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Westlake Legal Group > Posts tagged "Coronavirus (2019-nCoV)"

Even Asymptomatic People Carry the Coronavirus in High Amounts

Westlake Legal Group 06VIRUS-ASYMPTOMATIC-facebookJumbo Even Asymptomatic People Carry the Coronavirus in High Amounts your-feed-science Tests (Medical) South Korea Quarantines JAMA Internal Medicine (Journal) Fauci, Anthony S Disease Rates Coronavirus (2019-nCoV)

Of all the coronavirus’s qualities, perhaps the most surprising has been that seemingly healthy people can spread it to others. This trait has made the virus difficult to contain, and continues to challenge efforts to identify and isolate infected people.

Most of the evidence for asymptomatic spread has been based on observation (a person without symptoms nevertheless sickened others) or elimination (people became ill but could not be connected to anyone with symptoms).

A new study in South Korea, published Thursday in JAMA Internal Medicine, offers more definitive proof that people without symptoms carry just as much virus in their nose, throat and lungs as those with symptoms, and for almost as long.

“It’s important data, that’s for sure,” said Benjamin Cowling, an epidemiologist at the University of Hong Kong who was not involved in the work. “And it does confirm what we’ve suspected for a long time — that asymptomatic cases can transmit infection.”

Discussions about asymptomatic spread have been dogged by confusion about people who are “pre-symptomatic” — meaning they eventually become visibly ill — versus the truly asymptomatic, who appear healthy throughout the course of their infection.

The new study is among the first to clearly distinguish between these two groups.

“There’s been this big question pretty much since January, since data started coming out of China, about people that were asymptomatic or pre-symptomatic,” said Jason Kindrachuk, a virologist at the University of Manitoba who was not involved in the work. “What we haven’t really had any clue of yet is what role people who are asymptomatic play in transmission of disease.”

The new study measured the virus’s genetic material in the patients; the researchers did not follow the chain of transmission or grow live virus, which might have more directly confirmed active infections.

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Updated 2020-08-06T16:32:54.801Z

Still, experts said the results strongly suggest that asymptomatic people are unwitting broadcasters of the virus.

“They don’t look any different from the symptomatic population” in terms of how much virus they carry, said Marta Gaglia, a virologist at Tufts University in Massachusetts who was not involved in the work. “There’s no actual reason to believe a priori that they would transmit any differently.”

Dr. Cowling was more circumspect. Because asymptomatic people do not cough or sneeze, he said, it is possible that they are less efficient at expelling the virus than those who are clearly unwell.

On the other hand, Dr. Gaglia offered, people who feel ill tend to take to the bed or couch, whereas the infected but unaware may carry on with their business, sickening others along the way.

The South Korean team analyzed samples taken between March 6 and March 26 from 193 symptomatic and 110 asymptomatic people isolated at a community treatment center in Cheonan. Of the initially asymptomatic patients, 89 — roughly 30 percent of the total — appeared healthy throughout, while 21 developed symptoms.

The participants were mostly young, with a median age of just 25. (A study last week found that children, who are mostly mildly infected, also harbor at least as much virus as adults do.)

“The real strength of the study is they have a very large number of patients and they have very good follow-up,” Dr. Gaglia said. “When they talk about asymptomatic patients, they really, really know that these were true asymptomatics.”

The study’s estimate that 30 percent of infected people never develop symptoms is in line with findings from other studies. In a television interview on Wednesday, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, tendered 40 percent as the figure.

“The good news about Covid-19 is that about 40 percent of the population have no symptoms when they get infected,” Dr. Fauci said. But “even though you are likely not going to get symptoms, you are propagating the outbreak, which means that you’re going to infect someone, who will infect someone, who then will have a serious consequence.”

The participants in the new study were all isolated when they tested positive for the virus and did not have the opportunity to infect others. Doctors and nurses tracked their temperatures and other symptoms, and tested their sputum — which indicates virus present in the lungs — as well as their noses and throats.

“Both groups had similar amounts of virus pretty much throughout the entire course of infection,” Dr. Kindrachuk said. Asymptomatic people became virus-free a little sooner: around Day 17, compared with Day 19 or 20 for those with symptoms.

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Both estimates are much longer than the period of quarantine required in most countries, Dr. Gaglia noted. The Centers for Disease Control and Prevention recently decreased the recommended quarantine to 10 days from 14.

But several studies have suggested that infected people shed — or pass into the environment — live coronavirus for only about a week, even though the tests may pick up viral fragments in their bodies for much longer.

Dr. Cowling also noted that the study was retrospective, meaning the researchers looked at samples collected from people who had tested positive earlier, instead of following a group of people over time, identifying everyone who became infected as well as their contacts, and assessing their symptoms and virus levels.

“It would still be valuable to design a study like that,” he said. Still, he conceded that comparing people with symptoms and without was challenging because infected people are found in varying ways.

Most testing plans focus on people who need medical care, and rarely whole groups regardless of symptoms — especially in places like the United States, where tests are often scarce to begin with.

A lack of testing can also influence how much asymptomatic people contribute to the size of an outbreak.

With enough testing, everyone found to be infected could be separated from others. But if the testing is barely enough to catch the visibly ill, then asymptomatic people — particularly the young and social — may fan out into society and keep the virus circulating at high levels.

Many other viruses can be spread by people without symptoms, usually at negligible levels, Dr. Kindrachuk said.

It’s still unclear whether the new coronavirus is unusual in this respect, able to spread widely from asymptomatic people, he added, or whether it just seems so prolific because of the scale of the pandemic. Studies addressing those questions are underway.

“There are all these small nuances about this virus that are coming to light each day,” Dr. Kindrachuk said.

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Welcome Back to Germany. Now Take Your Free Coronavirus Test.

BERLIN — When she returned to Germany last week from a vacation in Serbia, one of the first things Snjezana Kirstein did was to stop at a pop-up coronavirus testing center at Berlin’s Tegel Aiport.

Whereas such tests can be hard to find in the United States, with unpredictable costs and results two weeks in coming, Ms. Kirstein was on her way in a matter of minutes after having her nose and throat swabbed. She expected an answer in 24 to 48 hours. The test was not only swift, it was free.

“I think it is super,” Ms. Kirstein said. “It was so easy to find, and best of all, it didn’t cost me a thing.”

As of Saturday, Germany will require that same simple test for all citizens or residents, like Ms. Kirstein, and other travelers who enter the country from coronavirus “hot spots,” again making it a leader in using testing as a firewall against the spread of the virus.

“I am very aware that this is an intrusion in personal freedom,” Jens Spahn, Germany’s health minister, said at a news conference Thursday. “But freedom always comes with responsibility for myself and for others.”

As Europe reopens, cases have begun ticking up nearly everywhere, to a greater or lesser extent, leaving countries in a constant, seesaw battle to tamp down outbreaks before they undo months of hard-won progress made during costly lockdowns this spring.

Germany is no exception. This week it recorded 1,045 new coronavirus infections in a single day, part of a rising trend that has begun to worry officials as people return from trips abroad during the summer vacation season.

One of the biggest concerns in Germany and across the continent is that travelers will carry the virus with them. Until now, Germany, like other countries, has relied on quarantining newly arriving travelers. But such measures are not always enforced, or strictly followed.

Since the start of the pandemic, Germany has made testing a primary tool in its battle against the virus. Now it is turning to that approach again to head off a potential second wave of infections. Its capacity to make testing efficient, affordable and available has distinguished it among industrialized nations.

Unlike the United States or Britain, both of which allowed their public health agencies to keep tight control over standards for tests and discouraged private clinics, labs or companies from developing their own, Germany disseminated a blueprint for a test as soon as it had one.

ImageWestlake Legal Group merlin_174081960_c3c1150d-6dbe-4ac3-b3b3-73bb9735f25b-articleLarge Welcome Back to Germany. Now Take Your Free Coronavirus Test. Travel and Vacations Tests (Medical) Quarantines Laboratories and Scientific Equipment Health Insurance and Managed Care Germany Europe Deaths (Fatalities) Coronavirus (2019-nCoV) airports
Credit…Ronald Wittek/EPA, via Shutterstock

In January, doctors at the Charité research hospital in Berlin developed one of the world’s first diagnostic tests for the new coronavirus. They quickly made it available to the country’s public hospitals and research laboratories, as well as a nationwide network of about 200 privately owned labs. Everyone focused on making test kits.

The World Health Organization later approved the kits and distributed instructions for developing them worldwide. At that time, the Centers for Disease Control and Prevention were still struggling to develop test kits in the United States.

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Updated 2020-08-06T10:15:02.458Z

While nearly 90 percent of Germany’s population of 83 million is covered by public insurance, people can also opt for private insurance that either competes with the public system, or provides top-up coverage.

By May, the German authorities required all insurance companies to cover the cost of testing. Initially it was limited to those with symptoms, but today it is available to just about everyone, with the government agreeing to help cover the costs.

“We have had a very important principle since the beginning of the pandemic — that testing in Germany is not a question of money,” Mr. Spahn said. “That is a big difference to many other countries that have failed to test enough over many months.”

Early on, the government also ordered hospitals and labs to reduce all but necessary treatments to free resources to process coronavirus tests, earmarking millions to support the effort and ensuring speedy results.

These measures allowed Germany to ramp up testing at a pace that prevented the country’s hospitals — well equipped in any case, with one of the world’s highest ratios of intensive care beds per capita and a centralized system to transfer patients between them — from becoming overwhelmed.

By March, Germany was one of the highest testers per capita in the world. Other countries have since overtaken it, in part because Germany has been so effective in targeting tests and following up on positive results to isolate those infected and shut down chains of infection before they get out of control.

So while Germany can carry out as many as 1.2 million tests per week, according the health ministry, it is only currently testing half that many people. That gives it the bandwidth to easily expand testing to incoming travelers, while still maintaining readiness should a big second wave arrive.

The United States has a capacity of 4.5 million tests per week, according to the Rockefeller Foundation, but its population is also roughly four times the size of Germany’s, and results can take five to 14 days.

The United States also lacks comprehensive contract-tracing, another factor that has left it struggling to contain the spread of the virus. Germany has had fewer than 10,000 deaths attributed to the virus, the United States more than 150,000.

Those awaiting test results in Germany are required to self-quarantine, and are released from the obligation immediately if the result is negative. They must also leave contact information in case they have a positive result and need to be traced.

Credit…Albert Gea/Reuters

The speed of the results, then, is critical to the containment effort. People are more likely to abide isolation for two days than for two weeks, and even if they don’t they still have less time to wander around and potentially expose others. Germany’s shorter turnaround also reduces the time that healthy people are taken out of productive roles in society.

Those who refuse a test must remain in quarantine for two weeks, unless they can provide a negative test less than 72 hours old. Under current E.U. travel restrictions, foreigners from outside the bloc are allowed to enter the country only if they have the right to live and work in Germany, with few exceptions.

Germany’s wide availability of testing has not made everyone happy, however, and not all agree on the benefits.

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Some experts warn that it could overwhelm laboratories and threaten the country’s readiness to deal with a resurgence of the virus when colder temperatures push people back indoors.

“It is questionable whether the general testing of travel returnees offers an appropriate balance between benefit and expense,” said Dr. Michael Müller, head of the Association of Medical Labs, which represents more than 200 labs across the country.

Others have questioned whether it is fair to saddle taxpayers with the burden of paying for the tests for those who willingly risk traveling outside Europe, despite warnings by government health authorities.

The requirement for travelers includes those coming from 130 countries and regions, including the United States and three districts in Spain, which the German authorities consider high-risk for spread of the virus.

But Mr. Spahn rejected the idea that only the wealthy were traveling, citing people with families in Turkey or elsewhere in Europe whom they visited.

“I know the saying, ‘Whoever can afford a ski trip can pay for their broken leg,’ but when you think that idea through, then especially in a pandemic, it compromises solidarity in society,” Mr. Spahn said. “So testing will remain cost-free.”

While Germans are normally quick to decry any encroachment on their personal privacy, the threat of the virus returning appears to frighten them more, and there has been little pushback to the proposed requirement for travelers.

On the second day after a testing station was set up at Tegel Airport, dozens of people pushing luggage trolleys stacked with suitcases or young children in strollers waited patiently for their turn to submit a voluntary test.

“It is an unbelievable hassle to set it up and organize it, but if it gives passengers back a sense of security when traveling, then it is worth it,” said Hannes Stefan Hönemann, spokesman for the airport’s operator.

The requirement for travelers include those coming over land as well if they have visited a hot zone. Health authorities in the southern state of Bavaria, the gateway for people returning by car from vacations on the Mediterranean coasts, set up test centers at three highway rest stops near the border, as well as at airports and major train stations.

Credit…Christof Stache/Agence France-Presse — Getty Images

Over the weekend, before the requirement went into effect this week, about 18,000 people were tested voluntarily, they said.

Bavaria made free testing available to all residents on July 1. The government invested 200 million euros, about $235 million, to expand laboratory capacity, both public and private, as well as personnel and working hours. Today it has the capacity for about 27,000 tests a day, state health minister, Melanie Huml, said.

“Test, test, test is the name of the game in Bavaria,” she said. “Our goal is to recognize infections as quickly as possible to stop chains of infection as early as early as possible.”

She estimates they can test as many as 2,000 travelers each day, the same capacity as expected in Berlin’s airports. Those who test positive will be alerted immediately, as will the public local health office, so it can follow up on care and contact tracing.

“Corona is not over and does not forgive any lack of vigilance,” Ms. Huml said. “We have to be careful to prevent a second wave from creeping up on us.”

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The Unique U.S. Failure to Control the Virus

Nearly every country has struggled to contain the coronavirus and made mistakes along the way.

China committed the first major failure, silencing doctors who tried to raise alarms about the virus and allowing it to escape from Wuhan. Much of Europe went next, failing to avoid enormous outbreaks. Today, many countries — Japan, Canada, France, Australia and more — are coping with new increases in cases after reopening parts of society.

Yet even with all of these problems, one country stands alone, as the only affluent nation to have suffered a severe, sustained outbreak for more than four months: the United States.

When it comes to the virus, the United States has come to resemble not the wealthy and powerful countries to which it is often compared but instead to far poorer countries, like Brazil, Peru and South Africa, or those with large migrant populations, like Bahrain and Oman.

As in several of those other countries, the toll of the virus in the United States has fallen disproportionately on poorer people and groups that have long suffered discrimination. Black and Latino residents of the United States have contracted the virus at roughly three times as high of a rate as white residents.

How did this happen? The New York Times set out to reconstruct the unique failure of the United States, through numerous interviews with scientists and public health experts around the world. The reporting points to two central themes.

First, the United States faced longstanding challenges in confronting a major pandemic. It is a large country at the nexus of the global economy, with a tradition of prioritizing individualism over government restrictions. That tradition is one reason the United States suffers from an unequal health care system that has long produced worse medical outcomes — including higher infant mortality and diabetes rates and lower life expectancy — than in most other rich countries.

“As an American, I think there is a lot of good to be said about our libertarian tradition,” Dr. Jared Baeten, an epidemiologist and vice dean at the University of Washington School of Public Health, said. “But this is the consequence — we don’t succeed as well as a collective.”

The second major theme is one that public health experts often find uncomfortable to discuss because many try to steer clear of partisan politics. But many agree that the poor results in the United States stem in substantial measure from the performance of the Trump administration.

In no other high-income country — and in only a few countries, period — have political leaders departed from expert advice as frequently and significantly as the Trump administration. President Trump has said the virus was not serious; predicted it would disappear; spent weeks questioning the need for masks; encouraged states to reopen even with large and growing caseloads; and promoted medical disinformation.

In recent days, Mr. Trump has continued the theme, offering a torrent of misleading statistics in his public appearances that make the situation sound less dire than it is.

Some Republican governors have followed his lead and also played down the virus, while others have largely followed the science. Democratic governors have more reliably heeded scientific advice, but their performance in containing the virus has been uneven.

“In many of the countries that have been very successful they had a much crisper strategic direction and really had a vision,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security, who wrote a guide to reopening safely for the American Enterprise Institute, a conservative research group. “I’m not sure we ever really had a plan or a strategy — or at least it wasn’t public.”

Together, the national skepticism toward collective action and the Trump administration’s scattered response to the virus have contributed to several specific failures and missed opportunities, Times reporting shows:

  • a lack of effective travel restrictions;

  • repeated breakdowns in testing;

  • confusing advice about masks;

  • a misunderstanding of the relationship between the virus and the economy;

  • and inconsistent messages from public officials.

Already, the American death toll is of a different order of magnitude than in most other countries. With only 4 percent of the world’s population, the United States has accounted for 22 percent of coronavirus deaths. Canada, a rich country that neighbors the United States, has a per capita death rate about half as large. And these gaps may worsen in coming weeks, given the lag between new cases and deaths.


Daily deaths per million in wealthy countries

Source: New York Times database from state and local governments. Includes all countries with a G.D.P. per capita of more than $25,000 and a population of at least 10 million people.

For many Americans who survive the virus or do not contract it, the future will bring other problems. Many schools will struggle to open. And the normal activities of life — family visits, social gatherings, restaurant meals, sporting events — may be more difficult in the United States than in any other affluent country.

In retrospect, one of Mr. Trump’s first policy responses to the virus appears to have been one of his most promising.

On Jan. 31, his administration announced that it was restricting entry to the United States from China: Many foreign nationals — be they citizens of China or other countries — would not be allowed into the United States if they had been to China in the previous two weeks.

It was still early in the spread of the virus. The first cases in Wuhan, China, had been diagnosed about a month before, and the first announced case in the United States had come on Jan. 21. In announcing the new travel policy, Alex M. Azar II, the secretary of health and human services, declared that the virus posed “a public health emergency.” Mr. Trump described the policy as his “China ban.”

After the Trump administration acted, several other countries quickly announced their own restrictions on travel from China, including Japan, Vietnam and Australia.

But it quickly became clear that the United States’ policy was full of holes. It did not apply to immediate family members of American citizens and permanent residents returning from China, for example. In the two months after the policy went into place, almost 40,000 people arrived in the United States on direct flights from China.

Even more important, the policy failed to take into account that the virus had spread well beyond China by early February. Later data would show that many infected people arriving in the United States came from Europe. (The Trump administration did not restrict travel from Europe until March and exempted Britain from that ban despite a high infection rate there.)

The administration’s policy also did little to create quarantines for people who entered the United States and may have had the virus.

Authorities in some other places took a far more rigorous approach to travel restrictions.

South Korea, Hong Kong and Taiwan largely restricted entry to residents returning home. Those residents then had to quarantine for two weeks upon arrival, with the government keeping close tabs to ensure they did not leave their home or hotel. South Korea and Hong Kong also tested for the virus at the airport and transferred anyone who was positive to a government facility.

Australia offers a telling comparison. Like the United States, it is separated from China by an ocean and is run by a conservative leader — Scott Morrison, the prime minister. Unlike the United States, it put travel restrictions at the center of its virus response.

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Updated 2020-08-06T10:04:45.639Z

Australian officials noticed in March that the travel restrictions they had announced on Feb. 1 were not preventing the virus from spreading. So they went further.

On March 27, Mr. Morrison announced that Australia would no longer trust travelers to isolate themselves voluntarily. The country would instead mandate that everyone arriving from overseas, including Australian citizens, spend two weeks quarantined in a hotel.

The protocols were strict. As people arrived at an airport, the authorities transported them directly to hotels nearby. People were not even allowed to leave their hotel to exercise. The Australian military helped enforce the rules.

Around the same time, several Australian states with minor outbreaks shut their own borders to keep out Australians from regions with higher rates of infection. That hardening of internal boundaries had not happened since the 1918 flu pandemic, said Ian Mackay, a virologist in Queensland, one of the first states to block entry from other areas.

The United States, by comparison, imposed few travel restrictions, either for foreigners or American citizens. Individual states did little to enforce the rules they did impose.

“People need a bit more than a suggestion to look after their own health,” said Dr. Mackay, who has been working with Australian officials on their pandemic response. “They need guidelines, they need rules — and they need to be enforced.”

Travel restrictions and quarantines were central to the success in controlling the virus in South Korea, Hong Kong, Taiwan and Australia, as well as New Zealand, many epidemiologists believe. In Australia, the number of new cases per day fell more than 90 percent in April. It remained near zero through May and early June, even as the virus surged across much of the United States.

In the past six weeks, Australia has begun to have a resurgence — which itself points to the importance of travel rules. The latest outbreak stems in large part from problems with the quarantine in the city of Melbourne. Compared with other parts of Australia, Melbourne relied more on private security contractors who employed temporary workers — some of whom lacked training and failed to follow guidelines — to enforce quarantines at local hotels. Officials have responded by banning out-of-state travel again and imposing new lockdowns.

Still, the tolls in Australia and the United States remain vastly different. Fewer than 300 Australians have died of complications from Covid-19, the illness caused by the virus. If the United States had the same per capita death rate, about 3,300 Americans would have died, rather than 158,000.

Enacting tough travel restrictions in the United States would not have been easy. It is more integrated into the global economy than Australia is, has a tradition of local policy decisions and borders two other large countries. But there is a good chance that a different version of Mr. Trump’s restrictions — one with fewer holes and stronger quarantines — would have meaningfully slowed the virus’s spread.

Traditionally, public health experts had not seen travel restrictions as central to fighting a pandemic, given their economic costs and the availability of other options, like testing, quarantining and contact tracing, Dr. Baeten, the University of Washington epidemiologist, said. But he added that travel restrictions had been successful enough in fighting the coronavirus around the world that those views may need to be revisited.

“Travel,” he said, “is the hallmark of the spread of this virus around the world.”

ImageWestlake Legal Group merlin_175041549_f4134f61-d95b-4dc5-af99-dfff4e1d68c9-articleLarge The Unique U.S. Failure to Control the Virus United States Trump, Donald J Tests (Medical) Quarantines Masks Disease Rates Coronavirus Reopenings Coronavirus (2019-nCoV)
Credit…Eve Edelheit for The New York Times

On Jan. 16, nearly a week before the first announced case of the coronavirus in the United States, a German hospital made an announcement. Its researchers had developed a test for the virus, which they described as the world’s first.

The researchers posted the formula for the test online and said they expected that countries with strong public health systems would soon be able to produce their own tests. “We’re more concerned about labs in countries where it’s not that easy to transport samples, or staff aren’t trained that thoroughly, or if there is a large number of patients who have to be tested,” Dr. Christian Drosten, the director of the Institute for Virology at the hospital, known as Charite, in Berlin.

It turned out, however, that the testing problems would not be limited to less-developed countries.

In the United States, the Centers for Disease Control and Prevention developed their own test four days after the German lab did. C.D.C. officials claimed that the American test would be more accurate than the German one, by using three genetic sequences to detect the virus rather than two. The federal government quickly began distributing the American test to state officials.

But the test had a flaw. The third genetic sequence produced inconclusive results, so the C.D.C. told state labs to pause their work. In meetings of the White House’s coronavirus task force, Dr. Robert R. Redfield, the C.D.C. director, played down the problem and said it would soon be solved.

Instead, it took weeks to fix. During that time, the United States had to restrict testing to people who had clear reason to think they had the virus. All the while, the virus was quietly spreading.

By early March, with the testing delays still unresolved, the New York region became a global center of the virus — without people realizing it until weeks later. More widespread testing could have made a major difference, experts said, leading to earlier lockdowns and social distancing and ultimately less sickness and death.

“You can’t stop it if you can’t see it,” Dr. Bruce Aylward, a senior adviser to the director general at the World Health Organization, said.

While the C.D.C. was struggling to solve its testing flaws, Germany was rapidly building up its ability to test. Chancellor Angela Merkel, a chemist by training, and other political leaders were watching the virus sweep across northern Italy, not far from southern Germany, and pushed for a big expansion of testing.

By the time the virus became a problem in Germany, labs around the country had thousands of test kits ready to use. From the beginning, the government covered the cost of the tests. American laboratories often charge patients about $100 for a test.

Without free tests, Dr. Hendrik Streeck, director of the Institute of Virology at the University Hospital Bonn, said at the time, “a young person with no health insurance and an itchy throat is unlikely to go to the doctor and therefore risks infecting more people.”

Germany was soon far ahead of other countries in testing. It was able to diagnose asymptomatic cases, trace the contacts of new patients and isolate people before they could spread the virus. The country has still suffered a significant outbreak. But it has had many fewer cases per capita than Italy, Spain, France, Britain or Canada — and about one-fifth the rate of the United States.

The United States eventually made up ground on tests. In recent weeks, it has been conducting more per capita than any other country, according to Johns Hopkins researchers.

But now there is a new problem: The virus has grown even more rapidly than testing capacity. In recent weeks, Americans have often had to wait in long lines, sometimes in scorching heat, to be tested.

One measure of the continuing troubles with testing is the percentage of tests that come back positive. In a country that has the virus under control, fewer than 5 percent of tests come back positive, according to World Health Organization guidelines. Many countries have reached that benchmark. The United States, even with the large recent volume of tests, has not.


Percent of coronavirus tests that come back positive

Seven-day averages. Source: Our World in Data. Includes all countries with a G.D.P. per capita of more than $25,000 and a population of at least 10 million people.

“We do have a lot of testing,” Ms. Rivers, the Johns Hopkins epidemiologist, said. “The problem is we also have a lot of cases.”

The huge demand for tests has overwhelmed medical laboratories, and many need days — or even up to two weeks — to produce results. “That really is not useful for public health and medical management,” Ms. Rivers added. While people are waiting for their results, many are also spreading the virus.

In Belgium recently, test results have typically come back in 48 to 72 hours. In Germany and Greece, it is two days. In France, the wait is often 24 hours.

For the first few months of the pandemic, public health experts could not agree on a consistent message about masks. Some said masks reduced the spread of the virus. Many experts, however, discouraged the use of masks, saying — somewhat contradictorily — that their benefits were modest and that they should be reserved for medical workers.

“We don’t generally recommend the wearing of masks in public by otherwise well individuals because it has not been up to now associated with any particular benefit,” Dr. Michael Ryan, a World Health Organization official, said at a March 30 news conference.

His colleague Dr. Maria Van Kerkhove explained that it was important to “prioritize the use of masks for those who need them most.”

The conflicting advice, echoed by the C.D.C. and others, led to relatively little mask wearing in many countries early in the pandemic. But several Asian countries were exceptions, partly because they had a tradition of mask wearing to avoid sickness or minimize the effects of pollution.

By January, mask wearing in Japan was widespread, as it often had been during a typical flu season. Masks also quickly became the norm in much of South Korea, Thailand, Vietnam, Taiwan and China.

In the following months, scientists around the world began to report two strands of evidence that both pointed to the importance of masks: Research showed that the virus could be transmitted through droplets that hang in the air, and several studies found that the virus spread less frequently in places where people were wearing masks.

On one cruise ship that gave passengers masks after somebody got sick, for example, many fewer people became ill than on a different cruise where people did not wear masks.

Consistent with that evidence was Asia’s success in holding down the number of cases (after China’s initial failure to do so). In South Korea, the per capita death rate is about one-eightieth as large as in the United States; Japan, despite being slow to enact social distancing, has a death rate about one-sixtieth as large.

“We should have told people to wear cloth masks right off the bat,” Dr. George Rutherford of the University of California, San Francisco, said.

In many countries, officials reacted to the emerging evidence with a clear message: Wear a mask.

Prime Minister Justin Trudeau of Canada began wearing one in May. During a visit to an elementary school, President Emmanuel Macron of France wore a French-made blue mask that complemented his suit and tie. Zuzana Caputova, the president of Slovakia, created a social media sensation by wearing a fuchsia-colored mask that matched her dress.

In the United States, however, masks did not become a fashion symbol. They became a political symbol.

Mr. Trump avoided wearing one in public for months. He poked fun at a reporter who wore one to a news conference, asking the reporter to take it off and saying that wearing one was “politically correct.” He described former Vice President Joseph R. Biden Jr.’s decision to wear one outdoors as “very unusual.”

Many other Republicans and conservative news outlets, like Fox News, echoed his position. Mask wearing, as a result, became yet another partisan divide in a highly polarized country.

Throughout much of the Northeast and the West Coast, more than 80 percent of people wore masks when within six feet of someone else. In more conservative areas, like the Southeast, the share was closer to 50 percent.

A March survey found that partisanship was the biggest predictor of whether Americans regularly wore masks — bigger than their age or whether they lived in a region with a high number of virus cases. In many of the places where people adopted a hostile view of masks, including Texas and the Southeast, the number of virus cases began to soar this spring.

Credit…Anna Moneymaker for The New York Times

Throughout March and April, Gov. Brian Kemp of Georgia and staff members held long meetings inside a conference room at the State Capitol in Atlanta. They ordered takeout lunches from local restaurants like the Varsity and held two daily conference calls with the public health department, the National Guard and other officials.

One of the main subjects of the meetings was when to end Georgia’s lockdown and reopen the state’s economy. By late April, Mr. Kemp decided that it was time.

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Georgia had not met the reopening criteria laid out by the Trump administration (and many outside health experts considered those criteria too lax). The state was reporting about 700 new cases a day, more than when it shut down on April 3.

Nonetheless, Mr. Kemp went ahead. He said that Georgia’s economy could not wait any longer, and it became one of the first states to reopen.

“I don’t give a damn about politics right now,” he said at an April 20 news conference announcing the reopening. He went on to describe business owners with employees at home who were “going broke, worried about whether they can feed their children, make the mortgage payment.”

Four days later, across Georgia, barbers returned to their chairs, wearing face masks and latex gloves. Gyms and bowling alleys were allowed to reopen, followed by restaurants on April 27. The stay-at-home order expired at 11:59 p.m. on April 30.

Mr. Kemp’s decision was part of a pattern: Across the United States, caseloads were typically much higher when the economy reopened than in other countries.


The United States reopened with more cases

Other countries relaxed their restrictions to America’s current level with far fewer cases per million.

Source: Oxford Covid-19 Government Response Tracker, New York Times database from state and local governments. Includes all countries with a G.D.P. per capita of more than $25,000 that have a population of at least 10 million people. Japan and Sweden never reached a high enough stringency level to be included.

As the United States endured weeks of closed stores and rising unemployment this spring, many politicians — particularly Republicans, like Mr. Kemp — argued that there was an unavoidable trade-off between public health and economic health. And if crushing the virus meant ruining the economy, maybe the side effects of the treatment were worse than the disease.

Dan Patrick, the Republican lieutenant governor of Texas, put the case most bluntly, and became an object of scorn, especially from the political left, for doing so. “There are more important things than living,” Mr. Patrick said in a television interview the same week that Mr. Kemp reopened Georgia.

It may have been an inartful line, but Mr. Patrick’s full argument was not wholly dismissive of human life. He was instead suggesting that the human costs of shutting down the economy — the losses of jobs and income and the associated damages to living standards and people’s health — were greater than the costs of a virus that kills only a small percentage of people who get it.

“We are crushing the economy,” he said, citing the damage to his own children and grandchildren. “We’ve got to take some risks and get back in the game and get this country back up and running.”

The trouble with the argument, epidemiologists and economists agree, was that public health and the economy’s health were not really in conflict.

Early in the pandemic, Austan Goolsbee, a University of Chicago economist and former Obama administration official, proposed what he called the first rule of virus economics: “The best way to fix the economy is to get control of the virus,” he said. Until the virus was under control, many people would be afraid to resume normal life and the economy would not function normally.

The events of the last few months have borne out Mr. Goolsbee’s prediction. Even before states announced shutdown orders in the spring, many families began sharply reducing their spending. They were responding to their own worries about the virus, not any official government policy.

And the end of lockdowns, like Georgia’s, did not fix the economy’s problems. It instead led to a brief increase in spending and hiring that soon faded.

In the weeks after states reopened, the virus began surging. Those that opened earliest tended to have worse outbreaks, according to a Times analysis. The Southeast fared especially badly.

States that reopened earlier are seeing bigger outbreaks

⟵ Reopened later Reopened earlier ⟶ //x Axis //yAxis 50 days since reopening 70 90 110 100 200 300 400Avg. new cases per million now Alabama Arizona California Florida Georgia Louisiana Michigan Mississippi Missouri Nevada New Jersey New York Oklahoma Texas

In June and July, Georgia reported more than 125,000 new virus cases, turning it into one of the globe’s new hot spots. That was more new cases than Canada, France, Germany, Italy, Japan and Australia combined during that time frame.

Americans, frightened by the virus’s resurgence, responded by visiting restaurants and stores less often. The number of Americans filing new claims for unemployment benefits has stopped falling. The economy’s brief recovery in April and May seems to have petered out in June and July.

In large parts of the United States, officials chose to reopen before medical experts thought it wise, in an attempt to put people back to work and spark the economy. Instead, the United States sparked a huge new virus outbreak — and the economy did not seem to benefit.

“Politicians are not in control,” Mr. Goolsbee said. “They got all the illness and still didn’t fix their economies.”

The situation is different in the European Union and other regions that have had more success reducing new virus cases. Their economies have begun showing some promising signs, albeit tentative ones. In Germany, retail sales and industrial production have risen, and the most recent unemployment rate was 6.4 percent. In the United States, it was 11.1 percent.

Credit…Hiroko Masuike/The New York Times

The United States has not performed uniquely poorly on every measure of the virus response.

Mask wearing is more common than throughout much of Scandinavia and Australia, according to surveys by YouGov and Imperial College London. The total death rate is still higher in Spain, Italy and Britain.

But there is one way — in addition to the scale of the continuing outbreaks and deaths — that the United States stands apart: In no other high-income country have the messages from political leaders been nearly so mixed and confusing.

These messages, in turn, have been amplified by television stations and websites friendly to the Republican Party, especially Fox News and the Sinclair Broadcast Group, which operates almost 200 local stations. To anybody listening to the country’s politicians or watching these television stations, it would have been difficult to know how to respond to the virus.

Mr. Trump’s comments, in particular, have regularly contradicted the views of scientists and medical experts.

The day after the first American case was diagnosed, he said, “We have it totally under control.” In late February, he said: “It’s going to disappear. One day — it’s like a miracle — it will disappear.” Later, he incorrectly stated that any American who wanted a test could get one. On July 28, he falsely proclaimed that “large portions of our country” were “corona-free.”

He has also promoted medical misinformation about the virus. In March, Mr. Trump called it “very mild” and suggested it was less deadly than the common flu. He has encouraged Americans to treat it with the antimalarial drug hydroxychloroquine, despite a lack of evidence about its effectiveness and concerns about its safety. At one White House briefing, he mused aloud about injecting people with disinfectant to treat the virus.

These comments have helped create a large partisan divide in the country, with Republican-leaning voters less willing to wear masks or remain socially distant. Some Democratic-leaning voters and less political Americans, in turn, have decided that if everybody is not taking the virus seriously, they will not either. State leaders from both parties have sometimes created so many exceptions about which workplaces can continue operating normally that their stay-at-home orders have had only modest effects.

“It doesn’t seem we have had the same unity of purpose that I would have expected,” Ms. Rivers, the Johns Hopkins epidemiologist, said. “You need everyone to come together to accomplish something big.”

Across much of Europe and Asia, as well as in Canada, Australia and elsewhere, leaders have delivered a consistent message: The world is facing a deadly virus, and only careful, consistent action will protect people.

Many of those leaders have then pursued aggressive action. Mr. Trump and his top aides, by contrast, persuaded themselves in April that the virus was fading. They have also declined to design a national strategy for testing or other virus responses, leading to a chaotic mix of state policies.

“If you had to summarize our approach, it’s really poor federal leadership — disorganization and denial,” said Andy Slavitt, who ran Medicare and Medicaid from 2015 to 2017. “Watch Angela Merkel. Watch how she communicates with the public. Watch how Jacinda Ardern in New Zealand does it. They’re very clear. They’re very consistent about what the most important priorities are.”

New York — both the city and the state — offers a useful case study. Like much of Europe, New York responded too slowly to the first wave of the virus. As late as March 15, Mayor Bill de Blasio encouraged people to go to their neighborhood bar.

Soon, the city and state were overwhelmed. Ambulances wailed day and night. Hospitals filled to the breaking point. Gov. Andrew M. Cuomo — a Democrat, like Mr. de Blasio — was slow to protect nursing home residents, and thousands died. Earlier action in New York could have saved a significant number of lives, epidemiologists say.

By late March, however, New York’s leaders understood the threat, and they reversed course.

They insisted that people stay home. They repeated the message every day, often on television. When other states began reopening, New York did not. “You look at the states that opened fast without metrics, without guardrails, it’s a boomerang,” Mr. Cuomo said on June 4.

The lockdowns and the consistent messages had a big effect. By June, New York and surrounding states had some of the lowest rates of virus spread in the country. Across much of the Southeast, Southwest and West Coast, on the other hand, the pandemic was raging.

Many experts now say that the most disappointing part of the country’s failure is that the outcome was avoidable.

What may not have been avoidable was the initial surge of the virus: The world’s success in containing previous viruses, like SARS, had lulled many people into thinking a devastating pandemic was unlikely. That complacency helps explains China’s early mistakes, as well as the terrible death tolls in the New York region, Italy, Spain, Belgium, Britain and other parts of Europe.

But these countries and dozens more — as well as New York — have since shown that keeping the virus in check is feasible.

For all of the continuing uncertainty about how this new coronavirus is transmitted and how it affects the human body, much has become clear. It often spreads indoors, with close human contact. Talking, singing, sneezing and coughing play a major role in transmission. Masks reduce the risk. Restarting normal activity almost always leads to new cases that require quick action — testing, tracing of patients and quarantining — to keep the virus in check.

When countries and cities have heeded these lessons, they have rapidly reduced the spread of the virus and been able to move back, gingerly, toward normal life. In South Korea, fans have been able to attend baseball games in recent weeks. In Denmark, Italy and other parts of Europe, children have returned to school.

In the United States, the virus continues to overwhelm daily life.

“This isn’t actually rocket science,” said Dr. Thomas R. Frieden, who ran the New York City health department and the C.D.C. for a combined 15 years. “We know what to do, and we’re not doing it.”

Contributing reporting were Damien Cave, J. David Goodman, Sarah Mervosh, Monika Pronczuk and Motoko Rich.

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Biden Will Not Attend Democratic Convention in Milwaukee

WASHINGTON — Joseph R. Biden Jr. acknowledged on Wednesday that he would not appear in Milwaukee to accept the presidential nomination he has sought on and off since the 1980s, bowing to the realities of a pandemic that has altered every aspect of life in 2020, including the November contest.

The decision to cancel major in-person appearances at the Democratic National Convention 90 days before the election, at the recommendation of health officials, was the final blow to the prospect that the fall campaign would resemble anything remotely like a traditional presidential contest, as the country confronts more than 150,000 deaths from the virus and cases continue to rise in parts of the country.

“The conventions as we traditionally have known them are no more,” said Terry McAuliffe, the former Democratic National Committee chairman who oversaw the party’s 2000 and 2004 conventions. “They will be more interactive and more digital, with more on social media.”

Other than the party chairman, Tom Perez, a small handful of Democratic officials will travel to Milwaukee from out of state to attend the convention. Some Wisconsin officials may deliver speeches from the crowd-free soundstage at the city’s convention center, where Mr. Biden was to deliver his nomination acceptance speech. He will now do that from his home state, Delaware.

President Trump and Republicans, who have careened from moving most of their convention from Charlotte, N.C., to Jacksonville, Fla., to canceling the made-for-TV portion of their event, have been slower to give up on the prospect of an in-person convention despite the serious health risks, and 336 delegates are still set to gather in North Carolina.

Party conventions once had a different kind of drama to them.

Much to the chagrin of political junkies, the days of convention floor flights over who would be a party’s presidential nominee are long past. Not since 1980, when Edward M. Kennedy forced a vote to free delegates from a commitment to President Jimmy Carter, has there been any real question about whom a major party would nominate, though Mr. Trump did face some opposition from Republicans at his convention in 2016.

In recent years, convention week has meant prime-time televised addresses from famous names and up-and-comers, highly produced balloon drops and delegates in patriotic regalia, all as a way to introduce voters to the candidate and to kick off the general election. It was a place to conduct party business, and also to throw actual parties — lavish events to reward donors and bigwigs, where celebrities mingled with state party chairs.

An introduction is less essential than ever in 2020, with both major candidates universally known by the American electorate, but Democrats still need to engage volunteers and flatter their foot soldiers, while communicating with a screen-weary homebound American electorate.

“Can you get a bounce? Yes,” said Leah D. Daughtry, who ran the party’s 2008 and 2016 conventions. “Can you make it interesting? That’s the challenge. You’ve got to make it interesting.”

Though a virtual convention will be a challenge, Democrats argued on Wednesday that the decision to forgo an in-person address reinforced a sharp contrast Mr. Biden has been pressing throughout the public health crisis: He takes the coronavirus outbreak seriously, and Mr. Trump does not. It is critical, allies have said, that Mr. Biden serve as a role model who adheres firmly to the public health guidelines Mr. Trump has often flouted.

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Updated 2020-08-06T04:05:02.791Z

“I’ve wanted to set an example as to how we should respond individually to this crisis,” Mr. Biden said at a fund-raiser on Wednesday. “Science matters.”

ImageWestlake Legal Group merlin_175341324_96a50878-566e-4e89-8580-0be0bb9c4e83-articleLarge Biden Will Not Attend Democratic Convention in Milwaukee Wisconsin Presidential Election of 2020 Milwaukee (Wis) Democratic Party Democratic National Convention democratic national committee delaware Coronavirus (2019-nCoV) Biden, Joseph R Jr
Credit…Stacy Revere/Getty Images

Mr. Trump is sure to suggest that Mr. Biden, who has done very little in-person campaigning since the pandemic hit, is simply hiding back in his home state, even though for the millions expected to watch his address on television and other screens, the experience of seeing Mr. Biden from a soundstage in Delaware will not be much different than it would have been in an empty convention center in Milwaukee.

For Mr. Trump, an August convention was seen as an opportunity to demonstrate that the country was firmly on the path to economic recovery, having vanquished the pandemic. Mr. Trump’s allies moved cities to ensure they could give the president the look and feel of a pre-virus coronation.

But now, with just weeks to go before the president accepts his renomination, and plans in two separate cities foiled, Republicans are still tossing out ambitious ideas of how to create a spectacle that will appeal to Mr. Trump’s supporters and earn high ratings on television.

Both Mr. Biden and Mr. Trump are visibly energized by crowds, and advisers must consider how they can deliver convention-bump-inducing speeches without roaring audiences, or in Mr. Biden’s case, even the smattering of party officials who could have made the journey to Wisconsin.

Democratic donors who are not traveling to Milwaukee will soon receive swag bags in the mail that are filled with commemorative pins, buttons and the formal credentials that would have been waiting for them at their hotels.

Some fund-raisers and donors had the option of “convention packages” that promise activities like “taste of the trail” (for donating $250,000), a “preferred convention welcome kit” ($100,000) or “afternoon briefings and other convention week daytime content” ($50,000 and up) — despite the largely virtual nature of the festivities.

The decision to keep Mr. Biden away from what was left of the Milwaukee convention — an event that in June was moved out of the city’s basketball arena to a smaller convention center, while delegates were told to stay home — came after epidemiologists determined it would not be safe for even 300 people to gather in one place from across the country.

“When it became clear in past days that the pandemic was not abating, we took these actions,” Mr. Perez said in an interview Wednesday. “We have an absolutely top-shelf team of people producing the convention and while it will be different from any convention before, I think it has real possibility to be more exciting and exhilarating than ever before.”

Moving the remaining convention segments planned for Milwaukee is a blow to the city, which has lost the chance to show how pleasant Wisconsin summers are to a global audience — and the hundreds of millions of dollars in economic impact envisioned when Mr. Perez awarded the city the convention in 2018.

“I completely understand the decision,” said Alex Lasry, the finance chairman for the convention’s host committee, but he added he was deeply disappointed for the city.

“For us to go there in person, we would put a whole bunch of people from Milwaukee and surrounding areas in harm’s way — not going to do that,” said Representative Cedric Richmond, a Louisiana Democrat who is a co-chairman of Mr. Biden’s campaign. “The convention is a big TV production anyway. We’re still going to have that, we’ll still have our speakers, make our case for why Joe Biden should be the next president.”

While Mr. Biden will formally accept the nomination from Delaware, other Democrats will appear on television screens from satellite locations from across the country. Stephanie Cutter, a veteran of the John Kerry and Barack Obama presidential campaigns, is still in the process of filling the two hours of nightly airtime.

Wisconsin officials are still expected to give speeches at the convention center in downtown Milwaukee, but leading Democrats, including Mr. Obama, Michelle Obama and Jill Biden, are expected to deliver their addresses from elsewhere.

Credit…Kamil Krzaczynski/Agence France-Presse — Getty Images

Hours after Democrats announced their entire convention would be conducted virtually, the Republican National Convention released health protocols for its scaled-back party gathering, which plans for 336 delegates to meet for four days in Charlotte in late August.

The Republican proposal includes “pre-travel Covid-19 testing of all participants prior to arrival in Charlotte,” temperature checks, social distancing and mask-wearing. The Democratic convention had required everyone inside the convention’s security perimeter to test negative for the virus each day before entry.

The conventions may be traditional in only this way: marking the start to a fall campaign that, like everything else this year, will be different from any other in modern American history.

The get-out-the-vote effort won’t have armies of volunteers knocking on doors to remind voters to go to the polls. Instead it will mean countless texts and phone calls and video chats to show people the proper procedures to apply for and send back an absentee ballot — and for some voters, in states like Wisconsin that have more restrictive vote-by-mail laws, how to find a legal witness to co-sign their ballot envelope so it can be counted.

For 2020, the days of neighbor-to-neighbor in-person campaigning are essentially over.

“You don’t even want to try,” said Gilberto Hinojosa, the Texas Democratic Party chairman. “You don’t want to upset the voter. The easiest way to lose a voter is to anger them by exposing them to Covid-19.”

Annie Karni contributed reporting.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Biden Will Not Attend Democratic Convention in Milwaukee

WASHINGTON — Joseph R. Biden Jr. acknowledged on Wednesday that he would not appear in Milwaukee to accept the presidential nomination he has sought on and off since the 1980s, bowing to the realities of a pandemic that has altered every aspect of life in 2020, including the November contest.

The decision to cancel major in-person appearances at the Democratic National Convention 90 days before the election, at the recommendation of health officials, was the final blow to the prospect that the fall campaign would resemble anything remotely like a traditional presidential contest, as the country confronts more than 150,000 deaths from the virus and cases continue to rise in parts of the country.

“The conventions as we traditionally have known them are no more,” said Terry McAuliffe, the former Democratic National Committee chairman who oversaw the party’s 2000 and 2004 conventions. “They will be more interactive and more digital, with more on social media.”

Other than the party chairman, Tom Perez, a small handful of Democratic officials will travel to Milwaukee from out of state to attend the convention. Some Wisconsin officials may deliver speeches from the crowd-free soundstage at the city’s convention center, where Mr. Biden was to deliver his nomination acceptance speech. He will now do that from his home state, Delaware.

President Trump and Republicans, who have careened from moving most of their convention from Charlotte, N.C., to Jacksonville, Fla., to canceling the made-for-TV portion of their event, have been slower to give up on the prospect of an in-person convention despite the serious health risks, and 336 delegates are still set to gather in North Carolina.

Party conventions once had a different kind of drama to them.

Much to the chagrin of political junkies, the days of convention floor flights over who would be a party’s presidential nominee are long past. Not since 1980, when Edward M. Kennedy forced a vote to free delegates from a commitment to President Jimmy Carter, has there been any real question about whom a major party would nominate, though Mr. Trump did face some opposition from Republicans at his convention in 2016.

In recent years, convention week has meant prime-time televised addresses from famous names and up-and-comers, highly produced balloon drops and delegates in patriotic regalia, all as a way to introduce voters to the candidate and to kick off the general election. It was a place to conduct party business, and also to throw actual parties — lavish events to reward donors and bigwigs, where celebrities mingled with state party chairs.

An introduction is less essential than ever in 2020, with both major candidates universally known by the American electorate, but Democrats still need to engage volunteers and flatter their foot soldiers, while communicating with a screen-weary homebound American electorate.

“Can you get a bounce? Yes,” said Leah D. Daughtry, who ran the party’s 2008 and 2016 conventions. “Can you make it interesting? That’s the challenge. You’ve got to make it interesting.”

Though a virtual convention will be a challenge, Democrats argued on Wednesday that the decision to forgo an in-person address reinforced a sharp contrast Mr. Biden has been pressing throughout the public health crisis: He takes the coronavirus outbreak seriously, and Mr. Trump does not. It is critical, allies have said, that Mr. Biden serve as a role model who adheres firmly to the public health guidelines Mr. Trump has often flouted.

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Updated 2020-08-06T04:05:02.791Z

“I’ve wanted to set an example as to how we should respond individually to this crisis,” Mr. Biden said at a fund-raiser on Wednesday. “Science matters.”

ImageWestlake Legal Group merlin_175341324_96a50878-566e-4e89-8580-0be0bb9c4e83-articleLarge Biden Will Not Attend Democratic Convention in Milwaukee Wisconsin Presidential Election of 2020 Milwaukee (Wis) Democratic Party Democratic National Convention democratic national committee delaware Coronavirus (2019-nCoV) Biden, Joseph R Jr
Credit…Stacy Revere/Getty Images

Mr. Trump is sure to suggest that Mr. Biden, who has done very little in-person campaigning since the pandemic hit, is simply hiding back in his home state, even though for the millions expected to watch his address on television and other screens, the experience of seeing Mr. Biden from a soundstage in Delaware will not be much different than it would have been in an empty convention center in Milwaukee.

For Mr. Trump, an August convention was seen as an opportunity to demonstrate that the country was firmly on the path to economic recovery, having vanquished the pandemic. Mr. Trump’s allies moved cities to ensure they could give the president the look and feel of a pre-virus coronation.

But now, with just weeks to go before the president accepts his renomination, and plans in two separate cities foiled, Republicans are still tossing out ambitious ideas of how to create a spectacle that will appeal to Mr. Trump’s supporters and earn high ratings on television.

Both Mr. Biden and Mr. Trump are visibly energized by crowds, and advisers must consider how they can deliver convention-bump-inducing speeches without roaring audiences, or in Mr. Biden’s case, even the smattering of party officials who could have made the journey to Wisconsin.

Democratic donors who are not traveling to Milwaukee will soon receive swag bags in the mail that are filled with commemorative pins, buttons and the formal credentials that would have been waiting for them at their hotels.

Some fund-raisers and donors had the option of “convention packages” that promise activities like “taste of the trail” (for donating $250,000), a “preferred convention welcome kit” ($100,000) or “afternoon briefings and other convention week daytime content” ($50,000 and up) — despite the largely virtual nature of the festivities.

The decision to keep Mr. Biden away from what was left of the Milwaukee convention — an event that in June was moved out of the city’s basketball arena to a smaller convention center, while delegates were told to stay home — came after epidemiologists determined it would not be safe for even 300 people to gather in one place from across the country.

“When it became clear in past days that the pandemic was not abating, we took these actions,” Mr. Perez said in an interview Wednesday. “We have an absolutely top-shelf team of people producing the convention and while it will be different from any convention before, I think it has real possibility to be more exciting and exhilarating than ever before.”

Moving the remaining convention segments planned for Milwaukee is a blow to the city, which has lost the chance to show how pleasant Wisconsin summers are to a global audience — and the hundreds of millions of dollars in economic impact envisioned when Mr. Perez awarded the city the convention in 2018.

“I completely understand the decision,” said Alex Lasry, the finance chairman for the convention’s host committee, but he added he was deeply disappointed for the city.

“For us to go there in person, we would put a whole bunch of people from Milwaukee and surrounding areas in harm’s way — not going to do that,” said Representative Cedric Richmond, a Louisiana Democrat who is a co-chairman of Mr. Biden’s campaign. “The convention is a big TV production anyway. We’re still going to have that, we’ll still have our speakers, make our case for why Joe Biden should be the next president.”

While Mr. Biden will formally accept the nomination from Delaware, other Democrats will appear on television screens from satellite locations from across the country. Stephanie Cutter, a veteran of the John Kerry and Barack Obama presidential campaigns, is still in the process of filling the two hours of nightly airtime.

Wisconsin officials are still expected to give speeches at the convention center in downtown Milwaukee, but leading Democrats, including Mr. Obama, Michelle Obama and Jill Biden, are expected to deliver their addresses from elsewhere.

Credit…Kamil Krzaczynski/Agence France-Presse — Getty Images

Hours after Democrats announced their entire convention would be conducted virtually, the Republican National Convention released health protocols for its scaled-back party gathering, which plans for 336 delegates to meet for four days in Charlotte in late August.

The Republican proposal includes “pre-travel Covid-19 testing of all participants prior to arrival in Charlotte,” temperature checks, social distancing and mask-wearing. The Democratic convention had required everyone inside the convention’s security perimeter to test negative for the virus each day before entry.

The conventions may be traditional in only this way: marking the start to a fall campaign that, like everything else this year, will be different from any other in modern American history.

The get-out-the-vote effort won’t have armies of volunteers knocking on doors to remind voters to go to the polls. Instead it will mean countless texts and phone calls and video chats to show people the proper procedures to apply for and send back an absentee ballot — and for some voters, in states like Wisconsin that have more restrictive vote-by-mail laws, how to find a legal witness to co-sign their ballot envelope so it can be counted.

For 2020, the days of neighbor-to-neighbor in-person campaigning are essentially over.

“You don’t even want to try,” said Gilberto Hinojosa, the Texas Democratic Party chairman. “You don’t want to upset the voter. The easiest way to lose a voter is to anger them by exposing them to Covid-19.”

Annie Karni contributed reporting.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Biden’s Milwaukee Trip Is Canceled, and So Is a Normal Presidential Campaign

WASHINGTON — Joseph R. Biden Jr. acknowledged on Wednesday that he would not appear in Milwaukee to accept the presidential nomination he has sought on and off since the 1980s, bowing to the realities of a pandemic that has altered every aspect of life in 2020, including the November contest.

The decision to cancel major in-person appearances at the Democratic National Convention 90 days before the election, at the recommendation of health officials, was the final blow to the prospect that the fall campaign would resemble anything remotely like a traditional presidential contest, as the country confronts more than 150,000 deaths from the virus and cases continue to rise in parts of the country.

“The conventions as we traditionally have known them are no more,” said Terry McAuliffe, the former Democratic National Committee chairman who oversaw the party’s 2000 and 2004 conventions. “They will be more interactive and more digital, with more on social media.”

Other than the party chairman, Tom Perez, a small handful of Democratic officials will travel to Milwaukee from out of state to attend the convention. Some Wisconsin officials may deliver speeches from the crowd-free soundstage at the city’s convention center, where Mr. Biden was to deliver his nomination acceptance speech. He will now do that from his home state, Delaware.

President Trump and Republicans, who have careened from moving most of their convention from Charlotte, N.C., to Jacksonville, Fla., to canceling the made-for-TV portion of their event, have been slower to give up on the prospect of an in-person convention despite the serious health risks, and 336 delegates are still set to gather in North Carolina.

Party conventions once had a different kind of drama to them.

Much to the chagrin of political junkies, the days of convention floor flights over who would be a party’s presidential nominee are long past. Not since 1980, when Edward M. Kennedy forced a vote to free delegates from a commitment to President Jimmy Carter, has there been any real question about whom a major party would nominate, though Mr. Trump did face some opposition from Republicans at his convention in 2016.

In recent years, convention week has meant prime-time televised addresses from famous names and up-and-comers, highly produced balloon drops and delegates in patriotic regalia, all as a way to introduce voters to the candidate and to kick off the general election. It was a place to conduct party business, and also to throw actual parties — lavish events to reward donors and bigwigs, where celebrities mingled with state party chairs.

An introduction is less essential than ever in 2020, with both major candidates universally known by the American electorate, but Democrats still need to engage volunteers and flatter their foot soldiers, while communicating with a screen-weary homebound American electorate.

“Can you get a bounce? Yes,” said Leah D. Daughtry, who ran the party’s 2008 and 2016 conventions. “Can you make it interesting? That’s the challenge. You’ve got to make it interesting.”

Though a virtual convention will be a challenge, Democrats argued on Wednesday that the decision to forgo an in-person address reinforced a sharp contrast Mr. Biden has been pressing throughout the public health crisis: He takes the coronavirus outbreak seriously, and Mr. Trump does not. It is critical, allies have said, that Mr. Biden serve as a role model who adheres firmly to the public health guidelines Mr. Trump has often flouted.

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Updated 2020-08-06T01:17:33.157Z

“I’ve wanted to set an example as to how we should respond individually to this crisis,” Mr. Biden said at a fund-raiser on Wednesday. “Science matters.”

ImageWestlake Legal Group merlin_175341324_96a50878-566e-4e89-8580-0be0bb9c4e83-articleLarge Biden’s Milwaukee Trip Is Canceled, and So Is a Normal Presidential Campaign Wisconsin Presidential Election of 2020 Milwaukee (Wis) Democratic Party Democratic National Convention democratic national committee delaware Coronavirus (2019-nCoV) Biden, Joseph R Jr
Credit…Stacy Revere/Getty Images

Mr. Trump is sure to suggest that Mr. Biden, who has done very little in-person campaigning since the pandemic hit, is simply hiding back in his home state, even though for the millions expected to watch his address on television and other screens, the experience of seeing Mr. Biden from a soundstage in Delaware will not be much different than it would have been in an empty convention center in Milwaukee.

For Mr. Trump, an August convention was seen as an opportunity to demonstrate that the country was firmly on the path to economic recovery, having vanquished the pandemic. Mr. Trump’s allies moved cities to ensure they could give the president the look and feel of a pre-virus coronation.

But now, with just weeks to go before the president accepts his renomination, and plans in two separate cities foiled, Republicans are still tossing out ambitious ideas of how to create a spectacle that will appeal to Mr. Trump’s supporters and earn high ratings on television.

Both Mr. Biden and Mr. Trump are visibly energized by crowds, and advisers must consider how they can deliver convention-bump-inducing speeches without roaring audiences, or in Mr. Biden’s case, even the smattering of party officials who could have made the journey to Wisconsin.

Democratic donors who are not traveling to Milwaukee will soon receive swag bags in the mail that are filled with commemorative pins, buttons and the formal credentials that would have been waiting for them at their hotels.

Some fund-raisers and donors had the option of “convention packages” that promise activities like “taste of the trail” (for donating $250,000), a “preferred convention welcome kit” ($100,000) or “afternoon briefings and other convention week daytime content” ($50,000 and up) — despite the largely virtual nature of the festivities.

The decision to keep Mr. Biden away from what was left of the Milwaukee convention — an event that in June was moved out of the city’s basketball arena to a smaller convention center, while delegates were told to stay home — came after epidemiologists determined it would not be safe for even 300 people to gather in one place from across the country.

“When it became clear in past days that the pandemic was not abating, we took these actions,” Mr. Perez said in an interview Wednesday. “We have an absolutely top-shelf team of people producing the convention and while it will be different from any convention before, I think it has real possibility to be more exciting and exhilarating than ever before.”

Moving the remaining convention segments planned for Milwaukee is a blow to the city, which has lost the chance to show how pleasant Wisconsin summers are to a global audience — and the hundreds of millions of dollars in economic impact envisioned when Mr. Perez awarded the city the convention in 2018.

“I completely understand the decision,” said Alex Lasry, the finance chairman for the convention’s host committee, but he added he was deeply disappointed for the city.

“For us to go there in person, we would put a whole bunch of people from Milwaukee and surrounding areas in harm’s way — not going to do that,” said Representative Cedric Richmond, a Louisiana Democrat who is a co-chairman of Mr. Biden’s campaign. “The convention is a big TV production anyway. We’re still going to have that, we’ll still have our speakers, make our case for why Joe Biden should be the next president.”

While Mr. Biden will formally accept the nomination from Delaware, other Democrats will appear on television screens from satellite locations from across the country. Stephanie Cutter, a veteran of the John Kerry and Barack Obama presidential campaigns, is still in the process of filling the two hours of nightly airtime.

Wisconsin officials are still expected to give speeches at the convention center in downtown Milwaukee, but leading Democrats, including Mr. Obama, Michelle Obama and Jill Biden, are expected to deliver their addresses from elsewhere.

Credit…Kamil Krzaczynski/Agence France-Presse — Getty Images

Hours after Democrats announced their entire convention would be conducted virtually, the Republican National Convention released health protocols for its scaled-back party gathering, which plans for 336 delegates to meet for four days in Charlotte in late August.

The Republican proposal includes “pre-travel Covid-19 testing of all participants prior to arrival in Charlotte,” temperature checks, social distancing and mask-wearing. The Democratic convention had required everyone inside the convention’s security perimeter to test negative for the virus each day before entry.

The conventions may be traditional in only this way: marking the start to a fall campaign that, like everything else this year, will be different from any other in modern American history.

The get-out-the-vote effort won’t have armies of volunteers knocking on doors to remind voters to go to the polls. Instead it will mean countless texts and phone calls and video chats to show people the proper procedures to apply for and send back an absentee ballot — and for some voters, in states like Wisconsin that have more restrictive vote-by-mail laws, how to find a legal witness to co-sign their ballot envelope so it can be counted.

For 2020, the days of neighbor-to-neighbor in-person campaigning are essentially over.

“You don’t even want to try,” said Gilberto Hinojosa, the Texas Democratic Party chairman. “You don’t want to upset the voter. The easiest way to lose a voter is to anger them by exposing them to Covid-19.”

Annie Karni contributed reporting.

Real Estate, and Personal Injury Lawyers. Contact us at: https://westlakelegal.com 

Coronavirus Leads Japan to Lock Borders, Shutting Out Foreign Workers

TOKYO — When Jeff Mazziotta, a director of a nonprofit wildlife conservation organization, left Japan for South Africa in early March, he planned to spend a month training park rangers on emergency field medicine before returning to Tokyo.

Nearly five months later, Mr. Mazziotta is still stuck abroad. He is one of nearly 100,000 foreign residents of Japan who have been prevented from re-entering the country since April under its stringent coronavirus-related travel restrictions.

Japan’s rules, which stand out for making permanent and long-term residents ineligible for travel privileges granted to citizens, have left Mr. Mazziotta and many others in a difficult bind.

He has been forced to rely on a friend for financial support because he has little cash and no access to his Japanese bank account. His office in Japan, where he works as an English teacher to supplement his nonprofit work, put him on unpaid leave, and he has been unable to pay the rent on his Tokyo apartment.

“How am I going to recover from four months of lost pay and the bills that have been building up?” Mr. Mazziotta, an American citizen, said during a video chat in late July. Foreign residents who feel abandoned, he added, are “questioning the time and energy they spent building a life in Japan.”

Japan, a country known for its hospitality but also for casting a sometimes wary eye on its foreign residents, has been promoting itself as the premier Asian destination for global capital and talent, with an eye on wooing financial firms fleeing Hong Kong. But its treatment of foreign residents during the pandemic has undercut that message and shaken the trust of the country’s international community.

The restrictions have provoked loud protests from foreign businesses and residents in Japan. Executives at major international firms say they are rethinking their ties to the country, including how its handling of foreigners could hinder business continuity in an already uncertain time.

ImageWestlake Legal Group merlin_175330320_cd475ce0-250d-4563-908b-143e85ca6242-articleLarge Coronavirus Leads Japan to Lock Borders, Shutting Out Foreign Workers Travel and Vacations Japan Immigration and Emigration Foreign Workers Coronavirus (2019-nCoV) Abe, Shinzo
Credit…Cassandra Zona

In response, Japan has said it will ease some of the re-entry rules to gradually allow those like Mr. Mazziotta who have been trapped abroad to return to the country. But the changes do not apply to everyone: As many as 17,000 long-term residents of Japan could remain stuck outside the country, according to government data.

For many, the damage is done: The restrictions have split up families, hurt careers and caused students to miss months of school. Some of those stranded outside the country have been saddled with mountains of debt as they continue to pay taxes and rents on homes in Japan while also bearing the costs of being abroad.

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The ban has also affected the 2.5 million foreigners who remain in Japan. Many have faced agonizing decisions over whether to leave to care for a dying parent, grieve the loss of a loved one or reunite with a spouse or child, knowing that doing so may make it impossible to return.

“If you’re thinking about setting up your business in a place that is as safe and predictable as possible, Japan certainly has that in its favor,” said Christopher LaFleur, the chairman of the American Chamber of Commerce in Japan.

But “the policy in terms of travel has de facto discriminated against the foreign national residents of Japan,” he said, adding that it “certainly is going to weigh on people’s calculus in the months ahead.”

Japan is far from the only country to tighten its borders to control the spread of the virus, with many nations restricting or even stopping short-term travel for business and tourism. All told, Japan has banned entry from 146 countries, including places, like New Zealand and Taiwan, that appear to have eradicated the virus.

Both New Zealand and Taiwan allow long-term residents to travel freely, requiring only a quarantine period upon arrival. Japan, by contrast, is the only member of the Group of 7 industrialized nations to restrict travel by foreign residents while allowing its citizens to come and go as they please.

Japanese officials have said the restrictions on foreign residents are necessary to protect the country from the larger-scale outbreaks abroad and to avoid overwhelming the capacity of airports to test travelers for infection.

More than six months into the crisis, Japan can test only about 33,000 people a day — far fewer than nearly all of its peer countries. Around 3,000 of those tests have been reserved for the country’s international airports — administered to both Japanese and foreign travelers — with plans to increase the number to about 10,000 in September.

Credit…Kimimasa Mayama/EPA, via Shutterstock

Long-term residents have generally been unable to re-enter Japan since April 3. Those who have sought to leave after that date are allowed to return only if they fall into one of a handful of special categories, including “humanitarian” exemptions allowing them to care for a sick relative or attend a parent’s funeral.

But the guidelines are ill defined, and even for those who would seem to meet the requirements, return is not guaranteed. Before leaving the country, travelers must sign a document acknowledging that they may not be allowed to return. The final decision rests with the immigration agent who greets them at the airport.

Julie Sergent, a consultant in the hospitality industry, made three unsuccessful attempts to leave the country to spend time with her family after her father’s death.

She said that in late July, a month after her most recent attempt, officials told her that her situation did not qualify for re-entry, questioning why she would still need to grieve with her family when so much time had passed since her father’s funeral.

“I promote Japan; I want the country to do well,” she said. But, she added, “if this situation drags on too long, I might take the decision to leave Japan and move to a country where I have more rights.”

Immigration officials said they could not comment about individual cases.

The travel rules have also made it harder for many people to do business. Mark Borer, a permanent resident of Japan, where he has lived for 25 years, owns a small plastics recycling company in Gunma Prefecture, northwest of Tokyo, that employs some 20 people, including six workers from Vietnam. He also has a real estate business in the United States.

The restrictions have hampered both ventures, he said in a recent phone call, noting that he and his employees alike had been unable to travel for either business or personal matters since April, when Japan briefly declared a national emergency.

“I really love the country, and I’ve been here half my life,” he said, but “it’s a punch in the gut.”

If the restrictions are not lifted in the next few months, he said, “you’re forced to think maybe we need to end up selling or closing down the business here.”

It’s not just foreign-owned businesses that have been affected. Japanese construction companies, said Gordon Hatton, co-chairman of the real estate committee at the American Chamber of Commerce in Japan, have become increasingly reliant on foreign workers to fulfill a range of functions from manual labor to structural engineering.

If foreign employees “have to leave for some personal reason and they can’t come back,” he said, “that’s a huge waste for the Japanese companies as well, not just these individuals, so it has an impact on the bigger economy.”

Aware of foreign residents’ concerns, Prime Minister Shinzo Abe said last month that Japan would loosen some of the rules. On Wednesday, immigration officials said at a news conference that they had begun readmitting those who left before the start of the restrictions in April.

Credit…Issei Kato/Reuters

But even as they moved to loosen restrictions, officials added 17 countries to the re-entry ban list and instituted a rule requiring that travelers take a coronavirus test and receive a negative result no more than 72 hours before departing for Japan. That may be impossible for residents who are stuck in countries where tests are in short supply or results come slowly.

The Asahi Shimbun, a leading newspaper, reported that Japan would initially allow an additional 500 foreigners a day to re-enter. That low figure, as well as the uncertainty over how the loosening would be carried out, has led people like Keifer Castigador, an engineer from the Philippines who left Japan in late February, to be wary of trying to return.

Mr. Castigador went to the Philippines to help his wife recover from an emergency cesarean section. He tried to return in May, when Japan announced that it was reopening to residents who had qualified for a humanitarian exemption. He confirmed his status with Japanese officials, but when he tried to re-enter the country, he was turned away, he said.

He was held in detention for a night at his own expense and returned to the Philippines, he said, where he had to go into quarantine. He is now waiting to see how the new rules play out before he tries to return.

“We’re sitting it out this time because it was too much for us last time,” he said.

For Mr. Mazziotta, the English teacher, the experience has left an indelible impression. He has applied to the Japanese Embassy in South Africa for permission to return under the new rules, but has not yet heard back. His Japanese work visa runs out in September, and with no clarity about when he will be allowed to return, he is beginning to lose hope.

“Even if I can go back,” he said, “I wonder if the mountain that has been built is too difficult to climb.”

Makiko Inoue contributed reporting.

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Coronavirus Live Updates: Governors Seek to Reduce Testing Times in U.S.

Westlake Legal Group coronavirus-live-updates-governors-seek-to-reduce-testing-times-in-u-s Coronavirus Live Updates: Governors Seek to Reduce Testing Times in U.S. Coronavirus (2019-nCoV)

Here’s what you need to know:

ImageWestlake Legal Group merlin_175270215_ae962d6e-964d-4859-b6be-744254f7da04-articleLarge Coronavirus Live Updates: Governors Seek to Reduce Testing Times in U.S. Coronavirus (2019-nCoV)
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After parents and teachers opposed a hybrid model, Chicago schools will reopen online only.

Public school students in Chicago, the nation’s third-largest district, will begin the academic year remotely in September, leaving New York City as the only major school system in the country that will try to offer in-person classes when schools start this fall.

Mayor Lori Lightfoot of Chicago and Dr. Janice Jackson, the chief executive of Chicago Public Schools, made the announcement Wednesday morning, as the Chicago Teachers Union was in the midst of tentative preparations for a strike over school safety.

The school district had originally planned to open using a hybrid model, with students divided into pods of 15 children each and attending in-person classes two days a week.

But many parents and teachers were opposed to that plan, arguing that it would spread coronavirus in schools and neighborhoods. In Chicago, more than 250 new coronavirus cases have been confirmed each day over the last several days, a number that has steadily increased in recent weeks.

Of the nation’s 25 largest school districts, only five now plan to open the school year with any form of in-person learning. Six of the seven largest will be online.

New York City schools, the nation’s largest district, are scheduled to reopen in about a month, with students having the option of attending in-person classes one to three days a week. But the city is confronting a torrent of logistical issues and political problems that could upend Mayor Bill de Blasio’s efforts to bring students back to classrooms.

Among them: There are not yet enough nurses to staff all city school buildings, and ventilation systems in aging buildings are in urgent need of upgrades. There may not even be enough teachers available to offer in-person instruction. Some teachers are threatening to stage a sickout, and their union has indicated it might sue over reopening.

Chicago faced the same resistance from its union, but city leaders said their decision to start remotely was based on health concerns and parent feedback.

In other parts of the country where schools have already opened, they have quickly encountered positive cases, with some having to quarantine students and staff members and even close down schools temporarily to contain possible outbreaks.

America is testing more. But the results are too slow, a survey finds.

Credit…William Widmer for The New York Times

Frustrated by a nationwide testing backlog, the governors of six states took the unusual step of banding together on Tuesday to reduce the turnaround time for coronavirus test results to minutes from days.

The agreement, by three Republicans and three Democrats, was called the first interstate testing compact of its kind. The six states — Louisiana, Maryland, Massachusetts, Michigan, Ohio and Virginia — agreed to work with the Rockefeller Foundation and two U.S. manufacturers of rapid tests to buy 3 million tests.

More than six months into the pandemic, the bipartisan plan highlights the depth of the testing problems in the United States as well as how the lack of a federal testing program has left municipalities and states to fend for themselves. The Trump administration has offered new support to hard-hit regions by providing free testing in cities through a “surge testing” program, but the bulk of government-sponsored testing has been provided by cities, counties and states that hire third-party contractors. As a result, the length of the delay varies between states, and within them.

The United States is testing about 755,000 people a day, up from about 640,000 per day a month ago, and far more than in April and May, according to the Covid Tracking Project. But numbers alone do not tell the whole story. With testing chemicals in short supply, and an increase in cases nationwide leading to skyrocketing demands, many people still have to wait many days for results, in effect rendering those tests useless.

Most who are tested for the virus do not receive results within the 24 to 48 hours recommended by public health experts to effectively stall the virus’s spread and quickly conduct contact tracing, according to a new national survey by researchers from Harvard University, Northeastern University, Northwestern University and Rutgers University.

The survey — representing 19,000 people from 50 states and Washington, D.C., who responded to an online questionnaire last month — found lengthy wait times among those who had been tested for the virus, about 18 percent of all respondents. Respondents in a vast majority of states reported a median turnaround time of at least three days, including residents of California, Florida, Texas and other hot spots. The survey also found disparities across racial groups, an indication that people who are hit hardest by the pandemic are also having to wait longer for test results.

“Testing is just not quick enough,” said Matthew A. Baum, a professor of public policy at Harvard University and one of the researchers in the group, which found that wait times were “strikingly similar” across the country. “This is an enormously widespread problem.”

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Where cases are rising fastest

Democrats and Republicans have agreed to work toward a deal on a relief package by the end of the week.

Credit…Erin Schaff/The New York Times

Negotiators on Wednesday will reconvene on Capitol Hill to continue hammering out the details of a coronavirus relief package, having agreed to work toward an agreement by the end of the week and have legislative text prepared for the following week.

Speaker Nancy Pelosi of California is expected to again host Mark Meadows, the White House chief of staff; Steven Mnuchin, the Treasury secretary; and Senator Chuck Schumer of New York, the minority leader, in her Capitol Hill suite. The four are also expected to meet with Louis DeJoy, the postmaster general, to “explain to us why there’s so many delays and how that might affect the election,” Mr. Schumer said on Tuesday.

The meeting with Mr. DeJoy, a Trump campaign megadonor, comes as mail delays fuel concerns over the politicization of the Postal Service and the administration’s moves to undermine mail-in voting ahead of the general election in November. Democrats are fighting for the inclusion of aid for the Postal Service and election security in an overall coronavirus relief package, while Republicans did not include any such funding in their $1 trillion proposal.

White House officials and Democratic leaders acknowledged some progress in talks on Tuesday. Senator Mitch McConnell of Kentucky, the majority leader, signaled he may be open to accepting a compromise measure, even if it contained provisions that he — and members of his conference — disagreed with, such as the extension of $600-per-week jobless-aid payments.

But it remains unclear whether negotiators would be able to adhere to the timeline they had agreed to, given the number of remaining policy divisions. Several Senate Republicans, particularly moderates facing tough re-election campaigns, have urged Republican leadership to keep lawmakers in Washington until a deal is reached, instead of departing for a scheduled monthlong recess at the end of this week.

Global roundup

The number of virus-related deaths worldwide has passed 700,000.

Credit…Jose Cabezas/Reuters

The number of coronavirus deaths around the world passed 700,000 on Wednesday, according to a New York Times database. The virus has sickened more than 18.5 million people.

Almost twice as many countries have reported a significant rise in new cases over the past two weeks as have reported significant declines, according to the database.

Among those are some countries that thought they had a handle on the virus, including Australia and Spain.

In other news from around the world:

  • The United States’ top health official, Alex M. Azar II, will lead a delegation on a trip to Taiwan, a rare high-level visit by an American official to the island that has won praise for its success in battling the coronavirus.

  • The state of Victoria in Australia reported 725 new cases and 15 deaths from the coronavirus on Wednesday, its highest numbers since the pandemic began. New curfews and restrictions in the state mean essential workers must now carry a permit before leaving home.

  • Sri Lanka is holding a general election on Wednesday after twice delaying it because of the pandemic. Voters were required to wear masks and were encouraged to bring their own pens to the voting booths, which will be outfitted with hand sanitizer. Sri Lanka has reported 2,834 coronavirus cases, 299 of which are currently active.

Johnson & Johnson to receive $1 billion from Operation Warp Speed for its experimental vaccine.

Credit…Tony Luong for The New York Times

The federal government has committed just over $1 billion to Johnson & Johnson for up to 100 million doses of its experimental coronavirus vaccine, the company announced Wednesday.

It’s the latest deal from Operation Warp Speed, the government’s multiagency effort to bring coronavirus vaccines and treatments to market as quickly as possible. The government has offered these large grants to several companies so that they can begin manufacturing their vaccines even before rigorous clinical trials have proved that they work.

The administration’s investment in coronavirus vaccine projects now totals more than $9 billion.

“With the portfolio of vaccines being assembled for Operation Warp Speed, the Trump administration is increasing the likelihood that the United States will have at least one safe, effective vaccine by 2021,” Alex M. Azar II, the health and human services secretary, said in a statement.

Johnson & Johnson recently began a so-called Phase 1 clinical trial of its vaccine to test if it is safe to use on people. Last week, the company published a study in Nature showing that the vaccine protected monkeys from infection in just one dose, unlike some of its competitors that require two doses.

As Trump praises plasma, researchers struggle to finish critical studies.

Credit…Juan Ignacio Roncoroni/EPA, via Shutterstock

American scientists are hoping Covid-19 patients in Brazil will help them answer a century-old question: Can this golden serum, loaded with antibodies against a pathogen, actually heal the sick?

The truth is that no one knows if it works.

Since April, the Trump administration has funneled $48 million into a program with the Mayo Clinic, allowing more than 53,000 Covid-19 patients to get plasma infusions. Doctors and hospitals desperate to save the sickest patients have been eager to try a therapy that is safe and might work. Tens of thousands more people are now enrolled to get the treatment that has been trumpeted by the President Trump and a number of celebrities.

But the unexpected demand for plasma has inadvertently undercut the research that could prove that it works. The only way to get convincing evidence is with a clinical trial that compares outcomes for patients who are randomly assigned to get the treatment with those who are given a placebo. Many patients and their doctors — knowing they could get the treatment under the government program — have been unwilling to join clinical trials that might provide them with a placebo.

The Food and Drug Administration is preparing an emergency authorization to use the treatment, according to scientists who have been briefed on the plans. The policy would ease the clerical burden on hospitals to get clearance for transfusions, further hampering clinical trials, researchers said. An F.D.A. spokeswoman declined to comment on whether such an authorization was in the works.

The move would mean the F.D.A. is “yielding to political pressure,” said Dr. Luciana Borio, who oversaw public health preparedness for the National Security Council under Mr. Trump and who was acting chief scientist at the F.D.A. under former President Barack Obama.

“I’m not as concerned about the political leaders having a misguided approach to science,” she said. “What I’m really concerned about is scientists having a misguided approach to science.”

Convalescent plasma, the pale yellow liquid that is left after blood is stripped of its red and white cells, has been used since the 1890s to treat infectious diseases, including the flu, SARS and Ebola. Scientists believe it may work by giving sick patients the antibodies of those who have recovered from the infection.

Insurers are not covering businesses’ pandemic interruption costs, so companies are taking them to court.

Credit…Rachel Elise Thomas for The New York Times

Thousands of business owners in the United States have discovered that the business interruption policies they bought, and have been paying thousands of dollars in annual premiums to sustain, will not pay them a thing — just as they are struggling through the biggest business interruption in modern memory. (Business interruption insurance is a type of coverage that replaces a portion of a firm’s lost revenue when a disaster forces it to suspend operations.)

Now, many of them — including proprietors of gyms, dental practices, high-profile restaurateurs and even a National Basketball Association team — are taking their insurers to court, hoping to force them to cover some of the financial carnage. So far, more than 400 business interruption lawsuits have been filed, according to insurance lawyers.

“I think business interruption claims should be paid when business is interrupted,” said Nick Gavrilides, who closed his dining room when Michigan went into lockdown and had expected that he would get some of his losses covered because he had paid for business interruption insurance. (When he did not get a cent, he sued.)

Insurance companies do not see it that way. Most business interruption policies include highly specific language stating that for a claim to be paid out, there has to be “direct physical damage” — say, a flood that washes away a building or a fire that burns down inventory, forcing a business closure.

On top of that, after SARS swept through Asia nearly two decades ago and caused widespread economic damage, many insurers began to write in language that excluded business interruption caused by viral epidemics.

Insurers say they are not being stingy; they simply do not have enough capital to cover all coronavirus-related claims and would suffer enormous losses if they had to pay out.

The American Property Casualty Insurance Association has estimated that if insurers were required to cover all U.S. business interruption losses tied to the shutdowns, regardless of policy exclusions — something proposed by lawmakers in some states — it would cost $1 trillion a month.

Coronavirus symptoms are unpredictable. How do you know if you have it?

Credit…Angela Weiss/Agence France-Presse — Getty Images

With more than 18 million cases of coronavirus worldwide, one thing is clear: The symptoms are varied and strange, they can be mild or debilitating, and the disease can progress, from head to toe, in unpredictable ways.

Despite hundreds of published studies on Covid-19 symptoms, just how common any given symptom is depends on the patient group studied. Patients in hospitals typically have more severe symptoms. Older patients are more likely to have cognitive problems. Younger patients are more likely to have mild disease and odd rashes.

“This is a very tricky and confounding virus and disease, and we are finding out surprising things about it every day,” said Dr. Asaf Bitton, executive director of Ariadne Labs at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health.

Anosmia, the loss of sense of smell that is also often accompanied by a loss of taste, is viewed as one defining symptom, but it is not foolproof. Even a symptom as common as fever can be tricky; in a European study of 2,000 Covid-19 patients with mild to moderate illness, 60 percent never had a fever.

“The problem is that it depends on who you are and how healthy you are,” said Dr. Mark Perazella, a kidney specialist and professor of medicine at Yale School of Medicine. “If you’re healthy, most likely you’ll get fever, achiness, nasal symptoms, dry cough and you’ll feel crappy. But there are going to be the oddballs that are challenging and come in with some symptoms and nothing else, and you don’t suspect Covid.”

One-third of Afghanistan’s population has been infected, according to a survey.

Credit…Mohammad Ismail/Reuters

About one-third of Afghanistan’s population, or roughly 10 million people, have likely been infected by the coronavirus and recovered, Afghanistan’s health ministry said on Wednesday, based on a survey that deployed rapid tests for antibodies.

Ahmad Jawad Osmani, Afghanistan’s acting health minister, said the infection rate varied across the country according to the “cross-sectional survey,” conducted with the help of the World Health Organization and Johns Hopkins University. Crowded urban centers showed higher rates than the rural areas. The ministry said about 9,500 people were tested for the survey.

“The survey showed that 31.5 percent of the population of Afghanistan has been infected by coronavirus according to rapid tests which show antibodies in the blood, and that they have recovered,” Mr. Osmani said.

Kabul, the capital city of more than five million people, has been worst hit, with about 53 percent of the residents infected. The rate of infection in the east of the country was nearly 43 percent, the west 34 percent, and the northeast 32.4 percent.

“In Kabul, 46 percent of children were infected by the virus, but they don’t have symptoms. And 57 percent of adults were also infected in Kabul,” Mr. Osmani said. “The infection rates were lowest in central parts of the country with 25 percent of adults and 14 percent of children infected.”

The country’s nascent health system has been overwhelmed by the virus at a time when the war continues to bring large numbers of casualties to the hospitals as well. Testing has been extremely limited, casting doubt on official numbers.

There have been 36,782 confirmed cases of the coronavirus in Afghanistan and 1,288 deaths, according to a New York Times database.

The University of Connecticut cancels its football season, becoming the first top-level program to do so.

Credit…Stephen Dunn/Associated Press

The University of Connecticut canceled its football season on Wednesday, becoming the first member of the Football Bowl Subdivision to abandon its schedule in full because of the pandemic.

Connecticut’s season was already in flux because of the decisions of leading conferences, including the Big Ten and Southeastern, to play exclusively within their leagues. By the time Connecticut announced its decision on Wednesday morning, a third of its planned games had been canceled.

But in a statement, David Benedict, the athletic director at Connecticut, cited the pandemic’s perils, not scheduling complications, as the reason to drop plans for the season, saying it put athletes “at an unacceptable level of risk.”

In a statement released through the university, football players said they supported the decision, in part because “not enough is known about the potential long term effects” of the virus.

The decision from Connecticut came as the National Collegiate Athletic Association prepared to offer more details on Wednesday about its plans for championships in 22 fall sports, not including football, which runs its national championships under a different system.

Job hunting tips for today.

It is no longer about a firm handshake and confident eye contact, but some of the usual job interview tips do still apply when you take your job hunt online.

Reporting was contributed by Fahim Abed, Alan Blinder, Emily Cochrane, Nicholas Fandos, Manny Fernandez, Hailey Fuchs, Virginia Hughes, Mujib Mashal, Sarah Mervosh, Tara Parker-Pope, Amy Qin, Michael D. Shear, Kaly Soto, Eileen Sullivan, Katie Thomas, Kenneth P. Vogel, Mary Williams Walsh, Noah Weiland and Billy Witz.

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The Many Symptoms of Covid-19

For a Texas nurse, the first sign that something was wrong happened while brushing her teeth — she couldn’t taste her toothpaste. For a Georgia attorney, it was hitting a wall of fatigue on a normally easy run. When a Wisconsin professor fell ill in June, he thought a bad meal had upset his stomach.

But eventually, all of these people discovered that their manifold symptoms were all signs of Covid-19. Some of the common symptoms — a dry cough, a headache — can start so mildly they are at first mistaken for allergies or a cold. In other cases, the symptoms are so unusual — strange leg pain, a rash or dizziness — that patients and even their doctors don’t think Covid-19 could be the culprit.

With more than 18 million cases of coronavirus worldwide, one thing is clear: The symptoms are varied and strange, they can be mild or debilitating, and the disease can progress, from head to toe, in unpredictable ways.

Despite hundreds of published studies on Covid-19 symptoms, just how common any given symptom is depends on the patient group studied. Patients in hospitals typically have more severe symptoms. Older patients are more likely to have cognitive problems. Younger patients are more likely to have mild disease and odd rashes.

“The problem is that it depends on who you are and how healthy you are,” said Dr. Mark A. Perazella, a kidney specialist and professor of medicine at Yale School of Medicine. “It’s so heterogeneous, it’s hard to say. If you’re healthy, most likely you’ll get fever, achiness, nasal symptoms, dry cough and you’ll feel crappy. But there are going to be the oddballs that are challenging and come in with some symptoms and nothing else, and you don’t suspect Covid.”

The Texas nurse who couldn’t taste her toothpaste said she developed fever, “horrible” body aches and coughing the next day. Her symptoms lasted for five days. (She and many others interviewed asked that their names not be used to protect their medical privacy or to protect their families from the stigma of Covid-19.)

Anosmia, the loss of sense of smell that is also often accompanied by a loss of taste, is viewed as a defining symptom. In a study of 961 health care workers who were tested for Covid-19, anosmia was the most predictive symptom, but it wasn’t foolproof. Only half the people who reported losing their sense of smell or taste tested positive, said Dr. Brian Clemency, the study’s lead author and an associate professor in the department of emergency medicine at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo.

Even a symptom as common as fever can be tricky when trying to predict if a patient might have Covid-19. Although many businesses are doing fever checks to screen for Covid-19, many Covid-19 patients never have a fever. In a European study of 2,000 Covid-19 patients with mild to moderate illness, 60 percent never had a fever. In the University at Buffalo study, fewer than one in three patients with fever also tested positive for Covid-19.

ImageWestlake Legal Group merlin_175269687_5a5a2618-61ee-4cf7-bef9-90abb3386800-articleLarge The Many Symptoms of Covid-19 Smell (Olfaction) muscles Fever fatigue Digestive Tract Coughs Coronavirus Risks and Safety Concerns Coronavirus (2019-nCoV)
Credit…John Locher/Associated Press

Rob Gregson, 52, of South Orange, N.J., went to bed feeling under the weather and woke up with chest tightness, a “weird” cough, difficulty breathing and “crazy fatigue.” It was March 11, just before lockdowns were imposed, and he immediately suspected Covid-19. But because he never had a fever, it took him more than a week to find a doctor to help and get a swab test. He tested positive.

“It’s been the fatigue that is the most debilitating,” said Mr. Gregson, executive director of a faith-based nonprofit, adding that he’s still struggling to regain his stamina nearly five months later. “I’ve been on the coronavirus roller coaster, feeling better and thinking I’ll be OK, then it comes roaring back.”

When Erin, a 30-year-old who works for a nonprofit in Washington, D.C., first developed a cough and headache in May, she wasn’t worried. “I did not have a fever, and I’d been very diligent about wearing a mask and washing my hands, so I figured it was allergies or a cold at the beginning,” she said.

About four days after the cough began, Erin was hit with severe fatigue, sore throat, congestion, chills, body aches and a slight loss of sense of smell — but still no fever. She also had one unusual symptom: severe pain in her hip muscles, which she described as “really weird.”

Although body aches are a common symptom of Covid-19, some patients are reporting severe joint and body pain, particularly in large muscles. Although it’s rare, Covid-19 can cause painful inflammation in the joints or lead to rhabdomyolysis, a serious and potentially life-threatening illness that can cause excruciating muscle pain in the shoulders, thighs or lower back.

A New York cyclist who developed severe leg pain in May was initially diagnosed via telemedicine with a bulging disc. She sought a second telemedicine opinion with Dr. Jordan Metzl, a sports medicine specialist at the Hospital for Special Surgery in New York, who asked her to move, twist and put pressure on her legs as he watched her on video.

“Down to her calf she said, ‘Ouch, that really hurts,’” said Dr. Metzl, who grew worried. “I’m not an alarmist doctor in the least, but I looked for the closest emergency room to her, which was 16 miles away. I said, ‘I want you to get in the car and drive yourself to the E.R. right now.’”

An ultrasound showed she had no pulse in her legs and severe clotting in both legs, putting her at risk of amputation. She was transferred to another hospital and underwent nine hours of emergency surgery. Dr. Metzl said it was fortunate that he had just had a conference call with colleagues about blood clots and Covid.

“It’s a terrifying story, which is why we need awareness around these weird presentations,” Dr. Metzl said. “Covid infection can affect different body parts differently. Some people get this hypercoagulable state and end up getting blood clots. We don’t always know who those people are.”

In June, John, a 55-year-old professor in Oshkosh, Wis., woke up one morning feeling like something he had eaten disagreed with him. The next day he was hit with debilitating fatigue and nausea, cramping and other gastrointestinal symptoms. He didn’t suspect Covid-19 because he had been wearing a mask and social distancing.

“By the second day I was just wanting to sleep all the time. I was probably sleeping 20 hours a day,” he said. “I even remember during that time my mind set changed. I could not imagine how my wife and son were able to be awake all day. I thought, ‘How can anyone possibly do that?’ I would get out of bed and go to the kitchen for a glass of water, and by the time I got there all I could think about was wanting to go back to bed.”

Doctors tested him for Covid-19 and Lyme disease. Both were negative. An ultrasound showed no problems, but blood work suggested he had an infection of some kind. A doctor prescribed a two-week course of a heartburn drug, and he lost 10 pounds. After two weeks, he began feeling better. Two months later, he tested positive for Covid-19 antibodies, suggesting his original Covid test had been a false negative.

Doctors say Covid patients with only gastrointestinal symptoms often test negative when tested with a nasal-pharyngeal swab. The virus might be more likely to show up in fecal testing, which is common in other countries, but not widely used in the United States. The gastrointestinal tract and the respiratory tract both are rich in a receptor called ACE2, which the virus uses to get into our cells. But it’s unclear why the virus sometimes seems to skip the respiratory tract and instead infects only the digestive tract.

“This is a very tricky and confounding virus and disease, and we are finding out surprising things about it every day,” said Dr. Asaf Bitton, executive director of Ariadne Labs at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health.

Dr. Ilan Schwartz, assistant professor of infectious diseases at the University of Alberta, said he was tested for Covid-19 after developing respiratory symptoms. The test came back negative, but then he developed Covid toes — painful red or purple lesions on the tips of fingers and toes that are believed to be a telltale symptom of coronavirus, particularly in younger patients. It may happen as a result of small blood clots or when the virus invades blood vessels.

“I started getting these sores on my feet and couldn’t figure out what was going on,” said Dr. Schwartz, who is 37. “They were really painful. I thought maybe I had stubbed them — like all of them, which would be unusual. Then I thought maybe there’s something wrong with my shoes. I’ve heard a lot of people with similar stories end up buying new shoes because they don’t know what’s going on. It’s such an unusual symptom that it’s not natural to think of a respiratory virus being responsible for sore toes.”

Thomas Ryan, 36, an Atlanta attorney, said the first sign that something was wrong hit him during exercise.

“I went for a run on a Thursday afternoon after work and felt awful,” he said. “I hit the wall like you do in a marathon on a very short run for me.”

The next morning, he woke up with a light cough, sore throat and a feeling in his chest like heartburn, and later developed fatigue, lung pain and shortness of breath. Although his Covid test was negative, his doctor told him that it was a false negative, and that based on his symptoms, he clearly had Covid-19.

“This is not great,” said Mr. Ryan, who was still coughing weeks after falling ill. “The amount of energy I have — I feel like I’m at altitude. It was two weeks of not being able to do anything. If this is a mild case, it makes me think people are taking a lot of risks they probably shouldn’t be.”

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If Public Schools Are Closed, Should Private Schools Have to Follow?

Facing a resurgence of the coronavirus, public schools in the suburbs of the nation’s capital decided in recent weeks that more than a million children would start the school year from home. On Friday, officials in Maryland’s most populous county said that private schools, including some of the nation’s most elite, had to join them.

Gov. Larry Hogan, a Republican, abruptly overruled that directive this week, contending that Maryland’s private schools should be allowed to make their own reopening decisions. The governor staked out his position on the same day that a group of parents filed a federal lawsuit seeking to overturn the county’s order, saying it discriminated against private and religious schools.

The wrangling threw into sharp relief the challenges facing local health officials as they piece together a response to the pandemic only to see their efforts encounter political resistance and legal pushback. Montgomery County officials said on Tuesday that they were reviewing the governor’s order to see whether it negated their directive.

The dispute represents a contentious new front in the discussion over inequality in American society, as some private and parochial schools — with their smaller class sizes, greater resources and influential supporters — find ways to move ahead with reopening plans that are outside the grasp of public school systems.

“Parents in private schools are just generally more able to get their preferences heard,” said Christopher Lubienski, a professor of education policy at Indiana University, adding that allowing private schools to opt out of public health orders provided new evidence of how schools in the United States were “really efficient engines of inequality.”

Mr. Hogan said on Monday that county health officers did not have the authority to order private schools to teach online, noting in his statement that school boards and superintendents have made individual decisions on plans for reopening with the help of local health officials. Private institutions, he said, should be allowed to do the same.

“This had nothing to do with public health, and everything to do with their own notions of fairness and equity,” said Timothy Maloney, the lawyer for parents suing the county health officer.

His clients include families whose children attend Our Lady of Mercy, a Catholic school in Potomac, Md., which plans to offer in-person learning options with a mask-wearing mandate and social distancing, among other measures.

“The community was in an uproar,” Mr. Maloney said. He noted that private and Catholic schools had been closely following the state’s guidelines for safely reopening schools, and had invested millions of dollars in retrofitting buildings.

Montgomery County is home to some of the most expensive and exclusive schools in the country, including St. Andrew’s Episcopal School in Potomac, attended by President Trump’s youngest son. St. Andrew’s has been preparing for scenarios that include online learning or a hybrid model involving some instruction on campus.

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Updated 2020-08-05T14:54:02.752Z

Mr. Trump has inserted himself often into the debate over schools reopening, threatening to withhold federal funds from those that do not teach in person. “Much of our Country is doing very well,” he tweeted on Monday. “Open the Schools!”

About 90 percent of U.S. children attend public schools, which tend to have less money and larger class sizes than private and parochial schools, and less flexibility to make changes to their curriculum, facilities or work force. Public schools in many places must also negotiate with teachers’ unions, many of which have pushed for their schools to remain online or adopt more stringent health measures.

“Public education is about leveling the playing field,” said Pia Morrison, president of the Service Employees International Union chapter that represents some public school employees in Maryland and Washington. But the pandemic has exacerbated the economic disparity between many public and private school students, she said.

ImageWestlake Legal Group merlin_172035255_949df75a-239d-4150-a8dd-7b0bbe0a7f31-articleLarge If Public Schools Are Closed, Should Private Schools Have to Follow? Private and Sectarian Schools Montgomery County (Md) Hogan, Lawrence J Education (K-12) Coronavirus Reopenings Coronavirus (2019-nCoV)
Credit…Samuel Corum for The New York Times

Returning to school has already proven challenging, with some districts that opened classrooms this week and last seeing positive cases immediately and having to quarantine students and staff members, or even shut down temporarily. On Tuesday, the second day of its school year, Cherokee County in Georgia closed a second-grade classroom after a student tested positive for the virus.

Schools in many parts of the United States face the near-certainty of outbreaks because of the prevalence of the virus in their communities, highlighting the tension between private school decisions and public health directives.

In New Mexico, Albuquerque Academy, one of the most prestigious private schools in the Southwest, developed an elaborate in-person reopening plan that included shifting to a trimester system, installing portable air filtration systems in every classroom and introducing touchless water fountains.

Public schools in Albuquerque, however, opted to start the year online as the state’s coronavirus cases started climbing at a fast clip.

New Mexico’s public education department does not have the authority to tell private schools when to start classes. But Gov. Michelle Lujan Grisham determined in July that private schools had to follow the same public health orders that apply to other businesses in the state, meaning they could operate only at 25 percent capacity.

Despite making several adjustments, Albuquerque Academy chose to start the year with teachers working on campus and students taking classes online; it will re-evaluate how things are going in several weeks.

“You need to abide by the public health order,” said Julianne Puente, the academy’s head of school, emphasizing that she appreciated the clear position from New Mexico’s governor. “You don’t have to agree, but at a time like this when there’s clarity, at least then you know, this is the structure.”

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Several of the country’s most elite boarding schools, including Phillips Academy in Massachusetts, Choate Rosemary Hall in Connecticut, and Phillips Exeter Academy and St. Paul’s School in New Hampshire, say they plan to reopen this fall. Those schools and others have described safety protocols that include staggered returns to campus, reduced athletic schedules and online classes to begin their terms.

In Florida, which is enduring some of the heaviest coronavirus caseloads in the country, Dr. Mary Jo Trepka, chair of the epidemiology department at Florida International University, said the decision by Miami-Dade County Public Schools — the nation’s fourth-largest district — to put off opening in person until at least October was “a really wise move.”

Credit…Geoff Crimmins/The Moscow-Pullman Daily News, via Associated Press

The Archdiocese of Miami announced last week that its schools would also provide instruction online until at least Sept. 18. And several of Miami’s elite private schools said this week that they, too, would keep teachers and students at home for now.

But some charter schools plan to reopen. At a special meeting of the Miami-Dade County Commission on Tuesday, Mayor Carlos Gimenez pressed the county attorney about whether his administration would have authority over public charter schools if they violated county rules requiring masks and prohibiting large gatherings. The answer: probably not.

Although the school district in Broward County, Fla., will also start the year online, Pine Crest, a prestigious private school with campuses in Fort Lauderdale and Boca Raton, will open on Aug. 19 with the option for parents to send their children to classrooms. Pine Crest had the resources to invest in equipment such as plexiglass dividers for desks, hand-sanitizing stations for classrooms and buses, and an app for students to screen their symptoms every morning.

In the Washington area, Georgetown Prep in North Bethesda, Md., had planned for at least some in-person classes until Montgomery County’s order on Friday. In a letter to families, the school’s president said on Monday that it would consider the county’s directive and Governor Hogan’s response and “evaluate how best to proceed.”

Many private school decisions in the Washington area remain in flux, just as they do across the country, said Amy McNamer, executive director of the Association of Independent Schools of Greater Washington, which has 76 members in the region.

“Right now, I have to tell you, it’s a very stressful time to be a school leader,” Ms. McNamer said, adding that some private schools that were planning two weeks ago for a hybrid opening have opted instead to return to school virtually.

Still, Ms. McNamer acknowledged that independent schools enjoyed some advantages, with the ability to make decisions based on the needs of a smaller community, compared with the array of factors that public school leaders have to consider.

“The comparison is perhaps, you know, the Titanic versus a small sailboat,” she said.

Colin Moynihan contributed reporting.

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