Facing New Projections, Officials Scramble to Slow Covid-19

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On Saturday night, with New York City Mayor Bill De Blasio’s encouragement, bars and restaurants stayed open in the city. On Sunday morning, De Blasio told a local radio show that he was resistant to shutting down the city’s school system in the face of the SARS-CoV-2 viral pandemic that has sickened thousands in New York City.

But by Sunday evening, New York City schools had been closed, and just two days later, De Blasio was calling for a near-total shutdown of the city and considering a drastic official order for residents to “shelter in place,” a measure adopted earlier this week by seven counties in the San Francisco Bay area.

De Blasio was not alone in experiencing whiplash, as increasingly dire reports from the outbreak in Italy, and new projections about the potential effects of its spread in the U.S., spurred policymakers to action. The most influential projection came from a team at Imperial College London. Released to the public earlier this week, the report predicts that, absent substantial measures to limit public life, Covid-19, the disease caused by the virus, could kill as many as 2.2 million people in the U.S.

Even with some measures to address the outbreak — isolating the sick, quarantining households exposed to the virus, and keeping elderly people away from everyone else — the ICL paper projects that, at the peak of the outbreak in the U.S. and U.K., “the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold.” As many as 1.2 million people in the U.S. would die.

Projections can be wrong, of course, and scientists still lack essential data about the lethality and spread of the coronavirus. But scenarios like the ones outlined in the ICL paper, along with other projections that circulated this week, have led to a dramatic change in daily life in the U.S. Businesses are shuttering and mass layoffs have begun. In California this morning, 40 million people awoke to dramatic restrictions on their movement — the first statewide lockdown of its kind in living memory.

Adjusting to this new order, though, will take time. Undeterred by the threat of transmitting the virus, students still flocked to beaches in Texas and Florida this week.

Social distancing has been challenging, also, for some of the very policymakers enacting the rules. Indeed, the morning after De Blasio announced that New York City schools would shut down, as state leaders pushed for more extensive distancing and the city braced for a possible surge in cases, the mayor was spotted in Brooklyn, going to the gym.

In this week’s Abstracts, we offer a roundup of other coronavirus themes that have defined the news this week, and that are likely to stay relevant in the days ahead.

• With an effective vaccine likely at least 12 months away, researchers are scrambling to find therapies for the coronavirus.

A small, preliminary trial in France, the results of which were published this week, suggested that hydroxychloroquine, a drug commonly used to treat malaria, as well as conditions including lupus and rheumatoid arthritis, might be effective at reducing the viral load in SARS-CoV-2 infected patients. The finding prompted the U.S. Food and Drug Administration to begin investigating the drug for use to treat the coronavirus. Such treatments are still preliminary, and researchers are exploring many other options. Regeneron, a large biotechnology company, is aiming to have doses of a plausible drug for Covid-19 ready for human clinical trials by early this summer, the company announced on Tuesday. Their approach uses genetically engineered mice that produce human antibodies when exposed to infection. Some of those antibodies, the company hopes, could be used to prevent and treat the virus. Researchers are exploring other possible therapies — some novel, like drugs that latch onto human proteins the virus needs for replication, and others more familiar, like the existing antiviral drug remdesivir, which, according to some doctors in China and California, may be effective against the coronavirus

• Researchers continue to learn more about the biology and pathology of the coronavirus.

In the few months since SARS-CoV-2 began its sweep around the world, scientists have been racing to better understand the infection. By February, researchers had clearly established that this particular pathogen was a coronavirus strain originating in wild bats; by early March, they’d discovered the somewhat encouraging news that it mutates only one or two times a month, a far slower rate than demonstrated in influenza viruses. Other researchers have begun to unravel the mechanism by which the virus infects human cells. A primary focus there has been proteins on the surface of the viral wall. Known as “spike” proteins, these bind the virus to human cell membranes by activating specific enzymes. Unlike some other, less dangerous coronaviruses, SARS-CoV-2 activates enzymes found in a range of organs, from lungs to liver, which suggests it has the potential to attack the body in multiple ways. The ability to mount a multi-pronged attack is one reason why scientists now worry that Covid-19 is more dangerous to younger victims than first thought. Spike proteins have also been studied in terms of the virus’s ability to move from person to person, but for now, such research is more focused on how long viral droplets from a cough can remain airborne (possibly up to three hours) and how long the virus stays active after landing on a surface material such as metal or plastic. There, the answer appears to be up to 72 hours, depending on the substance, reinforcing the importance of such cautionary advice as frequent handwashing, use of sanitizers, and avoiding touching one’s face.

• Some countries are deploying unprecedented surveillance to identify and track infected people.

As governments around the world escalate efforts to identify, track, and isolate infected citizens, some are scaling up surveillance infrastructure or tapping into existing data networks in new ways. In Israel, the government has authorized the country’s internal security agency, Shin Bet, to tap into a previously undisclosed repository of cellphone metadata to retrace the movements of those confirmed to have the virus and identify others with whom they may have crossed paths. Russian authorities plan to expand the country’s network of surveillance cameras and are using facial recognition technology to flag people ignoring home-quarantine orders. In Taiwan, officials tapped health and travel data for confirmed cases to trace the virus’ spread, and also used smartphone data to enforce quarantines. All new arrivals to Hong Kong must now wear a tracking bracelet, which, paired with a smartphone app, alerts authorities if they break their quarantine — though many haven’t yet had their bracelets activated. In both Singapore and South Korea, officials are publicizing granular data about confirmed cases, and civilian programmers have built dashboards to visualize the information. U.S. government officials are now in talks with technology companies to discuss uses of smartphone data in containment efforts. But privacy advocates are pushing back, igniting debates on the limits of state power in a public health crisis, with some critics voicing fears that increased surveillance will persist long after the pandemic has ended.

• The President has begun referring to SARS-CoV-19 as “the Chinese virus.”

President Donald J. Trump insisted on branding SARS-CoV-2 as the “Chinese virus” this week, ignoring criticism that the label is racist and inaccurately characterizes the virus’ indiscriminate spread around the globe. At a press conference on Thursday, Trump went so far as to suggest that he fancied himself a wartime president, with Covid-19 as America’s enemy. A photo circulating online showed the president’s notes with the word “corona” crossed out and replaced with “Chinese.” When questioned, Trump defended his use of the label, which comes at a time when Asian Americans have steadily reported instances of xenophobia and violence. “It’s not racist at all. It comes from China,” he told reporters on Wednesday. That same day, Mike Ryan, executive director of the World Health Organization’s Emergencies Program, made clear that the president’s blame is ill-informed. “Viruses know no borders and they don’t care about your ethnicity,” Ryan said, noting that while the 2009 influenza pandemic began in North America, “we don’t call it the North American flu.” It’s time, Ryan added, to come together in solidarity. “There is no blame in this.”

• There is still a shortage of tests.

More than two weeks after the Trump administration announced that it was just days away from being able to test 1.5 million samples for the novel coronavirus, only around 111,600 Americans have been tested for the virus, according to recent data from the Covid Tracking Project. The number pales in comparison to other countries battling the outbreak; Italy and South Korea, for instance, have each conducted more than 20 times as many tests per million people, according to recent data. The testing shortage has been a source of frustration for physicians and patients alike. Public health experts worry that the delays will hamper the nation’s ability to spot new outbreaks and treat patients, and some people have expressed concern that athletes and celebrities seem to be getting preferential treatment for testing.There are signs, however, that things may be turning around. Federal officials have now authorized states to make their own decisions, which have included tapping private laboratories for testing and announcing plans to expand drive-through testing around the country. The impacts are already being felt in the state of New York, which went from testing a few hundred people a day to more than 7,000 this Wednesday.

There’s a lot of excellent reporting and analysis out there.

Below is a list — updated and expanded from last week’s Abstracts — of some of the journalists, experts, and publications that Undark is following.

Undark will continue to provide weekly roundups of Covid-19 news each Friday for as long as the pandemic continues. You can find our own Covid-19 coverage here.

Deborah Blum, Jane Roberts, Ashley Smart, Frankie Schembri, and Lucas Haugen contributed to this roundup.

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Michael Schulson is a contributing editor for Undark. His work has also been published by Wired, Salon, Slate, Pacific Standard, the Daily Beast, and The Washington Post, among other publications.