Thursday, April 23, 2020
Covid-19 Arrived in Seattle. Where It Went From There Stunned the Scientists.
Scientists traced the virus brought to the Seattle area in January. They were astonished to learn that the same branch of the virus traveled on through at least a dozen states and to other parts of the world.
In recent days, the sequencing of new cases has revealed a surprising new possibility. A series of cases in British Columbia carried a genetic footprint very similar to the case of the Wuhan traveler. That opened up the possibility that someone could have carried that same branch of the virus from Wuhan to British Columbia or somewhere else in the region at nearly the same time. Perhaps it was that person whose illness had sparked the fateful outbreak.
A man suspected of bringing the coronavirus from China to the United States landed at Seattle-Tacoma International Airport, shown here in February.Credit...Miles Fortune for The New York Times
By Mike Baker and Dr Sheri Fink April 22, 2020
SEATTLE — As the coronavirus outbreak consumed the city of Wuhan in China, new cases of the virus began to spread out like sparks flung from a fire.
Some landed thousands of miles away. By the middle of January, one had popped up in Chicago, another one near Phoenix. Two others came down in the Los Angeles area. Thanks to a little luck and a lot of containment, those flashes of the virus appear to have been snuffed out before they had a chance to take hold.
By Mike Baker and Dr Sheri Fink April 22, 2020
SEATTLE — As the coronavirus outbreak consumed the city of Wuhan in China, new cases of the virus began to spread out like sparks flung from a fire.
Some landed thousands of miles away. By the middle of January, one had popped up in Chicago, another one near Phoenix. Two others came down in the Los Angeles area. Thanks to a little luck and a lot of containment, those flashes of the virus appear to have been snuffed out before they had a chance to take hold.
But on Jan. 15, at the international airport south of Seattle, a 35-year-old man returned from a visit to his family in the Wuhan region. He grabbed his luggage and booked a ride-share to his home north of the city.
The next day, as he went back to his tech job east of Seattle, he felt the first signs of a cough — not a bad one, not enough to send him home. He attended a group lunch with colleagues that week at a seafood restaurant near his office. As his symptoms got worse, he went grocery shopping near his home.
Days later, after the man became the first person in the United States to test positive for the coronavirus, teams from federal, state and local agencies descended to contain the case. Sixty-eight people — the ride-share driver at the airport, the lunchmates at the seafood restaurant, the other patients at the clinic where the man was first seen — were monitored for weeks. To everyone’s relief, none ever tested positive for the virus.
But if the story ended there, the arc of the coronavirus’s sweep through the United States would look much different.
As it turned out, the genetic building block of the virus detected in the man who had been to Wuhan would become a crucial clue for scientists who were trying to understand how the pathogen gained its first, crucial foothold.
Working out of laboratories along Seattle’s Lake Union, researchers from the University of Washington and the Fred Hutchinson Cancer Research Center rushed to identify the RNA sequence of the cases from Washington State and around the country, comparing them with data coming in from around the world.
Using advanced technology that allows them to rapidly identify the tiny mutations that the virus makes in its virulent path through human hosts, the scientists working in Washington and several other states made two disconcerting discoveries.
The first was that the virus brought in by the man from Wuhan — or perhaps, as new data has suggested, by someone else who arrived carrying a nearly identical strain — had managed to settle into the population undetected.
Then they began to realize how far it had spread. A small outbreak that had established itself somewhere north of Seattle, they realized as they added new cases to their database, was now responsible for all known cases of community transmission they examined in Washington State in the month of February.
And it had jumped.
A genetically similar version of the virus — directly linked to that first case in Washington — was identified across 14 other states, as far away as Connecticut and Maryland. It settled in other parts of the world, in Australia, Mexico, Iceland, Canada, the United Kingdom and Uruguay. It landed in the Pacific, on the Grand Princess cruise ship.
The unique signature of the virus that reached America’s shores in Seattle now accounts for a quarter of all U.S. cases made public by genomic sequencers in the United States.
With no widespread testing available, the high-tech detective work of the researchers in Seattle and their partners elsewhere would open the first clear window into how and where the virus was spreading — and how difficult it would be to contain.
Even as the path of the Washington State version of the virus was coursing eastward, new sparks from other strains were landing in New York, in the Midwest and in the South. And then they all began to intermingle.
A jigsaw puzzle
The researchers in Seattle included some of the world’s most renowned experts on genomic sequencing, the process of analyzing the letters of a virus’s genetic code to track its mutations. Before the outbreak, one of the labs had done more sequencing of human coronaviruses than anywhere else in the world — 58 of them.
When a virus takes hold in a person, it can replicate billions of times, some of those with tiny mutations, each new version competing for supremacy. Over the span of a month, scientists have learned, the version of the novel coronavirus moving through a community will mutate about twice — each one a one-letter change in an RNA strand of 29,903 nucleotides.
The alterations provide each new form of the virus with a small but distinctive variation to its predecessor, like a recipe passed down through a family. The mutations are so small, however, that it is unlikely that one version of the virus would affect patients differently than another one.
The virus originated with one pattern in Wuhan; by the time it reached Germany, three positions in the RNA strand had changed. Early cases in Italy had two entirely different variations.
For each case, the Seattle researchers compile millions of fragments of the genome into a complete strand that can help identify it based on whatever tiny mutations it has undergone.
“What we’re essentially doing is reading these small fragments of viral material and trying to jigsaw puzzle the genome together,” said Pavitra Roychoudhury, a researcher for the two institutions working on the sequencing in Seattle.
With some viruses, the puzzles are more challenging to assemble. The virus that causes Covid-19, she said, “was relatively well behaved.”
Researchers looked closely at the man who had flown in from Wuhan, who has not been publicly identified and did not respond to a request to speak to The New York Times.
They confirmed he had brought a strain of the virus that was already extending broad tentacles — from the Wuhan area to Guangdong on China’s Pacific coast to Yunnan in the mountainous west. Along the way, its signature varied significantly from the version of the virus that spread in Europe and elsewhere: Its mutations were at positions 8,782, 18,060 and 28,144 on the RNA strand.
That gave Dr. Roychoudhury and the scientists around the country she has been working with the unique ability to see what the contact tracers in Seattle had been unable to: the invisible footprints of the pathogen as it moved.
A flow cell used for sequencing the coronavirus at a lab in Seattle.Credit...Ruth Fremson/The New York Times
An alarming find
On the hunt for the virus’s path through the United States, one of the first signposts came on Feb. 24, when a teenager came into a clinic with what looked like the flu. The clinic was in Snohomish County, where the man who had traveled to China lived. Doctors gave the teenager a nasal swab as part of a tracking study that was already being done on influenza in the region.
Only later did they learn that the teenager had not had the flu, but the coronavirus. After the diagnosis, researchers in Seattle ran the sample through a sequencing machine. Trevor Bedford, a scientist at the Fred Hutchinson Cancer Research Institute who studies the spread and evolution of viruses, said he and a colleague sipped on beers as they waited for the results to emerge on a laptop.
It confirmed what they had feared: The case was consistent with being a direct descendant of the first U.S. case, from Wuhan.
The teenager had not been in contact with the man who had traveled to Wuhan, so far as anyone knew. He had fallen ill long after that man was no longer contagious.
Additional sequencing in the days afterward helped confirm that other cases emerging were all part of the same group. This could only mean one thing: The virus had not been contained to the traveler from Wuhan and had been spreading for weeks. Either he had somehow spread it to others, or someone else had brought in a genetically identical version of the virus.
That latter possibility has become more likely in recent days, after new cases entered into the researchers’ database showed an interesting pattern. A virus with a fingerprint nearly identical to the Wuhan traveler’s had shown up in cases in British Columbia, just across the border from Washington State, suggesting to Dr. Bedford that it might not have been the first Wuhan traveler who had unleashed the outbreak.
Either way, the number of cases emerging around the time the teenager’s illness was identified indicated that the virus had been circulating for weeks.
Video
An animation by Nextstrain shows, through genomic sequencing, the spread of the branch of the coronavirus that entered the United States in the Seattle area earlier this year.
‘I probably exposed a lot of people’
On its path through Washington State, one of the virus’s early stops appears to have been at a square dance on Feb. 16 in the city of Lynnwood, midway between Seattle and Everett.
It was a full month since the Wuhan traveler’s arrival. A couple dozen square dancers had gathered for a pie and ice cream social, capping off a series of practices and events from all over the region over the course of a three-day weekend.
Three groups of square dancers swung through promenades and allemandes — huffing and sweating to “Free Ride” and “Bad Case of Loving You.”
Stephen Cole, who was the dance caller that night, said he did not recall anyone showing signs of illness. But over the next few days, he and a woman who had been cuing the dance fell ill.
Another dancer, Suzanne Jones, had attended a class with Mr. Cole the day before. By the next weekend, Ms. Jones said, she started to feel symptoms she dismissed as allergies, since she had noticed the scotch broom starting to bloom.
After resting for a couple of days, Ms. Jones felt better and drove from her home in Skagit County more than 100 miles south to visit her mother in Enumclaw, helping pack some belongings for storage. On the way back, she visited the strip malls in Renton, then a store in Everett, then a laundromat in Arlington. She stopped to apply for a job with the Census Bureau.
“I probably exposed a lot of people that day,” she said.
Ms. Jones only realized it could be something more than allergies after getting a notification on March 2 that one of her square-dancing friends had died of the coronavirus as the outbreak began to emerge. She too tested positive.
There was minimal coronavirus testing in the United States during February, leaving researchers largely blind to the specific locations and mutations of the spread that month. The man who had traveled from Wuhan was not at the dance, nor was anyone else known to have traveled into the country with the coronavirus. But researchers learned that the virus by then was already spreading well beyond its point of origin — and all the cases of community transmission that month were part of that same genetic branch.
‘I probably exposed a lot of people’
On its path through Washington State, one of the virus’s early stops appears to have been at a square dance on Feb. 16 in the city of Lynnwood, midway between Seattle and Everett.
It was a full month since the Wuhan traveler’s arrival. A couple dozen square dancers had gathered for a pie and ice cream social, capping off a series of practices and events from all over the region over the course of a three-day weekend.
Three groups of square dancers swung through promenades and allemandes — huffing and sweating to “Free Ride” and “Bad Case of Loving You.”
Stephen Cole, who was the dance caller that night, said he did not recall anyone showing signs of illness. But over the next few days, he and a woman who had been cuing the dance fell ill.
Another dancer, Suzanne Jones, had attended a class with Mr. Cole the day before. By the next weekend, Ms. Jones said, she started to feel symptoms she dismissed as allergies, since she had noticed the scotch broom starting to bloom.
After resting for a couple of days, Ms. Jones felt better and drove from her home in Skagit County more than 100 miles south to visit her mother in Enumclaw, helping pack some belongings for storage. On the way back, she visited the strip malls in Renton, then a store in Everett, then a laundromat in Arlington. She stopped to apply for a job with the Census Bureau.
“I probably exposed a lot of people that day,” she said.
Ms. Jones only realized it could be something more than allergies after getting a notification on March 2 that one of her square-dancing friends had died of the coronavirus as the outbreak began to emerge. She too tested positive.
There was minimal coronavirus testing in the United States during February, leaving researchers largely blind to the specific locations and mutations of the spread that month. The man who had traveled from Wuhan was not at the dance, nor was anyone else known to have traveled into the country with the coronavirus. But researchers learned that the virus by then was already spreading well beyond its point of origin — and all the cases of community transmission that month were part of that same genetic branch.
There was another spreading event. On the Saturday after the dance, a group of friends packed the living room of a one-bedroom apartment in Seattle, sharing homemade food and tropical-themed drinks.
Over the following days, several people began coming down with coronavirus symptoms. “Among people who attended, four out of every 10 got sick,” said Hanna Oltean, an epidemiologist with the Washington State Department of Health.
Several people passed on the virus to others. By late March, the state health department had documented at least three generations of “transmission occurring before anyone was symptomatic,” Ms. Oltean said.
By then, it was becoming clear that there were probably hundreds of cases already linked to the first point of infection that had been spreading undetected. It left a lingering question: If the virus had this much of a head start, how far had it gone?
The large outbreak on the Grand Princess, a researcher said, could probably be traced to a single person linked to the Washington State cluster.Credit...Jim Wilson/The New York Times
Spreading beyond Seattle
As cases of the virus spread, scientists in other states were sequencing as many as they could. In a lab at the University of California, San Francisco, Dr. Charles Chiu looked at a range of cases in the Bay Area, including nine passengers from the Grand Princess cruise ship, which had recently returned from a pair of ill-fated sailings to Mexico and Hawaii that left dozens of passengers infected with the coronavirus.
Dr. Chiu was stunned by his results: Five cases in the San Francisco area whose origins were unknown were linked back to the Washington State cluster. And all nine of the Grand Princess cases had a similar genetic link, with the same trademark mutations — plus a few new ones. The massive outbreak on the ship, Dr. Chiu believed, could probably be traced to a single person who had developed an infection linked to the Washington State cluster.
But it did not stop with the Grand Princess. David Shaffer, who had been on the first leg of the cruise with members of his family, said passengers on that leg did not discover until after they disembarked that the coronavirus had been aboard — when they learned that a fellow passenger had died.
He and his family felt fine when they returned to their home in Sacramento, he said, and when he started feeling sick the next day, on Feb. 22, he at first assumed it was a sinus infection.
Days later, he was tested and learned he had the coronavirus. His wife later tested positive, too, as did one of his sons and one of his grandsons, who had not been on the cruise.
Dr. Chiu remembers going over the implications in his head. “If it’s in California and it’s in Washington State, it’s very likely in other states.”
A field hospital at the Javits Center in New York, which has seen cases of the same virus branch that originated in the Seattle area. Most of New York’s cases are of a branch that originated in Europe.Credit...Gabby Jones for The New York Times
U.S. flare-ups abound
The same day Mr. Shaffer got sick, another person landed at Raleigh-Durham International Airport in North Carolina, having just visited the Life Care Center nursing home in Kirkland, which would become a center of infection. At the time, there were growing signs of a respiratory illness at the facility, but no indication of the coronavirus.
A few days later, the traveler began feeling ill, but with no sign that it might be anything serious, he went out for dinner at a restaurant in Raleigh. Just then, officials in Washington State began to report a coronavirus outbreak at Life Care Center. The person in North Carolina tested positive a few days later — the first case in the state.
By the middle of March, a team at Yale gathered nine coronavirus samples from the Connecticut region and put them through a portable sequencing machine. Seven came back with connections to Washington State.
“I was pretty surprised,” said Joseph Fauver, one of the researchers at the lab. At the time, he said, it suggested that the virus had been spreading more than people had initially believed.
In sequencing more recent cases, the researchers have found cases emanating from a larger cluster, with its own distinct genetic signature, originating in the New York area.
A group of cases throughout the Midwest, first surfacing in early March, appears to have roots in Europe. A group of cases in the South, which emerged around the same time, on March 3, appears like a more direct descendant from China.
But of all the branches that researchers have found, the strain from Washington State remains the earliest and one of the most potent.
It has surfaced in Arizona, California, Connecticut, the District of Columbia, Florida, Illinois, Michigan, Minnesota, New York, North Carolina, Oregon, Utah, Virginia, Wisconsin and Wyoming, and in six countries.
And new cases are still surfacing.
One of the enduring mysteries has been just how the virus managed to gain its first, fatal foothold in Washington.
Did the contact tracers who followed the steps of the man who had traveled from Wuhan miss something? Did he expose someone at the grocery store, or touch a door handle when he went to the restaurant near his office?
In recent days, the sequencing of new cases has revealed a surprising new possibility. A series of cases in British Columbia carried a genetic footprint very similar to the case of the Wuhan traveler. That opened up the possibility that someone could have carried that same branch of the virus from Wuhan to British Columbia or somewhere else in the region at nearly the same time. Perhaps it was that person whose illness had sparked the fateful outbreak.
But who? And how? That would probably never be known.
Mike Baker reported from Seattle and Sheri Fink from New York.
Dr. Sheri Fink is a correspondent in the investigative unit. She won the 2010 Pulitzer Prize for Investigative Reporting and shared the 2015 Pulitzer Prize for International Reporting. She received her M.D. and Ph.D. from Stanford University. @sherifink • Facebook
Trump suggests using light, heat as coronavirus treatment
TRUMP ALSO SUGGESTED INJECTING YOURSELF WITH DISINFECTANT, LIKE BLEACH, WHICH WILL KILL YOU
SITTING UNDER A HEAT LAMP WILL NOT CURE YOU
TRUMP ALSO SUGGESTED INJECTING YOURSELF WITH DISINFECTANT, LIKE BLEACH, WHICH WILL KILL YOU
BY BRETT SAMUELS - 04/23/20
President Trump on Thursday suggested medical experts should study exposing the human body to heat and light as a treatment for the coronavirus during Thursday's White House briefing by the president's task force on the virus.
Trump's remarks followed a presentation from William Bryan, undersecretary for science and technology at the Department of Homeland Security.
Bryan presented the results of a study that showed the virus deteriorates more quickly when subjected to higher temperatures and humidity — a finding that quickly drew skepticism from other experts on social media and cable television given outbreaks in a number of places with warm climates, such as Singapore and Brazil.
Bryan presented data that found how long the virus can live on solid surfaces or in the air was cut significantly under high temperatures, higher humidity and when exposed to sunlight. He said his office was also studying how certain disinfectants might kill the virus more effectively than others, referencing isopropyl alcohol and bleach.
Trump latched onto the findings, inquiring multiple times about harnessing the light and heat as part of a potential cure.
"So, supposing we hit the body with a tremendous — whether it's ultraviolet or just very powerful light — and I think you said that hasn't been checked but you're going to test it," Trump said. "And then I said, supposing you brought the light inside of the body, which you can do either through the skin or in some other way. And I think you said you’re going to test that too. Sounds interesting."
Trump also asked if there was a way to use disinfectants on the body "by injection inside or almost a cleaning."
Pretty interesting suggestion from the president of the United States here. pic.twitter.com/o2UmDRVpW5— Joe Sonka #StayHome (@joesonka) April 23, 2020
Bryan later cautioned that the agency's findings did not mean that sunlight will kill the virus, nor should going outdoors supersede social distancing guidelines put in place by state and federal leaders.
"It would be irresponsible for us to say that we feel the summer is just going to totally kill the virus … that is not the case," he said.
But he occasionally sent mixed messages, telling one reporter he would personally opt to hold a family gathering outside rather than inside during the summer and explaining that sunlight could have an effect at getting rid of the virus on playground equipment or other surfaces.
Asked if it was dangerous to give the impression Americans would be safe from the virus going outside, Trump doubled down on his suggestion to use the heat and light as a cure.
"Maybe you can, maybe you can’t ... I’m not a doctor. But I’m, like, a person that has a good you-know-what," Trump said, pointing to his head.
He then turned to Deborah Birx, the White House coronavirus response coordinator, asking if she had ever heard of using "the heat and the light" to combat the coronavirus.
"Not as a treatment," Birx said. "I mean, certainly ... when you have a fever it helps your body respond. But I’ve not seen heat or light."
"I think it’s a great thing to look at," Trump said.
The U.S. has more than 873,000 confirmed cases of coronavirus, according to data from Johns Hopkins University, including in a number of warm weather and humid climates, further raising questions about the sunlight's impact on the disease. New Orleans was one of the country's first hot spots, while Florida and Georgia have seen increasing cases.
Countries located near the tropics have also dealt with infections.
President Trump on Thursday suggested medical experts should study exposing the human body to heat and light as a treatment for the coronavirus during Thursday's White House briefing by the president's task force on the virus.
Trump's remarks followed a presentation from William Bryan, undersecretary for science and technology at the Department of Homeland Security.
Bryan presented the results of a study that showed the virus deteriorates more quickly when subjected to higher temperatures and humidity — a finding that quickly drew skepticism from other experts on social media and cable television given outbreaks in a number of places with warm climates, such as Singapore and Brazil.
Bryan presented data that found how long the virus can live on solid surfaces or in the air was cut significantly under high temperatures, higher humidity and when exposed to sunlight. He said his office was also studying how certain disinfectants might kill the virus more effectively than others, referencing isopropyl alcohol and bleach.
Trump latched onto the findings, inquiring multiple times about harnessing the light and heat as part of a potential cure.
"So, supposing we hit the body with a tremendous — whether it's ultraviolet or just very powerful light — and I think you said that hasn't been checked but you're going to test it," Trump said. "And then I said, supposing you brought the light inside of the body, which you can do either through the skin or in some other way. And I think you said you’re going to test that too. Sounds interesting."
Trump also asked if there was a way to use disinfectants on the body "by injection inside or almost a cleaning."
Pretty interesting suggestion from the president of the United States here. pic.twitter.com/o2UmDRVpW5— Joe Sonka #StayHome (@joesonka) April 23, 2020
Bryan later cautioned that the agency's findings did not mean that sunlight will kill the virus, nor should going outdoors supersede social distancing guidelines put in place by state and federal leaders.
"It would be irresponsible for us to say that we feel the summer is just going to totally kill the virus … that is not the case," he said.
But he occasionally sent mixed messages, telling one reporter he would personally opt to hold a family gathering outside rather than inside during the summer and explaining that sunlight could have an effect at getting rid of the virus on playground equipment or other surfaces.
Asked if it was dangerous to give the impression Americans would be safe from the virus going outside, Trump doubled down on his suggestion to use the heat and light as a cure.
"Maybe you can, maybe you can’t ... I’m not a doctor. But I’m, like, a person that has a good you-know-what," Trump said, pointing to his head.
He then turned to Deborah Birx, the White House coronavirus response coordinator, asking if she had ever heard of using "the heat and the light" to combat the coronavirus.
"Not as a treatment," Birx said. "I mean, certainly ... when you have a fever it helps your body respond. But I’ve not seen heat or light."
"I think it’s a great thing to look at," Trump said.
The U.S. has more than 873,000 confirmed cases of coronavirus, according to data from Johns Hopkins University, including in a number of warm weather and humid climates, further raising questions about the sunlight's impact on the disease. New Orleans was one of the country's first hot spots, while Florida and Georgia have seen increasing cases.
Countries located near the tropics have also dealt with infections.
Trump mulls tying USPS changes to emergency coronavirus loan: report
BY J. EDWARD MORENO - 04/23/20
© Getty Images
The Trump administration is considering tying changes to the U.S. Postal Service to the emergency coronavirus loan from Congress, according to The Washington Post.
Treasury Department officials told the Post they are speaking with senior officials at the USPS about using the $18 billion loan allocated to the Postal Service by Congress as leverage to influence the way the agency charges for package delivery.
Treasury Secretary Steven Mnuchin is also reportedly seeking to influence the hiring process for senior officials at USPS.
Trump has often said that the way the Postal Service is run benefits companies like Amazon. The administration would like USPS to increase how much it charges for package deliveries in general and double what it charges Amazon.
Congress issued $10 billion in loans to USPS in the $2.2 trillion stimulus bill passed last month. Mnuchin rejected a bipartisan Senate proposal to give the Postal Service a bailout in early negotiations, according to the Post.
UPS and FedEx told the Post they are in favor of USPS maintaining flexibility, but would welcome accountability from the agency.
The Postal Service is projecting a $13 billion shortfall due to the pandemic while employees remain classified as essential. According to the American Postal Workers Union, 1,219 workers of the Postal Service’s 630,000-person workforce have tested positive for the coronavirus and 44 workers have died.
BY J. EDWARD MORENO - 04/23/20
© Getty Images
The Trump administration is considering tying changes to the U.S. Postal Service to the emergency coronavirus loan from Congress, according to The Washington Post.
Treasury Department officials told the Post they are speaking with senior officials at the USPS about using the $18 billion loan allocated to the Postal Service by Congress as leverage to influence the way the agency charges for package delivery.
Treasury Secretary Steven Mnuchin is also reportedly seeking to influence the hiring process for senior officials at USPS.
Trump has often said that the way the Postal Service is run benefits companies like Amazon. The administration would like USPS to increase how much it charges for package deliveries in general and double what it charges Amazon.
Congress issued $10 billion in loans to USPS in the $2.2 trillion stimulus bill passed last month. Mnuchin rejected a bipartisan Senate proposal to give the Postal Service a bailout in early negotiations, according to the Post.
UPS and FedEx told the Post they are in favor of USPS maintaining flexibility, but would welcome accountability from the agency.
The Postal Service is projecting a $13 billion shortfall due to the pandemic while employees remain classified as essential. According to the American Postal Workers Union, 1,219 workers of the Postal Service’s 630,000-person workforce have tested positive for the coronavirus and 44 workers have died.
Maxine Waters dedicates legislation to sister dying of coronavirus
BY TAL AXELROD - THE HILL - 04/23/20
© Greg Nash
Rep. Maxine Waters (D-Calif.) dedicated Congress’s $484 billion relief package to her sister, who she said is dying from the coronavirus.
“I not only rise in support of this legislation,” Waters said on the House floor. “I also would like to rise in support of what we’re doing for the health care enhancement act in this bill. And I’m going to take a moment to dedicate this legislation to my dear sister who is dying in a hospital in St. Louis, Mo., right now infected by the coronavirus.”
Rep. Maxine Waters: "I am going to take a moment to dedicate this legislation to my dear sister who is dying in a hospital in St. Louis, Missouri, right now infected by the Coronavirus." pic.twitter.com/sX58UK1A3L— The Hill (@thehill) April 23, 2020
Waters touted the relief package that has already passed the Senate and is currently being debated in the House. The legislation provides $370 billion in funding for small businesses as well as $100 billion for hospitals and coronavirus testing.
Her remarks were the first she's made that confirmed her sister was seriously ill with the coronavirus, which has infected more than 845,000 people in the U.S. and killed nearly 47,000.
Sen. Elizabeth Warren (D-Mass.) confirmed Thursday that her eldest brother died of the virus.
Waters, the chair of the House Financial Services Committee, said the next relief package must provide more funding for people hurting by the exploding economic fallout of the pandemic.
“Congress must now immediately turn to the next package of legislation to provide relief during the pandemic,” she said. “We need to do much more to help renters, homeowners, people experiencing homelessness and mom and pop landlords.”
BY TAL AXELROD - THE HILL - 04/23/20
© Greg Nash
Rep. Maxine Waters (D-Calif.) dedicated Congress’s $484 billion relief package to her sister, who she said is dying from the coronavirus.
“I not only rise in support of this legislation,” Waters said on the House floor. “I also would like to rise in support of what we’re doing for the health care enhancement act in this bill. And I’m going to take a moment to dedicate this legislation to my dear sister who is dying in a hospital in St. Louis, Mo., right now infected by the coronavirus.”
Rep. Maxine Waters: "I am going to take a moment to dedicate this legislation to my dear sister who is dying in a hospital in St. Louis, Missouri, right now infected by the Coronavirus." pic.twitter.com/sX58UK1A3L— The Hill (@thehill) April 23, 2020
Waters touted the relief package that has already passed the Senate and is currently being debated in the House. The legislation provides $370 billion in funding for small businesses as well as $100 billion for hospitals and coronavirus testing.
Her remarks were the first she's made that confirmed her sister was seriously ill with the coronavirus, which has infected more than 845,000 people in the U.S. and killed nearly 47,000.
Sen. Elizabeth Warren (D-Mass.) confirmed Thursday that her eldest brother died of the virus.
Waters, the chair of the House Financial Services Committee, said the next relief package must provide more funding for people hurting by the exploding economic fallout of the pandemic.
“Congress must now immediately turn to the next package of legislation to provide relief during the pandemic,” she said. “We need to do much more to help renters, homeowners, people experiencing homelessness and mom and pop landlords.”
US announces new funding for Greenland in push for stronger Arctic presence
© Getty Images
The U.S. is providing $12.1 million to Greenland in an effort to establish new diplomatic ties and increase its presence in the Arctic, the State Department announced on Thursday.
The funding was welcomed by Greenland’s government but criticized by officials in Denmark, its parent state that had brushed off President Trump's offer to buy the island last year.
“They have clearly crossed the line,” Karsten Honge, a member of the foreign affairs committee for the Socialist People’s Party in Denmark, told Reuters.
ADVERTISEMENT
“It’s completely unheard of that a close ally tries to create division between Greenland and Denmark this way.”
Greenland's government said in a statement Thursday the funding will go to civilian projects, including the mineral industry, tourism and education and be implemented “primarily as consultancy and advisory assistance from U.S. experts.”
But a senior State Department official said the funding is meant to safeguard U.S. interests for a “secure and stable Arctic” and counter threats from Russia and China.
The official said both Russia and China are on a pathway to “clash with the interests of the United States and our allies and our partners” in the Arctic.
The U.S. is expected to open a consulate in Greenland’s capital city Nuuk later this summer, the first American diplomatic presence there since 1953.
USA
The $484 billion relief package passed in a 388-5 vote just two days after the Senate unanimously approved it. The measure provides critical funding for small business loans, hospitals and virus testing. It now heads to President Trump’s desk for his expected signature.
The five lawmakers who voted against $484B in coronavirus relief
The sole Democrat to cast a no vote was liberal freshman firebrand Rep. Alexandria Ocasio-Cortez (N.Y.), who argued the series of relief packages passed by Congress have not gone far enough to provide assistance to working-class people or safeguards to ensure mom-and-pop businesses receive funding before big companies.
“It is a joke when Republicans say they have urgency around this bill. The only folks that they have urgency around are [chain restaurants] like Ruth’s Chris Steak House and Shake Shack. Those are the people getting assistance in this bill,” Ocasio-Cortez said in a fiery floor speech before the vote, where she noted that her Bronx and Queens district has been among the hardest hit by the coronavirus.
“You are not trying to fix this bill for mom and pops,” she added.
READ THE REST HERE
https://thehill.com/homenews/house/494419-the-five-lawmakers-who-voted-against-484b-in-coronavirus-relief
DID RUTH CHRIS STEAKHOUSE GET CANADIAN BAILOUT LIKE THEY GOT IN THE USA
On The Trail: Trump's demands for loyalty extend to scientists
The Trump administration's decision to sideline one of the government’s top vaccine specialists at the height of a global coronavirus pandemic has shocked scientists and science advocates who say the president is placing a greater value on loyalty to himself than on the facts and data that could save lives.
The administration this week forced out Rick Bright, the head of the Biomedical Advanced Research and Development Authority and an acting deputy assistant secretary of Health and Human Services for preparedness and response.
BARDA, the nation's top vaccine research organization, had entered into a partnership with Johnson & Johnson just weeks ago to develop a vaccine against the coronavirus that has killed tens of thousands of Americans.
Bright's ouster came after he voiced skepticism that two drugs President Trump had called potential “game changers” in the battle against the coronavirus — hydroxychloroquine and chloroquine — would actually prove effective.
Trump urged the Food and Drug Administration to approve the two treatments for use in Covid-19 patients in March, and Fox News hosts had been touting their potential — until several studies around the world were halted because the drugs did not show promise in treating Covid-19 or, in the case of a study of Veterans Administration patients given the drugs, fatality rates were actually higher.
Bright said his ouster was retaliation for speaking out in internal administration debates.
“I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the COVID-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit,” Bright said in a statement. “Specifically, and contrary to misguided directives, I limited the broad use of chloroquine and hydroxychloroquine, promoted by the Administration as a panacea, but which clearly lack scientific merit.”
Trump said Wednesday he had never heard of Bright.
But scientists said Bright's ouster fits a broader pattern that Trump established in the earliest days of his administration to bend hard data to his own benefit — or to squelch the scientists who challenged his beliefs on climate change and environmental regulations.
“The Trump administration has consistently worked to disregard inconvenient science, and it doesn't take much to be inconvenient,” said Michael Gerrard, director of the Sabin Center for Climate Change Law at Columbia Law School. “This can have immediate and possibly fatal impacts if it means that ineffective or harmful drugs are mindlessly hawked.”
The pattern has continued as the coronavirus pandemic has spread. Trump initially downplayed the threat of the virus, even as the World Health Organization declared it a public health emergency of international concern. Trump later put a hold on American funding for the global agency.
When a top official at the Centers for Disease Control and Prevention, Nancy Messonnier, said in February that the spread of the virus to the United States was “inevitable,” Trump threatened to fire her.
When Trump put Vice President Mike Pence in control of the administration’s response, the nation’s top infectious disease expert, Anthony Fauci, canceled several appearances on television shows. CDC director Robert Redfield has walked back statements or clashed with the media — as recently as Thursday — after his comments had been construed in ways that seem to contradict Trump's rosy forecasts. Trump himself has retweeted a post that included a hashtag to fire Fauci.
“In the pandemic, there's no greater time when you actually need the expertise up front. Nobody expects there isn't going to be any politics, but manipulating the information and suppressing the information is deadly,” said Andrew Rosenberg, director of the Center for Science and Democracy at the Union of Concerned Scientists. “Literally every person in the country is put at immediate risk.”
In a paper to be published Thursday, Rosenberg's group will report on a survey from last year showing high levels of dissatisfaction among government scientists who say they are demonized and their expertise dismissed.
A White House spokesperson denied any distance between Trump and his scientific advisors, including Fauci, Surgeon General Jerome Adams, coronavirus response coordinator Deborah Birx and FDA commissioner Stephen Hahn.
“Despite the media’s ridiculous efforts to somehow create distance between the President and his top health experts, it is simply fake news. President Trump has relied on and consulted with Dr. Adams, Dr. Birx, Dr. Fauci, Dr. Hahn, Dr. Redfield, and many others as he has confronted this unforeseen, unprecedented crisis and put the full power of the federal government to work to slow the spread, save lives, and place this great country on a data-driven path to opening up again,” the spokesman, Judd Deere, said in an email.
For years, the Trump administration has been accused of altering studies, deleting mentions of climate change, stifling its own scientists and obscuring government data. The Union of Concerned Scientists has documented 126 such incidents since Trump took office in 2017; the Sabin Center counts 417 events, the most recent of which was Bright’s dismissal from BARDA.
Trump’s habit of dismissing scientists in the name of political expediency is a potential threat to longstanding international cooperation between America and its chief allies, all of whom are the world's most significant funders of scientific research.
“Globally, we have been unbelievably important as a very large science enterprise with great freedom to pursue research, to interact with industry and to work internationally,” Rosenberg said. “The U.S. is no longer the trusted partner that we once were, because nobody knows whether we're going to be there.”
He said even tossing around ideas such as defunding the World Health Organization or pulling out of international agreements “signals to the world that the U.S. as an international technical and scientific partner is going to change with the political winds to a much greater extent that it has before.”
“In other words, we are an unreliable partner,” Rosenberg said.
Trump has touted his own scientific knowledge. In a visit to CDC headquarters in early March, Trump said his hosts had asked him how he knew so much about the virus he had been downplaying just days earlier.
“I like this stuff. I really get it. People are surprised that I understand it,” Trump said. “Maybe I have a natural ability. Maybe I should have done that instead of running for president.”
Fauci is perhaps the most intriguing case study in how Trump treats scientists, largely because he has been around Washington long enough to carry a brand of his own. He has alternated between insisting there is no distance between himself and the president who heeds his advice and making statements that directly contradict what Trump has said, sometimes only moments before.
On Thursday, Trump told reporters twice that the virus “may not come back at all” in the fall, citing “ten different people” without naming them. Fauci said he was “convinced” that the virus will resurge in the fall, citing Redfield.
Morgan Chalfant contributed reporting.
TRUMPS REVISIONIST LOYALTY DEMANDS OUT DOES STALIN
BY REID WILSON - 04/23/2020
The Trump administration's decision to sideline one of the government’s top vaccine specialists at the height of a global coronavirus pandemic has shocked scientists and science advocates who say the president is placing a greater value on loyalty to himself than on the facts and data that could save lives.
The administration this week forced out Rick Bright, the head of the Biomedical Advanced Research and Development Authority and an acting deputy assistant secretary of Health and Human Services for preparedness and response.
BARDA, the nation's top vaccine research organization, had entered into a partnership with Johnson & Johnson just weeks ago to develop a vaccine against the coronavirus that has killed tens of thousands of Americans.
Bright's ouster came after he voiced skepticism that two drugs President Trump had called potential “game changers” in the battle against the coronavirus — hydroxychloroquine and chloroquine — would actually prove effective.
Trump urged the Food and Drug Administration to approve the two treatments for use in Covid-19 patients in March, and Fox News hosts had been touting their potential — until several studies around the world were halted because the drugs did not show promise in treating Covid-19 or, in the case of a study of Veterans Administration patients given the drugs, fatality rates were actually higher.
Bright said his ouster was retaliation for speaking out in internal administration debates.
“I believe this transfer was in response to my insistence that the government invest the billions of dollars allocated by Congress to address the COVID-19 pandemic into safe and scientifically vetted solutions, and not in drugs, vaccines and other technologies that lack scientific merit,” Bright said in a statement. “Specifically, and contrary to misguided directives, I limited the broad use of chloroquine and hydroxychloroquine, promoted by the Administration as a panacea, but which clearly lack scientific merit.”
Trump said Wednesday he had never heard of Bright.
But scientists said Bright's ouster fits a broader pattern that Trump established in the earliest days of his administration to bend hard data to his own benefit — or to squelch the scientists who challenged his beliefs on climate change and environmental regulations.
“The Trump administration has consistently worked to disregard inconvenient science, and it doesn't take much to be inconvenient,” said Michael Gerrard, director of the Sabin Center for Climate Change Law at Columbia Law School. “This can have immediate and possibly fatal impacts if it means that ineffective or harmful drugs are mindlessly hawked.”
The pattern has continued as the coronavirus pandemic has spread. Trump initially downplayed the threat of the virus, even as the World Health Organization declared it a public health emergency of international concern. Trump later put a hold on American funding for the global agency.
When a top official at the Centers for Disease Control and Prevention, Nancy Messonnier, said in February that the spread of the virus to the United States was “inevitable,” Trump threatened to fire her.
When Trump put Vice President Mike Pence in control of the administration’s response, the nation’s top infectious disease expert, Anthony Fauci, canceled several appearances on television shows. CDC director Robert Redfield has walked back statements or clashed with the media — as recently as Thursday — after his comments had been construed in ways that seem to contradict Trump's rosy forecasts. Trump himself has retweeted a post that included a hashtag to fire Fauci.
“In the pandemic, there's no greater time when you actually need the expertise up front. Nobody expects there isn't going to be any politics, but manipulating the information and suppressing the information is deadly,” said Andrew Rosenberg, director of the Center for Science and Democracy at the Union of Concerned Scientists. “Literally every person in the country is put at immediate risk.”
In a paper to be published Thursday, Rosenberg's group will report on a survey from last year showing high levels of dissatisfaction among government scientists who say they are demonized and their expertise dismissed.
A White House spokesperson denied any distance between Trump and his scientific advisors, including Fauci, Surgeon General Jerome Adams, coronavirus response coordinator Deborah Birx and FDA commissioner Stephen Hahn.
“Despite the media’s ridiculous efforts to somehow create distance between the President and his top health experts, it is simply fake news. President Trump has relied on and consulted with Dr. Adams, Dr. Birx, Dr. Fauci, Dr. Hahn, Dr. Redfield, and many others as he has confronted this unforeseen, unprecedented crisis and put the full power of the federal government to work to slow the spread, save lives, and place this great country on a data-driven path to opening up again,” the spokesman, Judd Deere, said in an email.
For years, the Trump administration has been accused of altering studies, deleting mentions of climate change, stifling its own scientists and obscuring government data. The Union of Concerned Scientists has documented 126 such incidents since Trump took office in 2017; the Sabin Center counts 417 events, the most recent of which was Bright’s dismissal from BARDA.
Trump’s habit of dismissing scientists in the name of political expediency is a potential threat to longstanding international cooperation between America and its chief allies, all of whom are the world's most significant funders of scientific research.
“Globally, we have been unbelievably important as a very large science enterprise with great freedom to pursue research, to interact with industry and to work internationally,” Rosenberg said. “The U.S. is no longer the trusted partner that we once were, because nobody knows whether we're going to be there.”
He said even tossing around ideas such as defunding the World Health Organization or pulling out of international agreements “signals to the world that the U.S. as an international technical and scientific partner is going to change with the political winds to a much greater extent that it has before.”
“In other words, we are an unreliable partner,” Rosenberg said.
Trump has touted his own scientific knowledge. In a visit to CDC headquarters in early March, Trump said his hosts had asked him how he knew so much about the virus he had been downplaying just days earlier.
“I like this stuff. I really get it. People are surprised that I understand it,” Trump said. “Maybe I have a natural ability. Maybe I should have done that instead of running for president.”
Fauci is perhaps the most intriguing case study in how Trump treats scientists, largely because he has been around Washington long enough to carry a brand of his own. He has alternated between insisting there is no distance between himself and the president who heeds his advice and making statements that directly contradict what Trump has said, sometimes only moments before.
On Thursday, Trump told reporters twice that the virus “may not come back at all” in the fall, citing “ten different people” without naming them. Fauci said he was “convinced” that the virus will resurge in the fall, citing Redfield.
Morgan Chalfant contributed reporting.
Actor John Cho: 'Stand up for your fellow Americans' amid racism over the coronavirus pandemic
BY MARINA PITOFSKY - 04/23/20
© Getty Images
Actor John Cho penned a new op-ed addressing racism experienced by Asian American people amid the coronavirus pandemic.
“I called my parents a few nights ago to tell them to be cautious when stepping out of the house, because they might be targets of verbal or even physical abuse. It felt so strange. Our roles had flipped,” the "Star Trek" and "Harold & Kumar" star wrote in the piece published Wednesday.
“My plea mirrored the admonitions I received from them as a child growing up in Houston. The world, they cautioned, was hostile and it viewed us as strangers. So they warned me to stick close to my family. Close to my kind,” he continued.
At the end of last month, attacks against Asian American people skyrocketed to approximately 100 per day, according to Rep. Judy Chu.
Cho said that as he became a famous actor, “In some ways, I began to lead a life devoid of race.”
“But I’ve learned that a moment always comes along to remind you that your race defines you above all else,” he added.
He remarked on a time in 2004 when he was traveling with fellow actor Kal Penn and Penn’s friend, identified as Gabe. Gabe, who is white, forgot to remove a hunting knife from his backpack. Cho and Gabe were not stopped by airport security, while Penn, who is the child of Indian immigrants, had his bag searched.
“Asian Americans are experiencing such a moment right now. The pandemic is reminding us that our belonging is conditional. One moment we are Americans, the next we are all foreigners, who ‘brought’ the virus here,” Cho wrote in the op-ed.
“Like fame, the ‘model minority’ myth can provide the illusion of ‘raceless-ness.’ Putting select Asians on a pedestal silences those who question systemic injustice. Our supposed success is used as proof that the system works — and if it doesn’t work for you, it must be your fault,” he added.
Cho, who was born in South Korea, also remarked on his U.S. naturalization ceremony in 1990.
“I remember being surprised by the judge at the ceremony asking me whether I would defend my country in uniform if called upon. I wasn’t expecting that question, though my friends and I had been wondering about a possible draft, and I took my time to truly consider it. I answered yes and I meant it,” Cho said.
“I claimed the citizenship my parents wanted for me and I think I’ve spent my life earning it. I’m not going to let anyone tell me or anyone who looks like me that we are not really American,” he added.
Cho called on everyone to reject hate in their communities, saying: “Please don’t minimize the hate or assume it’s somewhere far away. It’s happening close to you. If you see it on the street, say something. If you hear it at work, say something. If you sense it in your family, say something. Stand up for your fellow Americans.”
BY MARINA PITOFSKY - 04/23/20
© Getty Images
Actor John Cho penned a new op-ed addressing racism experienced by Asian American people amid the coronavirus pandemic.
“I called my parents a few nights ago to tell them to be cautious when stepping out of the house, because they might be targets of verbal or even physical abuse. It felt so strange. Our roles had flipped,” the "Star Trek" and "Harold & Kumar" star wrote in the piece published Wednesday.
“My plea mirrored the admonitions I received from them as a child growing up in Houston. The world, they cautioned, was hostile and it viewed us as strangers. So they warned me to stick close to my family. Close to my kind,” he continued.
At the end of last month, attacks against Asian American people skyrocketed to approximately 100 per day, according to Rep. Judy Chu.
Cho said that as he became a famous actor, “In some ways, I began to lead a life devoid of race.”
“But I’ve learned that a moment always comes along to remind you that your race defines you above all else,” he added.
He remarked on a time in 2004 when he was traveling with fellow actor Kal Penn and Penn’s friend, identified as Gabe. Gabe, who is white, forgot to remove a hunting knife from his backpack. Cho and Gabe were not stopped by airport security, while Penn, who is the child of Indian immigrants, had his bag searched.
“Asian Americans are experiencing such a moment right now. The pandemic is reminding us that our belonging is conditional. One moment we are Americans, the next we are all foreigners, who ‘brought’ the virus here,” Cho wrote in the op-ed.
“Like fame, the ‘model minority’ myth can provide the illusion of ‘raceless-ness.’ Putting select Asians on a pedestal silences those who question systemic injustice. Our supposed success is used as proof that the system works — and if it doesn’t work for you, it must be your fault,” he added.
Cho, who was born in South Korea, also remarked on his U.S. naturalization ceremony in 1990.
“I remember being surprised by the judge at the ceremony asking me whether I would defend my country in uniform if called upon. I wasn’t expecting that question, though my friends and I had been wondering about a possible draft, and I took my time to truly consider it. I answered yes and I meant it,” Cho said.
“I claimed the citizenship my parents wanted for me and I think I’ve spent my life earning it. I’m not going to let anyone tell me or anyone who looks like me that we are not really American,” he added.
Cho called on everyone to reject hate in their communities, saying: “Please don’t minimize the hate or assume it’s somewhere far away. It’s happening close to you. If you see it on the street, say something. If you hear it at work, say something. If you sense it in your family, say something. Stand up for your fellow Americans.”
Inequities in COVID-19 are tragic but preventable
© Getty Images
We’re told that pandemics are “great equalizers,” impacting rich and poor alike. Yet black, Hispanic, and lower income individuals are dying from COVID-19 at disproportionately high rates.
For those of us who study health inequities, this tragic news is unsurprising. It is rooted in policies and practices that reinforce racial, ethnic and class inequalities. These factors predate the pandemic, but also put people at greater risk of COVID-19.
Failing to act is counter to extensive research that demonstrates how policies can narrow health inequities. Paid sick leave polices have an equalizing effect and reduce disease spread. Economic policies like the Earned Income Tax Credit and minimum wage increases can improve public health and reduce risk of death from multiple causes. Uniform health screening and treatment protocols improve patient outcomes and minimize health inequalities. Even initiatives like mandatory seat belt laws and smoking bans can reduce inequities in health risks.
The question is whether we have the will to use this knowledge and act. Here are approaches to address underlying social and economic conditions that put communities at health risk from COVID-19 and other causes.
Establish Worker ProtectionsTo prevent infection spread, we need worker protections (including paid sick leave and livable wage laws) for all. These are especially important for our most vulnerable essential workers, including grocery, warehouse, and care workers.
People in unstable jobs and without access to paid sick days face increased risk of poor health, both from chronic disease and COVID-19. Black, Hispanic, and low-income individuals are more likely to hold such jobs compared to white and higher income persons. Stable, living wage jobs afford people the resources they need to meet basic health needs, and paid sick leave allows workers to care for themselves and others without worry of losing their income or job.
Deploy Uniform Testing Protocols
We need uniform infection and antibody testing, regardless of race, income, or insurance status. Community and drive-through testing sites are disproportionately located in high-income, white areas, despite higher infection risk in poor and predominately black and Hispanic neighborhoods. And patients with COVID-19 symptoms are less likely to be tested if they are black.
These patterns mirror prior evidence. For example, educational and income disparities in screening rates emerged when mammograms for cancer became available. And when being treated for pain, providers are less likely to prescribe pain medications to black versus white patients.
Equalize Access to Health Care
We must ensure equitable access to health care and reduce administrative burdens for people to enroll. Concerns about acquiring COVID-19 and incurring costs may mean many avoid seeking care for ongoing or new health problems.
Health care systems should also share treatment protocols—including telemedicine and innovative clinical care models—to lessen the burden on providers to reinvent the wheel, while also reducing bias and expanding access to quality care.
And within hospitals and clinics, because black, Latino, and low-income individuals are more likely to be in poor health prior to COVID-19 infection, we need carefully-designed protocols that avoid exacerbating inequities in survival.
Provide Social and Economic Stability
Economic security is critical for health. Federal and state economic relief policies must equitably address inequalities in social and economic conditions that shaped health risks long before the pandemic.
Consider that unsafe and substandard housing affect residents’ chronic disease risk and ability to socially distance safely. Black, Hispanic, and lower income individuals are more likely to live in such places.
Meanwhile, discrimination and other daily stressors increase chances for heart disease, an important risk factor for COVID-19 death. Black, Hispanic, and lower income persons have especially high stress levels. These examples show how inequities in social and economic conditions due to racism and other inequalities shape risk for COVID-19 and related complications.
COVID-19 may be new, but the inequities it produces are not. If we want to alter recurring patterns—for COVID-19 and other health issues—we must address the social and economic conditions that put people at risk of health risks.
A pandemic reminds us that our lives—and fates—are interconnected. It also spotlights existing inequalities that unfairly leave the most vulnerable bearing the greatest economic and human loss. It’s time to decide what we’re willing to do to change that.
Elaine Hernandez (PhD, MPH) is an Assistant Professor of sociology at Indiana University-Bloomington. She examines how health inequalities emerge and persist across generations, as well as policy approaches to ameliorate them.
BY ELAINE HERNANDEZ, COURTNEY BOEN AND RICHARD M. CARPIANO,
OPINION CONTRIBUTORS — 04/23/20
THE VIEWS EXPRESSED BY CONTRIBUTORS ARE THEIR OWN AND NOT THE VIEW OF THE HILL
© Getty Images
We’re told that pandemics are “great equalizers,” impacting rich and poor alike. Yet black, Hispanic, and lower income individuals are dying from COVID-19 at disproportionately high rates.
For those of us who study health inequities, this tragic news is unsurprising. It is rooted in policies and practices that reinforce racial, ethnic and class inequalities. These factors predate the pandemic, but also put people at greater risk of COVID-19.
Failing to act is counter to extensive research that demonstrates how policies can narrow health inequities. Paid sick leave polices have an equalizing effect and reduce disease spread. Economic policies like the Earned Income Tax Credit and minimum wage increases can improve public health and reduce risk of death from multiple causes. Uniform health screening and treatment protocols improve patient outcomes and minimize health inequalities. Even initiatives like mandatory seat belt laws and smoking bans can reduce inequities in health risks.
The question is whether we have the will to use this knowledge and act. Here are approaches to address underlying social and economic conditions that put communities at health risk from COVID-19 and other causes.
Establish Worker ProtectionsTo prevent infection spread, we need worker protections (including paid sick leave and livable wage laws) for all. These are especially important for our most vulnerable essential workers, including grocery, warehouse, and care workers.
People in unstable jobs and without access to paid sick days face increased risk of poor health, both from chronic disease and COVID-19. Black, Hispanic, and low-income individuals are more likely to hold such jobs compared to white and higher income persons. Stable, living wage jobs afford people the resources they need to meet basic health needs, and paid sick leave allows workers to care for themselves and others without worry of losing their income or job.
Deploy Uniform Testing Protocols
We need uniform infection and antibody testing, regardless of race, income, or insurance status. Community and drive-through testing sites are disproportionately located in high-income, white areas, despite higher infection risk in poor and predominately black and Hispanic neighborhoods. And patients with COVID-19 symptoms are less likely to be tested if they are black.
These patterns mirror prior evidence. For example, educational and income disparities in screening rates emerged when mammograms for cancer became available. And when being treated for pain, providers are less likely to prescribe pain medications to black versus white patients.
Equalize Access to Health Care
We must ensure equitable access to health care and reduce administrative burdens for people to enroll. Concerns about acquiring COVID-19 and incurring costs may mean many avoid seeking care for ongoing or new health problems.
Health care systems should also share treatment protocols—including telemedicine and innovative clinical care models—to lessen the burden on providers to reinvent the wheel, while also reducing bias and expanding access to quality care.
And within hospitals and clinics, because black, Latino, and low-income individuals are more likely to be in poor health prior to COVID-19 infection, we need carefully-designed protocols that avoid exacerbating inequities in survival.
Provide Social and Economic Stability
Economic security is critical for health. Federal and state economic relief policies must equitably address inequalities in social and economic conditions that shaped health risks long before the pandemic.
Consider that unsafe and substandard housing affect residents’ chronic disease risk and ability to socially distance safely. Black, Hispanic, and lower income individuals are more likely to live in such places.
Meanwhile, discrimination and other daily stressors increase chances for heart disease, an important risk factor for COVID-19 death. Black, Hispanic, and lower income persons have especially high stress levels. These examples show how inequities in social and economic conditions due to racism and other inequalities shape risk for COVID-19 and related complications.
COVID-19 may be new, but the inequities it produces are not. If we want to alter recurring patterns—for COVID-19 and other health issues—we must address the social and economic conditions that put people at risk of health risks.
A pandemic reminds us that our lives—and fates—are interconnected. It also spotlights existing inequalities that unfairly leave the most vulnerable bearing the greatest economic and human loss. It’s time to decide what we’re willing to do to change that.
Elaine Hernandez (PhD, MPH) is an Assistant Professor of sociology at Indiana University-Bloomington. She examines how health inequalities emerge and persist across generations, as well as policy approaches to ameliorate them.
Courtney Boen (PhD, MPH) is an Assistant Professor of sociology and demography at the University of Pennsylvania. Her research examines the patterns and drivers of racial and social class inequalities in population health. She previously worked in public health policy at the state and local levels.
Richard M. Carpiano (PhD, MPH) is Professor of Public Policy and Sociology at the University of California, Riverside. His research focuses on social, economic, community, and policy factors that impact health and health disparities.
Subscribe to:
Posts (Atom)