Jack Drennan had tried to quit vaping before, but it took a global pandemic to make him finally follow through.
“I heard you get a lot sicker if you do vape and get coronavirus, so it kind of [pushed me] to quit,” says the Mississippi 20-year-old. Plus, “my mom’s on my ass [about it].”
Speculation about a link between vaping and COVID-19 has grown in recent weeks. News reports have noted that some young, hospitalized COVID-19 patients also vaped, and at a tele-town hall on March 19, a constituent asked New York Rep. Anthony Brindisi about the possibility of a connection. The National Institute on Drug Abuse wrote on its blog that people with substance-use disorders, including those who vape, could be especially hard-hit by COVID-19. In various corners of the internet, fringe theories with little-to-no scientific evidence have popped up making connections between a prior outbreak of vaping-related lung illnesses in the U.S. and COVID-19.
But is there any actual link between vaping and coronavirus? Experts say it’s impossible to say for sure.
Preliminary data show that a fairly high number of U.S. hospitalizations have been among younger adults—the same population known for vaping. At this point, though, that’s just an interesting observation; there is no real data to back up an association between vaping rates and COVID-19 rates in young adults.
The science around vaping is in general evolving. While some studies have shown that vaping can lead to lung damage and other health problems, the products have not been on the market long enough to speak confidently about their long-term effects. The science around COVID-19, which did not exist three months ago, is also still evolving. Putting the two topics together, then, makes for a lot of uncertainty.
Having a preexisting condition—especially one related to respiratory health—increases the chances that someone will experience complications from COVID-19, so it’s reasonable to think vaping could play a part. But since scientists can’t say for sure that vaping leads to lung disease or other chronic conditions, it’s also difficult to say whether it opens people up to more risks associated with COVID-19.
The New American Addiction
How JUUL hooked kids and ignited a public health crisis
Combustible cigarette-smoking is a clearer cause for concern during the outbreak, says Dr. Michael Siegel, a professor of community health sciences at the Boston University School of Public Health. Early data suggest men are more susceptible to COVID-19 than women, which could be associated with the fact that more men than women smoke—especially in China. Smoking-related conditions, such as heart and lung disease, put people at risk of more severe illnesses, Siegel says. Smoking also inhibits the body’s ability to heal from infections, he adds.
But “with vaping, we just don’t know,” Siegel says. “We don’t have the evidence.”
Yasmin Thanavala, an immunologist at Roswell Park Comprehensive Cancer Center in Buffalo, New York, says some of her group’s animal research suggests vaping may prevent the body from healing from bacterial infections. COVID-19, of course, is a viral infection, but Thanavala says “on a theoretical basis,” a similar effect could apply. There’s not conclusive evidence to say so definitively, though.
Even assuming vaping does cause some amount of lung damage, it’s unlikely that most people who vape have been using e-cigarettes long enough to see the full brunt of it, says Dr. Steve Schroeder, a professor of medicine at the University of California, San Francisco. The exceptions, of course, are patients who got sick during a vaping-related lung injury outbreak last year, which health authorities traced mainly back to THC vape products spiked with the additive vitamin E acetate.
Daniel Ament, a 17-year-old from Michigan who needed a double lung transplant after vaping, is one such patient. “I definitely am [at higher risk for COVID-19],” he says. “[Doctors] didn’t have to tell me that.” Given his past lung injury and fragile immune system post-transplant, Ament is staying inside, wearing a mask almost constantly and visiting his doctors and therapists virtually. His whole family self-quarantined starting last week, to avoid bringing home germs.
E-cigarette users without a known lung injury should not quit if it means they’ll go back to using combustible tobacco, Siegel says. “Relapsing to smoking is the worst thing they could do.” But for recreational vapers, COVID-19 may be the final push needed to quit—and that’s a silver-lining to the situation, Siegel says.
“It’s always better not to be breathing chemicals into your lungs. I would have said that even without this particular outbreak,” he says. “It would certainly be a potential incentive to get people who are vaping to stop, just as a precautionary measure.”
(Bloomberg) — The stomach-turning ride on global financial markets took a dramatic turn Monday, with U.S. stocks plunging the most since 1987 after President Donald Trump warned the economic disruption from the virus could last into summer.
The S&P 500 sank 12%, extending losses as Trump said the economy could fall into a recessoin. Equities opened sharply lower after central bank stimulus around the world failed to mollify investors worried about the damage the coronavirus is inflicting on economies.
The negative superlatives for American stocks are piling up. The S&P wiped out its gain in 2019 and is now down almost 30% from its all-time high. The Dow Jones Industrial Average lost almost 13%, falling 3,000 points to close at at two-year low. The Russell 2000 had its worst day on record, losing more than 14%.
“This is different. The thing that is scarier about it is you’ve never been in a scenario where you shut down the entire economy,” said Steve Chiavarone, a portfolio manager with Federated Investors. “You get a sense in your stomach that we don’t know how to price this and that markets could fall more.”
While the Fed cut rates toward zero and stepped up bond buying, investors continued to clamor for a massive spending package to offset the pain from closures of schools, restaurants, cinemas and sporting events. Companies around the world have scaled back activity to accommodate government demands to limit social interaction.
Here are some of Monday’s key moves across major assets:
All 11 groups in the S&P 500 fell, with eight of them down at least 10%.
The Dow Jones Industrial Average’s tumble from its record reached 30%.
Brent crude dipped below $30 a barrel for the first time since 2016.
Treasury yields retreated across the curve with moves most pronounced on the short end.
Shares tumbled in Asia and Europe, where the continent is now reporting more new virus cases each day than China did at its peak as more countries lock down.
The yen surged, the Swiss franc rallied and the dollar fluctuated.
Gold failed again to capitalize on the rush to havens and reversed an earlier gain to tumble.
Bonds declined across most of Europe, where a measure of market stress hit levels not seen since the 2011-2012 euro crisis.
The Fed and other central banks have dramatically stepped up efforts to stabilize capital markets and liquidity, yet the moves have so far failed to boost sentiment or improve the rapidly deteriorating global economic outlook. An International Monetary Fund pledge to mobilize its $1 trillion lending capacity also had little impact in markets.
The problem is, bad news keeps stacking up. The New York Fed’s regional gauge of factory activity plunged. Ryanair Holdings Plc said Monday it will ground most of its European aircraft while a consultant said the pandemic will bankrupt most airlines worldwide before June unless governments and the industry step in. Nike Inc. and Apple Inc. announced mass store closings.
“In normal circumstances, a large policy response like this would put a floor under risk assets and support a recovery,” Jason Daw, a strategist at Societe Generale SA in Singapore, wrote in a note. “However, the size of the growth shock is becoming exponential and markets are rightfully questioning what else monetary policy can do and discounting its effectiveness in mitigating coronavirus-induced downside risks.”
The yen rebounded from Friday’s plunge after the Fed and five counterparts said they would deploy foreign-exchange swap lines. Australian equities fell almost 10%, the most since 1992, even after the Reserve Bank of Australia said it stood ready to buy bonds for the first time — an announcement that sent yields tumbling. New Zealand’s currency slumped after an emergency rate cut by the country’s central bank.
Meanwhile, China reported Monday that output and retail sales tumbled in the past two months.
These are the main moves in markets:
The S&P 500 fell 11.98% as of 4 p.m. in New York.
The Dow Jones Industrial Average plunged 12.93%
The Stoxx Europe 600 Index lost 4.9%, paring a drop that reached 10%.
The MSCI Emerging Market Index declined 6.3%.
The MSCI Asia Pacific Index decreased 3.7%.
The Bloomberg Dollar Spot Index rose 0.2%.
The euro gained 0.5% to $1.1162.
The Japanese yen strengthened 1.8% to 105.94 per dollar.
The yield on two-year Treasuries sank 14 basis points to 0.35%.
The yield on 10-year Treasuries declined 22 basis points to 0.73%.
The yield on 30-year Treasuries declined 22 basis points to 1.31%.
Germany’s 10-year yield climbed seven basis points to -0.47%.
West Texas Intermediate crude fell 9.2% to $29.05 a barrel.
Gold weakened 4.3% to $1,463.30 an ounce.
Iron ore sank 2.5% to $86.10 per metric ton.
—With assistance from Claire Ballentine, Elena Popina and Elizabeth Stanton.
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On Monday, Italy placed its 60 million residents under lockdown, as the number of cases of the COVID-19 virus throughout the country continues to rise.
In less than a month, Italy has gone from having only three cases of the coronavirus to having the highest number of cases and deaths outside of China, with 463 deaths and at least 9, 172 of people infected throughout all 20 regions of the country. The number of cases rose by 50% on March 8 alone. Italy also faces an above average mortality rate of 4%.
“We all must give something up for the good of Italy,” Italian Prime Minister Giuseppe Conte said in a televised address on Monday while announcing the nationwide lockdown. “There is no more time.”
The nationwide lockdown is expected to have major economic repercussions on the country, where growth was already stagnating. While the government has not specified exactly how long the ban will last, it says it will remain in place until April 3.
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Here is how the virus spread across the country — and why it is so much worse in Italy than any other European country:
How did coronavirus start spreading in Italy?
Officially it began in Feb. 20, when a 38-year-old man checked himself into a local hospital in the town of Codogno in Lombardy. He tested positive with the virus, becoming the first recorded patient with the COVID-19 virus in Italy.
Yet some health officials believe that the virus arrived in Italy long before the first case was discovered. “The virus had probably been circulating for quite some time,” Flavia Riccardo, a researcher in the Department of Infectious Diseases at the Italian National Institute of Health tells TIME. “This happened right when we were having our peak of influenza and people were presenting with influenza symptoms.”
Before the first case was reported, there was an unusually high number of pneumonia cases recorded at a hospital in Codogno in northern Italy, the head of the emergency ward Stefano Paglia told the newspaper La Repubblica, suggesting it is possible patients with the virus were treated as if they had a seasonal flu. Health facilities hosting these patients could have become sites for infection, helping proliferate the spread of the virus.
The northern regions of Lombardy, Veneto and Emilia-Romagna, have been most affected by the outbreak. 85% of infected patients are in the region which is home to 92% of deaths so far. But the virus has been confirmed in all 20 regions of the country.
Why does Italy have such a high number of cases and deaths?
Because the virus spread undetected, some officials believe this is the reason for such a high number of cases in the country. “This started unnoticed which means by the time we realized it, there were a lot of transmission chains happening,” Riccardo says, noting that this may be why Italy has seen such a high number of cases.
Some officials also believe Italy, which has already tested over 42, 000 people, may have a higher number of cases as a result of performing more rigorous tests than their European counterparts.
Italy, however, is also reporting an above average mortality rate at 4%. The average age of coronavirus patients who have died because of the virus in Italy is 81, according to the National Health Institute. Italy, which has one the world’s oldest populations, could be facing a higher mortality rate as a result of its above-average elderly population. “Italy is the oldest country in the oldest continent in the world,” says Lorenzo Casani, the health director of a clinic for elderly people in Lombardy told TIME. “We have a lot of people over 65.”
Casani also suggests the mortality rate might be higher than average because Italy is testing only the critical cases. “We are not doing enough,” he said.
Casani says that pollution in northern Italy could be a factor in higher death rates. According to a report by the Swiss air monitoring platform IQAir, 24 of Europe’s 100 most polluted cities are in Italy. “Studies have shown a high correlation between mortality rates from viral respiratory conditions and pollution,” Casani says. “This could be a factor.”
Was the Italian government prepared for the outbreak?
The outbreak in Italy has come as a surprise to some, given the stringent measures Italy imposed to protect itself from the virus. A month before the first case was reported, the Italian Health Ministry created a task force to manage coronavirus. Italy was the first European Union country to ban flights to and from China.
The travel ban, however, may have encouraged travellers to come in on connecting flights without disclosing their country of departure. Some experts also believe the virus could have entered the country before the government took action, spreading undetected throughout the country.
How is the government responding now?
The Italian government has taken the biggest steps outside of China to curb the spread of the disease.
Under the new lockdown legislation, people can be issued fines for traveling within or outside the country without a permit, though foreigners still can travel to Italy. All public events are banned and schools have been cancelled throughout the country. Public spaces, such as gyms, theatres and cinemas, have also been closed by the government. Individuals who defy the lockdown could face up to three months in jail or a fine of $234. The new rules prohibit inmates from having visitors or day releases, which set off protests at 27 prisons throughout the country.
Why Overreacting to the Threat of the Coronavirus May Be Rational
The problem with COVID-19 is that it’s unclear what to do.
Many have applauded Italy’s actions. In a tweet, the Director-General of the World Health Organization commended Italy for its “bold, courageous steps” and for “making genuine sacrifices.”
The government & the people of 🇮🇹 are taking bold, courageous steps aimed at slowing the spread of the #coronavirus & protecting their country & 🌍. They are making genuine sacrifices. @WHO stands in solidarity with 🇮🇹 & is here to continue supporting you.https://t.co/Y2rkgUihtA
Some infectious disease and public health experts, however, have concerns about the effectiveness of the lockdown.
“These measures will probably have a short-term impact,” John Edmunds, a professor at the London School of Hygiene & Tropical Medicine told Reuters, noting that the measures were “almost certainly unsustainable.” He added, “if they can’t be sustained for the long term, all they are likely to do is delay the epidemic for a while.”
How is the Italian healthcare system handling it?
Italy’s current national health service, known as Servizio Sanitario Nazionale (SSN), provides free universal care to patients yet remains under-funded. Investments in public healthcare make up only 6.8% of the country’s gross domestic product (GDP), which is lower than other countries in the European Union including France and Germany.
“The continuous cuts—to care and to research—are obviously a problem right now,” Casani says. “We were not prepared. We do not have enough doctors for the people. We do not have an organized plan for pandemics.”
With the number of coronavirus cases on the rise, the Italian health ministry has doubled the number of hospital beds in infectious disease wards. The Governor of Lombardy Attilio Fontana has requested that universities grant degrees earlier this school year in order to increase the number of nurses in Italy. Yet some health officials fear these efforts will not be enough.
“Right now in Lombardy, we do not have free beds in intensive care units,” Casani says. He added that doctors “have to make this horrible choice and decide who is going to survive and who is not going to survive…who is going to get a monitor, a respirator and the attention they need.”
What impact will the lockdown have on the Italian economy?
The lockdown could push Italy into a recession. Berenberg bank, which before the outbreak estimated that Italy’s GDP would contract by 0.3%, now forecasts it will fall by 1.2% this year.
Conte said on March 9 that the government would deploy a “massive shock therapy” in order to protect the economy. Italy’s Deputy Economy Minister, Laura Castelli said in an interview with Rai Radio 1 today that “mortgages, taxes, everything is suspended” as a result of the lockdown. The government has also created a support package of $8.5 billion for families and businesses affected by virus.
Italy’s Deputy Economy Minister, Laura Castelli @LaCastelliM5s from the Five Star Movement saying decree tomorrow will suspend mortgages and taxes:
“ Mortgages suspended? Mortgages, taxes, everything is suspended.
But we need to look at the situation of the municipalities” https://t.co/fR6vwMl9T0
Some experts are concerned about the long-term implications of this spending.
Before the coronavirus outbreak, Italy was already struggling with a public debt that is at 134% of the country’s GDP. In the Europe Union, countries are not supposed to have debt that is higher than 60% of their country’s GDP. “With the increased spending that comes with having to support people and businesses, the deficit might explode,” says Pepijn Bergsen, a Europe Research Fellow at Chatham House.
An economic slowdown in Italy, a country in the Eurozone, will have impacts on the rest of the continent.
“It is likely there will be a Eurozone wide recession this year,” Bergsen says, citing both an Italian recession and potential future lockdowns in other European Union countries as contributing factors. “It will be difficult for authorities to come up with any measures that would avoid a recession.”
On Wednesday night, Trump finally took the coronavirus COVID-19 seriously. He banned all travel to EU countries for 30 days.
The disease may seem benign to some. Around 95% or more of the people who get it will survive and symptoms are generally mild and far from scary. But what is scary is how fast it spreads. And there are too many unknowns about the disease to find comfort in the fact that less than 1,000 people have it.
China went from 1,000 patients to 80,000 in a matter of roughly six weeks, mostly all of it in a self contained, quarantined state called Hubei.
Italy went from around 20 cases two and half weeks ago to over 12,000. It is now the Hubei of the Western world.
Travel bans on China helped mitigate spread from travelers coming to the U.S. from there. All early cases last month were from China travelers. They have since healed.
The U.S. was caught flat footed by Europe, cruises, and European business travelers at major conferences. The U.S. is now playing catch-up in the mitigation phase.
Trump reiterated what the World Health Organization said this week, calling the coronavirus a global pandemic.
We are probably one sick politician, or one more circuit-breaker on the Dow away from declaring a national emergency, forcing the NYSE to close.
“When people don’t want to go out to crowded events you start to wonder if fear begets more fear. We are seeing a lot of that now,” says Patrick Healey, founder and president of Caliber Financial Partners in Jersey City, N.J. “Until you see fewer cases in Europe, I’d be worried. The threat of spread is greater there than it was in China,” he says, citing France, Spain, Germany and the U.K.’s slow response to the crisis.
Cutting The Tail
Italy was about two weeks too late, but at least they are doing something to save Europe. They shut themselves off. This is literally a “stop the world I want to get off” moment. Italy took the China approach. They put themselves on lockdown.
The U.S. has two fairly solid case studies with how to respond to COVID-19. One is the China path of lockdowns and forced quarantining, coupled with massive stimulus.
The other model is South Korea’s massive free testing and treatment, which also corralled the disease and kept infection rates low. Mortality rates are even lower at just under 1%.
A hybrid model of both seems to be best: lockdown clusters of the virus. Test like crazy.
China is healing. It’s already got its stimulus plan lined up.
“The China approach has worked. It’s been a draconian clampdown and takes away quarterly growth,” says Philipp Carlsson-Szlezak, chief economist for Boston Consulting Group in New York. “The high frequency data in China, the proxies for movement for goods and people, all of those see a nice pick up. And the infection rate curve of new cases in South Korea has bent downward. Just hope we don’t see any worsening outbreaks.”
By slowing the spread of the virus, which includes potential spreaders who came from high risk countries like Italy, China, South Korea and Iran, buys healthcare officials time. It keeps hospitals from being overwhelmed, which is what is happening now in Italy as cases rise, Italy still seems to be fine with ICU bed capacity at hospitals.
A nearly three month lockdown of Hubei, the epicenter province, means Hubei now officially has fewer infections than Italy. The number of new patients in China’s “ground zero” has slowed to double digits, instead of thousands three to four weeks ago.
Eventually, South Korea may also be forced to implement a version of the lockdown model to stop the spread of infection after someone working in a call center tested positive for the disease.
Without any firm facts on transmission, the risk of spreading the disease without showing signs of it are high.
As a result, China has maintained strict control of peoples movements in major cities. The South Korea testing model is harder for China due to its massive, urban population, which is why it is so important to keep those cities fairly inoculated.
From on the ground accounts in Beijing, that inoculation requires school closures, no movies, no malls, no non-essential businesses open and most bank branches closed.
Businesses close at 6pm to get sprayed with disinfectant. Street fumigation takes place regularly. Building sterilization takes place several times a day.
Italy is doing exactly this now. Spraying public spaces, primarily.
In China, face masks must always be worn or else you can’t ride in taxis, take public transportation, or enter any business. Temperature readings are mandatory upon entering an office building. People with slight temps get sent straight to quarantine, according to sources there.
Entire neighborhoods are blocked off to non-residents, with security personnel patrolling to check for proof of residence.
Apartments housing someone with the coronavirus are forced into quarantine. No one can leave.
Beijing has under 200 cases today. Shanghai has under 30, according to Johns Hopkins University data.
“We just can’t impose a China style quarantine, but corporations can impose a work from home policy. You can cut off work travel and that is already happening,” says Brendan Ahern, CIO of KraneShares, who is working from home on Thursday. “Corporations here are acting pretty quickly.”
NBA has canceled its entire season. The NHL put the rest of its season on hold. Major League Baseball is thinking of postponing opening day. The BNP Paribas Tennis Open was canceled, scheduled for this week in Indian Wells. Coachella, the outdoor indie rock event, was postponed. Broadway has postponed shows for a month. Private colleges are sending kids home for the semester. Princess Cruises isn’t setting a course for adventure for the next 60 days.
If the U.S. is dragged reluctantly into a South Korea/China lockdown model, it would usher in a further drop in economic activity. Mega stimulus will be only thing keeping it alive.
It is unclear if Republicans and Democrats can work together on this, as some may see a destroyed economy as a way to finally get rid of Trump in 2021.
“You’ll have the market constantly repricing and mispring,” says Nancy Perez, a portfolio manager at wealth management firm Boston Private in Miami. “Both political parties will have to take this on. No party wants to be blamed for not doing something.”
To offset the drag, fiscal stimulus is necessary to make sure companies can meet payroll and rollover debts, preferably at no interest directly from the Fed.
Disaster relief legislation from Congress can draw on the unlimited checkbook of the Fed to help keep individual, corporate, and even municipal bankruptcies from soaring.
“I’m looking at dozens of companies in the S&P 500 right now that can literally go bankrupt if the government doesn’t act together on this,” CNBC star Jim Cramer said on Squawk Box this morning. “The government should not be collecting any cash right now.”
Quarantining a city like New York would represent a significant tax on all business activity. Administration talk of a payroll tax cut is not enough. Bold tax cuts and deferments would be best. For Cramer, a tax holiday for six months or longer is even better.
In the first 8 days of the month, China has:
Required banks to provide a grace period for the virus-hit small and medium sized enterprises (SME) immediately upon application in repaying the principal and interest of their outstanding loans until June 30.
Waived penalty interest
Banks are providing special loan quotas for firms in Hubei, and lowering the financing costs for SMEs.
The Politburo called for accelerating the investment on “new infrastructure”, including 5G networks and data centers
Beijing waived social security taxes for SMEs for five months retroactive to February 1.
Phases Of A Pandemic
According to the Center for Disease Control’s “Pandemic Influenza Plan,” updated in 2017, there are four distinct pandemic stages in terms of caseloads — initiation, acceleration, deceleration and preparation for the next wave.
Europe and the U.S. are now in the acceleration stage.
Hubei is in the deceleration phase, but this comes following two months of lockdown.
Self-protective quarantine, lockdowns of outbreak clusters and testing are the best precautionary approach to pandemic outbreaks, writes Nassim Nicholas Taleb, famous “black swan” forecaster and author of the book Skin in the Game.
Taleb and colleagues from New York University and the New England Complex Systems Institute wrote in a note published recently that cutting mobility in the early stages of an outbreak, especially when little is known about the pathogen, are essential.
“It will cost something to reduce mobility in the short term, but to fail do so will eventually cost everything,” they wrote.
Earlier this week, a shutdown announcement posted outside a hospital in Hubei province’s capital city of Wuhan, touted the treatment of more than 1,700 patients since February 2 without a single fatality.
“If a general return to work occurs this week and new infections do not spike, Chinese markets could quickly be on the mend,” thinks Vladimir Signorelli, head of Bretton Woods Research in Long Valley, New Jersey.
Indeed, they are doing better than the U.S. The S&P 500 is down 23.2%. The CSI-300 Index in Shanghai is down 8.3%.
Should new cases balloon out in Shanghai and Beijing, it would be a huge blow to containment efforts and worsen the global economic outlook. Investors would then calculate similar re-occurring outbreaks in Europe and then in the U.S. once they get cleared of the one they are dealing with now, possibly taking them well into the summer.
“We may have a couple quarters of negative growth and a technical recession because of demand destruction,” says Perez. “Prepare for the volatility.”
Says BCG’s Carlsson-Szlezak, “If we are still dealing with this until the summer, with China-style quarantine measures in effect in places like New York, it will have a massive impact on the economy,” he says. “How massive? We don’t know.”
I’ve spent 20 years as a reporter for the best in the business, including as a Brazil-based staffer for WSJ. Since 2011, I focus on business and investing in the big emerging markets exclusively for Forbes. My work has appeared in The Boston Globe, The Nation, Salon and USA Today. Occasional BBC guest. Former holder of the FINRA Series 7 and 66. Doesn’t follow the herd.
The Dow fell more than 12% in total last week. Peter Kraus, chairman and CEO of Aperture Investors, and Liz Young, director of market strategy at BNY Mellon Investment Management, join “Squawk Box” to discuss the week ahead in the markets as investors brace for more turbulence.
Markets in Asia and the Middle East opened sharply lower on Monday as investors digested the relentless global spread of the coronavirus and turmoil in the oil markets. Shares in Saudi Aramco, the state oil giant, dropped 10 percent leading to a halt in trading on the Riyadh stock market.
Asian markets opened sharply lower on Monday as investors digested the relentless global spread of the coronavirus and turmoil in the oil markets.Tokyo was down 4.7 percent at midmorning on Monday, while Hong Kong was down 4.1 percent. Futures markets showed investors predicting sharp drops in Wall Street and Europe as well.
The coronavirus has unnerved investors as it spreads, clouding the prospects for global growth. Italy on Sunday put a broad swath of its industrial northern region under lockdown as the virus has spread, making it one of the biggest sources of confirmed infections outside China. France, Saudi Arabia, Iran and other countries also took further steps to stop the spread.
In the United States, the number of confirmed infections exceeded 500 cases. A top American expert said on Sunday that regional lockdowns could be necessary.A clash over oil between Russia and Saudi Arabia, two major producers, further unnerved investors. As the coronavirus hits demand for fuel, Saudi Arabia slashed its export oil prices over the weekend, starting an apparent price war aimed at Russia.
Lower oil prices could help consumers, but it could unsettle countries that depend on oil revenue to prop up their economies. In futures markets, the benchmark price for American and Europe oil supplies tumbled $10, or about one-quarter.Investors fled to the safety of the bond market, driving yields lower. In the market for U.S. Treasury bonds, yields broadly fell below the 1 percent level for both short term and long term holdings. The 10-year Treasury bond, which is closely watched, was yielding about 0.5 percent.
In other Asian markets, South Korea was down 3.6 percent. Shanghai was down 1.5 percent.
Italy reported a huge jump in deaths from the coronavirus on Sunday, a surge of more than 50 percent from the day before, as it ordered an unprecedented peacetime lockdown of its wealthiest region in a sweeping effort to fight the epidemic. The extraordinary measure restricted movement for a quarter of the country’s population.“We are facing an emergency, a national emergency,” Prime Minister Giuseppe Conte said in announcing the government decree in a news conference after 2 a.m.
The move is tantamount to sacrificing the Italian economy in the short term to save it from the ravages of the virus in the long term. The measures will turn stretches of Italy’s wealthy north — including the economic and cultural capital of Milan and landmark tourist destinations such as Venice — into quarantined red zones until at least April 3.
They will prevent the free movement of roughly 16 million people. Funerals and cultural events are banned. The decree requires that people keep a distance of at least one meter from one another at sporting events, bars, churches and supermarkets. The Italian outbreak — the worst outside Asia — has inflicted serious damage on one of Europe’s most fragile economies and prompted the closing of Italy’s schools. The country’s cases nearly tripled from about 2,500 infections on Wednesday to more than 7,375 on Sunday. Deaths rose to 366.
More and more countries have adopted or are considering stronger measures to try to keep infected people from entering and to contain outbreaks. More and more countries have adopted or are considering stronger measures to try to keep infected people from entering and to contain outbreaks.
On Sunday, Saudi Arabia cut off access to Shiite Muslim towns and villages in the east of the kingdom, cordoning off an area in Qatif Governorate where all 11 of the country’s confirmed coronavirus cases have been identified. And local Saudi media reported that the country would temporarily close down all educational institutions and block travel to and from a number of countries in the region. The kingdom had already suspended pilgrimages to the Muslim holy cities of Mecca and Medina.
In Iran, which has been hit the hardest in the Middle East, state media reported that all flights to Europe would be suspended indefinitely. The health minister in France, one of Europe’s bigger trouble spots, announced a ban on gatherings of more than 1,000 people. The U.S. has counted at least 539 cases across 34 states — Connecticut reported its first case and Washington announced another patient being treated for coronavirus had died on Sunday — and the District of Columbia, and logged 22 deaths. Washington State, New York, California, Maryland and Oregon have declared emergencies.
A growing number of schools are shutting down across the country, raising concerns about the closings will affect learning, burden families and upend communities. The U.S. Army suspended travel to and from Italy and South Korea, now the world’s third largest hot spot, until May 6, an order that affects 4,500 soldiers and family members. And the Finnish armed forces announced that troop exercises planned for March 9-19 with Norway would be scrapped.
On Sunday, the leading U.S. expert on infectious diseases, Dr. Anthony S. Fauci, said that it was possible that regional lockdowns could become necessary and recommended that those at greatest risk — the elderly and those with underlying health conditions — abstain from travel. Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said the Trump administration was prepared to “take whatever action is appropriate” to contain the outbreak, including travel restrictions in areas with a high number of cases.
“I don’t think it would be as draconian as ‘nobody in and nobody out,’” Dr. Fauci said on “Fox News Sunday.” “But there’ll be, if we continue to get cases like this, particularly at the community level, there will be what we call mitigation.”
Even as the rate of new infections appeared to taper in China, the number of cases around the world continued to rise on Sunday, with some of the biggest clusters emerging in Europe. Besides the sharp rise in Italy, Germany reported more than 930 cases; Switzerland’s total reached 281; and Britain’s health department said that three people with the virus had died and that the number of cases in the country had jumped to 273 by Sunday. The smallest E.U. nation, Malta, reported its first confirmed case on Saturday: a 12-year-old girl recently returned from a vacation in northern Italy. Her condition was described as good.
The Spanish authorities announced on Sunday that three more people diagnosed with coronavirus had died in Madrid, raising the number of coronavirus fatalities in the country to 13. There are now over 500 cases, the authorities said. Salvador Illa, Spain’s health minister, said at a news conference in Madrid that several cases in Spain were linked to people who recently traveled to Italy.
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The rapid spread of the coronavirus and the illness it causes called COVID-19 has sparked alarm worldwide. The World Health Organization (WHO) has declared a global health emergency, and many countries are grappling with a rise in confirmed cases. In the US, the Centers for Disease Control and Prevention (CDC) is advising people to be prepared for disruptions to daily life that will be necessary if the coronavirus spreads within communities.
Below, we’re responding to a number of questions about COVID-19 raised by Harvard Health Blog readers. We hope to add further questions and update answers as reliable information becomes available.
Yes, the virus can spread from one person to another, most likely through droplets of saliva or mucus carried in the air for up to six feet or so when an infected person coughs or sneezes. Viral particles may be breathed in, land on surfaces that people touch, or be transferred when shaking hands or sharing a drink with someone who has the virus.
Often it’s obvious if a person is ill, but there are cases where people who do not feel sick have the virus and can spread it.
Quarantines and travel restrictions now in place in many counties, including the US, are also intended to help break the chain of transmission. Public health authorities like the CDC may recommend other approaches for people who may have been exposed to the virus, including isolation at home and symptom monitoring for a period of time (usually 14 days), depending on level of risk for exposure. The CDC has guidelines for people who have the virus to help with recovery and prevent others from getting sick.
What is the incubation period for the coronavirus?
An incubation period is the time between being exposed to a germ and having symptoms of the illness. Current estimates suggest that symptoms of COVID-19 usually appear around five days on average, but the incubation period may be as short as two days to as long as 14 days.
What are the symptoms of the new coronavirus?
Fever, dry cough, and trouble breathing are the common symptoms of COVID-19. There have been some reports of gastrointestinal symptoms (nausea, vomiting, or diarrhea) before respiratory symptoms occur, but this is largely a respiratory virus.
Those who have the virus may have no obvious symptoms (be asymptomatic) or symptoms ranging from mild to severe. In some cases, the virus can cause pneumonia and potentially be life-threatening.
Most people who get sick will recover from COVID-19. Recovery time varies and, for people who are not severely ill, may be similar to the aftermath of a flulike illness. People with mild symptoms may recover within a few days. People who have pneumonia may take longer to recover (days to weeks). In cases of severe, life-threatening illness, it may take months for a person to recover, or the person may die.
Can people who are asymptomatic spread coronavirus?
A person who is asymptomatic may be shedding the virus and could make others ill. How often asymptomatic transmission is occurring is unclear.
Can the coronavirus live on soft surfaces like fabric or carpet? What about hard surfaces?
How long the new coronavirus can live on a soft surface — and more importantly, how easy or hard it is to spread this way — isn’t clear yet. So far, available evidence suggests it can be transmitted less easily from soft surfaces than frequently-touched hard surfaces, such as a doorknob or elevator button.
According to the WHO, coronaviruses may survive on surfaces for just a few hours or several days, although many factors will influence this, including surface material and weather.
That’s why personal preventive steps like frequently washing hands with soap and water or an alcohol-based hand sanitizer, and wiping down often-touched surfaces with disinfectants or a household cleaning spray, are a good idea.
Should I wear a face mask to protect against coronavirus? Should my children?
Follow public health recommendations where you live. Currently, face masks are not recommended for the general public in the US. The risk of catching the virus in the US is low overall, but will depend on community transmission, which is higher in some regions than in others. Even though there are confirmed cases of COVID-19 in the US, most people are more likely to catch and spread influenza (the flu). (So far this season, there have been nearly 30 million cases of flu and 17,000 deaths.)
Some health facilities require people to wear a mask under certain circumstances, such as if they have traveled from areas where coronavirus is spreading, or have been in contact with people who did or with people who have confirmed coronavirus.
If you have respiratory symptoms like coughing or sneezing, experts recommend wearing a mask to protect others. This may help contain droplets containing any type of virus, including the flu, and protect close contacts (anyone within three to six feet of the infected person).
Should someone who is immunocompromised wear a mask?
If you are immunocompromised because of an illness or treatment, talk to your doctor about whether wearing a mask is helpful for you in some situations. Advice could vary depending on your medical history and where you live. Many people will not need to wear a mask, but if your healthcare provider recommends wearing one in public areas because you have a particularly vulnerable immune system or for other reasons, follow that advice.
Should I accept packages from China?
There is no reason to suspect that packages from China harbor COVID-19. Remember, this is a respiratory virus similar to the flu. We don’t stop receiving packages from China during their flu season. We should follow that same logic for this novel pathogen.
Can I catch the coronavirus by eating food prepared by others?
We are still learning about transmission of COVID-19. It’s not clear if this is possible, but if so it would be more likely to be the exception than the rule. That said, COVID-19 and other coronaviruses have been detected in the stool of certain patients, so we currently cannot rule out the possibility of occasional transmission from infected food handlers. The virus would likely be killed by cooking the food.
Should I travel on a plane with my children?
Keep abreast of travel advisories from regulatory agencies and understand that this is a rapidly changing situation. The CDC has several levels of travel restrictions depending on risk in various countries and communities.
Of course, if anyone has a fever and respiratory symptoms, that person should not fly if at all possible. Anyone who has a fever and respiratory symptoms and flies anyway should wear a mask on an airplane.
Is there a vaccine available for coronavirus?
No vaccine is available, although scientists are working on vaccines. In 2003, scientists tried to develop a vaccine to prevent SARS but the epidemic ended before the vaccine could enter clinical trials.
Is there a treatment available for coronavirus?
Currently there is no specific antiviral treatment for this new coronavirus. Treatment is therefore supportive, which means giving fluids, medicine to reduce fever, and, in severe cases, supplemental oxygen. People who become critically ill from COVID-19 may need a respirator to help them breathe. Bacterial infection can complicate this viral infection. Patients may require antibiotics in cases of bacterial pneumonia as well as COVID-19.
Antiviral treatments used for HIV and other compounds are being investigated.
There’s no evidence that supplements, such as vitamin C, or probiotics will help speed recovery.
How is this new coronavirus confirmed?
A specialized test must be done to confirm that a person has COVID-19. Most testing in the United States has been performed at the CDC. However, testing will become more available throughout the country in the coming weeks.
How deadly is this coronavirus?
We don’t yet know. However, signs suggest that many people may have had mild cases of the virus and recovered without special treatment.
The original information from China likely overestimated the risk of death from the virus. Right now it appears that the risk of very serious illness and death is less than it was for SARS and MERS. In terms of total deaths in the United States, influenza overwhelmingly causes more deaths today than COVID-19.
What should people do if they think they have coronavirus or their child does? Go to an urgent care clinic? Go to the ER?
If you have a health care provider or pediatrician, call them first for advice. In most parts of the US, it’s far more likely to be the flu or another viral illness.
If you do not have a doctor and you are concerned that you or your child may have coronavirus, contact your local board of health. They can direct you to the best place for evaluation and treatment in your area.
Only people with symptoms of severe respiratory illness should seek medical care in the ER. Severe symptoms are rapid heart rate, low blood pressure, high or very low temperatures, confusion, trouble breathing, severe dehydration. Call ahead to tell the ER that you are coming so they can be prepared for your arrival.
Can people who recover from the coronavirus still be carriers and therefore spread it?
People who get COVID-19 need to work with providers and public health authorities to determine when they are no longer contagious.
What Is Coronavirus (COVID-19)? The World Health Organization declared the new #Coronavirus disease (COVID-19) outbreak a global health emergency in January 2020. Experts at Johns Hopkins Medicine are closely monitoring the spread of the virus and offering useful information on what the disease is and how to help prevent transmission. For more information, please visit the #JohnsHopkins Medicine coronavirus website. https://www.hopkinsmedicine.org/coron…
Eleven people have now died in the United States after contracting the novel coronavirus. Ten of the U.S. deaths have been in Washington state and one has been in California, with the latest two fatalities confirmed on Wednesday.
At least 159 people have been diagnosed with the coronavirus—known as COVID-19—in the U.S. so far, according to a virus tracker from researchers at Johns Hopkins University. The infections are scattered across at least 16 U.S. states.
Pence said that all travel coming from Iran has been suspended and “even foreign nationals who visit either [China or Iran] are barred from coming into this country for 14 days.”
Pence also said that the Center for Medicaid and Medicare Services has issued new guidelines for nursing homes nationwide aiming to improve infectious disease control and ensure those operating these facilities are complying with federal standards. Many of the cases in Washington State have been linked with a nursing home.
At a press conference on Tuesday, Pence had said the U.S. is now “screening 100% of all travelers taking direct flights from all airports in Italy and South Korea” to the U.S and that Medicaid and Medicare would cover the cost for Americans who can’t afford COVID-19 testing. He added that new guidance would quickly be issued “to make it clear that, subject to a doctor’s orders, anyone can be tested.”
Federal officials noted that the American public should prepare for “more cases in the community” as the country improves its ability to track and diagnose the disease.
Outside Washington and New York, at least 14 other states have recorded confirmed COVID-19 cases. A number of these cases are Americans evacuated from the virus-stricken Diamond Princess cruise ship in Japan, where over 620 passengers and crew were diagnosed with the virus.
Globally, more than 94,000 cases of COVID-19 have been diagnosed or clinically confirmed as of March 4 and more than 3,200 people have died, according to Johns Hopkins University researchers. The vast majority of cases are in China, but diagnoses in the U.S. are expected to increase over the coming days and weeks, according to the CDC.
U.S. Citizens Document A Day In The Life On Lockdown In Wuhan
On early Wednesday morning, a U.S. plane evacuated around 240 Americans from Wuhan. Justin Steece and Priscilla Dickey were not on that plane with their families.
Here’s what to know about COVID-19 cases in the U.S.
California announced the state’s first COVID-19 death and State Gov. Gavin Newsom declared a state of emergency on Wednesday.
Local and federal health officials are now working to contact other cruise passengers as they “may also have been exposed,” according to Placer County health officials. Newsom said about 2,500 passengers traveled on the same voyage as the Placer Country victim.
As of Wednesday, 53 people had tested positive for COVID-19 in California. Of these, 24 were cases related to repatriation flights and 29 cases were not related to these flights; 12 were travel-related. 10 more involved person-to-person spread, four involved community transmission and three were “currently under investigation.”
Officials in Washington State confirmed a tenth coronavirus death on Wednesday and the state currently has 39 COVID-19 cases.
Nine of the deaths are in King County, and an additional death is in Snohomish County. The most recently reported deaths in King County include a woman in her eighties who was never hospitalized and died at her family home, and a man in his 50s who was hospitalized at Harborview Medical Center. Both of them died on Feb. 26 and were residents of Life Care Center in Kirkland, a long-term residential facility where more than 50 people have reported symptoms of possible COVID-19 infection.
On Tuesday, Acting U.S. Department of Homeland Security Secretary Chad Wolf said that he had ordered the facility to close “out of an abundance of caution” and “directed those employees to telework, if possible, in order to reduce the threat of community spread of the coronavirus.”
The center said in a statement Wednesday that there are several confirmed COVID-19 cases connected to the facility. It added that current residents and associates continue to be monitored closely” and that it is following the infection control recommendations from the CDC. The center had previously said all visits from family and volunteers are suspended for the time being, and new residents are currently not being admitted to the center.
King County announced an additional seven new COVID-19 cases on Tuesday. Thirty-one cases in the state, including those who died, are in King County. At least another nine are in Snohomish County, according to Washington State’s Department of Health. About 230 people at risk of having been exposed to the coronavirus are under medical supervision.
King County signed an emergency declaration on Sunday allowing it to take extra steps to respond to the COVID-19 outbreak. “Among the first actions: purchasing a motel and setting up modular housing units on publicly-owned parking lots and other available land,” the county said in a statement.
Health officials say the first patient who succumbed to the virus had no known history, travel or contact with a known COVID-19 case, suggesting he was infected by human-to-human transmission (often referred to as community transmission).
The results of a study published by Trevor Bedford, a computational biologist at Fred Hutchinson Cancer Research Center in Seattle, suggests that the true number of infections in the state is “a few hundred.”
The study “strongly suggests that there has been cryptic transmission in Washington State for the past six weeks,” Bedford tweeted.
Washington Governor Jay Inslee declared a state of emergency on Saturday in response to the new cases, and directed state agencies to use “all resources necessary to prepare for and respond to the outbreak.”
The first case of COVID-19 in the U.S. appeared in Washington on Jan. 21. A 35-year-old man presented himself to an urgent care clinic in Snohomish County, Wash., after four days of cough and fever, according to the New England Journal of Medicine, which reported that he had recently been visiting family in Wuhan.
The man was released from a Washington hospital on Feb. 4, according to the Associated Press.
Cruise ship evacuees
On Feb. 17, the U.S. State Department evacuated more than 300 American citizens from a quarantined cruise ship in Japan. The Diamond Princess has the largest outbreak of the novel coronavirus outside China, with at least 621 confirmed cases so far.
During the evacuation process, American officials learned that 14 of the Americans being repatriated were infected with COVID-19, according to a joint statement from the U.S. State Department and U.S. Department of Health and Human Services.
After consulting with HHS, officials with the State Department decided to allow the 14 individuals, “who were in isolation, separated from other passengers, and continued to be asymptomatic, to remain on the aircraft to complete the evacuation process,” the statement said.
CDC spokesperson Richard Quartarone told TIME hospitalized patients are at facilities in Sacramento and San Antonio, Texas, or at the Nebraska Medical Center.
Evacuees who were not hospitalized were held in quarantine for 14 days after departing planes at Travis Air Force Base in Sacramento, Calif. and Joint Base San Antonio-Fort Sam Houston in San Antonio, Texas, officials said.
Most, if not all, of these evacuees have since been released from federal quarantine.
More than 100 American citizens who had been on the Diamond Princess remained in Japan, including in hospitals, the CDC said on Feb. 18. The CDC specified that these citizens will only be allowed to fly back to the U.S. if they test negative for and don’t show any symptoms of the virus during the 14-day period.
“If an individual from this cruise arrives in the United States before the 14-day period ends, they will still be subject to a mandatory quarantine until they have completed the 14-day period with no symptoms or positive coronavirus test results,” the CDC said.
The CDC also highlighted concerns with the quarantine process on board the ship, saying that it may have slowed the spread of the disease but that it “may not have been sufficient to prevent transmission among individuals on the ship.”
On Thursday, New York Gov. Andrew M. Cuomo confirmed 11 additional cases of COVID-19, bringing the total in the state to 22. Of the new cases, eight are in Westchester, two are in New York City and one is in Nassau County. “We are trying to contain as much as possible the spread of each case we find – but we expect more cases,” Cuomo said.
Thursday’s cases in New York City include a man in his 40s and a woman in her 80s; neither had traveled to areas with known outbreaks or are connected to other individuals already diagnosed with the disease, according to New York City Mayor Bill de Blasio.
On Wednesday afternoon, Cuomo confirmed five new cases, all in a single family from New Rochelle: a wife and husband in their 40s and three of their children. The entire family is under self-quarantine, Cuomo said.
On Wednesday morning, Cuomo had confirmed an additional four cases of coronavirus. All four are tied to the state’s second case of COVID-19, announced Tuesday — a man in his 50s who lives in Westchester County and works in Manhattan. Those four cases included his wife, two of his children and a neighbor who drove him to the hospital, Cuomo said.
The female child attends SAR Academy and High School in the Bronx and the male child attends Yeshiva University in Manhattan and has not been on campus since Feb. 27, according de Blasio. The children and their mother remain isolated at their home in Westchester, de Blasio said.
Cuomo noted on Tuesday that the man in his fifties had not traveled to regions with increasing COVID-19 cases, but had recently been to Miami. However he noted “that is not a place we have known there is any cluster of coronavirus.”
On Sunday, Cuomo confirmed New York’s first case of the coronavirus. He said on Twitter that a woman in her late 30s contracted the virus while traveling in Iran. She has mild respiratory symptoms but is not in serious condition, and is currently isolated in her home.
Cuomo said there is “no reason for anxiety” as the “general risk remains low in New York.” Still, residents rushed to purchase masks and hand sanitizers at pharmacies, which saw long lines out the door, according to the New York Times. Many said they were out of stock.
Doctors in Nebraska have treated 13 COVID-19 patients — all of whom were on the Diamond Princess cruise ship in Japan, according to the New York Times.
Eleven involve evacuees who were infected overseas before arriving at the San Antonio Lackland Air Force Base for quarantine. The only case identified outside of the site is a man in his 70s who lives in the Houston area. He recently returned from travel abroad and is currently isolated in the hospital, according to Texas Health and Human Services.
The City of San Antonio Metropolitan Health District and the CDC announced Feb. 13 that the first person testing positive for COVID-19 in Texas was one of the Americans evacuated from Wuhan and transported to the military base on Feb. 7, after leaving Wuhan the previous day.
On the morning of Feb. 11, the patient exhibited signs of a fever, Jennifer McQuiston, a CDC division deputy director, said. The person was transported to a hospital that morning, where samples were gathered and sent to the CDC overnight. Officials received the positive diagnosis the following day.
“[That patient is] receiving excellent medical care,” McQuiston said at a Feb. 13 press conference. “They were, of course, not happy to learn of their diagnosis last night, and they do have loved ones in the United States that they are in contact with by phone, and we wish this individual well.”
Dr. Anita Kurian, assistant director at the San Antonio Metropolitan Health District, also said at the press conference that “the risk for us at this time to the community here is still considered low.”
Illinois officials said it has four “presumed positive” cases on Tuesday. The third and fourth cases are a married man and woman in their seventies.
The first case in Illinois was a woman in her 60s who had returned to the U.S. from Wuhan on Jan. 13, health officials said at a press briefing on Jan. 30. Her husband then contracted the virus, becoming the first confirmed case of person-to-person transfer of the virus in the U.S.
The Illinois Department of Public Health announced Feb. 12 that it became the first state in the U.S. to begin in-state testing for the virus.
Oregon has confirmed three “presumptive positive” cases of COVID-19 in the state. One of those cases was confirmed by the CDC on Wednesday.
State officials confirmed a third case on Tuesday: an adult Umatilla County resident who is hospitalized in Walla Walla, Wash. Initial reports suggest that the resident recently went to a youth basketball game at a middle school. Athena-Weston School District officials closed the gym in question and would “conduct a deep cleaning out of an abundance of caution,” health officials said in a statement.
The state’s first and second COVID-19 cases are adults in Washington County who live together. Neither person has “ a history of travel to a country where the virus was circulating, nor is believed to have had a close contact with another confirmed case,” health officials said in a statement. “As such, public health officials are considering it a likely community-transmitted case, meaning that the origin of the infection is unknown.”
The CDC confirmed two cases of COVID-19 in Florida, the Florida Department of Health said on Monday. Officials said on Tuesday that a third person in the state had tested positive; she is the sister of a person already confirmed to have the virus.
The agency had said in a previous statement on Sunday that the first patient is an adult resident of Manatee County who has not traveled to countries identified for restricted travel by the CDC; the second patient is an adult Hillsborough County resident who had traveled to Italy. Both individuals would continue to “remain isolated until cleared by public health officials,” the Florida Department of Health said.
Georgia Gov. Brian Kemp confirmed the state’s first two cases of COVID-19 on Monday evening.
Both individuals are residents of Fulton County who live in the same household; one recently returned from Italy and both are isolated at home with mild symptoms, according to a statement from the governor’s office.
“We knew that Georgia would likely have confirmed cases of COVID-19, and we planned for it. The immediate risk of COVID-19 to the general public, however, remains low at this time,” said Dr. Kathleen E. Toomey, Commissioner of the Georgia Department of Public Health.
Rhode Island announced its first COVID-19 “presumptive positive” case on Sunday: a person in their 40s who had traveled to Italy in mid-February.
Dr. Nicole Alexander-Scott, Director of the Rhode Island Department of Health, said in a statement that the agency has been “preparing for weeks” and “fully anticipated having a first case of COVID-19.”
“We are not seeing widespread community transmission in Rhode Island, and the general level of risk for Rhode Islanders is still low,” Alexander-Scott said.
The agency announced a second COVID-19 “presumptive positive case” later the same day: a teenager who is “at home with mild symptoms.” She had been on the “same trip to Europe in mid-February as the male in his 40s,” according to the Rhode Island Department of Health.
“All 38 of the people who went on this trip will be self-monitoring for symptoms at home for 14 days with public health supervision, the department said in a statement. “They have been instructed to not go to school or work and to remain at home for these 14 days.”
Arizona confirmed on Tuesday its second “presumed positive” case of COVID-19, in a man in his twenties.
“This individual is a known contact of a presumed positive case outside of Arizona who had traveled to an area with community spread of COVID-19,” the Arizona Department of Health Services news release.
The first case of COVID-19 was confirmed in Arizona by the CDC on Jan. 26. The person had also recently returned to the U.S. after visiting Wuhan. The Arizona Department of Health Services said in a public statement that the person is “a member of the Arizona State University community who does not live in university housing,” and added that they were not severely ill but would be kept in isolation.
The infected man was subsequently released from isolation 26 days after testing positive for COVID-19, according to the Associated Press.
The state’s first case was announced Monday in a hospital employee who had recently traveled to Italy. Health officials later learned this person broke quarantine to attend a social event on Feb. 28 and said they would contact attendees who “had close contact with the person.”
New Hampshire announced its second “presumed positive” case of COVID-19 on Tuesday. State officials said the person, an adult male from Grafton County, had close contact with the first case and is currently isolated at home.
At this time, there is no evidence of more widespread community transmission in New Hampshire,” said state Epidemiologist Dr. Benjamin Chan in a statement after the first case was announced.
On Wednesday, New Jersey announced its first “presumptive positive case” of COVID-19 — a man in his 30s who has been hospitalized in Bergen County.
Health officials maintained that “most New Jersey residents” are still at low-risk.
On Monday, state health officials announced a presumptive case: a woman who had recently traveled to Italy.
On Feb. 1, the CDC announced that a man in his 20s who lives in Boston was diagnosed with COVID-19; he had recently traveled to Wuhan.
The Massachusetts Department of Public Health said the man sought medical care soon after his return to Boston. He has since been in isolation, and those who came in contact with him have been identified and are being monitored for symptoms, the agency said in a public statement.
“We are grateful that this young man is recovering and sought medical attention immediately,” said Monica Bharel, Massachusetts Public Health Commissioner, in the statement. “Massachusetts has been preparing for a possible case of this new coronavirus, and we were fortunate that astute clinicians took appropriate action quickly. Again, the risk to the public from the 2019 novel coronavirus remains low in Massachusetts.”
The Wisconsin Department of Health Services and the CDC announced the first case of COVID-19 in the state on Feb. 5. The person was only identified as “an adult with a history of travel to Beijing, China prior to becoming ill and was exposed to known cases while in China.”
Wisconsin health officials said in a public statement that the person is isolated at home, and is doing well.
North Carolina announced its first “presumed positive” case of COVID-19 on Tuesday. According to state officials, the person traveled to Washington state and was exposed at a long-term care facility where there is currently a COVID-19 outbreak.
Topline: California Governor Gavin Newsom declared a state of emergency on Wednesday after the state reported its first coronavirus death, making it the third state to declare an emergency in response to the disease.
The first patient who died was an elderly adult with underlying health conditions in Placer County, which is north of Sacramento.
The patient was a former passenger on the Grand Princess cruise, which departed from San Francisco to Mexico last month, raising concerns that others aboard may have been exposed, Newsom said. (The cruise company, Princess Cruises, also operated the Diamond Princess ship that was quarantined in Japan last month.)
State health officials are working to contact people who were on the ship, and the vessel is currently being prevented from docking back in San Francisco while the CDC tests symptomatic passengers on board.
Washington state, which has seen the most cases, and Florida have already declared states of emergencies.
Practically, an emergency declaration loosens up regulations to allow state agencies to procure medical supplies and resources faster.
There are 53 positive cases in the state, 24 of which involve patients who have been repatriated from abroad.
Crucial quote: “This proclamation, I want to point out, is not about money. It’s about resourcefulness. It’s about our ability to add tools to the tool kit,” Newsom said in a press conference.
News peg: Eleven people have died and more than 100 people have been infected by the coronavirus in the U.S. as officials brace for an outbreak. Public health experts say the U.S. should expect to see more cases in the coming weeks as the CDC begins to test more people after some early stumbles limiting its testing capacity.
I’m a San Francisco-based reporter covering breaking news at Forbes. Previously, I’ve reported for USA Today, Business Insider, The San Francisco Business Times and San Jose Inside. I studied journalism at Syracuse University’s S.I. Newhouse School of Public Communications and was an editor at The Daily Orange, the university’s independent student newspaper. Follow me on Twitter @rachsandl or shoot me an email firstname.lastname@example.org.
A group of scientists in Germany have identified a drug called camostat mesylate, that they believe may work to combat COVID-19, the disease caused by the SARS-CoV-2 coronavirus.
The new study published last week in Cell, shows that SARS-CoV-2 binds to human cells in a similar way to the original SARS coronavirus (SARS-CoV) that caused a worldwide outbreak in 2003, with this binding depending on viral proteins called ‘spike’ proteins.
“Spike is so named because that’s what it looks like: a spike on the surface of the virus particle,” said Angela L. Rasmussen, PhD, a virologist in the faculty of the Center for Infection and Immunity at the Columbia Mailman School of Public Health. “In order for a virus to infect a cell, it has to attach itself to a protein on the surface of that cell which we call the receptor. For SARS-CoV-2, this is a protein called ACE2. Spike binds ACE2 and allows SARS-CoV-2 to enter and infect cells,” she added.
As well as this initial process, the spike protein has to be primed by an enzyme called a protease in order for the virus to complete entry into the cell. The study showed that similar to SARS-CoV, SARS-CoV-2 uses a protease called TMPRSS2 to complete this process.
The scientists then looked at whether there were any compounds available that could stop the entry of coronavirus into the cell by stopping the TMPRSS2 protease from working. From previous work on SARS-CoV, they found one potential candidate called camostat mesylate and showed that the drug stopped SARS-CoV-2 from infecting lung cells in a dish.
“We found that SARS-CoV-2, like SARS-CoV, uses the host proteins ACE2 and TMPRSS2 to enter cells. Both viruses should therefore infect similar cells in patients and may cause disease via similar mechanisms,” said Markus Hoffmann, PhD, researcher in the Infection Biology Unit of the German Primate Center, Leibniz Institute for Primate Research, Göttingen, Germany and first author of the paper.
Developing new drugs for infectious diseases or even diseases such as cancer or neurological conditions can take years, even decades. But camostat mesylate has already been tested in people, albeit not for the treatment of COVID-19.
“We knew from our previous work that camostat mesylate was active against other coronaviruses, including SARS-CoV. Therefore, we tested whether it is also active against SARS-CoV-2,” said Stefan Pöhlmann, PhD, Professor in the same institute in Göttingen. “Our study shows that camostat mesylate blocks infection of cells with SARS-CoV-2-like particles and with authentic, patient-derived SARS-CoV-2. Moreover, camostat mesylate inhibited infection of important target cells – human lung epithelial cells,” he added.
The compound is approved in Japan for the treatment of a number of non-infectious conditions in people, such as chronic pancreatitis and postoperative reflux esophagitis and has also had some tests in mice infected with SARS-CoV. However, it has never been tested in humans with COVID-19.
“It does require trials in humans to determine if it’s effective, and I suspect it would also require pre-clinical animal work with SARS-CoV-2 specifically before human trials could start. If it has been shown to be safe for clinical use in other countries, it may be fast-tracked for FDA approval or the FDA may authorize emergency off-label use,” said Rasmussen, indicating that the FDA will have to examine safety data and pre-clinical data before determining which, if any course of action to take with investigating the drug further.
One concern is that TMPRSS2 might not be the only protease that controls spike priming and hence blocking it may be ineffective in people as other proteases may act as backups, still allowing the virus entry into cells. There are also questions to be asked about how the drug would actually alter the ability of the virus to cause disease in people.
“Pathogenesis can’t be studied in cultured cells, so these questions will need to be addressed using animal models and human clinical samples,” said Rasmussen.
Given the similarities between SARS-CoV and the current virus SARS-CoV-2, the researchers also looked at whether people who recovered from SARS had any immunity to the new virus strain. They took serum containing antibodies taken from 3 recovering SARS-CoV patients back around the time of the original outbreak in 2003 and showed that this blocked entry of SARS-CoV-2 into cells. The serum was taken from patients b
“Antibodies from patients who had recovered from SARS blocked the SARS-CoV-2 from infecting cells in culture. This suggests that antibodies against SARS might be useful as a treatment for SARS-CoV-2,” said Rasmussen.
SARS in 2003 was a smaller outbreak compared to the current situation with only 8,098 cases formally recorded and over 7,000 people surviving. It is not known how many of these people are still alive today, but it is possible that they will have some immunity to COVID-19. On a wider scale, studying these people may provide incredibly useful clues about successfully treating COVID-19. So, what are the next steps for the researchers?
“We are currently analyzing whether camostat mesylate-related inhibitors show improved antiviral activity. So far we have not been contacted by others regarding off-label use of camostat mesylate. However, we are contacting physicians to discuss this option,” said Pöhlmann.
I am a postdoctoral research scientist focusing on childhood cancers and new, targeted cancer therapies. As a survivor of childhood leukemia myself, I am a determined advocate for research into better, less-toxic cancer treatments and how to reduce the long-term side effects of current drugs. I am an award-winning science communicator and have written for The Times, The Guardian and various cancer-focused outlets. I am also a 2017 TED Fellow, having done my TED talk this year on cancer survivorship and I regularly do public talks on topics ranging from ‘Why haven’t we cured cancer yet?’ to ‘Cannabis and cancer; hype or hope?’. I am passionate about using social media to communicate science and frequently share pictures and stories from my own laboratory work in real-time on my Twitter account @vickyyyf, alongside commentary about important research breakthroughs. You can find out more about me and how to get in contact via my website drvickyforster.com. All of my articles reflect my personal views and not those of my employer.