Tuesday, March 24, 2020

Congress' $2 trillion coronavirus stimulus package

A visual guide to the cost of Congress plans for coronavirus stimulus package to send cash to Americans and help distressed industries, in graphics.



Javier Zarracina, Ledyard King, and Nicholas Wu, USA TODAY 3/24/2020

Feb. 24: The Trump administration proposes $2.5 billion to fight Coronavirus. The proposal includes money taken from existing programs, including funding to combat the Ebola crisis in 2015. Congress rejects that as far too small.

March 4: Congress passes $8.3 billion which includes:
Roughly $500 million to allow Medicare providers to administer telehealth services to assist elderly patients unable to leave their homes.
$2.2 billion for federal, state, and local public health agencies to prevent, prepare for and respond to the coronavirus.
$1 billion in loan subsidies to be made available to help small businesses, small agricultural cooperatives, small aquaculture producers, and nonprofit organizations.
More than $3 billion for research and development of vaccines, therapeutics and diagnostics to prevent or treat the effects of coronavirus

March 18: Congress passes Families First Coronavirus Response Act which is designed to cover:
Full cost of Covid-19 testing for all Americans, including those uninsured.
Two weeks of paid sick leave for workers at companies with 500 or fewer employees, or about 87 million Americans combined.
More than $1 billion to maintain federal nutrition assistance, such as subsidized lunches for low-income children, food banks, and meals for eligible seniors.
$1 billion to help states process and cover unemployment insurance claims.

What’s happening now:

Congressional leaders are negotiating a third stimulus package that could reach $2 trillion and include relief for major industries such as airlines, small businesses that have seen revenues dwindle or disappear, and workers facing layoffs and loss of health coverage.

GOP leadership proposal for next stimulus: 

Direct payments of up to $1,200 for most individuals and $2,400 for most married couples filing jointly with an extra $500 for each child.

Waives penalties for early withdrawal from qualified retirement accounts for coronavirus-related purposes of up to $100,000. 

Allows deferral of student loan payments and allows students who were forced to drop out of school due to coronavirus to keep their Pell grants. 

Increases Medicare payments to hospitals treating a patient admitted with coronavirus.
Provides small businesses access to private bank loans equal to four months of expenses (payroll, rent, utilities, etc.) that would be covered by the federal government if they stayed open, maintained their workforce and paid their bills.

Provides a financial lifeline of several hundred billion dollars to industries hardest hit by crisis. Initial proposals called for help for passenger airlines (up to $50 billion), air cargo lines (up to $8 billion) and “other major industries" (up to $150 billion) severely impacted by government health restrictions to combat coronavirus. Companies receiving assistance would be barred from raising the pay of certain executives.

Provides tax relief to businesses by deferring tax payments, increasing deductibility for interest expenses and allowing immediate expensing of qualified property improvements, especially for the hospitality industry. 



Democratic leaders’ proposal: 
Requires President Donald Trump invoke the Defense Production Act that can be used to order private companies to manufacture respirators, masks and other needed equipment.

Provides more workers the security of guaranteed paid family and medical leave 

Give states nearly $40 billion to stabilize school funding and help colleges continue operating during the crisis. 

Gives states billions in grant funding for states to help hold elections, including expansion of early, absentee and mail voting. 

Protection for workers by increasing unemployment insurance and Medicaid. 

More strings attached for financial loans to industry than Republicans are proposing to make sure bailouts aren't followed by layoffs. Banning companies that receive significant federal assistance from “buying back stock, rewarding executives and laying off workers.” 

Protections for individuals facing eviction, foreclosure or forbearance because of the loss of employment due to coronavirus. 

Ensures relief for the 44 million federal student loan borrowers. 

What could happen:


Items potentially on table that have yet to generate broad support: 

On Democratic side:
Minimum wage hike to $15
Cancel all student debt
Universal health care 


Larger individual payments
Changes to targeted lending/bailouts
Democrats oppose loans to large corporations, especially those that bought back lots of stock

Aid for Americans to prevent utility shut-offs.


On Republicans side:

Bailouts of cruise lines, hospitality industry and others disproportionately affected by economic shutdown.
Payroll tax holiday


Originally Published 10:02 a.m. MDT Mar. 23, 2020
Updated 40 minutes ago

THE 100 YEAR PANDEMIC
The Spanish flu devastated Alaska. This time with coronavirus, villages aren't taking any chances.

Trevor Hughes USA TODAY 3/24/20

Statewide quarantines to help control the coronavirus outbreak are raising heartbreaking memories for many Alaska Natives whose families were devastated by the two-year Spanish flu epidemic that wiped out half the population of some villages.

Taking a cue from drastic measures imposed during the 1918-1919 flu outbreak that spread via mail carrier and traders to remote villages, the 200-person village of Grayling on the Yukon River has banned all visitors and is mandating that anyone who leaves during the outbreak be quarantined for 30 days. Other villages are taking similar steps by banning all flights except for in the case of medical emergencies.


Even the famous Iditarod dog sled race — which in part commemorates the delivery of life-saving medical supplies to Nome during a 1925 diptheria outbreak — saw one of its normal sled dog musher checkpoints moved away from the coastal village of Shaktoolik after residents there grew concerned about an influx of outsiders who could be carrying coronavirus. Researchers say the Spanish flu killed all but six of Shaktoolik's residents.

The moves by towns like Grayling and Shaktoolik are reminiscent of how the 600-person village of Shishmaref, near Nome, weathered the Spanish flu outbreak: Tribal leaders posted armed guards to ban anyone from entering, likely saving hundreds of lives. During that same outbreak, the nearby village of Wales didn't implement similar restrictions and lost 170 residents, many of whom are buried in a mass grave marked by a wooden cross.

"It is so recent. This happened in my grandparent's generation. It's not that long ago," said Dalee Sambo Dorough, 60, chairwoman of the Anchorage-based Inuit Circumpolar Council. "This is still with us."


The U.S. has reported almost 46,500 confirmed COVID-19 cases, with the national death toll at almost 600 as of Tuesday, according to the Johns Hopkins University data dashboard. Alaska has not reported any coronavirus deaths.

Many Alaska Native villages can only be reached by aircraft or snow machine in the winter, or cargo barge in the summer, in theory limiting their connections with the outside world. But at the same time, few villages have comprehensive medical care, requiring that anyone who gets sick must be flown to a larger city for treatment. Additionally, regular cargo flights are needed to keep the residents supplied with basic household items, from food to toilet paper.

"For Inuit, they do recognize there's an upside to being rural and remote. But at the same time, we have too many gaps in terms of infrastructure within those communities that requires cargo flights and barges," Dorough said.


Across the country, mayors and governors have ordered people to stay at home except for necessary trips for supplies, medical appointments or to exercise. Nationally, about 100 million Americans are subject to the self-quarantine orders, including in New York, California, Ohio, Louisiana, Delaware and Indiana. But some skeptics, including President Donald Trump, are asking whether the restrictions recommended by public health officials are truly necessary.

A 2006 study for the federal government that examined several isolated communities, including one in Vermont and another in Colorado, concluded that isolated areas that enforced strict quarantines during the Spanish flu pandemic fared better than the nation as a whole.

Gunnison, Colorado, for instance, erected barriers and checkpoints to limit people from entering town, enforced with fines and jail time for violators. The quarantine lasted four months, but the town suffered few deaths from the outbreak, concluded the report titled "A Historical Assessment of Nonpharmaceutical Disease Containment Strategies Employed by Selected U.S. Communities During the Second Wave of the 1918-1920 Influenza Pandemic", which was written for the federal Defense Threat Reduction Agency.


That report also concluded that communities that rolled back their quarantine orders and then were forced to re-implement them when the outbreak returned were less likely to see voluntary compliance the second time around.


Now, quarantine and shelter-in-place orders are spreading across the country, from Hawaii to New York. And residents of Anchorage, Alaska's largest city, have been ordered to "hunker down" to help slow the spread of the virus. While the state is generally considered remote, the Ted Stevens Anchorage International Airport is the fourth-busiest air cargo airport in the world, thanks to being 10 hours from 90% of the industrialized world. Every day, a steady stream of cargo airplanes from Asia land in Anchorage to refuel and swap out crews.

Sean Asiqłuq Topkok, a professor at the University of Alaska, Fairbanks, said Alaska Native communities that have decided to quarantine themselves are honoring their ancestors.

"From an Alaska Native perspective, the Iñupiat in Shishmaref had sentinels to make sure nobody entered into their community regardless if a person was infectious or not, for the well-being of the whole community," said Topkok, who holds a PhD in indigenous studies and is part Iñupiaq.

"There were many other villages who didn’t survive as well as Shishmaref. What I learned from their survival is vigilance and Iñuuniaqatiunik Ikayuutiłiq," he added, which means "responsibility to tribe" in Iñupiat.

Topkok, 53, said Alaska Native Elders, who are respected older adults within the community, are particularly vulnerable because the coronavirus seems to be more dangerous to older people. In contrast, the Spanish flu epidemic killed large numbers of children.

"Whenever any Elder starts to tell a story, which are all lessons, I stop what I am doing to give them my full attention," Topkok said. "They are the voices of our ancestors. They have witnessed such dramatic change these past couple generations. It’s not only what they know that important to listen to, but also how they continue to adapt to the changes while maintaining resilient people."
What life was like in 1918:Before coronavirus, Seattle was under siege by the deadliest flu in history.

Topkok and Dorough said Alaska Native villages have struggled for generations to access infrastructure taken for granted by other Americans: clean running water, indoor plumbing and even reliable Internet access. Take handwashing, Dorough said: While health officials recommend that people wash their hands frequently with soap and water for 20 seconds at a time, "that's great if you have potable water, a clean source of water."

Many homes in Alaska Native villages use water tanks for drinking water, or collect ice, and toilets are just containers lined with a plastic bag, known as a "honey bucket."

Such conditions have led to long-term problems with pneumonia and tuberculosis outbreaks in villages, compounding existing complications from climate change, which is flooding some coastal villages and changing the ecosystems that subsistence hunters depend on for food, Dorough said.

'It's kind of wave after wave after wave — even though our communities are remote, they are being impacted by things that are now global. And that's affecting our of way of life," she said. "This outbreak is just the latest chapter in that."


---30---
Funerals, grieving death faces changes during the coronavirus outbreak
Sarah HauerJohn Steppe Milwaukee Journal Sentinel 3/23/2020


MILWAUKEE – How we grieve – often by holding a large gathering to celebrate a life – is changing during the coronavirus outbreak.

As limits are placed on gatherings and businesses close, funerals are being rethought to restrict attendance.

The practice of social distancing to slow the spread of coronavirus has canceled school, postponed weddings and will alter how we hold funerals.

Funeral homes are adapting to reduced attendance for end of life celebrations and ask families to consider a smaller funeral or even wait until after the pandemic to hold a large memorial service.



"Irrespective of (the restrictions), you're going to have deaths," said John Maher, the director of Brett Funeral Home. "So we have to keep working the best that we can. ... May there be an increase? I'm afraid to say there likely will be."

Religious services will change to allow for social distancing. The Episcopal Diocese of Milwaukee is not holding funerals. Bishop Steven Miller said in a letter that "until the time of social distancing can be ended," there would be no funerals.


Miller wrote that priests could officiate at graveside services, but they should be aware of the number of attendees. Catholics in the Archdiocese of Milwaukee will still be able to hold funerals, but attendance will be limited. Rabbis will probably stop sitting shiva at someone's home in the event of a death.The Islamic Society of Milwaukee said in a letter that its mosque was closed, and funeral prayers could not be performed there. Funeral prayers could be held at a funeral home with just family members, the Islamic Society said, or preferably at the cemetery.



Burials and memorials impacted


In parts of Italy hardest hit by the virus, funerals, witnessed by a relative or two, last five minutes and end without any embraces, just the few people who were there hurrying back to their cars.

Some cemeteries don’t allow graveside services at all.

“We just take deceased up to the grave and bury them,” said Terry Harmon, owner of Chapman Funeral Home in Orange, California, where a nearby cemetery said burials would be attended by one relative and one clergy.

The Rev. Marshall Hatch, a minister in Chicago, decided to stop presiding over funerals after a service at his church attracted 400 people. In the ensuing days, as the government kept reducing the number of people allowed at public events, he couldn’t shake the memory of all those mourners hugging each other.

“I thought, ‘What did we just do?’ ” Hatch said, a day before officials in Georgia said they had evidence of an unspecified number of infections linked to two funerals.


Some funerals are delayed altogether. Country singer Reba McEntire postponed one for her mother, posting on social media that “we will continue to monitor the situation and let you know as soon as possible about future plans to celebrate her life.”

When singer Kenny Rogers died Friday, his family posted a statement that it planned a private service, with a public memorial to be held at a later date.


Virtual funerals?

Maher said he understands people's need for closure, but there are other ways to get closure than risking contracting coronavirus at a large service.

"Here's a death, and you don't want to have more of them because of a funeral," Maher said. "You don't want to take a bad situation like a death of whatever nature and make it worse."

Maher said much of Brett Funeral Home's work is done on behalf of other funeral homes, cremation or small services.

Brett Funeral Home does not have the capability of doing a virtual funeral, but Maher said he envisions people recording funerals to send to loved ones.

"We always have had visitors who have recorded it in some fashion and send it, for instance, out of the country," Maher said. "It had nothing to do with COVID-19. It was visa issues. So this has been done for a long time."


Jeff Kleczka, co-owner of Prasser-Kleczka Funeral Home in Wisconsin, said he asks people to avoid attending a funeral if they do not feel well and to consider alternatives to physical embraces such as putting a hand over one's heart or bowing.

Kleczka said that if a family wants to do a smaller ceremony right away, an additional memorial service at a later date would come "with little to no expense to them."

Prasser-Kleczka is being "even more so vigilant" in sanitizing common surfaces such as door handles and railings.

"This is the history of funeral homes and funeral service," Kleczka said. "Our profession always adapts. We always do what we have to do for the families that we help."

Contributing: Don Babwin and Amy Taxin of The Associated Press


The US had a chance to learn from anthrax, SARS, H1N1 and Ebola. So why is the federal coronavirus response so messy?

BECAUSE THE KNOW NOTHING T PARTY IS IN CHARGE 



Dennis Wagner Donovan Slack USA TODAY


Former U.S. Sen. Joe Lieberman says it was as if Paul Revere rode across the country and no one paid attention.

For more than two decades, Robert Kadlec has warned leaders that the United States is not just vulnerable to a pandemic but doomed by dysfunction if one were to strike.

Several years ago, his warnings gained traction.

Congress passed a law in 2016 mandating a federal plan to protect against contagious diseases.

In 2018, President Donald Trump adopted a National Biodefense Strategy. It largely followed recommendations of a commission founded and directed by Kadlec, a retired U.S. Air Force colonel and physician who has held senior positions at the White House, Senate and Pentagon.

Kadlec was appointed to oversee preparedness and response at the Department of Health and Human Services.

But the document approved by Trump was a blueprint, not a game plan. The ideas weren't implemented before COVID-19 arrived in the USA. And the federal government’s response shows it. 



One example: The government has been criticized for taking too long to create and distribute tests to detect the virus. There are shortages of medical supplies and equipment such as protective masks and ventilators. Anticipating such shortages, the biodefense strategy calls for setting up excess manufacturing capacity to produce these necessities quickly in an emergency.

The same biodefense strategy called for a Cabinet-level committee to oversee protection against contagious diseases, but it never met to discuss the coronavirus outbreak.

The Coronavirus Task Force created by Trump one month into the epidemic did not include Kadlec, the person who had warned of this sort of catastrophe for years.

The nation’s biodefense network remains a labyrinth, according to the Bulletin of Atomic Scientists, in which responsibility is shared by at least 19 federal agencies, three executive offices, 50 political appointees and all state, local, tribal and territorial governments. Their roles are codified in a dizzying mix of laws, directives and action plans.

The system is so complex, a Department of Energy lab used its policy mapping tool known as the “Spaghetti Monster” to illustrate the overlapping linkages.


The National Biodefense Strategy is supposed to untangle that mess. Among its sweeping goals: “Ensure decision-making is informed by intelligence, forecasting, and risk assessment.” And “Rapidly respond to limit the impacts of bioincidents."

Lieberman and Asha George, executive director of the Bipartisan Commission on Biodefense, said those objectives have not been implemented.

In February, in the heat of the coronavirus pandemic, the Government Accountability Office concluded the national strategy has “no clear, detailed processes, roles, and responsibilities for joint decision-making.”

Even the administration’s messaging about coronavirus seemed to defy principles of the biodefense strategy. It calls for “timely, regular, coordinated, and consistent” communication to the public.

On the same day this month, Trump downplayed COVID-19, saying it is “something we have tremendous control over,” while his top infectious disease expert, Anthony Fauci, said it could kill hundreds of thousands of Americans.

'How bad is this? It's bad.':Trump shifts tone as pandemic worsens, crisis hits economy

“It really is a Pearl Harbor moment, and are we going to be able to gear up?” Lieberman asked. “Here we are now, it’s a crisis and maybe going to be a catastrophe. … We’d be in a lot better shape if people had acted earlier.”

A senior administration official, who refused to be identified because he was not authorized to speak publicly, said the biodefense strategy laid out a single, coordinated effort across the federal government for the first time, and its goals are being implemented in response to the coronavirus pandemic.

The administration official said the steering committee outlined in the biodefense strategy was superseded by the Coronavirus Task Force.

The official said Trump created the biodefense strategy to improve response time in situations such as the coronavirus pandemic, and it's working.

20 years of warnings about biological threats like coronavirus

In March 2019, Kadlec told Congress the nation’s biological protection system was understaffed by 2,000 workers. “Emerging disease outbreaks, particularly those with pandemic potential, are an international flight away,” he said.

Ten months later, the novel coronavirus broke out of China and traveled halfway around the world to the USA. It was an opportunity to put strategy into action.

Over the years, Kadlec sounded his fears in sometimes apocalyptic scenarios. He could not be reached for an interview for this story.

In 1998, Kadlec envisioned an anthrax assault on New York City. “Conservative estimates put the number of deaths occurring in the first few days at 400,000,” the Vancouver Sun reported. “Beyond the immediate health implications of such an attack, the potential panic and civil unrest would create an equally large response.”

In 2001, Kadlec anticipated a genetically modified disease. “It’s not your mother’s smallpox,” he warned. “It’s an F-15 Stealth fighter – it’s designed to be undetectable, and to kill. ... We are flubbing our efforts at biodefense.”


His mission began with the Defense Department in the 1990s. He moved to the White House during the 2000s as director of biodefense on the Homeland Security Council and as a special assistant to President George W. Bush.

Kadlec repeatedly told Congress that U.S. biodefense plans were disastrously flawed. No central leadership. Muddled national strategy. Insufficient money, supplies and manpower to handle a lethal contagion – whether it was naturally occurring or the result of biological warfare or terrorism.

In 2014, he founded a nonprofit organization, the Blue Ribbon Study Panel on Biodefense, to attack the problem as a civilian. Kadlec persuaded Lieberman, an independent and former Democrat, and ex-Homeland Security Secretary Tom Ridge, a Republican, to co-chair the effort.

That panel, renamed the Bipartisan Commission on Biodefense, completed a scathing report in 2015 and sent it to President Barack Obama. “The Nation lacks the leadership, coordination, collaboration and innovation necessary to respond,” the commission wrote.

It proposed a blueprint for biodefense with clearly defined roles and the vice president in charge. It warned that pandemics carry “the possibility of millions of fatalities and billions of dollars in economic losses.”

The report caught the eye of lawmakers. Just before Obama left office, Congress passed a law mandating the creation of a plan.

Trump released the National Biodefense Strategy in September 2018. By then, he had appointed Kadlec as an assistant secretary of Health and Human Services, in charge of preparation and response.

Essentially, Paul Revere was tagged as the point man.

Untangling the nation’s plans for an epidemic

Over the past few decades, epidemics, terrorist attacks and natural disasters have spurred an onslaught of statutes, plans and directives from the nation’s capital.

Efforts to fend off public health threats gained urgency amid the anthrax attacks of 2001, when letters laced with the deadly disease were sent through the U.S. mail, killing five and sickening 17.

In 2004, after the Severe Acute Respiratory Syndrome (SARS) outbreak, President George W. Bush signed a directive that focused on biological weapons and addressed how to contain and treat infectious diseases.

Five years later, after the H1N1 epidemic, Obama issued his own strategy with measures to combat “infectious diseases of natural, accidental, and deliberate origin.”

After Americans who traveled to West Africa contracted Ebola in 2014, responsibility for biodefense was still spread across Washington bureaucracies.

Members of the blue-ribbon panel studied the system for a year, gathering testimony from dozens of experts. They concluded the nation’s risks from biological threats had reached “critical mass.”

The first of its 33 recommendations in 2015 called for centralized command. Kadlec had argued for years that biodefense directives must come from the top – above Cabinet secretaries – and from someone who could take an active role.

“The Nation lacks a single leader to control, prioritize, coordinate and hold agencies accountable,” the commission's report said. “Leadership of biodefense should be institutionalized at the White House with the Vice President.”

Former homeland security and counterterrorism adviser Lisa Monaco said the Obama administration agreed with the spirit of that recommendation, though not the letter. Near the end of his administration, Obama created a unit within the National Security Council assigned full-time to disease preparedness.


“In 2018, unfortunately, that structure was dismantled,” Monaco said, referring to Trump’s decision to eliminate the White House pandemic office. Monaco is a member of the Bipartisan Commission on Biodefense and a public health adviser to former Vice President Joe Biden, who seeks the Democratic nomination for president.

'Gross misjudgment':Experts say Trump's decision to disband pandemic team hindered coronavirus response

Instead of putting the vice president in charge of the biodefense strategy, Trump assigned that role to himself, while National Security Council staff oversaw policy and Health and Human Services coordinated pandemic response.

“That’s a real problem because the secretary of health has absolutely no authority to push other Cabinet members,” said Kenneth Bernard, a former assistant surgeon general who wrote the 2004 biodefense plan under Bush. “That was, I think, a major, major error.”
Coronavirus puts the strategy to the test

Once a biodefense strategy was adopted, it was only a matter of time before it would be tested.

Trump designated a Cabinet-level steering committee to oversee its implementation, but that committee has never met to confront COVID-19 issues.

Instead, on Jan. 29, a day before the World Health Organization declared a global emergency, the president announced a Coronavirus Task Force. That arrangement isn’t mentioned in the Biodefense Strategy.

By Feb. 26, the virus had reached 37 countries outside China and established a foothold in the USA, where there were more than 50 known cases and countless undiagnosed because of a shortage of test kits.

That day, Trump named Vice President Mike Pence to lead the Coronavirus Task Force.

Jeremy Konyndyk, who served in the Obama administration as director of U.S. Foreign Disaster Assistance, said that seemed “pretty striking.” Although Trump’s biodefense strategy said Health and Human Services would lead the effort, “in an actual crisis, the leadership is back at the White House, where it should have been in the first place.”

“We’re playing catch-up,” Lieberman said. “It is really, profoundly disappointing to me.”


The unnamed senior Trump administration official said Pence’s experience as a governor made him a perfect point person as the administration expanded its efforts to combat the virus. The official said that before Pence's appointment, the president had taken a “range of decisive actions reflective of his whole-of-government approach,” including imposing travel restrictions.

Lieberman and George noted that the Coronavirus Task Force is dominated by White House advisers and Health and Human Services administrators, and one name is noticeably missing: Robert Kadlec, the federal health official responsible for preparedness and response. His boss, Health and Human Services Secretary Alex Azar, is on the task force.

The Department of Health and Human Services did not respond to questions and an interview request.

On March 2, Kadlec was named to lead Health and Human Services' response.
'Hung up in the bureaucracy'

The next step after creating the biodefense strategy, George said, was to implement it and untangle all those laws, policies and duties. That got “hung up in the bureaucracy.”

“It didn’t really work,” she said, referring to the strategy. “I don’t know if ‘dismayed’ is the right word, but I look at what’s going on right now, and I just think, geez, there’s so much that could have been done in advance.

“It bothers me that people are going to get sick and die because we didn’t have plans and policies.”

By mid-March, Americans were panic-buying at supermarkets, wiping out supplies of toilet paper and pasta. Major cities shut down gathering places, and some ordered residents to shelter in place.

Then, another change in the administration’s approach: The Federal Emergency Management Agency was announced as the lead in coordinating the federal response to COVID-19, something at least one former FEMA official expected would have happened earlier.

The decision came five days after Trump signed a national emergency declaration, and eight weeks after coronavirus was first diagnosed in the USA.

On Sunday, asked on ABC News’ “This Week” why FEMA hadn’t taken the lead earlier and wasn’t part of the coronavirus task force, FEMA Administrator Peter Gaynor said he wasn’t going to discuss “what should have been done, what wasn't done.”

“The public health medical mission – that authority lies with HHS,” he said. “My mission, FEMA, prior to this, (was) natural disasters and those catastrophic events that happen. Now it's a different world.”

Amid this turmoil, the GAO completed a review of the National Biodefense Strategy that it began in 2018, well before COVID-19 emanated from a wet market in Wuhan, China.

As the disease spreads, the GAO said in a report to Congress, “the federal government must take necessary steps to protect the American public. … However, the Strategy is only as good as its implementation.”

Friday, Trump defended the nation’s response to the pandemic: “This administration inherited an obsolete, broken, old system that wasn't meant for this. We discarded that system. ... And we’re very proud of what we’ve done.”

To which Bernard, the former assistant surgeon general, replied: “If it was broken, why didn’t you fix it two years ago?”

Contributing: Bart Jansen, David Jackson, Ledyard King
We need an immediate five-week national lockdown to defeat coronavirus in America

Locking down the country would reduce infections and allow time for massive testing. There will be staggering human and economic costs if we delay.


Yaneer Bar-Yam
Opinion contributor 3/23/2020

I am an MIT-trained physicist and complexity scientist who studies pandemics. I have warned about global pandemics due to increasing travel for 15 years. I recommended community-based monitoring of symptoms to stop Ebola in West Africa in 2014, and it worked. The fastest and even the only way to contain COVID-19 in the United States is a five-week national lockdown.

Closing schools, bars and movie theaters are good measures, but not enough. Our relaxed approach to social distancing is insufficient to stop the exponential growth of COVID-19. Until Americans consistently adopt strong social distancing recommendations — a lockdown — the disease will continue to spread exponentially.

During a five-week national lockdown, federal, state and local authorities would ensure that all Americans stay home except to obtain food and other essentials, access medical care or do work essential to the functioning of society. Travel would cease: We would close our borders and airports and prohibit all unnecessary travel across state and county (or town) lines within the United States. The U.S. government would have to provide aid to citizens separated from their sources of income and ensure care for vulnerable members of society.

Lockdown would sharply reduce cases

During the first two weeks of a lockdown, infected individuals will either recover from mild cases of COVID-19 at home or seek medical attention for the 14% of cases that are severe. During the third, fourth and fifth weeks, any newly infected family or cohabitants of infected individuals will recover or seek medical attention, and their isolation will prevent further spreading. By the end of the lockdown, the number of infections will be a small fraction of what they are now. 

Don't panic:The best thing everyday Americans can do to fight coronavirus? #StayHome, save lives

The lockdown will give us time to dramatically scale up our supply of COVID-19 test kits and capacity to process them. If we reduce the number of infections using the lockdown and start a massive testing regime in the United States, we can control COVID-19 after five weeks without such extreme social distancing measures. Isolating sick individuals and their immediate contacts will be enough.
The human and economic costs of delaying this lockdown will be staggering. The COVID-19 outbreak has many more cases now than are visible (tip of the iceberg) and they are growing rapidly. We had about 33,500 cases in the United States on Sunday, over 9,000 more cases than the previous day. At this rate, without a lockdown, in one week there will be about 300,000. In two weeks: 3 million.

One in 7 cases require hospitalization and 5% require intensive care with ventilators to survive. There aren’t nearly enough ventilators available.

We can buy time:Coronavirus reality check: 7 myths about social distancing, busted

The effectiveness of a five-week lockdown will be dramatic — and also entirely predictable.

We know a U.S. lockdown can work because it worked in China. At the height of its COVID-19 crisis in mid-February, China had locked down an estimated 760 milllion people, approximately half of its population. This policy was so successful that Wuhan is now much safer from coronavirus than New York City or Washington, D.C. The few new COVID-19 cases in China now stem from foreign travelers rather than local transmission, and all are safely quarantined.

We know what we have to do. President Donald Trump, governors and local leaders must act now to save millions of lives.

Yaneer Bar-Yam is the founding president of the New England Complex Systems Institute, where he is an expert on pandemics and other complex systems. He is spearheading the effort of over 3,000 volunteers working to stop the outbreak at endcoronavirus.org. Follow him on Twitter: @yaneerbaryam

STOCK MARKET IN THE TIME OF COVID-19 TOON

People are making DIY masks to fight coronavirus. But do they actually work? (NO)

Lorenzo Reyes USA TODAY 3/23/2020

As the coronavirus pandemic continues to engulf the United States, a national shortage of N95 masks and depleting stock of loose-fitting surgical masks has induced a creative solution: do-it-yourself versions.

Some of the millions of Americans who remain relegated to their homes due to shelter-in-place orders are using that time to sew and assemble masks out of spare and recycled fabric, elastic and other materials.

Experts advise, however, that while the homemade alternatives can create a loose-fitting barrier that may mitigate the spread of some germs, they are not designed to block the spread of COVID-19, the official name of the pandemic that has swept the globe.

“The only mask that the CDC considers safe from you getting the coronavirus, the only way to actually prevent you from inhaling it, is the N95 mask,” Captain Michael Doyle, a U.S. Army New York National Guard physician assistant, told USA TODAY. Doyle is the commanding officer at the drive-in coronavirus testing site in New Rochelle, New York.
“The DIY masks, albeit creative, are only to serve as a reminder for us to not touch our face," Doyle said. "The virus can travel up to six feet if you cough, sneeze, vape, second-hand vape. Although, when you are out in public, you do not necessarily need the mask, unless you yourself are sick. And if you are sick, it is advised that you do not go out in public.”


The Centers for Disease Control and Prevention says the best way to prevent illness is by avoiding exposure to the virus. It advises, above all else, for people to avoid person-to-person contact and practice social distancing, avoid touching the eyes, nose and mouth, cover coughs and sneezes with tissue or the inside of the elbow, and to frequently and thoroughly wash hands for at least 20 seconds.

N95 masks are tight-fitting masks that filter out at least 95% of small and large airborne particles, according to the CDC. They are recommended for use by health care workers in the treatment of the coronavirus. The FDA added, however, that even when properly fitted, an N95 mask “does not completely eliminate the risk of illness or death.”

Homemade masks many are sewing, rather, resemble loose-fitting surgical masks, also known as facemasks, that do not meet the N95 standards.

“The role of facemasks is for patient source control, to prevent contamination of the surrounding area when a person coughs or sneezes,” the CDC said on its website. “Patients with confirmed or suspected COVID-19 should wear a facemask until they are isolated in a hospital or at home. The patient does not need to wear a facemask while isolated.”

The CDC further advises that individuals who are not sick do not need to wear a facemask unless caring for someone who is ill.

"Facemasks may be in short supply and they should be saved for caregivers," the website reads.

Facemasks, including N95 masks, are becoming scarcer, subject to increasing demand and even facing price gouging as local officials seek to bolster their stockpile through the private sector. In response, several companies are undertaking initiatives to replenish medical supplies at hospitals across the country.

JOANN fabrics launched a program Friday that gives away free fabric, elastic and other essential materials so that customers can make facemasks at home to donate to hospitals. The company even has a video tutorial on its website that shows the proper methods to assemble the masks.


In Arizona, a nonprofit in Flagstaff, Threaded Together, is using surgical fabric recycled by the Flagstaff Medical Center to sew masks. A Gilbert small business, My Little Homemade Shop, started sewing masks and giving them away for free after local health care workers reported not being provided masks because they were not considered “at-risk,” and after the owner of the shop heard that doctors in the Neonatal Intensive Care Unit Staff were wearing bandanas instead.

Meanwhile, a number of companies and retailers have shifted their operation to help manufacture masks. The clothing company Hanes, for example, is retrofitting its factories to produce masks, though the company will not have the capabilities for them to meet N95 standards.

“The masks we are making use 3-ply cotton fabric and are reusable and washable,” HanesBrands chief communications officer Matt Hall wrote in an email to USA TODAY. “They are designed to be used when N-95 respirator masks or formal surgical masks are not required or are not available.”

Fashion designer Christian Siriano, Los Angeles Apparel founder and former head of American Apparel Dov Charney and swimsuit designer Karla Colletto have also committed to producing personal protective equipment for medical staff.

The Federal Emergency Management Agency does have a strategic reserve of N95 masks and has begun distributing them to states in need, but many local hospitals fear that stockpiles will soon be entirely depleted.

Many health care workers are being forced to ration their N95 masks and some who don’t have access to N95 masks are resorting to surgical masks, otherwise known as facemasks. Yet, the CDC advises against health care professionals using these masks when treating coronavirus patients.

The FDA does not have specifications for homemade masks, but the DIY masks many in the country are crafting are most like the loose-fitting surgical masks.

The FDA states that when properly worn, surgical masks are “meant to help block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), keeping it from reaching your mouth and nose.”

The FDA added, however, that a surgical mask “by design, does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures.”
William S. Burroughs Reads Edgar Allan Poe’s “The Masque of the Red Death”

in Audio Books, Literature | January 26th, 2016

The label "American original" gets slapped onto a lot of different people, but it seems to me that, especially in the realm of letters, we could find no two luminaries who merit it more in the 19th century than psychological horror pioneer Edgar Allan Poe, and in the 20th century William S. Burroughs, sui generis even within the Beat Generation. So how could we resist featuring the recording just below, free to hear on Spotify (whose software, if you don't have it yet, you can download here), of Burroughs reading Poe's tale — because, as you know if you read him, he wrote not stories but tales — "The Masque of the Read Death"?


The 1842 tale itself, still haunting today more than 170 years after its publication, tells of a prince and his coterie of a thousand aristocrats who, in order to protect themselves from a Black Plague-like disease---the titular Red Death---sweeping through common society, take refuge in an abbey and weld the doors shut. In need of amusements (this all takes place about century and a half before Netflix, remember), the prince throws a masquerade ball. What, then, should interrupt this good time but the inexplicable arrival of an uninvited guest in a costume reminiscent of the corpse of a Red Death victim — possibly an embodiment of the Red Death itself?

Poe could tell a seriously resonant tale, and so could Burroughs. Though completely different in form, aesthetic, setting, and psychology, both writers' works strike just the right ominous tone and leave just enough unexplained to seep into our subconscious in vivid and sometimes even unwanted ways. And so it makes perfect sense for Burroughs and his voice of a jaded but still amused ancient to join the formidable lineup of Poe's interpreters, which includes Christopher Walken, Vincent Price, Christopher Lee, James Earl Jones, Iggy Pop, Lou Reed, and Stan Lee. But among them all, who better than Burroughs to articulate "The Masque of the Red Death's" final line: "And Darkness and Decay and the Red Death held illimitable dominion over all."

You can hear more of Burroughs reading Poe, in performances recorded for the computer game The Dark Eye, in Ted Mills' previous post here.

Related Content:

William S. Burroughs Reads Edgar Allan Poe Tales in the Vintage 1995 Video Game, “The Dark Eye”

Iggy Pop Reads Edgar Allan Poe’s Classic Horror Story, “The Tell-Tale Heart”

Edgar Allan Poe’s “The Raven,” Read by Christopher Walken, Vincent Price, and Christopher Lee

Lou Reed Rewrites Edgar Allan Poe’s “The Raven.” See Readings by Reed and Willem Dafoe

Download the Complete Works of Edgar Allan Poe on His Birthday

Aubrey Beardsley’s Macabre Illustrations of Edgar Allan Poe’s Short Stories (1894)

Based in Seoul, Colin Marshall writes and broadcasts on cities and culture. He’s at work on a book about Los Angeles, A Los Angeles Primer, the video series The City in Cinema, the crowdfunded journalism project Where Is the City of the Future?, and the Los Angeles Review of Books’ Korea Blog
Follow him on Twitter at @colinmarshall or on Facebook
LIKE THE MASQUE*** OF THE RED DEATH
How an Upscale Connecticut Party Became a Coronavirus 'Super Spreader'


Elizabeth Williamson and Kristin Hussey NYTIMES





Businesses have closed along Main Street in Westport, Conn., where a surge in coronavirus cases has been reported.  SLIDES © Dave Sanders for The New York Times

About 50 guests gathered on March 5 at a home in the stately suburb of Westport, Conn., to toast the hostess on her 40th birthday and greet old friends, including one visiting from South Africa. They shared reminiscences, a lavish buffet and, unknown to anyone, the coronavirus.

Then they scattered.

The Westport soirée — Party Zero in southwestern Connecticut and beyond — is a story of how, in the Gilded Age of money, social connectedness and air travel, a pandemic has spread at lightning speed. The partygoers — more than half of whom are now infected — left that evening for Johannesburg, New York City and other parts of Connecticut and the United States, all seeding infections on the way.

Westport, a town of 28,000 on the Long Island Sound, did not have a single known case of the coronavirus on the day of the party. It had 85 on Monday, up more than 40-fold in 11 days.

At a news conference on Monday afternoon, Gov. Ned Lamont of Connecticut said that 415 people in the state were infected, up from 327 on Sunday night. Ten people have died. Westport, with less than 1 percent of the state’s population, now makes up more than one-fifth of its Covid-19 infections, with 85 cases. Fairfield County, where Westport is, has 270 cases, 65 percent of the state’s total.

Governor Lamont pleaded with federal officials for hospital capacity and protective gear. “I urge them: Don’t think in terms of New York, think in terms of the hot spots,” he said. “And that’s New York City, Westchester County — and Fairfield County.”


Science cannot definitively link those escalating numbers to New York, which now accounts for about half of the coronavirus infections in the United States. But the Westport soirée “may be an example of the kind of thing we call a super-spreading event,” said William Hanage, an associate professor of epidemiology at Harvard, especially since some of the partygoers later attended large social events in the New York metropolitan area.

“Some of the early cases in Northern Italy were associated with small towns, and people thought, ‘Oh, it’s just in the small towns.’ But then you suddenly find cases emerging from Milan Fashion Week and spreading internationally,” Dr. Hanage said. “Everywhere you think the virus is, it’s ahead of you."

The visitor from Johannesburg — a 43-year-old businessman, according to a report from South Africa — fell ill on his flight home, spreading the virus not only in the country but possibly to fellow passengers. The party guests attended other gatherings. They went to work at jobs throughout the New York metropolitan area. Their children went to school and day care, soccer games and after-school sports.

On the morning of March 8, three days after the party, Julie Endich, one of the guests, woke up in Westport with a fever that spiked to 104 degrees and “pain, tightness and heaviness like someone was standing on my chest,” she later wrote on Facebook. She knew her symptoms suggested Covid-19, the disease caused by the novel coronavirus, but it would be four days before she could get test results confirming that she had it.

At noon that day, town and county health officials convened a coronavirus forum at the Westport Library. About 60 people attended, and many others watched on Facebook. When asked whether people, especially Westport’s many older residents, should follow federal government guidance and avoid large gatherings, officials were sanguine.

“It is not out in our community that we’re aware of yet,” said Mark A.R. Cooper, the director of the Westport Weston Health District. “Give it some thought, but again, your risk is low.”

A moderator next passed the microphone to an older man.

“How many test kits do we have in Westport now?” he asked.

“Zero,” Mr. Cooper replied. “None. They’re not available.”

Three days later, on March 11, Mr. Cooper got a phone call: A South African businessman who had stopped in Westport for a party had fallen ill on the plane home to Johannesburg.

“I thought it was good old man flu,” the businessman told The Sunday Times in South Africa, speaking anonymously in a March 15 article. Unlike in the United States, where tests remain in short supply and results come slowly, the man was tested and received word in a day. He was positive.

Mr. Cooper and his staff of nine dusted off their pandemic response plan and began calling party guests, identified by the Westport hosts. A number of the guests had children. Several hours later, Westport closed its schools and most public buildings. Jim Marpe, the Westport first selectman — the equivalent of a mayor — convened a hasty news conference on the steps of the Westport Town Hall.

“We’ll assess the health of those individuals and try to give them some helpful advice in terms of protecting themselves and family and helping prevent further spread,” Mr. Cooper told the crowd.

But, he warned, “The reality is, once it starts to spread in a community, it’s beyond trying to stop it.”

The health district worked with a private company to conduct drive-through testing for party guests only on March 12. About 38 guests showed up, and more than half their tests came back positive. Ms. Endich, after days of rejected attempts, was tested at Stamford Hospital and received her positive result on March 12.

“What we were trying to do was put our arms around it quickly and snuff it out,” Mr. Cooper said. “Never did we dream that in a week’s time we were going to be in the middle of an epidemic.”

The number of sick people in Fairfield County then soared. On March 16, Governor Lamont closed restaurants and public buildings statewide. Even in a well-connected, affluent town like Westport, contact tracing quickly overwhelmed health officials. Beyond the 50 attendees, “there were another 120 on our dance list,” some of whom probably were not at the party, Mr. Cooper said. One of the party guests later acknowledged attending an event with 420 other people, he said. The officials gave up.

“They think at least 100 times as many people are infected as what the tests are showing,” Arpad Krizsan, who owns a financial advisory firm in Westport and lives in the community, said on Saturday. “And everybody goes to the same four shops.”

Worry, rumors and recriminations engulfed the town. Political leaders fielded hundreds of emails and phone calls from residents terrified that their children or vulnerable family members had been exposed. Who threw the party, and who attended? They wanted to know. Rumors flew that some residents were telling health officials they had attended the party so they could obtain a scarce test.

Officials refused to disclose the names of the hosts or any guests, citing federal and state privacy rules. Mr. Marpe posted a videotaped statement to the town website on March 20. “The fact of the matter is that this could have been any one of us, and rumor-mongering and vilification of individuals is not who we are as a civil community,” he said.

As the disease spread, many residents kept mum, worried about being ostracized by their neighbors and that their children would be kicked off coveted sports teams or miss school events.

One local woman compared going public with a Covid-19 diagnosis to “having an S.T.D.”

“I don’t think that’s a crazy comparison,” said Will Haskell, the state senator who represents Westport. He has been fielding frantic phone calls from constituents.

Most residents were exercising recommended vigilance, Mr. Haskell said, but one call that stuck out to him was from a woman awaiting test results whose entire family had been exposed to the virus. “She wanted to know whether or not to tell her friends and social network,” he said, because she was worried about “social stigma.”

Mr. Haskell, who has been delivering his grandparents’ medication to their Westport doorstep and leaving it outside, was incredulous. “This is life or death,” he said in an interview. “Westport really is a cautionary tale of what we’re soon to see.”

The party hosts remain unknown to most, though speculation is rife. Two of the guests, Ms. Endich and Cheryl Chutter, an attendee who lives in Stamford, have identified themselves.

Though she said she was “relentless” in demanding a test, Ms. Chutter did not learn of her diagnosis until March 17. She notified her son’s private school, and “they sent him home in an Uber and closed the school three hours later,” she said. His youth soccer league scrapped the rest of the season for 1,500 players after she informed team leaders that she had stood with other parents cheering on the sidelines before she got sick.

Ms. Chutter and Ms. Endich both emphasized the kindness of their neighbors, who spontaneously delivered food, water and encouragement. Ms. Chutter said health officials called daily to check on her. She is also aware of blaming and efforts to out the party attendees.

“It’s no use pointing fingers,” she said in an interview. “It’s not like you’re going to lock that one person up when there are millions of people in the world who have it. We’re so past that.”

The first partygoer to learn that he was ill with the virus passed word from Johannesburg to Westport that he had fully recovered and even planned to go for a jog.

“I don’t believe I’m the problem anymore,” he told The Sunday Times. “It seems that the real problem is now the people who are too scared to say anything. The problem is the ignorance of the public.”

Sheila Kaplan contributed reporting from Washington. Kitty Bennett contributed research.

How an Austrian ski resort helped coronavirus spread across Europe

By Denise Hruby for CNN


Henrik Lerfeldt has fond memories of Kitzloch, a popular restaurant and bar in the Austrian ski resort town of Ischgl, where he partied several nights while on vacation three weeks ago.
© Jakob Gruber/APA/AFP/Getty Images Authorities closed down Kitzloch in Ischgl, Austria, on March 9.

The 56-year-old Dane, who spoke to CNN from self-quarantine at his home 50 miles from Copenhagen last week, said that his time in Kitzloch in the Austrian province of Tyrol was the way "after-ski" is supposed to be. "Lots of people, lots of drinks, and nice waiters happy to serve you more."


Four days after his return home, Lerfeldt tested positive for the coronavirus, or Covid-19, as did one of his friends he was traveling with. But they are just two among hundreds of people from all over Europe whose infections are traced back to Ischgl, some of them directly to Kitzloch, according to European authorities.

Kitzloch declined to comment when contacted by CNN for comment. Its owner, Bernhard Zangerl, told German news site t-online on March 16 that his employees must have also contracted the virus from someone, and the site reports Zangerl as saying it was audacious to try to pin this on one company.

Despite an official warning from the Icelandic government on March 4 that a group of its nationals had contracted coronavirus in Ischgl, Austrian authorities allowed ski tourism -- and the partying that goes with it -- to continue for another nine days before fully quarantining the resort on March 13. Bars in Ischgl were closed on March 10.

Even after a bartender tested positive for the virus, the medical authority of Tyrol -- where ski tourism is one of the biggest economic drivers -- reiterated in a press release on March 8 that there was "no reason to worry." CNN has reached out to Franz Katzgraber, the director of Tyrol's medical authority, for further comment and not received a response.

Ischgl and its neighboring villages draw around 500,000 visitors each winter, with high-profile celebrities and politicians such as Paris Hilton, Naomi Campbell and Bill Clinton among them in previous years.


After a string of rebuttals that the town and bar were linked to the spread of the virus, Austrian authorities have since conceded that they were.


In a statement emailed to CNN, the provincial government denied it had dragged its feet, saying it acted in a timely and efficient manner. "With the measures taken, the authorities were able to contain the continuation of the chain of infections," Bernhard Tilg, Tyrol's provincial councilor responsible for health, care facilities, science, and research, said in the statement.

Health experts, however, say otherwise.
Raising alarm bells

The assistant to the director of health at the Icelandic health directorate told CNN that the country's chief epidemiologist Thorolfur Gudnason informed Austrian authorities on March 4 that several Icelandic tourists were infected with the virus while in Ischgl. Gudnason used Europe's official Early Warning and Response System, the directorate confirmed in an email.

On March 5, the day after Iceland notified Austria that Icelandic tourists had contracted Covid-19, Reykjavik added Ischgl to its list of risk zones for Covid-19 transmission, putting the risk of infection in the village on par with China, South Korea, Italy and Iran.

Jan Pravsgaard Christensen, a professor of immunology of infectious diseases, at the University of Copenhagen, told CNN that Iceland's listing should have immediately raised alarm bells.

"Considering that it is a place where people are in close contact in bars, restaurants, and so on, once they know of ... people infected in the same area, they should have initiated a quarantine very quickly," he said.

However, regional authorities in Tyrol downplayed the risk. In a first official reaction to Iceland's listing, Katzgraber said in a March 5 press release that it was "unlikely" there was contagion in Tyrol.

Based on a statement by a single traveler who said that a sick tourist who had visited Italy shared the same flight home to Iceland, Katzgraber said in the same press release that the group of Icelandic tourists likely contracted the virus after they left Austria, giving no evidence.

Oral beer pong and sharing whistles

On March 7 -- three days after Iceland's warning -- a 36-year-old bartender at Kitzloch tested positive. Twenty-two of the bartender's contacts were quarantined, 15 of whom have since tested positive for Covid-19, the provincial government confirmed in press releases.

The outbreak had spread far beyond the Tyrol.

The most recent available Danish government figures show that out of more than 1,400 cases in Denmark, 298 contracted the virus in Austria. In comparison, only 61 cases are linked to travel to Italy, so far the hardest-hit country in Europe.

As of March 20, Icelandic authorities are aware of eight people who got infected with coronavirus in Ischgl specifically, the health authority told CNN.

"At first, we didn't understand how this many cases could have happened," Christensen, who had been briefed by experts working on Iceland's response to the pandemic, said. But a clearer picture emerged when officials worked out what was going on in some of Ischgl's tightly packed bars and clubs.

"We realized that they exchanged saliva because they were playing beer pong," using their mouths, he said, although he did not single out any specific bars where the game took place. The game involved spitting ping pong balls out of their mouths into beer glasses, and those balls were then reused by other people.

Lerfeldt reported that Kitzloch bartenders, including the 36-year-old who later tested positive for coronavirus, blew on a brass whistle to get people to move out of their way as they took shots to customers. Several customers also blew the whistle for fun, Lerfeldt said. "I can see why people would want to whistle it -- and nobody knew he was sick," Lerfeldt said.

Monika Redlberger-Fritz, head of the influenza department at the Medical University of Vienna, told CNN that the way the virus spread in Ischgl means there was likely at least one person who infected a large number of other people.

"That means that there was at least one patient who had a very high viral load, and while most people will infect two to three others on average, these people can transmit the disease to 40, 50, or 80 people." Redlberger-Fritz said that this may have cut the lead time for authorities to react by several days.

Anita Luckner-Hornischer, an official with Tyrol's medical authority, said in a press release on March 8 that "a transmission of the virus onto the guests of the bar is, from a medical point of view, rather unlikely." She gave no evidence.

Authorities closed down Kitzloch on March 9 and said there was no increased risk of transmission.

By March 10, Günther Platter, the provincial governor of Tyrol, said at a press conference that all new cases confirmed in the province that day -- 16 in total -- were tied to a single bar and one of its barkeepers. Local authorities later confirmed the bar to be Kitzloch, the small but bustling bar where Lerfeldt said he and his friends partied for five nights.

"We have found that the risk of infection is very high in the bars. All cases go back to one bar," Platter said at the press conference.
Hundreds of cases traced back to Ischgl

At least four countries have now reported links to Ischgl, showing how the tiny village, home to no more than 1,600 permanent residents, became a major vector in spreading Covid-19.

Alongside Denmark and Iceland, Germany has traced about 300 cases back to Ischgl, more than 80 of them in Hamburg and 200 in the small city of Aalen, according to German media. CNN has been unable to independently verify these figures.

The count is so high that Aalen set up a new email address specifically for people who have visited Ischgl to get in touch with authorities. In a virtual press conference on March 17, the health minister of the German state Baden-Württemberg said, according to German state news agency DPA: "Our problem isn't called Iran, it's Ischgl."

Norway also confirmed that, as of March 20, 862 out of its 1,742 cases were contracted abroad, and said it traced 549 of them back to Austria, according to the Norwegian Institute of Public Health.

Kitzloch has a capacity for 100 people and, when Lerfeldt was there, was packed with patrons from Denmark, Sweden, Norway and Germany, he said.

When the national government announced a lockdown of the area on the afternoon of March 13 -- nine days after Iceland's notification -- the remaining tourists were asked to leave the village and return home without stopping.

Most returned straight to their respective home countries, Tilg, the provincial councilor responsible for health, care facilities and research, told Austrian public broadcaster ORF, but hotel owners in the provincial capital of Innsbruck confirmed to local media that hundreds of Ischgl tourists who were stranded that Friday afternoon checked into their establishments to wait for flights Saturday.

"The authorities acted correctly in every aspect," Tilg reiterated several times in the ORF interview on March 16, and rejected all criticisms in an email to CNN.

Tilg blamed the spread of the virus in Tyrol -- which accounts for about a quarter of Austria's more than 4,400 coronavirus cases as of March 23 -- on tourists who either carried it into the province or did not follow regional authorities' advice to return home immediately.

Europe is now the epicenter of the coronavirus outbreak and the European Union has closed its borders to all non-essential travel as it attempts to slow its spread. The Austrian government put Ischgl under full quarantine on March 13. Five days later, on March 18, local officials extended these measures and ordered all 279 communities in Tyrol to isolate themselves.

While Lerfeldt and his friends say they have fully recovered, Christensen said that it is impossible to determine the number of people who were infected by Ischgl's ski tourists once they returned home, to countries all over Europe.


***a form of amateur dramatic entertainment, popular among the nobility in 16th- and 17th-century England, which consisted of dancing and acting performed by masked players. 

CHRISTOPHER LEE READS