The U.S. plays catch-up
American officials are scrambling to ramp up testing for the coronavirus, after weeks of setbacks and missteps that may have allowed the virus to gain a foothold.
Many scientists wonder if the moves came too late, and a surge of positive test results has raised critical questions: Why weren’t more Americans tested sooner? How many may be carrying the virus now?
The Centers for Disease Control and Prevention botched its first attempt to mass-produce a diagnostic test kit. A replacement test took several weeks, and the C.D.C. imposed stringent, narrow criteria and still did not permit state and local laboratories to make final diagnoses. The result: A relatively tiny number of Americans have been tested, with consequences that are now becoming clear.
“There has been a silent epidemic of Covid-19 in the United States that is not going to be silent any longer,” said Michael Osterholm, an epidemiologist at the University of Minnesota.
Health care systems are tied in knots
The strains that the coronavirus is putting on the world’s health care systems are becoming increasingly evident.
In China, home to the vast majority of coronavirus cases, some hospitals are turning away patients with other urgent medical needs, including children with cancer. One health expert told The Times it was likely that preventable deaths from other causes could ultimately outnumber the lives saved by treating coronavirus patients.
Low-paid health workers in Britain, where there have been 51 cases so far, say they will show up to work even if they are ill, because they cannot afford the lost wages if they quarantine themselves. And in the United States, coronavirus cases in Oregon and New York have prompted the quarantine of dozens of doctors, nurses and other staff members.
Greater disruptions may follow: Chinese factories that supply the raw ingredients for drugs have been hobbled, prompting India to ban exports of many generic drugs, most of them antibiotics, without explicit government permission.
Iran’s coronavirus response: paranoia and chaos
Iranian officials said as recently as two weeks ago that the coronavirus would not touch their country, and mocked quarantines as “archaic.”
Now, nearly three dozen Iranian officials and lawmakers are sick, and the government is considering sending troops door to door to forcibly sanitize homes. After bragging about sending protective masks to China in February, the government is threatening to execute anyone who hoards masks or other supplies.
The official death toll there rose to 77, with more than 2,300 total cases, but some experts say those numbers could be a vast understatement.
A prominent pathologist in Tehran said patients and health care workers are threatened if they tell the truth about the outbreak — a lesson in what happens when a secretive state with limited resources tries to play down a crisis.
Is the economy infected, too?
Peter S. Goodman, our economics correspondent based in London, calls it a “nasty feedback loop.” And there may not be much that policymakers can do about it.
The Federal Reserve cut interest rates by half a point on Tuesday, hoping to boost confidence. But it may have raised worries instead about what the Fed might see coming. The stock market, which usually likes interest-rate cuts, slumped after the announcement.
Economists say a pandemic could throw the United States into a recession, and not just a slowdown. The real sign of trouble, said Tara Sinclair, an economist at George Washington University, will be when companies that are not in directly affected sectors like travel or manufacturing start reporting a slump.
Italy’s death toll jumped to 79 on Tuesday, an increase of 27 in one day, officials said. Most of the 2,502 infections confirmed so far have been concentrated in the northern part of the country.
France, home to the second most cases in Europe, announced 21 new infections, raising its total to 212, and reported one new death.
In the U.S., two people who died in the Seattle area on Feb. 26 had undetected coronavirus infections, officials said, suggesting that the virus had spread there earlier than previously known. The news brought the country’s death toll to nine people, all in Washington State, including seven residents of a nursing home in Kirkland.
What does ‘mild’ mean, exactly?
We caught up with Donald G. McNeil Jr., our infectious-diseases reporter, to ask him what it’s actually like to contract the coronavirus, based on what we’ve learned so far from China, which has the vast majority of cases.
What does this illness look like? I’ve heard some people compare it to the flu.
No, it’s different from flu. It’s a lung disease, not a stuffy nose disease. Ninety 90 percent of people get a fever, 80 percent get a dry cough, and then it drops down to 30 percent get shortness of breath and malaise — you know, being tired.
A runny nose shows up in only 4 percent, and that may be people who also happen to have a cold or flu, too.
What are we learning about asymptomatic cases?
The good news is that a large study from China suggests that less than 1 percent of cases are asymptomatic. Almost all people get sick.
But that means that the real fatality rate is something like the fatality rate you see outside of Hubei Province, which is between 1 and 2 percent. That’s definitely not good news.
What you can do
The basics: Keep your hands clean, washing them thoroughly with soap and water, or using a hand sanitizer that’s at least 60 percent alcohol. Avoid touching your face, especially your eyes, nose and mouth. Clean surfaces using a simple disinfectant, which is enough to kill the virus.
Know the symptoms, which include fever, cough and difficulty breathing.
If you feel sick, stay home and call your doctor’s office so it can prepare for your visit. When you go, wear a mask to prevent transmission. Follow the same guidance if someone in your family gets sick.
Is there a cure? There is no approved antiviral drug for the coronavirus, though several are being tested. Doctors recommend medicine to reduce pain and fever, and fluids to avoid dehydration.
What about a vaccine? An experimental vaccine may be ready for human testing in a few months, but it will be much longer, at least a year or two, before the vaccine is available for widespread use.
If you are flying, there are steps you can take to disinfect your seat on the plane.
What else we’re following
WhatsApp has become a major vector of coronavirus misinformation as users around the world spread conspiracy theories, The Washington Post reports.
N.B.A. players will be giving fans fist-bumps instead of high-fives after the league sent its recommendations for handling the virus.
How do you get the public’s attention? Vietnam found a new way with its coronavirus hand-washing song, which has inspired a TikTok dance challenge. (But don’t expect Weird Al Yankovic to chime in with a virus-inspired “My Corona” parody.)
Makers of household cleaners like Purell, Clorox and Lysol are cranking up production to meet consumer demand, according to The Wall Street Journal.
Religious leaders have asked congregants to forgo certain rituals — using a communal cup, holding hands during prayer, greeting with handshakes — to prevent the virus’s spread.
Comparisons to the 1918 pandemic are everywhere, but one expert writes in The Atlantic that in many ways the coronavirus won’t resemble the Spanish flu.
A novelist who was in China during the 2009 swine flu pandemic relays how she got through a 10-day quarantine (Coke and Pringles helped).
We want to hear from you
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Melina Delkic, Adam Pasick, Lara Takenega and Tom Wright-Piersanti contributed to this briefing.