lambeth were retired physicians who attended elite Carnival balls, like many of the independent living residents, according to obituaries and interviews with families of residents. All of the deceased were men. The Centers for Disease Control and Prevention in Atlanta has a research team at Lambeth House seeking epidemiological data.
Unlike the 2005 impact of Hurricane Katrina flooding, which hit hardest in poorer, downriver wards, the coronavirus’ tentacles first reached into an elite enclave in the wealthy Uptown neighborhood. Lambeth residents pay a $275,000 registration fee with 90 percent refundable to designated heirs upon the person’s demise, unless the resident withdraws first. Monthly fees start at $2,971, depending on apartment size, according to its website.
Against the background of a leap-frogging death toll, the three-week Mardi Gras parade season that ended Feb. 25 is now widely seen as a rolling vector, infecting untold numbers of revelers in the vast crowds. The city population of 393,000 more than triples with tourists and visitors during the last four days of parades, parties, jammed nightclubs, and high-end balls. Three of the Lambeth deceased attended the upper-crust Krewe of Hermes ball the week before Fat Tuesday, according to a Lambeth family member.
Among those deaths now attributed to COVID-19, Roland W. Lewis, 68, was a longtime Mardi Gras Indian leader and founder of House of Dance and Feathers, a small museum with displays of the parading culture in a Lower Ninth Ward neighborhood.
Other prominent figures have fallen ill. New Orleans Saints head coach Sean Payton and Roman Catholic Archbishop Gregory Aymond have tested positive. So has Phil Frazier, the fabled tuba player and founder of Rebirth Brass Band.
Coronavirus testing sites are up and running at several places in the city. But with testing kit orders backlogged, the results are slow to come. Locals who came back 15 years ago after the massive flooding to dig out and rebuild have been thrown into survival mode once again.
Food distribution outlets are popping up on St. Claude Avenue, a thoroughfare of local bohemia, among other locations, in a city where nearly a third of the people live at or below the poverty level.
The virus’s lethal threat fell across the city like a fog of déjà vu, stirring memories of 2005 and the flooding that engulfed 80 percent of the city, an area seven times the size of the island of Manhattan. Residents bracing for the virus invoked the resilience of people who came back, dug out, and rebuilt over the next several years: We have been here before, and we’ll get through it again.
George Ingmire, a sound engineer for film sets and music productions, and a popular deejay on WWOZ FM, the city’s roots radio station, compared the social distancing orders to the massive displacement of people across the metro area caused by the vast flooding after Katrina. “It’s like an evacuation without an evacuation,” he said.
Ingmire is one of the tens of thousands of New Orleanians in the gig economy—freelancers of all stripes, artists, writers, people working in music, film, the once-flourishing art galleries, sous-chefs, waitstaff, and food subcontractors—who are once again being thrown into a scramble for existence.
Many in Ingmire’s position normally don’t qualify for unemployment benefits and hope that Congress’ relief package will provide a lifeline. Ingmire said he lost jobs totaling $3,500 over the past two weeks.
In response to workers like Ingmire in the gig economy, the New Orleans Business Alliance
created a relief fund
. New Orleans Saints owner Gayle Benson donated $1 million to the Greater New Orleans Foundation for assistance to people outside the sphere of unemployment relief.
Katrina’s impact was so shattering that on the third day of the flood, with the vast majority of residents evacuated, a beleaguered WWL radio reporter, Dave Cohen, assessing the widespread damage,
voiced a collective angst
: “New Orleans is over. Where do I live?”
But as the city slowly drained and Congress moved at an aching pace on a relief package, people came back to dig out and rebuild. The reporting on the flood and its aftermath by the
Times-Picayune
won two Pulitzer Prizes, much of it by reporters who lost their homes.
Today’s descendant of that paper, the
Times-Picayune/New Orleans Advocate
, won another Pulitzer two years ago for local reporting, yet now its editor, Peter Kovacs, a veteran of the 2005 coverage, sent a candid email to subscribers, seeking donations and stating, “our journalism was so vivid because we were both covering and experiencing the event simultaneously. The current coronavirus crisis feels very much the same.
“We have a staff of about 120 journalists, the largest in Louisiana, and every one of us is living and covering the health emergency. We have people self-quarantining and others working on the front lines, visiting the medical facilities where they are caring for the sick. We have staff members with children unexpectedly at home, sagging from boredom. We face the same kind of uncertainties as workers in other businesses, and we are watching nervously.”
According to an
internal memo
quoted in the
Washington Post
, the paper is issuing temporary furloughs to “about a tenth of our 400-member workforce and the rest of us will begin four-day workweeks. … The furloughs will chiefly impact people who cover sports and social events, which have been curtailed.” The paper also instituted a 20 percent pay cut for all employees.
A city that’s adept in costume and mask-making has shown a grassroots resilience. Volunteers are organizing supply drives and sewing face masks for nurses and medical workers. IATSE Local 478—a union of film set workers, part of the International Alliance of Theatrical Stage Employees, Moving Pictures Technicians, Artists, and Allied Crafts—coordinated with the crew of NCIS: New Orleans and local costume and prop houses to manufacture and
deliver
some 30,000 gloves, thousands of N95 masks and respirators, hundreds of isolation gowns, coveralls, caps, soap, sanitizer, alcohol, wipes, personal toiletries, and full face shields to first responders and medical staff at local health facilities that are stretched to the brink.
Similarly, distilleries are
converting their operations
to produce hand sanitizer instead of booze, the
Times-Picayune/New Orleans Advocate
reported.
But the flipside of this homespun mentality is a rooted indifference to politics. For hard-pressed officials, it’s hard to persuade people steeped in a culture of open air music festivals, cookouts, and parades of all kinds through the seasons to stay inside. Mayor LaToya Cantrell canceled the St. Patrick’s Day and Mardi Gras Indian Super Sunday parades on March 17. Crowds took to the streets on St. Patrick’s Day anyway. “Use your head, stop the spread,” she insisted, calling for social distancing a week before Edwards’ statewide order.
As the social distancing blanket, wrinkled with boredom and fear, fell across a city whose DNA trumpets a celebration of life lived large, revelers are slowly learning to adapt. Jazz musicians like Jon Cleary and Tom McDermott have taken to livestreaming music from their homes.
New Orleans may be accustomed to adapting to calamity, but the suddenly silent streets are creating bizarre new problems. A viral video from last week shows
scores of rats scrambling
in the middle of the typically packed Bourbon Street, outside an empty restaurant. With restaurants operating takeout only, the garbage dumpsters in which rats feasted on leftovers held thinner pickings.
“For most people it was obvious that the separation must last until the end of the epidemic,” Albert Camus writes in
The Plague
, his 1947 novel of bubonic plague spread by rats in the Algerian seacoast town of Oran. Coronavirus springs from a different source, but the parallels with social distancing are striking. Camus writes: “This drastic, clean-cut deprivation and our complete ignorance of what the future held in store had taken us unawares.”
Bourbon Street is empty of the nightly flow of humankind. City workers are resorting to putting rat bait in sewers.
Yet across town, a survivor emerged. On a balmy morning Uptown, 77-year-old George Krall, a retired school teacher and Lambeth House resident, was taking a walk outside, after two weeks of self-quarantine due to a positive test for the virus. He credited the nurse practitioner who checked on him, taking his temperature as he took Tylenol. “Now I’m allowed to leave my apartment,” Krall
told the Times-Picayune/New Orleans Advocate
. “I’ve gone two weeks with no fever, no symptoms.”
----
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This story was originally published on
POLITICS
.
Jason Berry is finishing a film documentary based on his recent book,
City of a Million Dreams
, in which burial traditions form a prism on New Orleans history. He may be reached via email at
jasonberry167@gmail.com
.
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Back to Work? You First
Let the lieutenant governor of Texas, raring to sacrifice himself on the altar of the free market, become a grocery store worker. Let the CNBC pundits become retail cashiers.A direct and compelling headline
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U.S. President Donald Trump looks on as Treasury Secretary Steven Mnuchin speaks during a briefing about the coronavirus outbreak in the press briefing room at the White House on March 17, 2020 in Washington, DC. (Photo by Drew Angerer/Getty Images)
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MARCH 24, 2020 - "We must reopen the economy,” you say. “It is vital that we send people back to work,” you say. Well, it sounds important. By all means—you first.
The cure must not be worse than the problem, the president says. It is important that we not disincentive work, right-wing economists say. Keeping things closed could devastate the economy, business leaders say. These things are a
tradeoff
, you see. Yes, some people will die if we put everyone back to work sooner than the health experts say. But these things are inevitable. And the economic damage could be awful if we don’t.
Okay. All of you line up, to report to work.
Lloyd Blankfein, the reasonable
cheerleader
for restarting commerce, you can be a doorman, throwing open the doors of your Manhattan office building for all the bankers to return to their desks. The doorman, who prefers not to die, can be the CEO of Goldman Sachs. That office is sufficiently large for social distancing, I’m sure.
Art Laffer, the
discredited
economist, can be a waiter in a crowded restaurant. A waiter, who prefers not to die, can become an economist. No waiter could be a worse economist than Art Laffer, anyhow.
Let the lieutenant governor of Texas, raring to sacrifice himself on the altar of the free market, become a grocery store worker. Let the CNBC pundits become retail cashiers. Let the Washington corporate lobbyists beating the drum for restarting production become warehouse workers. And let the regular people who work in crowded restaurants and crowded stores and crowded warehouses and crowded factories take jobs in statehouses, and on cable TV, and at think tanks. It is only fair that the bold leaders urging us all to be brave enough to disregard scientifically sound warnings of millions of deaths in order to prop back up American business be the first ones out there, in close proximity to the infectious public, getting coughed on as they enable each and every one of the transactions that will get money flowing again. That is what leadership is all about.
Besides, there will certainly be a number of job openings in politics and cable TV punditry and think tanks once all of those free marketeers go out into the workforce and promptly catch coronavirus.
There is an unspoken and underlying assumption in all of the push to end our national shutdown before the pandemic has passed, which is: Rich people will not be the victims of this. This belief is untrue, but the rich can be forgiven for believing it—in normal circumstances, it is a very reliable rule. The rich have been sending poor people to their deaths in wars for the sake of profits for centuries. Nothing new at all about that. In violent conflicts, non-rich people are just grease in the wheels of the capitalist machine. It is not remarkable that business leaders and their allies would want to enact the same pattern of human sacrifice now, with the stock market plummeting. The difference is that the pandemic will kill the rich, too. They are currently acting as if they can buy their own safety, because they haven’t seen their peers die too much yet. But they will.
The voices pushing to send millions of people back to work at the cost of what could be
millions
of lives will say that they are being hardheaded realists. They will say that the cost of our ongoing economic shutdown, with its attendant unemployment and bankruptcies, will be even worse. But the only world in which that could possibly be true is a world in which we preserve our old, suddenly absurd economic arrangements at all costs. It is only true in a world in which we refuse to consider debt forgiveness, and a massive government wage subsidy, and health care for all. It is only true if you accept the premise that, during this economic shutdown, all small businesses will go bankrupt and workers will lose their jobs permanently and we’ll all become buried in debt.
If you instead assume a world in which we recognize the obvious reality that, as a result of this unprecedented public health crisis, we must waive many debts and let government spending carry us past the dangerous period, then keeping people at home in order to save a million or two million lives is the only choice. But recognizing the necessity of what must be done means that, on the other end of this, the capitalists must take a loss. They will not take all of the loss, or even a permanent loss, but they will take a loss, because economic activity will almost cease for a period of time.
That loss—of a year or two’s profits—is what is considered unacceptable. So, of course, we must all get back to work while the pandemic is still raging. And if a couple million people must die in order to ensure that we do not forgive any loans in this country, then that is just how it is going to be. It’s just plain common sense. Okay? Fine.
You first, fuckers. See you in hell.
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The 9 Most Important Unanswered Questions About Covid-19
Is reinfection possible? Will it be seasonal? How prevalent is it really? These are some of the top questions on researchers’ minds.
by Brian Resnick, Vox.com
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The Imperial College study emphasised the importance of social distancing
to lessen surges that could overwhelm the NHS,
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MARCH 20, 2019 - It’s easy to forget that just a
few months ago
, the virus that is causing the
Covid-19
pandemic around the world was not known, at all, to science.
In the months and weeks since, researchers have been learning as much as they can about this pathogen — and at breakneck speed. Scientists have sequenced its genome and begun to
create vaccines
in the hope of making people immune to it. They’ve also learned, critically, that people can pass the virus on to others before they get symptoms themselves. That makes the virus hard to contain. But it also makes it clear that severe actions — like the
social distancing measures
in place in the US and around the world — are necessary in the fight to save lives.
We still don’t know how this pandemic will play out. That’s in large part because there are crucial unanswered questions about this virus and the disease it causes. For example, researchers don’t yet have precise estimates of how deadly the virus is or an exact understanding of how it spreads. The answers to these questions will provide key insights into stopping this pandemic in the least disruptive way possible.
It may be too easy to look at these uncertainties and the lack of data and feel cavalier: Maybe this all isn’t as bad as people are saying.
Do not take comfort in these uncertainties. Take caution.
“The way we deal with the uncertainty is we have to cover all of our bases,” Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College. “A year from now we’ll realize some of the things that we did may not have been necessary.” But we have to proceed with extreme vigilance due to the many unknowns of this virus and the serious risk it poses to so many around the globe.
These are the nine most important unanswered questions about Covid-19 that will help determine the course of this outbreak. Be humbled by this list. We are. And take care.
1) How, exactly, does Covid-19 spread?
The virus — known as SARS-CoV-2 — that causes Covid-19 has
infected more than 222,000 people
since its emergence. (Of them, at least 9,000 have died.) That’s just the confirmed cases. A great many more may have occurred (more on that later).
Why has it spread so fast? “The best explanation for this rapid spread is that the virus is being passed through
droplets
from coughing or sneezing,” Vox’s Julia Belluz
explains
. “When these virus-laden droplets from an infected person reach the nose, eyes, or mouth of another, they can transmit the disease.”
But it’s still unknown how significant other modes of transmission are in spreading the disease.
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Hand-washing instructions posted in a restroom on Capitol Hill
in Washington, DC, on March 19, 2020.
Alex Wong/Getty Images
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It’s
possible
that the virus can spread
through
feces. (The CDC
says
, though, “the risk is expected to be low based on data from previous outbreaks of related coronaviruses.” But if you weren’t already washing your hands vigorously after defecating, please do so now.). There are also uncertainties over how long the
virus can linger in the air
after a person coughs or sneezes.
You may have heard that the new coronavirus isn’t “airborne” — meaning that unlike extremely contagious diseases like measles, it’s unlikely to linger in the air for hours on end. But that doesn’t mean the virus can’t linger in the air for some amount of time.
As Wired
explains
, although some experts say the new coronavirus isn’t airborne, that’s based on a narrow scientific definition of the term. The virus can possibly
still linger in the air for some time
and under some conditions. As the journal
Stat
reports,
we don’t yet know
precisely what those conditions are. It will definitely be in the air in the moments after an infected person sneezes or coughs, but it’s unclear when the particles eventually come to rest on the ground (or surrounding surfaces).
“The studies suggesting that [the virus] can be aerosolized [i.e., linger as small particles in the air] are only preliminary, and other research contradicts it, finding no aerosolized coronavirus particles in the hospital rooms of Covid-19 patients,”
Stat
reports
. More research is needed.
So all three transmission routes — droplets, airborne, and fecal — are still possible contributors to the spread of the virus. “Almost certainly, one of these is probably the predominant one, and the others might be minor modes of transmission, but we don’t really understand this,” Hotez says. Some good news is that scientists are figuring out how long the virus can live on some surfaces. Here’s the
latest
: It’s around three days for plastic and steel, about a day for cardboard, and less than a day for copper. This information helps direct sanitation efforts to where they are needed most.
2) Can people become reinfected? And, if so, after how long?
Another huge unknown: Can people become reinfected with Covid-19 after they’ve had it? There
are some reports
of people in China and Japan testing positive after recovering from the infection. Though, to be clear, it’s unknown whether those people were truly reinfected or still just had low levels of the virus in their systems after they felt better.
“I would say that the biggest unknown is how potent is the immune response generated in an infected person,” Akiko Iwasaki, an immunobiologist at the Yale School of Medicine, writes in an email. “How long would [immune] protection last? ... The answers to these questions are key to understanding whether herd immunity is effective.“
Herd immunity is when enough people have contracted the virus and become immune that its spread can be slowed and potentially stopped. If reinfection is possible, however, herd immunity may not be an option. (Also, stopping the virus via herd immunity is not an ideal scenario. It would first mean millions upon millions of infections and potentially millions of deaths.)
Right now, there’s limited research on the question of reinfection in humans. It’s just too early. Angela Rasmussen, a virologist at Columbia University, points to a hopeful, if small, study in
Macaque monkeys
. The monkeys had been infected with the virus and then, after they got better, exposed again to the virus. Good news: They didn’t get reinfected. The study, Rasmussen says, “bodes well for vaccine development, because that suggests the virus — or viral proteins — can elicit an immune response,” and protect monkeys at least from reinfection.
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The last group of patients leave a gymnasium turned temporary
hospital in Wuhan, China, on March 10, 2020.
Costfoto/Barcroft Media via Getty Images
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A woman who recovered from the coronavirus hugs a medical staff member
before leaving a temporary hospital in Wuhan, China, on March 10, 2020.
Stringer/AFP via Getty Images
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Studies on humans will come in time. Researchers will be able to test the blood of people who have recovered from Covid-19 in the weeks and months following their infection and see if they still are immune.
But even if people do become immune, “one thing we don’t know about that still is how long that immunity would last,” Rasmussen says. “And that’s unfortunately not something we can determine until we wait months or years in the future, and test again and see if those antibodies are still there.”
For coronaviruses that cause the common cold (in the same family of viruses as the one that causes Covid-19), she says, reinfection is possible, but on a timescale of years, not weeks or months. Again, we’re going to have to wait and see if this also applies to Covid-19.
For now, at least, Rasmussen says, “I have not seen any data that is convincing that reinfection occurs.”
3) How many cases of Covid-19 are in the US, and where are we on the curve?
This is one of the scariest unknowns. Due to the continued lack of Covid-19
diagnostic testing
in most of the US, we just don’t know how many cases are in the US.
“There’s speculation that there may be many mild infections who aren’t seeking care — or, even if they are, can’t be tested due to insufficient testing capacity,” says Harvard epidemiologist Maimuna Majumder. This obfuscates our knowledge of where the virus is, and how many vulnerable people may be in its path.
Repeating my plea to media: PLEASE stop saying "there are now X number of cases in the US" and start saying "as of today X cases have been reported in the US. Because of limited testing, experts agree the real number is far higher." We don't know how much higher but many times
As of March 19, the CDC said there were 10,442 confirmed cases of Covid-19 in the US. But viral genetic data suggests the real number could be much higher. Here is one estimate from a computational virologist at Fred Hutchinson Cancer Research Center in Seattle (with a very wide range) from nearly a week ago;
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I could easily be off 2-fold in either direction, but my best guess is that we're currently in the 10,000 to 40,000 range nationally. 11/13
Another problem with insufficient testing is that we don't know where we are on the epidemic curve. How do we know when the worst spikes in the number of cases are coming? It seems we’re
early
, but we don’t know how early or how big the wave of future cases is. We need to know this to make sure hospitals are prepared for a surge of patients.
If we know how many people are getting the disease without symptoms or getting it at a level that does not warrant medical attention, scientists can make better estimates for how deadly the virus is and for whom, and they can refine their assumptions about how contagious the virus is. More testing can also help researchers determine the true role asymptomatic transmission plays in the outbreak, and what factors make a person likely to transmit the virus before they feel sick.
4) How deadly, exactly, is Covid-19?
Knowing the true number of infections that exist in the US or around the globe (or at least getting a better estimate of the true number) will help researchers determine another crucial metric about Covid-19: its case fatality rate, meaning how deadly it is.
Right now, it’s looking like some countries
have higher death rates
for Covid-19 than others. These rates also keep changing. Now, the estimated death rate for Wuhan, China — the city where the outbreak began — is 1.4 percent, per a new
study
in
Nature Medicine
. In late February, the World Health Organization
estimated
the rate in Wuhan was 5.8 percent. South Korea, on the other hand, was estimated to have a
death rate of less than 1 percent
. Italy’s seems to be, for now,
several percentage points higher
.
Are these estimates different because the citizens of these countries are at different levels of risk for some yet-to-be-determined variables? Are their caregivers better at treating the virus? Or are their health care systems falling short in the testing of cases? All of these questions may be in play.
It’s also the case that the fatality rate can change over time, as Belluz
explains
:
CFRs do change over time. That’s exactly what happened in China, as you can see in this figure from the WHO. Even the first and hardest-hit province, Hubei, saw its death rate tumble as public health measures were strengthened and clinicians got better at identifying and treating people with the disease:
Crucially, it’s not just the overall CFR that matters but also the knowledge of who is most at risk for death. It does seem clear that older people — particularly those older than 80 — and those with chronic medical conditions are in the riskiest group for dying of Covid-19. But we need more knowledge on other subgroups so we can better protect them.
5) Is it seasonal?
For a variety of reasons, some viruses — but not all — become less transmissible as temperatures and humidity rise in the summer months. The viruses themselves may not live as long on surfaces in these conditions. The droplets that transmit the virus also may not spread as far in humid air. (When the air contains more water vapor, those virus droplets will collide with water molecules more frequently and may not travel as far. The humid air is kind of like a shield for virus-containing droplets.) Also, human behavior changes, and we spend less time in confined spaces.
“A lot of how the outbreak ends or at least how things progress in the next few months really depends on if this is seasonal,” Nathan Grubaugh, an epidemiologist at the Yale School of Public Health, says.
There are actually two important questions here. The first: Will Covid-19 show seasonal effects? The second: Will those seasonal effects make a meaningful difference in slowing down the spread of the pandemic?
The answer to the first question, right now, is
maybe
.
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Boston Public School workers help to load boxes of homework
to be distributed to students on March 19, 2020.
Jessica Rinaldi/The Boston Globe via Getty Images
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Mauricio Santillana, the director of the Machine Intelligence Lab at Boston Children’s Hospital,
has been studying
the potential seasonality of Covid-19 by looking at the best available data from China.
Before China instituted massive lockdowns, “we saw a signature that places that were colder and drier showed slightly larger transmissions before interventions,” Santillana says. Though he admits the data is limited, and it’s hard to analyze the exact impact temperature and humidity have on transmission. That’s because, once China locked down, it became hard to disentangle the effects weather has on transmission from the mitigation policies from the government. Santillana and his colleagues are still working out what exact effect the weather may have on transmissibility, and he says it’s too soon to report a specific number.
But be prepared to be disappointed on this. On the second question, Santillana is firmer: “We cannot rely on weather alone to take care of the outbreak,” he says, pointing to warmer and more humid climates — like in
Singapore
— where the virus has spread. “We think the spring temperatures will not be enough to mitigate the outbreak.”
It’s just too contagious — and too few people are immune.
That said, it’s not futile to keep studying seasonality effects. “This virus may be with us for the coming years,” Santillana says. Predicting spikes based on weather, however small, will give us “a more precise way to deploy resources around the world.”
6) What role do children play in the spread of Covid-19? And why aren’t they getting very sick with it?
“When there’s an influenza epidemic, kids are often some of the biggest community spreaders,” Hotez explains.
But with Covid-19, kids generally
don’t seem to be getting severely ill
. Which is leading researchers to ask: Are kids a big source of transmission of this virus? “When we’re talking about closing schools, we’re doing that under the assumption that kids are significant community transmitters,” Hotez says. “If we knew that one way or another, we could make a more informed decision.”
On this, the data is slowly coming in.
“We do know that children tend to have more mild infection, have more mild disease, but we have seen [at least one child] die from this infection,” Maria Van Kerkhove, the Covid-19 technical lead at the World Health Organization, said in a press conference on March 16. “We can’t say universally that it’s mild in children, so it’s important that we protect children as a vulnerable population.”
While kids usually seem to be spared the worst, so many questions remain, as Vox’s Umair Irfan explains: “A small percentage of younger people, from babies to young adults, have also suffered serious harm,” he writes. “Few children are being tested for the virus, so there still isn’t much good information about how many children are getting infected overall. And from there, it’s hard to gauge the rate of severe illness for the young.”
7) What leads some people to be at higher risk for the worst symptoms of Covid-19?
On the question of risk factors, there seems to be one clear answer for the most prominent factor: age. Older people appear to be dying in much higher numbers from Covid-19 than younger people.
Though the risks to older people are being emphasized, young people are also being hospitalized. New data from the CDC now
shows
that while Covid-19 is currently less than 1 percent fatal among those ages 20 to 54, this group makes up 38 percent of the hospitalizations so far (with 20 percent of the hospitalization occurring among those ages 22 to 44).
“It’s really an open question to try to figure out why some of these younger people are getting really, really severe disease, and if there are other risk factors that we are not appreciating,” Rasmussen says. “Some of that will just have to wait until we have really detailed clinical data on all the cases that are coming out now in Italy and in the United States.” Knowing who is most at risk, she says, “will help in terms of
flattening the curve
.” If we learn how to protect the young people most at risk and keep them out of hospitals, we can decrease strain on our health care system.
And a big part of keeping the health care system working well is ensuring its workers — who are often in this 20- to 54-year-old group — remain healthy. “We don’t understand why hospital workers also seem to be at higher risk for severe disease than you would expect based on their age,” Hotez says. “Is it just that they get exposed to a large dose of the virus? Do they have some type of susceptibility that we don’t understand?”
Currently, we don’t know.
8) How, exactly, did it start?
This is still a little bit of a mystery. Scientists know this virus jumped from an animal to a human, but they are not sure exactly how or where. “If you don’t understand where it came from, then it’s hard to make policies, procedures, to prevent it from happening again,” says Krutika Kuppalli, an infectious disease physician and
Emerging Leader in Biosecurity fellow
at the Johns Hopkins University Center for Health Security.
What researchers have to figure out now is how exactly the coronavirus jumped to humans: perhaps through a human eating an infected animal, or through humans being exposed to infected feces or urine. “All we know [is] its likely distant source was bats, but we don’t know who was between bats and people,” said
Vincent Racaniello
, a professor of microbiology and immunology at Columbia and host of the
This Week in Virology
podcast
. “It could be a direct infection [between bats and humans] as well.”
A lot of the evidence points toward the outbreak either starting or significantly gaining steam at a live animal market in Wuhan, China. The more we know about how this virus made the jump from animals to humans, the more authorities can help make sure an outbreak with this origin doesn’t happen again.
9) When will it end? And how? Will it become endemic?
The response to the
Covid-19 pandemic
is infiltrating every aspect of life, and we’re already longing for it to end. But this fight may not end for months or a year or even more. It’s also possible that Covid-19 will become endemic, meaning it becomes a disease that regularly infects humans and never really goes away.
But there are so many unknowns that will determine how long we have to live with this:
- Could a pharmaceutical treatment emerge that will prevent people from dying from Covid-19? (Many drugs, including HIV-fighting antivirals, and common, cheap ones — like those to ward off malaria — are being tested right now, or may be tested soon.)
- Will one of the many vaccine formulations that have been created in recent weeks (some of those trials are already underway) prove to be safe and effective?
- If no drug works to treat the virus or stop its spread, we may need to live with strict social distancing for many months, if not a year or more, to prevent hundreds of thousands from dying. Will governments support that level of sustained disruption to the economy? Or could we find an alternative, like aggressive testing coupled with relentless contact tracing, quarantines of those exposed, and isolation of the sick?
As we learn more about this disease, our approach to fighting it will become more precise. We may be able to find a balance between protecting the vulnerable and letting our economy and society function again. But for now, we have to confront the possibility that this virus will disrupt life for a long while.
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A closed playground in Wyomissing, Pennsylvania, on March 19, 2020.
Ben Hasty/Reading Eagle via Getty Images
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“I think this idea … that if you close schools and shut restaurants for a couple of weeks, you solve the problem and get back to normal life — that’s not what’s going to happen,” says Adam Kucharski, an epidemiologist at the London School of Hygiene & Tropical Medicine and author of
The Rules of Contagion
, a book on how outbreaks spread. “The main message that isn’t getting across to a lot of people is just how long we might be in this for.”
But given that scientists have only known about this virus for a few short months, “it’s actually quite remarkable how much we’ve learned,” Hotez says. “We’ve learned more information about this virus in this short period of time than any other virus.”
The learning won’t stop. And because of that, hopefully, the spread of this pandemic someday will.
Brian Resnick is a science reporter at Vox.com, covering social and behavioral sciences, space, medicine, the environment, and anything that makes you think "whoa that's cool." Before Vox, he was a staff correspondent at National Journal where he wrote two cover stories for the (now defunct) weekly print magazine, and reported on breaking news and politics.
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Mayor Cantrell Issues Stay Home Mandate in Response to COVID-19
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NEW ORLEANS (3/20/20) — Mayor LaToya Cantrell today issued a Stay Home Mandate, a guidance document from the City Health Department that takes its legal force from the proclamation issued on Monday of this week.
"We are hereby mandating that residents stay home whenever possible, going out only for critical needs. We are telling our people and our businesses to stay home. The more people who stay at home, the more lives that we will save," said Mayor Cantrell. "Don't look for ways for the rule to not apply to you. Do not look for ways to be an exception. Stay home. If there are any gray areas, err on the side of caution. Stay home."
In consultation with the New Orleans Health Department, Mayor Cantrell issued the following restrictions:
- All residents and visitors to the City of New Orleans should take personal responsibility to prevent the further spread of COVID-19, including but not limited to, avoiding gatherings, and remaining in their homes unless performing essential functions;
- Individuals should maintain at least six feet from other individuals, wash hands with soap and water for at least 20 seconds as frequently as possible or using hand sanitizer, cover coughs and sneezes, and avoid shaking hands;
- Essential service providers should comply with social distancing guidelines and continue to operate;
- For employers in the City of New Orleans that do not provide essential business or government services, take all steps reasonably necessary for employees to work remotely from home;
- Businesses not considered essential service providers should have the least number of staff on premises necessary to continue basic operations and must fully comply with social distancing requirements as set forth;
- Individuals are prohibited from engaging in gatherings, even in outdoor parks and spaces;
- Restaurants are prohibited from seating patrons at tables or bars, and are further requested to provide curbside carry-out and/or delivery services only, with gatherings prohibited on site. This includes outdoor tables and courtyards.
- Movement around the City should be restricted to only that necessary for travel to and from authorized work environments, accessing essential services, and for personal recreation (i.e. walking, hiking, and running), with strict adherence to social distancing guidelines.
The mandate also provided more detailed examples of what qualifies businesses and services as “essential,” and reiterated the need for closings of bars, gyms/fitness centers, shopping centers, live performance venues, reception facilities, art studios, and indoor amusement facilities.
The mandate concludes with the following paragraph:
"Mayor Cantrell has declared a state of emergency to exist in New Orleans via proclamation on March 11, 2020 and has imposed orders subject to these penalty provisions in her March 16, 2020 Proclamation. These emergency orders will be strictly enforced, and compliance is of the utmost importance."
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Survival ethos marks New Orleans, now an epicenter of COVID-19
Jason Berry, Guest Columnist
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NEW ORLEANS (3/19/2020) -
In March, the azaleas blossom like tiny valentines on the grassy St. Charles Avenue median where streetcars trundle past the Garden District, heading toward Uptown. It is barely three weeks since the last Mardi Gras parade. Doused in milky sunlight, the plastic beads tossed by maskers on the decorated floats hang in oak limbs that snagged them from waiting hands. And now, the coronavirus pandemic curls its tentacles around a city of festive folkways, squeezing us into an eerie new abnormal.
On March 10, Louisiana had its first reported coronavirus case. Eight days later, 240 people have tested positive, out of 575 tested in less than a third of the civil parishes, or counties, with six deaths attributed to COVID-19, the disease caused by the virus, according to state officials. The deaths and 176 cases have been reported in New Orleans, the epicenter of a state that "now has the third-highest rate per capita in the country," reports the Times-Picayune/Advocate.
The three-week Carnival season of crowds at parades, dancing at balls and packed music clubs seems now a perfect storm for "community spread."
On Monday, May 16, Mayor LaToya Cantrell ordered the closure of bars, music clubs, casinos, and gyms and restricted restaurants to deliveries only. Gov. John Bel Edwards issued a similar order statewide for at least 30 days. Archbishop Gregory Aymond announced the cancellation of church Masses indefinitely to support social distancing. The hope behind these measures is to "flatten the curve," reducing the acceleration rate of the virus, which has devastated Italy and tilted the world economy.
Tourism is the top industry here. In 2018, the city enjoyed a $9.1 billion impact from 18.5 million visitors, according to a consultant study by D.K. Shifflet & Associates. As news of the virus surged, large conventions began cancelling. So did two major conferences scheduled for late March: Tulane's New Orleans Book Festival, with John Grisham and Malcolm Gladwell among its speakers, and the Tennessee Williams Literary Festival, in its 34th year, the headliners including St. Joseph Sr. Helen Prejean and novelist Colm Tóibín.
April's French Quarter Festival featuring several music stages cancelled, costing hundreds of musicians and sound engineers their expected paychecks, along with anticipated revenues from restaurants and bars in the economy's peak season. French Quarter Fest announced its hope of rescheduling in October, barring a worse free-fall in tourist travel.
The 50-year old New Orleans Jazz and Heritage Festival draws hundreds of thousands of music aficionados for a 10-day stretch between the last weekend of April and first weekend of May. Jazz Fest is a $300 million annual pump for the economy. On March 17, the festival announced it would postpone the event, hoping to reschedule in the fall.
Mayor Cantrell, who ran as a populist, cancelled the St. Patrick's and Mardi Gras Indians Super Sunday parades on March 14. The mayor recoiled from media coverage of people drinking and partying in the warm sunlight on Magazine Street in the Irish Channel neighborhood, outside Tracey's Bar — a violation of the city's order, at the time, of no crowd exceeding 250 people. New Orleans police scattered the crowd.
The next day, Cantrell urged people to be "vigilant" in social distancing. "Use your head, stop the spread."
"A lot of people haven't come to terms with this pandemic, certainly our president hasn't, " Vincentian Fr. Louis Arceneaux, who has ministered in the city for decades, told NCR. "People outside Tracey's don't get it — fact that you may not be sick, but go home and hug your grandmother, and she can get sick! I don't see people catching on how communicable this stuff is."
"I did the 10 a.m. Mass on Sunday at St. Joseph's [in the mid-city medical district]. I brought up coronavirus in the sermon. After Mass, people thanked me, and wanted to hug. I'm a hugger, but I'm not hugging. I tell people, 'I love you but I really don't want you to touch me.' "
Tracking social spread
As church bells tolled on St. Patrick's Day, the hardest-hit facility in New Orleans was Lambeth House, a multi-story retirement complex with a nursing wing. The large brick structure at a corner of affluent Uptown has sweeping views of the Mississippi River from balconies and terraces. With three deaths from COVID-19 confirmed, Lambeth House is under quarantine, with a cluster of 12 residents or patients testing positive as of March 18.
Lambeth House residents pay a $275,000 registration fee with 90% refundable to designated heirs upon the person's demise, unless he or she withdraws first. Monthly fees start at $2,971, depending on apartment size, according to its website.
Many Lambeth residents come from prominent families and have active social lives, particularly at the winter Carnival balls; some travel abroad. As the Centers for Disease Control and Prevention sent specialists to conduct testing, one relative of a Lambeth resident, who spoke on background, suggested the cases may be tied to the funeral of a society matriarch, just after Mardi Gras, which drew many mourners, including Lambeth residents, among people who had gone to the parades, and others returning from European travel.
Social distancing strikes a weird tone in the rhythms of a city that thrives on crowds at parades, outdoor markets, music clubs and dozens of festivals where bands play and people feast on boiled crawfish, jambalaya (seasoned rice with shrimp and sausage), gumbo and fried oysters. High cholesterol is not a major issue in these latitudes.
But a survival ethos marks New Orleans to its marrow. The overarching lesson of the epic Hurricane Katrina flooding in 2005 is one of human grit. Most of the city's 484,000 residents fled by car, as 80% of the urban area filled with water; the city barred people from returning for a month. Musicians were among the first wave getting back, to kickstart the night clubs and perform at funerals despite many of the players having lost their homes.
Countless people exhausted their savings while fighting with insurance adjustors, digging muck out of flooded homes, stripping walls, and making repairs that ran for months and sometimes years.
A $9 billion federal relief program, Road Home, plagued by bureaucratic inertia, nevertheless paid an average grant of $69,000 to cover the difference that insurance companies did not pay. Today, the population stands at 393,000.
The character of this offbeat town — where the 1960's mayor, Victor Hugo Schiro, famously declared, "Don't believe any rumors unless they come from my office" — is rife with cynicism toward politicians and the police department. Yet as the pandemic grew like some sci-fi plague, the logic of the emergency measures began settling like a dark cloud.
Cost to jobs in the arts and hospitality industries
"Before these orders kicked in, I lost a $2,500 job for three days of film work, postponed till May," says George Ingmire, a sound engineer for film and music productions. "I don't know what to expect. There won't be much work unless I'm in my home studio doing audio or video editing."
Like thousands of people in the so-called gig economy, Ingmire does part-time work as a tour guide and operates a pedicab to supplement his other contracts. "At 51, I'm 20 years older than other people pedicabbing. I need work that allows flexibility. I told the company on Sunday I felt like a sitting duck, touching money and surfaces, with people coughing; now with all these shut-downs, the foot traffic is gone. The whole country is evacuating, but not evacuating, so to speak."
Ingmire's plunge is typical of some 7,400 workers in Louisiana's burgeoning film industry, as estimated by the state. Many, unlike Ingmire, are union members. The state provides tax credits to film companies, allowing them to recoup some of their expenses, feeding an annual economy of roughly $500 million with dozens of productions at a given time.
"Right now, we're aware of only two production crews at work, with 30 people each," says Cory Parker, business agent of the 1,500-member Local 478 of the International Alliance of Theatrical Stage Employees, Moving Pictures Technicians, Artists and Allied Crafts.
Parker estimates "about 5,000 people in film and television production now out of work. That figure does not include stage-hands who do convention work," theatrical stage employees, ushers, ticket-takers and concession workers, whose ranks constitute some 10,000 entertainment laborers, mostly in New Orleans.
IATSE Local 478 is guiding its members to apply for unemployment. "Most of them have never done that," says Parker. "We're talking with the state, trying to streamline the process. IATSE has a national benefit fund, and they're working on a plan to help people keep their health coverage."
Nationally, IATSE officials are lobbying Congress to include entertainment workers in House Resolution 6201 (Families First Coronavirus Response Act), which has gone to the Senate but not been taken up there for consideration yet — and will require an amendment in the final bill for a major relief package.
As the massive shutdown rolls out, Fr. Peter Finney III, pastor of St. Rita Catholic Church, planned to livestream Mass on Facebook. He worried about working mothers of the children who attend the parish school. "A private school or more affluent Catholic school can come up with a distance learning alternative. This parish is a small operation. Our scholars don't have Wi-Fi — they go to the library for that," he told NCR. "To say 'set up parallel learning' is hard for a clientele like ours. … Many people are wondering how they will last a month."
As the pandemic escalates, economists and civic leaders interviewed in local media have found a mantra, estimating a 30-day period of social distancing before the economy tanks. What if it takes 60 or 90 days? An acute concern voiced by health officials and medical workers on the front line is whether hospitals and clinics have enough capacity for the number of sick people, destined to rise, especially in areas with poor people, who account for nearly a third of the population here.
------
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Jason Berry is finishing a film documentary based on his recent book,
City of a Million Dreams
, in which burial traditions form a prism on New Orleans history. He may be reached via email at
jasonberry167@gmail.com
.
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