Washington state sounds alarm over rising coronavirus cases

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Health officials in Washington are warning that the coronavirus is spreading more widely throughout the state, an increase likely driven by transmissions that took place over Memorial Day weekend.

In a report issued Saturday, the Washington State Department of Health pointed to two distinct hot spots, both of which are showing worrying signs of increased spreading.

Confirmed COVID-19 cases are rising fastest in four counties east of the Cascade Mountains, mostly rural and agricultural areas that were spared from the first substantial outbreak in Washington.

Both cases and the rate at which tests are coming back positive are increasing in Yakima, Spokane, Franklin and Benton counties. Projections in three of those counties show they are at risk of recording hundreds of new cases a day by the end of the month; Yakima County is already recording cases at that rapid rate.

The outbreaks east of the Cascades are now comparable to the worst days of the coronavirus epidemic in King County, home to Seattle, in mid-March. Though they are much more sparsely populated, there are as many cases per capita now in the eastern counties as there were in Seattle during the height of its outbreak.

King County has a population 2.25 million and has recorded 8,611 coronavirus cases, according to state health department figures, or a little under four cases per 1,000 residents. Yakima County, population 250,000, has recorded 5,129 confirmed cases, a per capita ratio five times higher than King County.

The state health department also said it was concerned about a growing number of cases confirmed in western Washington. Models maintained by epidemiologists at the University of Washington show the estimated reproductive threshold — the average number of people someone infected with the virus infects — rising above the 1.0 threshold needed to keep cases on the decline.

Washington, the state that suffered the first confirmed coronavirus case back in January, is now beginning to reopen its economy. In a statement Saturday, Gov. Jay Inslee (D) said the new report was cause for concern.

“The report estimates cases and deaths will soon increase substantially if COVID-19 continues to spread at current levels,” Inslee said. “This data will force us to look for some creative solutions and strengthen our strong local – state partnerships to address the disease activity.”

He asked Washingtonians to wear masks more vigilantly and to continue practicing social distancing.

“This is not the time to give up on efforts to protect ourselves, our families and our communities. We are still in the middle of a pandemic that is continuing to infect and kill Washingtonians,” Inslee said.

In a statement, Kathy Lofy, Washington state’s health officer, said the increased number of cases was likely a result of Memorial Day weekend festivities about three weeks ago. That stretch of time would give people a sufficient period in which to get sick, develop symptoms and progress to a state in which they seek treatment for their illness.

Lofy said the new cases are not indicative of any spread at protests over the murder of George Floyd, an unarmed black man who was killed by police in Minneapolis. The protests that have been especially large in Seattle, Tacoma and other western Washington towns.

Any new cases among protesters probably have not had time to manifest in substantial ways yet and likely would not show up for at least another week.

After about a month at a stable plateau, the number of confirmed coronavirus cases across the country has started to rise. More than 20,000 new cases have been identified on each of the last four days, according to the COVID Tracking Project. Doctors confirmed nearly 24,000 cases on Thursday and more than 26,000 cases on Friday.

States that raced to reopen their economies, such as Texas, Florida, Arizona and the Carolinas, are seeing substantial increases. But so too are states such as Washington, where restrictions have been lifted more slowly.

More than 2,066,000 people in the United States have been diagnosed with the coronavirus. More than 115,000 have died, by far the highest total of any country in the world.

Lockdown Measures Return To Beijing As Testing Reveals Cluster At Major Food Market

Paramilitary police officers wear face masks and goggles as they stand guard at an entrance to the closed Xinfadi market in Beijing on June 13, 2020.

Greg Baker /AFP via Getty Images

China’s capital of Beijing has discovered 42 symptomatic new cases of the coronavirus since Thursday, leading city authorities to resurrect lockdown measures and elevating fears of a second wave of infections.

All the new cases were linked to the sprawling Xinfadi wholesale food market in the south of Beijing, which supplies the city and its environs with 1,500 tons of seafood, 18,000 tons of vegetables and 20,000 tons of fruit every day, according to the market’s website.

The first new case was confirmed Thursday, after one man who bought produce from the seafood and meat section of the Xinfadi market on June 3 tested positive for COVID-19. It is not yet clear how he became infected as he denied having any recent travel history. Two more cases were identified the following day, and the market was sealed off as of early Saturday morning.

Authorities said they tested 5,803 people working at the market on Saturday alone — all were negative for the coronavirus — as well as 2,383 samples taken from surfaces within the market. Those have been in contact with the market or people who have contacted the market since May 30 have been asked by municipal authorities to voluntarily submit themselves to a nucleic acid exam.

On top of the 42 cases, authorities have discovered at least 48 asymptomatic cases of the coronavirus linked to the market, meaning the people carrying the virus have yet to show symptoms. They are being kept under medical observation in quarantine, Beijing health authorities said over the weekend.

Lockdown measures, which had been rapidly easing up before the cluster of cases was discovered in Beijing, are now partially returning.

Municipal authorities shut down sporting events and tourism sites in the capital on Saturday. Restaurants are once again discouraged from accepting large groups for dining together. Eleven residential complexes near the market have been locked down and its residents forbidden from leaving. Beijing’s Fengtai district, where Xinfadi market is located, was designated a high risk area on Sunday.

Wu Zunyou, an epidemiologist with China’s center for disease control, said Sunday the virus was likely transmitted from seafood and meat products whose surfaces were contaminated after being handled by infected people elsewhere.

Two samples taken from the market detected variants of the coronavirus that were more similar to those that are prevalent in Europe rather than the variant most commonly detected in patients in China, Zeng Guang, another epidemiologist at China’s center for disease control, told Chinese media.

Many of the cities largest luxury hotels and restaurants said they were voluntarily disposing of all their raw fish and would stop serving seafood.

Others urged restraint and calm.

“Beijing will not became a second Wuhan. It will not spread the virus to other cities around the country or warrant a city-wide lockdown,” a former health commission senior expert, Zeng, told state media on Sunday.

Beijing closes food market, locks down district after new coronavirus outbreak

Beijing swiftly shut down the city’s largest wholesale market after dozens of people became infected with coronavirus, and officials have declared “wartime management” in one district, according to reports.

Of the 500 people who were tested on Friday, seven tested positive and showed symptoms of COVID-19, with an additional 46 asymptomatic people testing positive. The cases mark the first local transmissions of the disease in the Chinese capital in 55 days, according to the South China Morning Post.

People wearing face masks to protect against the new coronavirus stop at a checkpoint outside the Xinfadi wholesale food market district in Beijing, Saturday, June 13, 2020. Beijing closed the city's largest wholesale food market Saturday after the discovery of seven cases of the new coronavirus in the previous two days.

People wearing face masks to protect against the new coronavirus stop at a checkpoint outside the Xinfadi wholesale food market district in Beijing, Saturday, June 13, 2020. Beijing closed the city’s largest wholesale food market Saturday after the discovery of seven cases of the new coronavirus in the previous two days. (AP Photo/Mark Schiefelbein)

Patient Zero in the new outbreak is believed to have visited the Xinfadi market in the Fengtai district, a market that accounts for roughly 90 percent of the city’s produce.

Traces of the disease were found on cutting boards, forcing a citywide scramble to remove fish – particularly salmon – from restaurant menus and supermarket shelves.

Pang Xinghuo, deputy director of Beijing’s Center for Disease Control and Prevention, confirmed that all of the new cases were linked to the Xinfadi market.

The Beijing Health Commission has said that at least three of the symptomatic patients were employees at the market, according to The New York Times.

Eleven neighborhoods around the market have issued a stay-at-home advisory, and citizens have been urged to avoid traveling in or out of Beijing. Sporting events and tour group trips to Beijing have been suspended and classes have been cancelled for students in kindergarten and the first three years of elementary school.

Officials have said that more than 10,000 people who work at the market will be tested, and the market itself will be disinfected.  All patients who have tested positive are in quarantine and under observation.

More than 1,900 workers at markets across the city have already been tested, according to the commission.

Feng Zhanchun, a public health expert, said the links between the number of positive cases means the virus is spreading in the community. The spread and response have so far echoed that of Wuhan at the start of the pandemic.

“If it can’t be put under control right now, the virus will affect many people in a short time because of the high density of population in cities,” Feng said.

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Also see: https://www.npr.org/sections/coronavirus-live-updates/2020/06/13/876544822/beijing-in-wartime-emergency-mode-amid-fresh-cluster-of-coronavirus-cases

Beijing district in ‘wartime emergency’ after virus spike shuts market

KEY POINTS
  • Concern is growing of a second wave of the pandemic, which has infected more than 7.66 million people worldwide and killed more than 420,000, even in many countries that seemed to have curbed its spread.
  • The virus was first reported at a seafood market in Wuhan, the capital of central China’s Hubei province, in December.
People carry goods out of a side entrance of the Jingshen seafood market in Beijing on June 13, 2020. - The market was closed for disinfection and investigation on June 12 after it was found that a newly identified coronavirus patient had visited it.
People carry goods out of a side entrance of the Jingshen seafood market in Beijing on June 13, 2020. – The market was closed for disinfection and investigation on June 12 after it was found that a newly identified coronavirus patient had visited it.
GREG BAKER / Contributor

A district of Beijing was on a “wartime” footing and the capital banned tourism on Saturday after a cluster of novel coronavirus infections centred around a major wholesale market sparked fears of a new wave of COVID-19.

Concern is growing of a second wave of the pandemic, which has infected more than 7.66 million people worldwide and killed more than 420,000, even in many countries that seemed to have curbed its spread.

The virus was first reported at a seafood market in Wuhan, the capital of central China’s Hubei province, in December.

Chu Junwei, an official of Beijing’s southwestern Fengtai district, told a briefing on Saturday that the district was in “wartime emergency mode”.

Throat swabs from 45 people, out of 517 tested at the district’s Xinfadi wholesale market, had tested positive for the new coronavirus, though none of them showed symptoms of COVID-19, Chu said.

A city spokesman told the briefing that all six COVID-19 patients confirmed in Beijing on Friday had visited the Xinfadi market. The capital will suspend sports events and inter-provincial tourism effective immediately, he said.

One person at an agricultural market in the city’s northwestern Haidian district also tested positive for the coronavirus that causes COVID-19 without showing symptoms, Chu said.

As part of measures to curb the spread of the virus, Fengtai district said it had locked down 11 neighbourhoods in the vicinity of the market.

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Authorities closed the Xinfadi market at 3 a.m. on Saturday (1900 GMT on Friday), after two men working at a meat research centre who had recently visited the market were reported on Friday to have been infected. It was not immediately clear how the men had been infected.

“Preliminary judgment suggests these cases may have come into contact with a contaminated environment in the market, or were infected after being in contact with infected people. We cannot rule out subsequent cases in the future,” said Pang Xinghuo, an official at the Beijing Center for Disease Control.

Beijing authorities had earlier halted beef and mutton trading at the Xinfadi market, alongside closures at other wholesale markets around the city.

Reflecting concerns over the risk of further spread of the virus, major supermarkets in Beijing removed salmon from their shelves overnight after the virus causing COVID-19 was discovered on chopping boards used for imported salmon at the market, the state-owned Beijing Youth Daily reported.

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Beijing authorities said more than 10,000 people at the market will take nucleic acid tests to detect coronavirus infections. The city government also said it had dropped plans to reopen schools on Monday for students in grades one through three because of the new cases.

Health authorities visited the home of a Reuters reporter in Beijing’s Dongcheng district on Saturday to ask whether she had visited the Xinfadi market, which is 15 km (9 miles) away. They said the visit was part of patrols Dongcheng was conducting.

China reported 11 new COVID-19 cases and seven asymptomatic infections of the virus for Friday, the national health authority said on Saturday. All six locally transmitted cases were confirmed in Beijing.

In lockdown’s calm, glossy ibis finds prime nesting conditions in Sri Lanka

America Is Giving Up on the Pandemic

MEL D. COLE / GETTY / THE ATLANTIC

After months of deserted public spaces and empty roads, Americans have returned to the streets. But they have come not for a joyous reopening to celebrate the country’s victory over the coronavirus. Instead, tens of thousands of people have ventured out to protest the killing of George Floyd by police.

Demonstrators have closely gathered all over the country, and in blocks-long crowds in large cities, singing and chanting and demanding justice. Police officers have dealt with them roughly, crowding protesters together, blasting them with lung and eye irritants, and cramming them into paddy wagons and jails.

There’s no point in denying the obvious: Standing in a crowd for long periods raises the risk of increased transmission of SARS-CoV-2, the virus that causes COVID-19. This particular form of mass, in-person protest—and the corresponding police response—is a “perfect set-up” for transmission of the virus, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said in a radio interview on Friday. Some police-brutality activists (such as Black Lives Matter Seattle) have issued statements about the risk involved in the protests. Others have organized less risky forms of protests, such as Oakland’s Anti Police-Terror Project’s massive “caravan for justice.”

The risk of transmission is complicated by, and intertwined with, the urgent moral stakes: Systemic racism suffuses the United States. The mortality gap between black and white people persists. People born in zip codes mere miles from one another might have life-expectancy gaps of 10 or even 20 years. Two racial inequities meet in this week’s protests: one, a pandemic in which black people are dying at nearly twice their proportion of the population, according to racial data compiled by the COVID Tracking Project at The Atlantic; and two, antiblack police brutality, with its long American history and intensifying militarization. Floyd, 46, survived COVID-19 in April, but was killed under the knee of a police officer in May.

Americans may wish the virus to be gone, but it is not. While the outbreak has eased in the Northeast, driving down the overall national numbers, cases have only plateaued in the rest of the country, and they appear to be on the rise in recent days in COVID Tracking Project data. Twenty-two states reported 400 or more new cases Friday, and 14 other states and Puerto Rico reported cases in the triple digits. Several states—including Arizona, North Carolina, and California—are now seeing their highest numbers of known cases.

These numbers all reflect infections that likely began before this week of protest. An even larger spike now seems likely. Put another way: If the country doesn’t see a substantial increase in new COVID-19 cases after this week, it should prompt a rethinking of what epidemiologists believe about how the virus spreads.

But as the pandemic persists, more and more states are pulling back on the measures they’d instituted to slow the virus. The Trump administration’s Coronavirus Task Force is winding down its activities. Its testing czar is returning to his day job at the Department of Health and Human Services. As the long, hot summer of 2020 begins, the facts suggest that the U.S. is not going to beat the coronavirus. Collectively, we slowly seem to be giving up. It is a bitter and unmistakably American cruelty that the people who might suffer most are also fighting for justice in a way that almost certainly increases their risk of being infected.


The protests have led to unusually agonized public-health communication. They have not been met with the stern admonition to stay home that has greeted earlier mass gatherings. Given the long-standing health inequities that black Americans have experienced, hundreds of public-health professionals signed a letter this week declining to oppose the protests “as risky for COVID-19 transmission”: “We support them as vital to the national public health and to the threatened health specifically of Black people in the United States,” they wrote. Yet the protests are indisputably risky, and officials at the Centers for Disease Control and Prevention have warned the gatherings might “seed” new outbreaks.

But the evidence does not reveal universal compliance with public-health guidelines. Protesters lay close together on the ground in many cities for nearly nine-minute-long “die-ins,” evoking the length of time that Derek Chauvin, a Minneapolis police officer, knelt on Floyd’s neck. Many protests have involved some form of shouting, chanting, or singing, which research suggests can be especially effective modes of transmission for the virus. Earlier this week, near the White House, a mostly masked crowd loudly sang “Lean on Me.”

Protesters and public-health officials alike may be taking into account what The New York Times called “a growing consensus” that being outdoors mitigates some risk of transmission. The virus appears to perish quickly in a sunny, humid environment, even at room temperature, according to research conducted in April by the Department of Homeland Security. (Viral particles may survive for hours longer in drier conditions, and epidemiologists do not believe that these climatic effects alone will dampen the outbreak.) The virus also seems to be more difficult to transmit outside, especially during the day, though scientists still do not know enough about the virus to say confidently that large outdoor gatherings are completely safe. The number of protests over the past week means that researchers will soon have a much better understanding of the risks of outdoor transmission.

Many of the potential drivers of coronavirus transmission this week do not involve protester tactics: Dozens of police forces have used security measures that could allow the virus to spread more easily. In Washington, D.C., for instance, federal officers used tear gas or another chemical irritant on hundreds of peaceful protesters gathered in front of the White House on Monday so that President Donald Trump could pose for a photograph. Tear gas and chemicals like it force people to cough and gag, a fertile mode of transmission for the virus. Later that night, city police crowded protesters together before arresting them one by one, an aggressive crowd-control technique known as “kettling.” Hundreds of protesters who were arrested this week were sent—even if briefly—to the city’s jails, which have so many coronavirus cases that the District government has separated that number out from the citywide total.

In Philadelphia, city police teargassed hundreds of peaceful protesters marching on a freeway, prompting them to cough and gag. (There is no evidence that the demonstrators posed a threat to the safety of officers or bystanders, or were becoming violent, according to the local NPR affiliate.) In New York City, officers crammed hundreds of peaceful demonstrators together, then struck them with batons. From Iowa to Texas, officers used tear gas on large, largely peaceful gatherings; in at least five states, police deployed pepper spray or tear gas on children or teenagers, some of whom just happened to be nearby and were not attending the protests.

Journalists from across the country have reported that police officers are wearing masks less often than protesters. “The state is the one with the duty to protect public health,” Alexandra Phelan, a professor of global-health law at Georgetown University, told us earlier this week. Regardless of what the police think of the protests, she said, it is their obligation under international and domestic law to keep the protesters safe, including minimizing the health risk from viral spread.


There are too many variables to know exactly what the summer has in store for the outbreak in America, including what effect the protests will have. There are some signs of hope. Masks are in use around the country. Outdoor transmission seems to be fairly unlikely in most settings. And testing availability has improved. According to data from the COVID Tracking Project, the United States can now conduct 3 million tests a week. The public-health system is discovering and diagnosing a much greater percentage of cases than it did in the early days of the outbreak. Morgan Stanley estimated that the transmission rate in the U.S. was just above 1; this suggests that there has not been explosive growth in the number of active cases in recent weeks.

But that estimated rate also implies that cases are not rapidly declining. And the slow growth reflects the time before the full data from states’ recent moves to reopen their economy became available—before large swaths of the public returned to work, and before the mass protests and jailings began.

Few people believe that the U.S. is doing all it can to contain the virus. A brief glance at Covid Exit Strategy, a site that tracks state-by-state progress, reveals that most states are not actually hitting the reopening marks suggested by public-health experts. Yet state leaders have not stuck with the kinds of lockdowns that suppressed the virus in other countries; nobody has suggested that cases must be brought to negligible levels before normal activity can resume. No federal official has shared a plan for preventing transmission among states that have outbreaks of varying intensity. The Trump administration did not use the eight weeks of intense social distancing to significantly expand our suppression capacity.

What our colleague Ed Yong called “the patchwork pandemic” appears to have confused the American public about what is going on. The virus is not following one single course through the nation, but, like a tornado, is taking a meandering and at times incomprehensible path through cities and counties. Why this workplace but not another? Why this city or state but not others?

Chart tool by covidcharts.tech;, data from the COVID Tracking Project at The Atlantic

The virus has not mapped neatly onto American political narratives, either. While some questions remain about their accounting, Georgia and Florida—where leaders opened up early and residents seemed relatively defiant of public-health advice—have seen relatively flat numbers, while California, which took a more conservative approach, has seen cases grow. The state most poised for major trouble seems to be Arizona, where the outbreak is spreading very quickly. Not only is the state (which lifted its stay-at-home order on May 16) setting new records for positive tests and people in the hospital, but the percentage of tests that are coming back positive is also growing. So much for warm weather and sunshine alone stamping out viral transmission, as some had hoped: Phoenix saw only a single day’s high under 90 degrees during May. The state’s age demographics also haven’t played an obvious role: The state is slightly younger than the U.S. as a whole.

Chart tool by covidcharts.tech; data from the COVID Tracking Project at The Atlantic

Americans have not fully grasped that we are not doing what countries that have returned to normal have done. Some countries have almost completely suppressed the virus. Others had large outbreaks, took intense measures, and have seen life return to normal. Americans, meanwhile, never stayed at home to the degree that most Europeans have, according to mobility data from Apple and Google. Our version of the spring lockdown looked more like Sweden’s looser approach than like the more substantial measures in Italy, or even the United Kingdom and FranceSwedish public-health officials have acknowledged that this approach may not have been the best path forward.

For several weeks at the beginning of the outbreak in the U.S., the need to control the virus took precedence over other concerns. Now, for many people, the pandemic is no longer the most pressing national issue. As protesters and some public-health officials have said they are weighing the harms of police violence against the risk of increased viral spread and choosing to gather in the streets, state governments have made similar risk-reward arguments about balancing public-health and economic concerns. The virus does not care about these trade-offs. Retail reopenings and racial-justice protests may exist on different moral planes, but to the virus they both present new environments to spread.

Maybe the U.S. will somehow avoid another New York–style outbreak. Maybe the number of new infections will not grow exponentially. Maybe treatments have sufficiently improved that we will see huge outbreaks, but fewer people will die than we’ve come to expect. If so, it won’t be because the United States made concerted, coordinated decisions about how to balance the horrors of the pandemic and the frustration of pausing everyday life. Instead, the United States has moved from attempting to beat the virus to managing the harm of losing.

This is America. The problems with our response to the pandemic reflect the problems of the country itself. Our health-care system is almost uniquely ill-suited to dealing with a national health crisis; preexisting health disparities, entrenched and deepened by decades of racism, cannot be erased overnight; state and local health departments desperately needed federal leadership they did not receive; the Senate has not entertained a longer-lasting economic-rescue package that would allow a more prolonged period of sheltering in place; states are facing a fiscal cliff.

And yet, even though this health crisis reflects our nation’s political, social, and civic infrastructure, this plague has no consideration for morality. People partying in a pool may live while those protesting police brutality may die. People who assiduously followed the rules of social distancing may get sick, while those who flouted them happily toast their friends in a crowded bar. There is no righteous logic here. There is no justice in who can breathe easy and who can’t breathe at all.

Here’s what WHO says your mask should have to prevent COVID-19 spread

For homemade masks, you’re probably doing it wrong, guidance suggests.

A masked woman operates a sewing machine.
Enlarge / French fashion student sews homemade protective face masks to stop the spread of COVID-19.

The World Health Organization on Friday updated its guidance on the use of masks amid the COVID-19 pandemic, making several changes and additions. Most notably, the agency is now recommending that governments encourage healthy members of the general public to wear masks in specific situations as part of comprehensive prevention efforts.

The new guidance puts the agency more in line with many countries worldwide that have already recommended masking the public, including the US Centers for Disease Control and Prevention, which made the recommendation in early April.

However, the WHO made its updated guidance with many caveats—and some highly specific recommendations not provided by the US CDC.

“I wish to be very clear that the guidance we are publishing today is an update of what we have been saying for months: that masks should only ever be used as part of a comprehensive strategy in the fight against COVID,” WHO Director-General Tedros Adhanom Ghebreyesus (Dr. Tedros) said in a press conference Friday.

“Masks on their own will not protect you from COVID-19.”

The technical guidance, released later Friday, is equally cautious, noting: “At the present time, the widespread use of masks by healthy people in the community setting is not yet supported by high quality or direct scientific evidence and there are potential benefits and harms to consider.”

Who and when

But, the WHO’s decision to recommend masking the public was swayed by concerns that the disease spreads from infected people who don’t show symptoms (pre-symptomatic and asymptomatic transmission), according to the guidance. The agency also took into account “individual values and preferences” and the reality that physical distancing is difficult if not impossible in some contexts.

Last, the WHO emphasized that its updated guidance is based on fresh data and offers detailed technical advice on homemade mask construction.

“This is new novel research, that WHO commissioned, that we didn’t have a month ago,” Maria Van Kerkhove, WHO’s technical lead on the COVID-19 response, said in the press conference Friday.

Specifically, WHO now recommends that healthy members of the public wear homemade or commercially available fabric masks in places where the new coronavirus is circulating widely and where physical distancing (staying 6-feet apart, etc.) is not possible or is difficult.

Who should wear a mask and when.
Enlarge / Who should wear a mask and when.

Detailed design

And those recommended masks aren’t just any face coverings. The agency looked over the filtration and breathability of a variety of common fabrics and materials. It noted that the French Standardization Association (AFNOR Group) has developed a technical standard for non-medical masks, which includes a minimum of 70 percent solid-particle filtration or droplet filtration.

The WHO noted that breathability—the difference in pressure across the mask as you breathe, reported in millibars (mbar) or Pascals (Pa)—should be below 49 Pa/cm2 for a medical mask. But, for non-medical masks, an acceptable pressure difference should be below 100 Pa.

Last, the WHO calculated the filter quality factor, dubbed “Q,” which is a function of filtration and breathability, with higher values indicating better overall efficiency. The bare minimum for homemade fabric mask should be Q of 3, according to WHO expert consensus.

Next, the analysis turned to assembly of the mask—the best materials and layering method. Folding a single fabric into two layers can boost filtration two to five times. Folds making four layers boosts filtration up to seven times.

The WHO determined that a minimum of three layers is required for fabric masks. But, masks may need more, depending on the fabric used. For instance, folding cotton handkerchiefs into four layers still only led to maximum filtration efficiency of 13 percent, the WHO noted. Notably, the homemade masks recommended by the US CDC only have two or three layers of cotton.

Analysis of potential mask materials.
Enlarge / Analysis of potential mask materials.

With the lower standards even for the best homemade masks, the WHO stressed that these masks are for source control only, not personal protection—that is, they can help prevent the person wearing the mask from spreading the virus, but they will not necessarily protect the wearer from becoming infected. As such, it’s important that mask wearing should always be accompanied by frequent hand washing and physical distancing.

In all, the expert analysis landed on this mask design:

The ideal combination of material for non-medical masks should include three layers as follows: 1) an innermost layer of a hydrophilic material (e.g. cotton or cotton blends); 2), an outermost layer made of hydrophobic material (e.g., polypropylene, polyester, or their blends) which may limit external contamination from penetration through to the wearer’s nose and mouth; 3) a middle hydrophobic layer of synthetic non-woven material such as polypropylene or a cotton layer which may enhance filtration or retain droplets.

Van Kerkhove noted in the press conference that “the evidence we have through this research is that, with those three layers and in that combination, that fabric [masks] can actually provide a mechanistic barrier. If someone were infected with COVID-19, it could prevent those droplets from going through and infecting someone else.”

Mask dos and don'ts.
Enlarge / Mask dos and don’ts.

The guidance didn’t offer specific details on the testing of the recommended mask design or comparisons with others, such as those recommended by the CDC. Ars has reached out to WHO for additional data and will update this piece if it is available.In addition to the fabric masks for public use, the WHO is also now recommending that in areas where COVID-19 is spreading, all healthcare worker always wear medical masks—even if they are not treating COVID-19 patients specifically.

And, in areas with COVID-19 spread, all people aged 60 years or over and anyone with an underlying health condition should wear a medical mask when physical distancing is not possible.

Last, the WHO offers advice on washing your mask and how to safely put it on and take it off.

“Masks are not a replacement for physical distancing, hand hygiene, and other public health measures,” Dr. Tedros said. “Masks are only of benefit as part of a comprehensive approach in the fight against COVID-19. The cornerstone of the response in every country must be to find, isolate, test, and care for every case and to trace and quarantine every contact. That is what we know works. That is every country’s best defense against COVID-19.”

‘COVID-19 May Be A Dress Rehearsal For The Coming Plague’ Warns Dr. Greger

‘As long as there is poultry, there will be pandemics’
The way we farm animals is likely to lead to further pandemics, says Dr. Greger

The way we farm animals is likely to lead to further pandemics, says Dr. Greger

The COVID-19 pandemic may just be a ‘dress rehearsal for the coming plague’, according to acclaimed plant-based doctor Dr. Michael Greger.

Dr. Michael Greger, who has a background in infectious disease, is an internationally recognized speaker on nutrition, food safety, and public health issues. He is the author of Bird Flu: A Virus Of Our Own Hatching, which looks at infectious diseases and human’s role in them – as well as how we can protect ourselves.

Now his new book How To Survive A Pandemic* looks at the pathogens that cause pandemics and how to face them – and the role chicken farming is playing in the risk of future pandemics.

‘Just a dress rehearsal’

In a promotional video for the book, Dr. Greger says: “The current COVID-19 pandemic, as deadly as it may be, may just be a dress rehearsal for the coming plague.

“Decades ago, a flu virus was discovered in chickens that would forever change our understanding on how bad pandemics could potentially get. It was named H5N1 and appeared capable of killing more than half the people it infected. Half. Imagine if a virus like that started spreading explosively human to human. Consider a pandemic 100-times worse than COVID-19, not the fatality rate of two in 100, but more like one in two. A coin toss.

“Thankfully, H5N1 has so far remained more poultry than people, but it – and other new deadly animal viruses like H7N9 are still out there, still mutating, with an eye on that eight billion-strong buffet of human hosts. With pandemics, it’s always a matter of when not if. A universal outbreak with more than just a few percent mortality wouldn’t just threaten financial markets, but civilization itself as we know it.”

How To Survive A Pandemic

Dr. Greger goes on to discuss how the new book contains ‘everything you need to help protect yourself and your family from the current threat’ as well as tackling the question of what can we do to stop the emergence of pandemic viruses in the first place.

According to Dr. Greger, many infectious diseases including tuberculosis, measles, AIDS, and COVID-19 ‘share a common origin story: human interaction with animals’. So when it comes to limiting the risk of H5N1, Dr. Greger’s proposals including changing the farm system.

He says first we should move away from factory farms, where stressed chickens are kept in cramped, dirty conditions, and fed antibiotics to smaller free-range operations, and then stop eating birds completely.

He said: “The pandemic cycle could theoretically be broken for good. Bird flu could be grounded…[but] as long as there is poultry, there will be pandemics. In the end, it may be us or them.”

*How To Survive A Pandemic is available on Kindle and in audiobook format, and in paperback from August 20.

Coronavirus: Sex workers fear for their future

Escort Estelle Lucas stands in her bedroom with her eyes cast downImage copyrightESTELLE LUCAS
Image captionEstelle Lucas has lost nearly all her income during the coronavirus outbreak

With social distancing rules in place and strip clubs and brothels closed, sex workers around the world have seen their incomes disappear almost overnight as a result of the coronavirus pandemic. Fearing for their livelihoods, as well as their health, some are offering services online to keep their business going, while others are turning to charities for help.

Estelle Lucas has worked as an escort for the past 10 years in Melbourne, carefully building relationships with her clients. But the spread of Covid-19 and the need for social distancing has prompted a ban on sex work, leaving her worried those efforts will go to waste.

“It’s fair to say that if I’m not working for six months, a lot of people are going to forget me,” she says.

“I can’t contact my clients and just have a conversation with them. That doesn’t work in my industry. We need to build intimacy and that’s just not possible in the current environment.”

Before the coronavirus outbreak, Estelle says she was earning an above-average income, and had hoped to soon pay off the mortgage on her home in Melbourne’s inner suburbs.

Now nearly all her income has been lost. She has tried to adapt by moving her business online, but says that cannot replace physical contact.

Sex worker Estelle Lucas sits on her bed looking at her smartphoneImage copyrightESTELLE LUCAS
Image captionEstelle Lucas has organised an online support group to help other sex workers during the crisis

“Unfortunately, there are things that can’t be translated,” she says. “I have made efforts to go online but not everyone is tech savvy. Some of my clients don’t even really know how to use a smartphone.”

While the regional government has outlined a clear roadmap to reopening restaurants and cafes, there has been no plan for the sex industry. That uncertainty, coupled with the many unknowns surrounding the virus itself, has left many sex workers with deep anxiety.

“I’m scared that all my work will come back to zero and I will just have to start hustling like I did when I first started out,” Estelle says. She also fears for her clients’ health. “Are they even going to be there?” she says. “There’s a lot of nervous energy going around.”

Financial assistance from the Australian government is available to those who have lost their income because of the Covid-19 crisis, but to qualify for the payments workers need to be able to show they have been paying tax – something that unregistered sex workers including migrants and trans people, often won’t be able to do.

It’s a problem facing sex workers in dozens of countries around the world, according to Teela Sanders, a criminology professor at the University of Leicester.

“Governments have been very good at providing social protection for the majority of people, particularly self-employed people, but sex workers are not included,” she says.

That’s left sex worker collectives and advocacy groups calling for members of the public to donate to emergency funds.

So far, an online appeal by the Las Vegas Sex Worker Collective has raised $19,300 (£15,680) while a campaign by a coalition of support groups in Italy has raised almost €21,700 (£19,500).

“These have been a real lifeline to sex workers for immediate bill paying, access to food etc,” says Prof Sanders.

Some sex workers have been forced to continue working, risking hefty fines or exposure to the virus.

Media captionThe BBC investigation revealed some brothels were still trading

“In developing countries, sex workers are often the main breadwinner for the whole family, for their siblings, their children and their grandparents. So this affects the whole extended family,” Prof Sanders says.

Niki Adams from the English Collective of Prostitutes echoes that view. She told the BBC most sex workers in the UK are mothers and if they are continuing to work, it is because they are desperate for money.

But some sex workers find themselves unable to keep working – even if they would choose to.

In Daulatdia brothel in Bangladesh, police guard the entrance, preventing customers from entering.

"Nazma"
Image caption“Nazma” says even if the brothel were open, she would be scared to see clients in case they had the virus

It is one of the world’s biggest brothels, a shanty town made up of tin sheds and narrow alleyways that is home to 1,300 women and their 400 children.

The brothel has been closed since March, leaving many of the women struggling to buy essential items and relying on donations from charities.

“We cannot work now, so we don’t have any income, which is scary,” says “Nazma”, who didn’t want to give her real name.

Nazma supports three children who live with her sister back in her village. She came to the brothel 30 years ago when she was just seven. Although she needs money, she worries about the dangers of working during the pandemic.

“Even if we could work, people’s lives are at risk from the virus. We’d be scared to go to bed with our clients anyway, as we don’t know who is affected,” she says.

Daulatdia sits on the banks of the Padma River, near a major ferry terminal. It is the main transport hub that connects the Bangladeshi capital Dhaka with the country’s southern districts.

A sex worker in the alleyways of Bangladesh's Daulatdia brothel.
Image captionSome 1,300 women live in the shanty town brothel, which is now closed for business

Prior to the coronavirus outbreak, thousands of truck drivers would pass through the area every day, delivering agricultural products and other goods to Dhaka.

Many of the women and children who live in the brothel are victims of trafficking.

“A lot of them who were kidnapped as children were sold there,” says Srabanti Huda, a lawyer and human rights activist based in Dhaka.

While the Bangladeshi government and local aid organisations have delivered some emergency funds to the women, Srabanti says it hasn’t been enough and some women received nothing at all.

“The amount of donations they’ve received from the government does not even cover a packet of powdered milk for the children,” she says.

In early May, Srabanti organised a private aid delivery, distributing packets of basic supplies for each of the 1,300 women registered at the brothel.

“There was one woman who said she has not been able to get her insulin or diabetic medications for over a month,” Srabanti says. “Another said she has not been able to buy her blood pressure medications since the lockdown started two months ago.”

Activist and aid worker Srabanti Huda wearing a face mask
Image captionSrabanti Huda organised an emergency aid delivery to Daulatdia brothel in Bangladesh

Reduced access to healthcare services is an issue facing sex workers globally, according to Prof Sanders. The problem is particularly acute in areas where there is high demand for regular antiviral drugs from those living with HIV.

“There’s been real issues around access,” she says.

Prof Sanders is working with a team in Nairobi to develop an “Uber-style” app that will enable sex workers to order medication using their phones and have it delivered.

“It’s sent directly to them via a mode of transport rather than the person coming into the clinic,” she says.

Back in Daulatdia brothel, another sex worker who didn’t want to be named is returning from a trip to see her daughter, who lives in a nearby home for the children of sex workers.

Even when the brothel reopens, it will take a long time for the industry to recover, she says.

“People are afraid if they come to us, they might get infected,” she says. “We are afraid too. We might get infected from them. This fear of getting infected will come up all the time.”

Additional reporting by Salman Saeed.

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The fight against Covid-19 should also be the fight against tobacco

Smoking kills more than 8 million people a year, according to the World Health Organization.
Smoking kills more than 8 million people a year, according to the World Health Organization. Valery Sharifulin/TASS/Getty Images

Editor’s Note: Kelly Henning is the director of public health at Bloomberg Philanthropies. The views expressed in this commentary are her own. 

Protecting people from the dangers of tobacco products — and holding tobacco companies accountable for their global actions — is a critical component in the fight against Covid-19.

Smokers are more likely than non-smokers to develop severe complications with Covid-19, according to a review of studies by public health experts convened by the World Health Organization. And, a new study of 169 hospitals in Asia, Europe and North America found that smokers have nearly double the likelihood of in-hospital death than non-smokers.

But just as important, tobacco use — a pandemic in its own right — is costly to individual smokers and to society. Smoking kills more than 8 million people a year, mainly in low- and middle-income countries. These deaths are preventable and come mostly from cancer, heart disease, stroke, chronic lung disease and diabetes — conditions that also contribute to high rates of Covid-19 mortality. The human price is exacerbated by the economic toll in health care costs and lost productivity costs that reaches $1.4 trillion annually worldwide.

We’ll be better able to fight this pandemic, and future ones, if we commit ourselves to improving the world’s health. Helping smokers quit will reduce the amount of people with underlying conditions that could make them more susceptible to Covid-19 and other infections. At the same time, to adequately fund efforts to fight coronavirus and prepare for unknown health emergencies to come, we must lower health care costs for households and health care systems and shift our economy away from production and purchase of harmful products, such as tobacco.

https://www.cnn.com/world/live-news/coronavirus-pandemic-06-03-20-intl/h_4ebad693f81837b61c9f78b765d4ca9e