Thursday, April 02, 2020


“Silent Carriers” Are Helping Spread The Coronavirus. Here’s What We Know About Them.

People with no COVID-19 symptoms may be spreading the disease — but big questions remain about how much they are driving the pandemic.

Stephanie M. LeeBuzzFeed News Reporter April 2, 2020

Nurphoto / Getty Images
People walk in a New York City park despite social distancing orders, March 26.

Fever, a dry cough, fatigue: By now, these have become the telltale signs of COVID-19. But can it be unwittingly spread by people with no symptoms?

In late January and early February, when the disease had begun to spread outside China, leading health officials, including the World Health Organization, told the public that transmission from asymptomatic people was likely “rare,” based on information available at the time. “In all the history of respiratory-borne viruses of any type, asymptomatic transmission has never been the driver of outbreaks,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Jan. 28.

Those assessments were based on early data out of China, where the virus originated in late December. A few months later, as the coronavirus has afflicted more than 1 million people worldwide and killed 51,000 of them, scientists know a lot more about how the virus spreads. And an emerging body of data suggests that there are probably a significant number of infected people who don’t have symptoms but are likely to be transmitting the virus. Since they may not know that they’re sick, they may be taking fewer precautions than people with symptoms.

Researchers still don’t know how common these cases are or how much they are driving the pandemic. On Monday, the director of the CDC told NPR that the number of asymptomatic individuals “may be as many as 25%.”

Here’s what we know so far about these so-called silent carriers.

1. First, it’s important to keep in mind that “asymptomatic” is different from “presymptomatic.”

Being presymptomatic means you’ve been infected and don’t feel any symptoms at the time you get tested, but will develop them later on. In contrast, asymptomatic people never have any symptoms during the course of their infections at all.

That difference matters for the scientists who are racing to identify and count cases to study the spread of the virus. If you’re truly asymptomatic, you’re probably not going to get tested and would therefore never be counted by the health care system. But you may still be contributing to the virus’s spread.

Alternatively, suppose you are symptom-free when you test positive, only to later develop a fever and cough that you don’t report to your doctor. You might be mistakenly counted as asymptomatic rather than presymptomatic.

“Previously we had commonly used asymptomatic to include both groups so it's tough to break out of that thinking and lexicon,” Tara Smith, an epidemiologist at Kent State University, said by email. “But I think this pandemic has shown that there may be nuance between those who are not YET symptomatic and those who might NEVER show symptoms, and that seems to be important here.”

To Jeffrey Shaman, an infectious disease expert at Columbia University, the simpler and more important distinction is between “documented” versus “undocumented” cases — the latter being all infected people who aren’t diagnosed. Those could include a person who is very sick but “hates to go to the hospital or see a doctor and toughs it out at home,” he told BuzzFeed News.

It’s more likely that a lot of these undocumented COVID-19 cases have symptoms mild enough that they don’t feel the need to see a doctor, but are walking around in the world anyway, he said.

The slight differences in these terms matter. “They’re not all the same thing but are getting conflated,” Smith said.


Carl Court / Getty Images

2. Estimates for how many “silent carriers” there are vary. For asymptomatic cases, estimates range from 18% to 30% of all infections.

It’s tough to quantify the number of asymptomatic people, because they’re unlikely to seek testing on their own. But the coronavirus outbreak on the Diamond Princess cruise ship gave researchers a unique chance to study this — even if it was a nightmare for the 3,700 passengers and crew members trapped off the coast of Japan.

Held under quarantine over two weeks in February, many of the people on board were repeatedly tested and their symptoms, or lack thereof, were tracked. CDC researchers found that 46.5% of infected people did not have symptoms at the time of testing. Many eventually did develop symptoms, but statistical models suggest that 18% of infected cases remained asymptomatic.

One caveat is that the passengers were older than the general population. Elderly people are more likely to be severely affected or killed by COVID-19, while younger people are more likely to develop mild symptoms.

Because of the skewed demographics, Gerardo Chowell, a Georgia State University mathematical epidemiologist who led a study about asymptomatic cases aboard the Diamond Princess last month, thinks the true number of asymptomatic people in the world is around 30% or 40%. “We know there’s a substantial fraction of asymptomatic” cases, he told BuzzFeed News.

Other researchers have produced estimates in this ballpark. One recent report said 29%, but was based only on a group of two dozen people in China. Another reported 30% of COVID-19 patients may not have symptoms, based on screenings of 565 Japanese citizens evacuated out of Wuhan in February.

CDC director Robert Redfield offered up yet another percentage this week, telling NPR, “One of the [pieces of] information that we have pretty much confirmed now is that a significant number of individuals that are infected actually remain asymptomatic. That may be as many as 25%.” He did not cite what that figure was based on.

Part of why it has taken a while for scientists to realize the outsize role that people without symptoms may play in spreading the disease may be because of how the initial data out of China was reported.

As of Feb. 11, the Chinese Center for Disease Control and Prevention was reporting that of more than 72,000 reported cases in mainland China, about 1.2% were asymptomatic. The WHO–China joint report about the coronavirus, from mid-February, stated, “The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.”

But last week, the South China Morning Post reported that, according to confidential Chinese government data, more than 43,000 people in China had tested positive for the virus by the end of February “but had no immediate symptoms.” These people were not included in the government’s official tally, according to the news outlet, which suggested that these people could therefore be as high as one-third of those who test positive. Researchers told BuzzFeed News that this estimate seemed plausible.

Putting aside the presence or absence of symptoms, low testing rates, especially in the US, mean that we do not know about a large proportion of people with COVID-19.

Shaman, the Columbia infectious disease expert, thinks the proportion of undocumented cases — infected people who are not officially diagnosed — could be as high as 86% in some places, meaning that these “invisible” cases are driving the pandemic. That estimate, published last month, was based on projected activity in Wuhan in the weeks before China imposed strict travel restrictions to stem transmission.

Since the virus has spread beyond Wuhan, Shaman said, “We’re seeing increasing evidence that there’s a lot of virus out in the community, a lot of infections out there, much more so than are being confirmed.”

More precise numbers won’t be possible to determine without health-care systems that can treat and diagnose lots of patients — which may not exist in developing countries — and robust, widespread testing. The US was slow to start testing compared to countries like South Korea and still has not scaled it up to a level that public health experts say is necessary.

The most definitive testing would include running blood antibody tests on everybody, which could detect whether they ever had the virus even if they didn’t show symptoms. Singapore has been using these tests to trace infections, and the United Kingdom is preparing to roll them out as well.

TRUMP'S "INVISIBLE" ENEMY/SCOURGE/ETC.
IS ACTUALLY QUITE VISIBLE UNDER A MICROSCOPE

NIH
Colorized scanning electron micrograph of a cell (blue) infected with the coronavirus, isolated from a patient sample.

3. Presymptomatic people can transmit the virus for a few days before they have symptoms, studies suggest.

The virus’s incubation period — the time between getting infected and showing symptoms — is about five days. That’s similar to that of the coronavirus that caused SARS. (For COVID-19, virtually everyone who develops symptoms does so by day 12.)

The problem is that people seem to be unwittingly spreading the new virus before they have symptoms, research suggests, and this presymptomatic transmission is happening at a more rapid rate than it did with SARS. With COVID-19, such transmission may even be happening more frequently than transmission from those with symptoms, researchers from Japan said in a study in late February.

“This suggests that a substantial proportion of secondary transmission may occur prior to illness onset,” they wrote.

Other research also supports the idea that presymptomatic transmission can happen for a few days before symptoms kick in. On Wednesday, the CDC released data about such cases in Singapore from late January to mid-March. In these cases, a person gave the virus to someone before they themselves developed symptoms, with no evidence that the second person had been exposed to anyone else who was infected.

In cases where researchers were able to confirm the dates of exposure, transmission happened one to three days before the originally infected patient developed symptoms, according to the report.

Scientists are still figuring out exactly when someone crosses the threshold from being infected to being able to infect others. The CDC says that someone can transmit the virus up to 48 hours before symptoms develop.
4. We don’t know with certainty that asymptomatic people are spreading the virus — though they probably are.

Completely symptom-free people can still carry around substantial amounts of the virus, also known as a person’s “viral load,” evidence suggests.

For example, researchers in China recently reported on one coronavirus patient who never developed symptoms, but whose viral load was similar to that of 17 others who did have symptoms. This “suggests the transmission potential of asymptomatic or minimally symptomatic patients,” according to a preliminary report in the New England Journal of Medicine last month. There have been other individual cases of asymptomatic transmission seeming to happen, as reported by researchers in China in February.

But it still hasn’t been definitively proven that these people are giving the virus to others. Proving that would mean checking asymptomatic people to see if they were actually excreting live virus, and therefore were infectious. Antibody tests, which can be done after an infection ends, would also confirm they were truly infected. Right now, “we really don’t know if people who are truly asymptomatic can transmit or not,” said Smith of Kent State University.
5. All of this reinforces the importance of staying home as much as you can (and, some say, of wearing a mask).

The possibility that people can unknowingly spread the virus has inspired a heated debate over whether everyone should be wearing masks in public — including homemade, nonmedical ones — to help avoid getting sick as well as to prevent infecting others. The CDC currently discourages healthy people from wearing them, but is reconsidering that guidance.

How well a mask wards off infection varies depending on the setting, use, and fabric, studies show. But Chowell, among other experts, is pro-mask all the time. “We all should be wearing some sort of mask whenever you go out and have to interact with other people,” he said.

Whether you cover your face or not, it’s still important to help prevent transmission by practicing socially distancing, which means staying 6 feet away from others in public, staying home as much as possible, and avoiding crowded places, according to public health experts and the CDC’s national guidelines. In a further attempt to reduce transmission, at least 30 states are issuing shelter-in-place orders that have closed schools, offices, parks, and nonessential businesses.

Until the virus is under control, we likely won’t fully understand what role non-diagnosed cases are playing in the outbreak.

“We know we have a problem,” said Juan Gutierrez, a mathematics professor who specializes in infectious disease modeling at the University of Texas at San Antonio. “We have a hint of what could be the size of the problem. And a story will emerge many months from now when we have widespread testing in the population and we can start ascertaining, ‘Who got affected?’ and then asking people, ‘did they ever get symptoms?’”

---30---



Stephanie M. Lee is a science reporter for BuzzFeed News and is based in San Francisco.
Some Amazon Employees With Fevers Are Being Sent Home Without Pay

Amazon said employees who test positive for the coronavirus get two weeks paid leave, but those sent home with a fever should use paid time off if they have it or take unpaid leave if they don’t.


Caroline O'Donovan BuzzFeed News Reporter
Posted on April 2, 2020

Jeenah Moon / Reuters
Protesters at an Amazon building on Staten Island, March 30.

Atiya felt under the weather when she reported to work at Amazon’s JFK8 Staten Island facility on Wednesday. But her condition worsened during her shift, she told BuzzFeed News, and when she asked management to take her temperature it was 101.1 degrees.

Management immediately gave Atiya, who asked to be identified only by her first name for fear of losing her job, a mask and escorted her out of the facility. She said she was handed a piece of paper with information about COVID-19, the disease caused by the novel coronavirus, sent home, and told not to report back until she was fever-free for 72 hours. Since then, Atiya, who started working at Amazon a little over two weeks ago, said she hasn't heard from anyone at the company about whether she’ll continue to be paid while she stays home from work.

By Thursday, her fever was 102 degrees, and she said she’d spoken to a health care worker in Brooklyn who told her not to come for a coronavirus test but to stay home in quarantine for the next two weeks. Atiya currently has $50 in her bank account and is expecting a paycheck from Amazon on Friday. Because she’s only worked for the company for a couple of weeks, she’s only accrued a couple shifts' worth of paid time off, most of which she’d already used to stay home to care for her 4-year-old daughter.

“I received my pay statement today and it says $0.”

Amazon did not immediately respond to a request for comment. Responding to questions regarding temperature checks and paid leave for those sent home, a company spokesperson said Wednesday: “All hourly employees are welcome to use paid and unpaid time off options. This includes unlimited unpaid time off through the end of April.”

Last month, Amazon announced that any employee who tested positive for the coronavirus or was ordered to quarantine by a medical professional would receive up to two weeks of pay. But workers the company has sent home with fevers, which may or may not have been caused by the coronavirus, said Amazon wasn't giving them paid leave beyond any paid time off they had already accrued.


Inland Empire Amazonians United

Amazon started checking employees’ temperatures at work earlier this week. According to a text message sent to Amazon employees in Southern California, “If someone has a temperature of 100.4F or above, we’ll require them to go home until you have been fever free for 72 hours.”

But the company, which made $3.3 billion in profit in the last quarter of 2019, said employees sent home with fevers should use their accrued paid time off if they have it or go without pay if they don’t.

“[Amazon hasn’t] reached out to me to find out my status or what’s going on,” said Atiya.”If I don’t get any type of funds, I’m not sure what to do, especially if I have to quarantine myself. I don’t know too many pantries around here. I’m not sure where I can get food ... for my family.”

Other workers told to self-quarantine are unsure whether they’ll be paid for the time they spend at home. “I’m still waiting on a case manager to give me a call,” a Detroit-based Amazon employee who declined to be named told BuzzFeed News. “Our payday is this Friday. I received my pay statement today and it says $0.”

This employee received written quarantine instructions from his doctor last Thursday and said he was supposed to hear from Amazon within three to five business days, but he’s still waiting. “Financially I’m wrecked at this point in time,” he said.

Amazon employees around the country have said that, despite the company’s claims about enhanced cleaning and workplace safety, it’s not doing enough to protect them from the coronavirus pandemic. Thousands of employees, including more than 500 white-collar tech workers, have signed petitions demanding that Amazon provide more hazard pay and paid sick leave and temporarily close facilities where employees have tested positive for disinfection. Dozens of employees in New York, Chicago, and Detroit have walked off the job and picketed outside Amazon facilities in protest of inadequate sanitation and unsafe working conditions.


Amazon is also under a spiraling PR crisis today after a leaked memo was published in Vice in which the company's general counsel called Chris Smalls — a New York worker whom the company fired for failing to adhere to quarantine orders as he protested its handling of the pandemic — "not smart or articulate." Smalls' termination has become a rallying cry for critics of the company, with Sen. Bernie Sanders on Wednesday calling it "absolutely immoral."

Amazon’s new temperature screenings are intended to make the company’s facilities safer by preventing sick people from infecting their coworkers, but employees say the process is confusing, inconsistent, and potentially causing more problems.

Amazon “is forcing employees to test their coworkers for fever because no one would volunteer to do this,” an employee in Edison, New Jersey, who requested anonymity, told BuzzFeed News. “All people who are tested are less than 6 feet between tester and the employee being tested.” He said Amazon is providing “no additional protections for testers.”

Amazon did not immediately respond to request for comment on its fever screening procedures.

Meanwhile, he said that despite the concerns he and others have voiced, Amazon still isn’t disinfecting individual work stations.

“Mr. Bezos is the richest man in the world and Amazon workers deserve better.”

Federal health and safety guidelines recommend employers not require employees to present documentation of illness to receive financial aid during the pandemic, but companies like Instacart, Uber, and Amazon are still requiring workers to present positive tests. This requirement is proving to be a problem for many workers in states that have test shortages.

“Here in NJ people are lined up for hours at driving through testing centers,” said the New Jersey–based Amazon employee. “[It] takes weeks to get the result. Many centers run out of tests before the end of the day.”

More than a dozen lawmakers, including four US senators, have signed letters to Amazon CEO Jeff Bezos demanding answers on employee concerns about safety protections during the coronavirus pandemic. Last Friday, Brian Huseman, Amazon's vice president for public policy, wrote in a public response that the company wouldn't penalize employees who missed work if they needed to stay home and seek medical help.

In response to the news that Amazon wasn't guaranteeing paid leave to employees who failed its temperature screening, Ohio Sen. Sherrod Brown said: “Jeff Bezos is putting employees at risk of contracting the virus by forcing workers to go without pay and failing to implement critical health protections. Mr. Bezos is the richest man in the world and Amazon workers deserve better."


Employees At Office Depot Stores Don’t Think They’re Providing Essential Services During The Coronavirus Pandemic. They Still Have To Go To Work Anyway.

“We’re getting a bunch of people who are kind of just bored shopping,” one employee said.

OFFICE DEPOT OPERATES IN CANADA AS WELL AS THE USA

April 2, 2020

Joe Raedle / Getty Images

As businesses have shuttered around the US, Office Depot has kept thousands of employees in stores, bringing them face-to-face with customers who the company says need access to toilet paper, cleaning products, and equipment to work from home.

In reality, employees told BuzzFeed News, stores can’t keep household essentials stocked on shelves, and some customers are coming in just to browse. With limited access to supplies to sanitize stores and no masks or gloves, employees fear they’re putting their health at risk to provide a service that’s far from essential: ringing up a box of pens, desk accessories, or other trivial items.

“Everything that corporate said that makes us essential we have been either completely sold out of for more than two weeks or we’ve been getting like maybe one or two of these items on the truck and selling out of those within 15 minutes,” a store employee in Michigan said.




Supplied
The shelves inside an Office Depot store.

As officials in more than 30 states order people to stay home and nonessential businesses to close to curb the spread of the novel coronavirus, the office supply company has argued that it provides goods and services that help keep essential businesses running. In general, officials have agreed, but at least one state, Pennsylvania, has specifically ordered office stores to close.

As of Thursday, BuzzFeed News called multiple Office Depot locations in the state and found they were still open for business. One employee said he was frustrated that his bosses were ignoring the law.

“They were very clearly outlined by the state as not being a life-sustaining business and to go against that and be like, ‘Oh sure we are. We have some water and hand sanitizer occasionally when we get it in,’ is — I don't know it just seems like they’re flouting the legal definition of what was established,” he told BuzzFeed News.

Office Depot did not immediately respond to questions. A spokesperson for the Pennsylvania Governor's Office said anyone who believes a business is violating the order to close should contact law enforcement.

"All non-life-sustaining businesses in Pennsylvania should be closed if they do not have an exemption from the commonwealth," the spokesperson said. "Failure to comply with these requirements will result in enforcement action that could include citations, fines, or license suspensions."

Legal definitions aside, more than 20 employees in 13 states said they don’t think they’re providing essential services and worry they are only contributing to the spread of COVID-19 by going to work — putting themselves and their loved ones at risk of getting sick. The employees spoke to BuzzFeed News on the condition of anonymity because they feared getting fired.

“I'm dealing with 50+ customers a day, and handling their stuff. I don't know where they've been or who they've been around. I don't know if they're sick and if they're passing something onto me that I can potentially pass onto someone else,” an employee said in an email to BuzzFeed News. “I'm risking my health, the health of my family, and customers [sic] health every day.”

And, like workers at Costco, CVS, Amazon, Starbucks, and other major retail stores, associates and managers at Office Depot, which also operates Office Max stores, said the company isn’t doing enough to protect them from being exposed to the virus. They’re still coming into close contact with customers who ignore social distancing guidelines and insist that employees handle their personal devices for repairs and copies. They said they’re told by corporate that they’re not allowed to wear masks or gloves, though some are wearing them anyway, and the company has not provided adequate cleaning supplies for them to properly sanitize the stores.



Supplied
A box of supplies sent to a store for employees.

“A lot of people will say retail workers are expendable because like, to most companies, people are expendable, but it's never just been so apparent in your face every day at work,” another employee in Texas said.

While some employees who spoke to BuzzFeed News have been calling out of work, most said they can’t afford to stay home because they don’t have any paid time off or paid sick leave. The company has said in communications reviewed by BuzzFeed News that employees will be excused from work if they have any concerns about COVID-19, but some said they’ve been told otherwise.


A manager in Oklahoma said he was pressured into coming in to work on a reduced schedule after requesting to use his PTO to stay home. He was concerned he could bring the virus home and expose his mom — who could then expose his elderly grandparents.

“My mom is one of the sole caregivers for them, so it’s really important I can’t let her or them get sick,” he said.

Despite the company’s written guidance, another manager in St. Louis said anyone who is refusing to work during the pandemic is supposed to be reported to human resources. She added she is trying her best “to make sure no one is having to come in sick,” but she is not allowed to require that her staff stay home.

Another now-former employee at a store in Canton, Ohio, told BuzzFeed News her store manager told her she had to resign last week if she didn’t come into work.

“I was like, ‘I can’t continue to keep putting my family in danger ... so she was like, ‘So you're resigning then?’ And I was like, ‘I guess so,’” said the former employee, who lives with her grandmother, who is in her seventies, and other extended family. “I gave her ... the lock for my locker and my name tag, and that was it.”

When it came down to it, she said she couldn't bear the thought of possibly getting her family sick and dealing with the guilt of that even though she has medical bills, a phone bill, and other expenses to pay.

“I have to pick and choose what I pay and hope for the best,” she said.

Health officials agree the best way to prevent the spread of the disease is for people to stay home as much as possible and to keep a distance of at least 6 feet from others when out in public.

But orders and guidance issued by state officials on the closure of nonessential businesses have been somewhat vague. For example, California’s list of essential workers does not specifically mention office supply retail stores, but a spokesperson for the state’s Department of Public Health told BuzzFeed News that Office Depot is considered an essential commercial retail business because its stores “supply essential sectors.”

In documentation the company sent to employees, Office Depot claimed it provides “necessary products and services to essential businesses, critical infrastructure industries, and other customers” because it sells household products and equipment, like laptops, phones, and printers. The company said it also provides necessary tech and shipping services that support an at-home workforce, the remote learning educational community, and other essential businesses.

But employees said they’re constantly out of stock of cleaning supplies and other items, like webcams, monitors, and headsets that people may use to work from home, and are seeing customers who come in to the store to buy nonessential items or just browse.
“We’re getting a bunch of people who are kind of just bored shopping,” an employee in Texas said in an email, adding that most of their store’s sales have been furniture.

In a March 27 letter to customers, Office Depot outlined a number of measures the company was taking in its stores to ensure employee and customer safety, including providing curbside pickup at most locations, reducing the hours stores are open, limiting store occupancy to no more than 25 people, and “enabling a six-foot distance requirement” for employees and customers.

Supplied

Employees say it’s not enough, noting that many customers are still choosing to come inside rather than order online and pick up items at the curb. They also said they have been unable to enforce the 25-person limit and distancing requirements.

“It’s just words on paper just to prove that they wrote something down and said, ‘Oh no we gave the orders out, we gave the protocols and the guidelines — we laid everything out for them,’” the manager in Oklahoma said.

Employees said they want the company to offer them paid sick leave and hazard pay or a raise for continuing to work under these conditions, provide personal protective equipment and more adequate cleaning supplies to disinfect the stores, and switch operations to only curbside pickup orders, like Best Buy has done, or close the physical stores altogether.

“Any time the company sends like a message or an email, it just kind of seems like a slap in the face like, ‘Oh we’re so happy that you're risking your health and safety for us,’” a Texas employee said. “It feels like they don't care about us.”

MORE ON THIS
This Major Wine Retailer Is Calling Itself “Essential” During The Coronavirus Lockdown, And Not Everyone Is HappyKatie J.M. Baker · March 24, 2020
Stephanie K. Baer is a reporter with BuzzFeed News and is based in Los Angeles.
Albert Samaha is an investigative reporter for BuzzFeed News and is based in New York.
FDA Now Says It Will Allow Imports Of KN95 Masks,  An Alternative To Scarce N95 Masks
Although the regulator recently authorized use of many kinds of foreign-certified respirators, it left the Chinese masks off the list.

Ken Bensinger BuzzFeed News Reporter April 2, 2020

Bryan R. Smith / Getty Images
A member of the medical staff listens as Montefiore Medical Center nurses call for N95 masks and other critical PPE to handle the coronavirus epidemic in New York, April 1.

In a move that could significantly ease national shortages of personal protective equipment, a top Food and Drug Administration official said Thursday that the agency will not block imports of KN95 respirator masks, a Chinese equivalent to the N95 masks needed by health care workers on the front lines of the coronavirus epidemic.

Until now, the legality of importing KN95 masks has been unclear. A little more than a week ago, the regulator authorized use of a variety of foreign-certified respirators as a substitute for scarce N95 masks on an emergency basis. That authorization came amid a growing public outcry over doctors and nurses forced to reuse respirators or even fashion masks from bandanas

But the FDA’s emergency authorization omitted the KN95 mask — despite the fact that the Centers for Disease Control and Prevention had previously included it on a list of “suitable alternatives” to the N95 mask.

That omission has sown considerable confusion among hospitals, health care workers, importers, and others who had considered turning to KN95 respirators when the market for N95 masks became overheated.


A BuzzFeed News story about the KN95 published earlier this week led to demands from members of the public, experts in the import business, and even a member of Congress that the FDA clear the path for KN95 masks. A KN95 petition launched early this week has to date gained more than 2,500 signatures.

“The FDA is not blocking KN95 mask importations,” said Anand Shah, the agency’s deputy commissioner for medical and scientific affairs in an interview.


But he added that even though the agency will allow importers to bring the equipment into the country, they would be doing so at their own risk. Unlike normally certified devices, or those authorized on an emergency basis, KN95 masks would have none of the legal protections or other support provided by the federal government.

The Chinese-certified KN95 mask is designed to similar standards as the N95 — which is certified by the National Institute for Occupational Safety and Health — yet is currently cheaper and far more abundant. Prices for N95s have, in some instances, risen to $12 or more per mask, while KN95 masks are available for less than $2, according to importers and manufacturers’ marketing materials.

While some hospitals and government entities have decided to accept donations of KN95 masks, many others have refused, citing a lack of clear guidance from the FDA, which regulates medical devices. And importers have worried that their shipments of masks could get tied up by US Customs at the border. Some of those importers said they remain concerned that without full federal authorization, they could be sued should someone fall ill after using one of the respirators.

“Our lawyer warned us we could get in trouble with these KN95s,” said Shawn Smith, a Santa Monica, California, entrepreneur who has been attempting to bring masks into the country to sell to hospitals. “He said we could get sued or even face criminal charges.”

As a result, Smith said, he’s had to join the fray of those trying to make deals to bring in N95 masks, an effort that he said has driven up prices sharply in the past few weeks.

Another would-be importer who emailed the FDA was told Tuesday that the agency “does not object to importation and use of these respirators during the emergency.”

But the FDA has not to date publicly explained the exclusion of KN95 masks from its emergency use authorization. In fact it has made no mention at all of the masks in any public forum. That left those considering purchases or donations of the protective equipment to make potentially costly decisions in an information vacuum, and fostered what amounts to a gray market for the much-needed masks — as well as considerable concern.

Shah said the FDA’s decision to omit the masks was not based on the quality of Chinese certification standards.


Kena Betancur / Getty Image
A couple wears face masks and surgical gloves as they walk in Central Park on March 22 in New York City.

“There are a number of countries that we feel are as vigorous as” US standards, said Shah, “and China is one of them.” Despite that, he said the agency chose not to include KN95 masks “due to the challenges of authenticating product imported from China,” noting that the agency has identified “inauthentic” products labeled as KN95 masks coming into the US. Shah declined to elaborate on what issues were found with those masks.

According to manufacturers, suppliers, and importers, as much as 80% of the world’s supply of all respirator masks of all types are manufactured in China, including US-certified N95 masks and those certified under European Union and other national standards. And multiple cases of counterfeit or nonfunctional masks labeled as N95 have been reported in recent weeks.

One hospital in Teaneck, New Jersey, last week said it had received 1,000 N95 masks from a trusted vendor and discovered they were fake. The CDC maintains an entire web page dedicated to phony N95 masks.


Ahmad Gharabli / Getty Images
Jerusalem Mayor Moshe Lion, wearing a KN95 mask, arrives at a drive-through testing location for COVID-19 in the Palestinian neighborhood of Jabal Mukaber in east Jerusalem, April 2.

Ken Bensinger  is an investigative reporter for BuzzFeed News and is based in Los Angeles. He is the author of "Red Card," on the FIFA scandal. His DMs are open.

Health Care Workers Are Risking Their Lives Treating COVID-19 Patients


What You Need To Know About The Great Face Mask Debate

Whether more people should wear masks has become one of the fiercest debates of the coronavirus pandemic. New data about how the virus spreads may be tipping the scales.

Zahra HirjiBuzzFeed News Reporter April 2, 2020

Michael Bryant / AP
A Costco employee, right, looks towards a shopper wearing a mask and snorkel to go shopping in King of Prussia, Pennsylvania

A growing number of public health experts are arguing that people should wear masks while in public to help prevent spreading the coronavirus, as new data shows people without visible symptoms are likely spreading COVID-19 more than previously believed.

Just this week, the Trump administration announced the CDC was considering the idea. "The idea of getting a much more broad communitywide use of masks outside of the health care setting is under very active discussion,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a member of the president’s coronavirus task force, told ABC News.

As Americans wait for more guidance from the federal government, we’ll tackle three questions currently at the heart of the fast-changing mask debate: Who can spread the virus? Can the virus be airborne? What’s the difference between the types of masks? But first, some overall context:

The debate over mask use — happening inside the Trump administration, academia, and hospitals whose workers are caring for COVID-19 patients — is getting increasingly heated. Public health experts have been pushing back against the narrow federal guidelines stating that face masks should only be worn by health care workers, people caring for the ill, or those who are actively displaying symptoms.

What it means for the general public is still confusing and ethically murky. There is a lethal shortage of medical masks — both the rigid, snug-fitting N95 respirators and the looser-fitting surgical masks — for health care workers, and there will be even fewer if the general public buys them en masse. And as people turn to making homemade masks from craft kits or old T-shirts, it’s still unclear how much these even help prevent the spread of the disease or prevent the wearer from contracting it.
Part of the confusion stems from misleading messaging in the early days of the US outbreak. In late February, US Surgeon General Jerome Adams forcefully said that the public should not wear masks. His widely shared tweet made the contradictory argument that masks would not protect the public against the virus — but that, at the same time, health care workers needed them for protection. He also didn’t specify what counted as a mask. An N95? A surgical mask? A fabric mask?


U.S. Surgeon General@Surgeon_General
Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk! https://t.co/UxZRwxxKL912:08 PM - 29 Feb 2020

Similarly, the CDC’s guidance has been unchanged from the beginning: Healthy people do not need masks. “You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers,” the agency’s website says.

Even the World Health Organization still does not endorse widespread mask use.

Meanwhile, countries where widespread mask use predated the pandemic — including China, Japan, and South Korea — are embracing masks more than ever. George Gao, director-general of the Chinese Center for Disease Control and Prevention, told Science the biggest mistake countries like the US were making in response to the outbreak “is that people aren’t wearing masks.”

PM SHINZO ABE JAPANESE PARLIAMENT 

In recent weeks, some US hospitals have changed their guidelines, requiring all of their staff to wear masks, instead of just those interacting with COVID-19 patients. And US public health experts are pushing back, including Scott Gottlieb, the former commissioner of the US Food and Drug Administration, who cowrote a report recommending “everyone, including people without symptoms, should be encouraged to wear nonmedical fabric face masks while in public.”

The subsequent mask debate inside the federal government, first reported by the Washington Post, is a stark departure from previous federal recommendations.

When asked on Wednesday about whether the public should wear masks, President Donald Trump said: “We don’t want to take them away from our medical professionals, but I don’t see it hurting.” And Los Angeles Mayor Eric Garcetti this week recommended everyone in the city wear a nonmedical mask, such as a homemade mask or bandana.

Public health officials consulted by BuzzFeed News declined to criticize the CDC’s decision-making on masks, saying it was appropriate based on what we knew about the coronavirus at the time. But now that our understanding of the spread has shifted, they said, so too should our guidance on masks.

“The first reason to wear a mask is so we all protect each other,” said Roger Shapiro, a Boston doctor and an associate professor of immunology and infectious diseases at Harvard, the best rationale for wearing a mask “is so you don’t infect someone else.”

There may also “be a small benefit” to a noninfected mask wearer, he added, “since we don’t know everything about how this disease transmits.”

All sides of the debate still agree that masks will only be effective in helping to slow the spread of the coronavirus if used in addition to regular handwashing and social distancing.

Here’s what we know so far:


Mary Altaffer / AP
Passengers wear face masks as they wait in line to check in for their flights on March 24 at JFK airport in New York.

People with no symptoms can spread the virus — so more masks could help stop the spread.

According to the early information coming out of China, where the outbreak began, the virus was predominantly being spread by visibly sick people who were coughing and sneezing into the air close to others and on surfaces.

If those sick people self-isolate, or at least stay 6 feet away from others, and wear a mask to cut down on the germs they are spewing, they would cut down on their chances of infecting others.

Since then, a growing body of data suggests that some percentage of people who test positive for the virus never display any symptoms, but are likely to still be capable of spreading the disease (though such transmission hasn’t been confirmed). In the cases of people who do develop symptoms, they can be contagious for a few days before that happens, other research shows. This means people who the CDC currently says should not wear masks could be spreading the disease without knowing it.

It’s for this same reason that some hospitals have started mandating widespread mask use among health care workers.

The new policy was put in place at Boston’s Massachusetts General Hospital and Partners HealthCare hospitals in recent weeks “based on our recognition that there is widespread community transmission of COVID-19, as well as our recognition that there is significant asymptomatic spread — in other words, COVID-19 can be spread by people who don’t feel ill at all,” Paul Biddinger, chief of emergency preparedness for both MGH and Partners, told the Globe.

Shapiro, whose hospital also changed its guidelines, said that new policy shifted his thinking on masks more generally. “If I’m going to do it in the hospital, it raises that question of why not do it in other settings,” Shapiro said. “But I can tell you I haven’t changed my personal practice.”

There are also questions about whether the virus can be airborne.

When an infected person is coughing, sneezing, or likely even talking, they are spewing both small particles and large droplets into the air. This is how the virus is most likely transmitted, public health officials say, which is why they recommend staying 6 feet away from others to be outside the possible splash zone, as well as washing your hands and avoiding touching your face in case you touched an infected surface.

But new research suggests the virus can sometimes spread through the air, where small particles have stayed aloft for up to 3 hours in a lab setting. That’s much longer than originally thought. But it’s important to stress that experts don’t actually know whether the virus is really spreading this way in the real world, unlike well-known airborne diseases such as measles.

There’s at least one case where local officials are considering the possibility of airborne spread, at a choir recital in Washington state. No one was visibly ill at the event, but afterward at least 45 choir members likely got COVID-19, and at least one died.

But most masks wouldn’t protect against airborne exposure.

Not all masks offer equal protection.

For the purposes of the coronavirus outbreak, there are three main types of masks: respirators, surgical masks, and fabric, or homemade, masks.

N95s
Rigorously lab-tested and government-approved, N95 respirators are designed to protect someone from 95% of the particles in the air. They are so protective both because the mask material is relatively non-porous, designed to keep out large droplets and small particle aerosols, and they are securely fitted to a wearer’s face to ensure stray particles can’t slip in through the sides.
In the coronavirus outbreak, N95s are only recommended for health care workers performing procedures that put them most at risk of virus exposure, such as testing for the virus by swabbing a patient’s nose or mouth. They are most effective when used only once, but are currently being reused by doctors and nurses due to mass shortages.

Getty Images

Surgical masks
Surgical masks are approved by the FDA, and they help protect the wearer against large droplets. Since they are more porous than N95 respirators and loose fitting, they do not protect against small particles in the air. They are disposable and most effective in single-patient interactions.
In the coronavirus outbreak, surgical masks are recommended for health care workers, caregivers, and people who are sick. They are also being reused due to supply shortages.

Alamy

Fabric or home-made masks
They can range widely in material and quality. While they may offer some protection against large droplets, it’s unknown how effective they are at doing so, and they do not protect against small particles in the air. According to one small study, they were three times less effective than surgical masks.
In the coronavirus outbreak, the CDC is only recommending people wear such masks when caring for COVID-19 patients “as a last resort.” But this may change, and some public officials are already recommending the general public wear such masks.

Ben King / BuzzFeed News; BQE Bags

N95 respirators are considered the gold standard for those on the frontlines. When worn properly — securely fitted to a wearer’s face — they offer protection from about 95% of small particles (0.3 microns in size) and large droplets. Individual coronavirus particles are smaller than this. But when they are coughed or sneezed up, they likely travel in small clumps of spit and mucus.

The WHO and the CDC only recommend N95s for health care workers at the greatest risk of virus exposure, such as those who test patients for COVID-19 by swabbing their noses or mouths or those who connect patients to respirators. In an ideal setting, N95s are only worn once and then tossed out. But due to supply shortages, health care workers are having to repeatedly wear the respirators, raising questions about whether the masks are getting contaminated from repeated exposures and removals. No one is recommending the public wear N95 respirators.

Surgical masks are the next step down, offering protection against large droplets. This is the type of mask CDC currently recommends for most health care workers, caregivers, and people who are sick. In recent weeks, a wave of hospitals in Boston, San Francisco, and Providence, and other US cities, have started requiring all of their health care workers wear these masks, six doctors and nurses told BuzzFeed News.

The current shortage of surgical masks for health care workers is shaping the government’s thinking on whether to start recommending them to the public.

Consequently, the discussions over changing the CDC’s mask guidance are about whether most people should start wearing homemade fabric masks, which may offer some protection against large droplets but don’t protect against small particles in the air. Not considered official “personal protective equipment” by the CDC, the agency only recommends them for health care workers “as a last resort.” Their effectiveness against droplets is unknown due to minimal study and the wide range in fabric materials that can be used.

According to a 2013 study in the journal Disaster Medicine and Public Health Preparedness, fabric masks that fit snugly on the face provided three times less protection than surgical masks. “We found they are not as good as surgical masks,” Anna Davies, the lead study author, told BuzzFeed News.

Davies and her colleagues found a surgical mask had about a 90% filtration efficiency for very small particles (around 2 microns). The next best materials found at home at blocking particles were vacuum cleaner bags (about 86% filtration efficiency) and tea towels (about 72% filtration efficiency), but they would be so difficult to breathe out of that they wouldn’t be suitable for a mask. Meanwhile, a cotton mix material had about 70% filtration efficiency compared to roughly 57% for a pillowcase, about 62% for linen, about 54% for silk, nearly 51% for a 100% cotton T-shirt, and nearly 49% for a scarf.

“An improvised face mask should be viewed as the last possible alternative if a supply of commercial face masks is not available,” the study authors wrote, and should be paired with other protective measures.

Davies noted this was a very small study, not a clinical trial, and that much more research was needed on the effectiveness of homemade masks in a pandemic environment.

Some of the health experts most resistant to universal mask-wearing largely cite concerns that people would not wear masks properly or adhere to other safety precautions less as a result. If someone is constantly fidgeting with their mask, or is emboldened to get closer to people than 6 feet or leave the house more than they might otherwise, the potential benefits of a mask would likely be negated.

“I suspect probably if everyone wore masks, and alongside all social distancing, you’d probably see a reduction in transmission,” Davies said. “The masks don’t give you a normal life back, unfortunately.”

Many questions remain about how to best use fabric masks: How do you decontaminate them? Can they be reused? How long should you wear a homemade mask for?

But public health officials are increasingly coming on board to the idea of more people covering their faces, or at least supporting people who want to.

“No one should be yelled at because they decide to wear a mask,” said Georges Benjamin, executive director of the American Public Health Association. “They are not crazy. They are trying to protect themselves. And may it reduce their risk a little bit? Maybe.” ●



Zahra Hirji is a science reporter for BuzzFeed News and is based in Washington, DC


A Glimpse Inside "One Of America's Most Dangerous Cults"

"With every line of the prayer came another blow to Matthew’s chest. All he could think was ... 'Am I going to die?'" (An excerpt from Broken Faith: Inside the Word of Faith Fellowship, One of America's Most Dangerous Cults.)

Holbrook MohrBuzzFeed Contributor

Posted on March 29, 2020

Ben Kothe / BuzzFeed News; Hanover Square Press

Matthew Fenner was 16 years old in 2010, when his family joined Word of Faith Fellowship. Wiry, neatly dressed, with a quick smile and kind eyes, he grabbed Danielle Cordes’s attention right away. Danielle was always intrigued when new kids arrived. She wondered where they came from, the things they’d seen and done in the world outside. Matthew was something special. His soft voice and body language radiated kindness, something Danielle longed for more than anything. She fell in love. The church approved. But Matthew was not what he seemed to be.

Now, three years later, he was gone. Disappeared. And no one in the church would talk about it. Maybe it was because of the vicious beating he’d taken in the sanctuary, a blasting so violent Danielle thought he might be killed. Danielle had been there; she had done what she could to stop it. But when she didn’t see Matthew in class at Isothermal Community College a few days after the beating, she knew something was very wrong. She asked the professor about Matthew. He said the young man had dropped the class. She was perplexed. Danielle knew how much school meant to Matthew. If he’d escaped, if he was somewhere on the outside, she’d join him somehow. She had tried to escape before, but didn’t get far. This time she’d be more careful. She couldn’t take Word of Faith without Matthew. He was her hope

Over the years, Danielle figured she’d been beaten by at least 40 different adults in her life — her parents, teachers, principals, and ministers — not to mention being slapped and thrown to the floor countless times by her peers during blasting sessions — ear-piercing, screaming group prayers meant to drive out demons. Danielle never believed the prayers were meant to help her. No, she believed the people in those circles wanted to hurt others, whether they stomped your toes, yanked your hair, or punched you in the chest. Jane Whaley liked to say to “do whatever it takes.” In Danielle’s life, violence “was normal and encouraged.” And how could she forget her freshman year of high school, when an accusation of impure feelings for a boy escalated, leading to a confrontation with Jane Whaley. Whaley alternated hands, slapping her on each side of the face “probably fifty times.” The violence only fed her determination to someday escape.

Matthew and his family first attended a service at the Word of Faith Fellowship in 2010. Matthew thought the church was “a wild mess,” and he never wanted to go back. He didn’t believe in God, so church seemed like a waste of time. But his mother, Linda Addington, was impressed. When she heard Whaley preach about the sin of homosexuality, she believed God had led her home. The year before, Matthew had come out as gay to his family. He’d always known he was different. Even as a child, when his friends talked about growing up and getting married, he pictured himself with a man. Linda tried to ignore the signs. She believed homosexuality was a sin condemned in the Bible.

Once Linda joined the Word of Faith Fellowship, the church’s teachings reinforced her fears. Matthew was an angry teen, but now he had a bargaining chip. His mother was intent that he go to church. He agreed to attend the Friday night fellowship meetings if his mom would let him to go out with a boy he liked. Matthew knew his mother couldn’t accept him for who he was, but he longed for her love and approval. He agreed to keep an open mind about the church. And the first time he attended a Friday night social event, something surprising happened: He liked it.

Everyone was fun and friendly. Nobody asked about his sexuality. For the first time in years, he felt like he fit in. And there was something else: People in the church seemed so much better off than his family. While his mom and siblings struggled at times, depending on unemployment and food stamps to get by, people in the church had nice clothes, new cars, and beautiful homes.

When church minister Brooke Covington asked Matthew if they could spend some time together, he happily agreed. She picked him up and drove to a McDonald’s restaurant. They ordered from the drive-through window. Matthew, a vegetarian at the time, ordered only water. Brooke ordered a drink and fries. They sat in her car in the parking lot and she asked him about his dreams and aspirations.

The longer they talked, the more comfortable he felt. It was “like a therapy session, only less formal,” he later said. He told Brooke about how his parents had divorced when he was a child, and how difficult his relationship with his father had become. His mother got sick, he said, so they had to live with his grandparents.

And Matthew had been sick, too, he said. He’d been diagnosed with melanoma when he was 13 years old. It was in remission now, but he worried about it coming back.

She nodded, listening intently as the young man unloaded a lifetime of pain and resentment. When he finished, he felt relieved. Covington seemed to care about what he had to say. He felt important, like his life and struggles mattered. Over time, Matthew came to believe that the Word of Faith Fellowship was the right place for him. Soon as his junior year of high school ended, he transferred to the Word of Faith Christian School.

He committed himself to the church, attending events nearly every day. It was a “fresh start,” his mother said. She hoped Matthew would meet a nice girl and “live a normal life,” maybe even give her grandchildren one day

Matthew was observant by nature, watching closely how others behaved and interacted. He made mental notes of what seemed to please the church leaders and what made them mad.

This place is a big, nonstop psychological game, he thought. Like a method actor, Matthew slipped into character. He dressed the way he was told and prayed the way he was expected. He told on others when he believed they were in sin, participated in blasting, and “dealt with” people who needed it.

And when it was his turn to be blasted, he found a dramatic way to signal a breakthrough: He’d pretend to have a seizure, flopping around on the floor. It was over the top, but it thrilled the ministers.

Yes, he had figured things out. Listen to what they say, observe everything that’s going on, and just play the part. But there was one part Matthew was not ready for. By their senior year, teenagers were expected to start looking for a mate. It wasn’t a surprise when Robin Webster announced to Matthew’s class that it was time to start “walking out a relationship.”

“Is anyone carrying anyone?” she asked. “If you are, raise your hand.”

Danielle lowered her head, wanting to be as small as possible, invisible. She didn’t know what to say. She wanted to leave the church. Getting paired up with someone wasn’t going to make that any easier.

But Matthew raised his hand. He knew that his mother wanted him to be with Danielle, and if he had to spend time with a girl, it might as well be her. She was friendly and outgoing and, best of all, trustworthy. Only a few ministers in the church knew he was gay, and they were convinced God could change that.

“I feel like I should fellowship with Danielle,” he said.

Danielle felt her heart beat faster. Matthew was an outsider. She had wanted to leave the church ever since she was a child. Maybe Matthew would be her way out.

And just like that, they were a couple. They sat together at Friday night youth socials, where couples gathered around tables for pizza and salad. Danielle began having Sunday lunch with Matthew’s family. In time, she developed strong feelings for him. He could sense that she was falling for him, but what could he do? He wanted to tell her he was gay, but he was too afraid. So he continued playing the part, hoping his feelings would eventually change.


Chuck Burton / AP
Word of Faith Fellowship church leader Jane Whaley talks to members of the media Thursday, March 2, 1995, accompanied by her husband, Sam, in Spindale, N.C.

In the spring of 2012, Whaley said God wanted the Fenners to move into the Covington house. It seemed a natural fit. Brooke had taken Matthew under her wing. A dozen other people lived there, too, including Patrick Covington. He and Matthew found they had a lot in common.

Both were “bubbly and excitable, not hypermasculine.” When they could steal moments alone, they talked about the outside world. They realized that when Patrick had been in foster care during a custody battle, they had attended the same elementary school. They knew some of the same people. They talked about music and movies they remembered from their time outside the church, and the things they’d like to do someday. There were giddy moments, with a “flirty undertone.”

That was dangerous. The ministers noticed. “The way you two interact with each other is not godly,” they were told. “It’s not what it means to be a godly man.”

One day in late January 2013, Matthew was working in the laundry room at the Covingtons’ house when Patrick walked in and closed the door. Spontaneously, as if it was something they couldn’t control, they embraced. Then they locked eyes and kissed. It shocked them both.

“We need to go,” Matthew said. “If they find us here, we’ll be in trouble.”

For Matthew, it was a pivotal moment. He had been trying to suppress his feelings for Patrick, but now he felt validated. It was terrifying, too. Matthew shuddered to think what would happen if anyone found out.

The following day they were sent together to paint the basement of a church member’s house. While one of them stood on a ladder painting, the other grabbed a leg, slowly edging his hand higher, trying to see how far things would go. Eventually they were touching each other’s crotches, enjoying the excitement of a new, forbidden romance.

Danielle was oblivious to it all.

When Brooke and Jayne Caulder pulled her aside after a church service, they only confused her. “We know that you know about Matthew’s problem,” Brooke said. “You need to deal with his sin. If you don’t do something, he is going to leave the church. If that happens, his blood will be on your hands.”

Danielle nodded, but she had no idea what Brooke was talking about. She knew Matthew was a little different than other boys in the church, but strict rules forbade any kind of intimate knowledge of his character, much less his sexuality. Everyone worked hard to keep her in ignorance, then expected her to understand it all.

She’d been taught there was a sin called “homosexuality,” but that was it. Sexuality was a taboo subject, and homosexuality was beyond the realm of her understanding. Danielle couldn’t figure it out exactly, but she knew something was seriously wrong.

Ever since they’d moved in with the Covingtons, Patrick’s sisters Sarah and Rachel were on the fast track to becoming ministers, Brooke’s sidekicks. They sat alongside as Brooke and Jane discussed church business at the dinner table. They were good girls. They followed the rules, and made sure others did, too.

Sarah was assigned to “watch over” Matthew at church and school, so it was no surprise when she approached Danielle after the Sunday morning service on January 27, 2013.

“I think there’s something going on with Matthew,” Sarah said.

“What do you think it is?” Danielle asked.

“I don’t know — he just kept smirking at Patrick. I feel like something is going on between them. I think he has the unclean,” Sarah said.

That night after church, Matthew was taken aside by Brooke, Sarah, and Sarah’s husband, Nick Anderson. They asked him to “open up about the sin in his life.”

At the same time Jayne Caulder accused Danielle of having “perversions” for her sister, meaning their relationship was too personal. “You need prayer,” Caulder said.

Danielle knew exactly what to do. She “went through the motions,” listened to the screaming, confessed her sin, and “had a breakthrough.”

When it was over, Danielle noticed a commotion across the room, where a growing number of people had surrounded Matthew. They were blasting him. She wanted to go over to him, but Caulder waved her away. Matthew started to scream, real bloodcurdling screams.

Danielle bolted to the other side of the sanctuary, where Matthew was seated within a circle of nearly two dozen people. Brooke was pushing on his chest, screaming, “Open your heart!”

Sarah slapped him hard in the face, leaving four red fingerprints on his cheek. Before he knew what was happening, Matthew was being shoved and punched. He weighed only about one hundred and thirty pounds, and a week earlier doctors had taken biopsies to ensure his melanoma hadn’t returned.

“The way you hold your hands, the way you cross your legs, that’s all homosexual devils. We are going to get it out of you,” Brooke screamed. “Did you have homosexual thoughts in a dream? Did your body manifest?”

Danielle had seen and heard many blasting sessions over the years, but this seemed more frightening, more hysterical, and clearly more violent. She shivered when she heard her name.

“Danielle, get over her and deal with your friend,” Brooke shouted.

When Danielle approached, Brooke “shoved” her into the middle of the circle. Matthew was crying and pleading, shaking his head, denying he’d done anything wrong. Danielle had to do something or she’d be in the same spot.

“Matthew, you better tell your sin,” Danielle wailed. Others joined in.

“Come out of him, you wicked demon. You’re so wicked!”

“You disgust me!”

“You’re going to die and go to hell.”

“You satanist!”

“You’re going to burn in hell.”

“He’s not saying what his sin is,” Brooke exclaimed. Sarah and Patrick’s brother Justin grabbed Matthew and began “beating him in the sternum.” Adam Bartley stood behind Matthew “with his hands wrapped around his neck,” shaking hard. With every line of the prayer came another blow to Matthew’s chest. Matthew felt “frail.” All he could think was, “Is my neck going to break? Am I going to die?”

Danielle thought he might. All the punching, slapping, choking, being thrown to the floor only to be picked up and beaten more. At one point he lost consciousness and urinated in his pants. It went on for two hours.

Danielle couldn’t watch Adam Bartley choking him anymore. She slid her hands under Bartley’s fingers, “trying to peel them off.” Bartley looked at Danielle with wide eyes, then turned to tell Brooke she was interfering. Danielle knew what would happen if she was accused of “getting in the way of God’s will.” She had to think fast. She brought up Matthew’s biopsy on his neck.

“Adam, wait, wait, wait,” she pleaded. “He just had surgery on his neck. Remember?”

Bartley paused and shook his head, satisfied with Danielle’s explanation. He pulled his hands away.

Matthew finally got his “breakthrough.” He panted on the floor, dripping with sweat. His face was ghostly white, his eyes dark and sunken. To Danielle, he looked “like a dead person.”

The crowd broke up. Danielle helped Matthew to his feet and helped him get home. Matthew felt like he’d been flattened by a truck, but there was no time to rest. He had to get out. He waited until Patrick passed in the hallway, then pushed him into the bathroom.

“Look, Patrick, after what happened tonight, I’m getting out of here,” Matthew said. “They’re going to get on to me again. It’s about to get really bad for me here. I can’t do it. I’ve got to go. If I’m going to be safe, I have to leave. You can come with me if you want. Either way, I have to go.”

Patrick didn’t hesitate. “I’m coming,” he said.

“OK. So let’s give it till tomorrow. Tomorrow night we’re out of here,” Matthew said. “You just need to listen to what I say and do it. Just trust me.”

Matthew went over the plans. The next night, they’d each pack a bag, making it look like they were taking work clothes for a church project.

“Just get what you need. We can’t try to take too much. We won’t have time. And we can’t make anyone suspicious,” he said.

Then at 2:10 a.m. they’d sneak out of the house, jump into his mother’s car and drive to his grandparents’ house. He knew they’d take them in. They had been trying to get him out of the church for years.

The next night, everything was set. Matthew kept checking the clock, but couldn’t sleep. He still had some time, so he went to his mother’s room and crawled onto her bed.

“How are you doing, Mom?” he asked, hugging her.

“I’m fine, Matthew, how are you?”

“I’m fine. I need to get ready for bed,” he said. “I just wanted to say I love you.”

“I love you, too.”

Matthew palmed the car keys on the night table. He glanced back as he was walking out of the room. He wondered if he would see her again. He went to his room, which he shared with his younger brother Madison, and chatted to him until he drifted off to sleep.

Matthew set the alarm for 1:55 a.m., but he didn’t need it. He couldn’t sleep. He listened as people came into the house from working late at church projects. He counted each time the door closed, trying to account for everyone in the house. His heart raced.

When it was time to meet Patrick, Matthew grabbed a backpack and tossed in extra underwear and a stuffed corduroy bear he’d had since childhood. He slipped on his shoes and began to tiptoe toward the stairs. Suddenly, he heard a bang. He crept down the stairs as fast as he could to the ground floor. It was Patrick; he was coming up another set of stairs from the basement, carrying his trombone. He’d banged it against the wall.

“Put that down and go,” he whispered. “Go, go, go! Don’t look back,” Matthew said. “We’ve gotta get out of here.”

They ran out of the house and down Brooke Breeze Lane, through the woods and finally into Matthew’s mother’s white Ford Edge.

“Here we go!” Matthew said.

Patrick was excited, like a bank robber making an escape after a daring heist. “I can’t believe we’re doing this!”

Matthew turned the key, yanked the stick into Reverse, and stomped the gas pedal, nearly slamming into another vehicle parked in the driveway. He took a deep breath and glanced at Patrick.

“This is it,” Matthew said. He shifted the car into gear and sped down the winding driveway onto Hunting Drive, past the homes of other church members.

“I’m free. I can’t believe it, I’m free!” Patrick shouted.

“I know,” Matthew said. “Let’s listen to some music.”

Matthew pulled out his phone and played the song “Fragile” by John Ralston, soaking in the lyrics he loved before the church took away his ungodly music: “We’re so fragile, we’re so calm. We are innocent of what went wrong…”

Matthew gripped the steering wheel with both hands, hugging curves and blowing through stop signs. Patrick rolled down the window and let out a long “woohoo.” As they pulled into the driveway of Matthew’s grandparents’ house, the two looked at one another and let out a sigh.


“We made it,” Matthew said. “Let’s go inside.”

Matthew’s grandfather answered the door and wiped the sleep from his eyes.

“What’s going on?” he asked.

“Something bad happened. We had to get out of there,” Matthew said. “Can you please take me to drop Mom’s car off? I don’t want to get in trouble for taking it.”

Matthew drove the car alone. His grandfather and Patrick followed in another vehicle. Matthew left his mother’s car just down the hill from the Covington home. Riding back with his grandfather, he stared out the window.

“Are y’all sure you want to do this?” his grandfather asked. “You know what’s going to happen.”

“Yes,” Matthew said. “We had to get out.”

“Well, you know they’re going to be calling. They’re going to try to get you back.”

“I know,” Matthew said. “It’s going to be a big mess. I just can’t stay there anymore. A bunch of stuff happened. There’s no way I can go back.”

“You know I’ll do whatever I can to help you.”

When they got back to his grandparents’ house, Matthew and Patrick told them everything. It was worse than his grandparents had imagined. They promised to stand by the boys.

“Well, we better get some sleep,” his grandfather said. “It’s going to be a long day tomorrow.” ●

Excerpted from Broken Faith by Mitch Weiss and Holbrook Mohr, Copyright © 2020 by Mitchell Weiss and Holbrook Mohr. Published by Hanover Square Press.


Mitch Weiss is a Pulitzer Prize-winning investigative journalist with the Associated Press and the co-author most recently of The Heart of Hell: The Untold Story of Courage and Sacrifice in the Shadow of Iwo Jima.

Holbrook Mohr is an award-winning investigative journalist for the Associated Press.