Tuesday, March 24, 2020

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. 

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