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Westlake Legal Group > Posts tagged "Texas"

As Coronavirus Slams Houston Hospitals, It’s Like New York ‘All Over Again’

HOUSTON — Over the past week, Dr. Aric Bakshy, an emergency physician at Houston Methodist, had to decide which coronavirus patients he should admit to the increasingly busy hospital and which he could safely send home.

To discuss questions like these, he has turned to doctors at hospitals where he trained in New York City that were overwhelmed by the coronavirus this spring. Now their situations are reversed.

Thumbing through a dog-eared notebook during a recent shift, Dr. Bakshy counted about a dozen people he had treated for coronavirus symptoms. His colleagues in Houston had attended to many more. Meanwhile, friends at Elmhurst Hospital in Queens told him that their emergency department was seeing only one or two virus patients a day.

“The surge is here,” Dr. Bakshy said.

As Houston’s hospitals face the worst outbreak of the virus in Texas, now one of the nation’s hot zones, Dr. Bakshy and others are experiencing some of the same challenges that their New York counterparts did just a few months ago and are trying to adapt some lessons from that crisis.

ImageWestlake Legal Group merlin_174122397_95fdf103-14d4-4b26-993a-f137d295364b-articleLarge As Coronavirus Slams Houston Hospitals, It’s Like New York ‘All Over Again’ Texas Remdesivir (Drug) New York City Mount Sinai Medical Center Houston Methodist Hospital Houston (Tex) hospitals Elmhurst Hospital Center Dexamethasone (Drug) Coronavirus Risks and Safety Concerns Coronavirus Reopenings Coronavirus (2019-nCoV) Brooklyn Hospital Center Bellevue Hospital Center Abbott, Gregory W (1957- )
Credit…Erin Schaff/The New York Times

Like New York City in March, the Houston hospitals are experiencing a steep rise in caseloads that is filling their beds, stretching their staffing, creating a backlog in testing and limiting the availability of other medical services. Attempts to buy more supplies — including certain protective gear, vital-sign monitors and testing components — are frustrated by weeks of delays, according to hospital leaders.

Methodist is swiftly expanding capacity and hiring more staff, including local nurses who had left their jobs to work in New York when the city’s hospitals were pummeled. “A bed’s a bed until you have a staff,” said Avery Taylor, the nurse manager of a coronavirus unit created just outside Houston in March.

But with the virus raging across the region, medical workers are falling ill. Dr. Bakshy was one of the first at Methodist to have Covid-19, getting it in early March. As of this past week, the number of nurses being hired to help open new units would only replace those out sick.

Methodist, a top-ranked system of eight hospitals, had nearly 400 coronavirus inpatients last Sunday. Nearly a week later — even as physicians tried to be conservative in admitting patients and discharged others as soon as they safely could — the figure was 569. The flagship hospital added 130 inpatient beds in recent days and rapidly filled them. Now, administrators estimate that the number of Covid-19 patients across the system could reach 800 or 900 in coming weeks, and are planning to accommodate up to 1,000.

Other Houston hospitals are seeing similar streams of patients. Inundated public hospitals are sending some patients to private institutions like Methodist while reportedly transferring others to Galveston, 50 miles away.

“What’s been disheartening over the past week or two has been that it feels like we’re back at square one,” Dr. Mir M. Alikhan, a pulmonary and critical care specialist, said to his medical team before rounds. “It’s really a terrible kind of sinking feeling. But we’re not truly back at square one, right? Because we have the last three months of expertise that we’ve developed.”

Houston’s hospitals have some advantages compared with New York’s in the spring. Doctors know more now about how to manage the sickest patients and are more often able to avoid breathing tubes, ventilators and critical care. But one treatment shown to shorten hospital stays, the antiviral drug remdesivir, is being allocated by the state, and hospitals here have repeatedly run out of it.

Methodist’s leaders, who were planning for a surge and had been dealing with a stream of coronavirus patients since March, pointed to the most important difference between Houston now and New York then: the patient mix. The majority of new patients here are younger and healthier and are not as severely ill as many were in New York City, where officials report that over 22,000 are likely to have died from the disease.

Credit…Erin Schaff/The New York Times

But so far, the death toll has not climbed much in Texas and other parts of the South and West seeing a surge.

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Updated 2020-07-04T12:05:27.384Z

“We are having to pioneer the way of trying to understand a different curve with some very good characteristics versus the last curve,” said Dr. Marc Boom, Methodist’s president and chief executive.

But he cautioned, “What I’m watching really closely is whether we see a shift back in age — because if the young really get this way out there and then start infecting all of the older, then we may look more like the last wave.”

Dr. Sylvie de Souza, head of the emergency department at Brooklyn Hospital Center, which on Friday reported no new coronavirus admissions and no current inpatient cases, said that she was receiving distressing text messages from doctors elsewhere in the country asking for advice. “It’s disappointing,” she said. “It sort of brings me back to the end of March, and it’s like being there all over again.”

One of the most worrisome trends, hospital administrators said, is the increased politicization of public health measures against the virus. The hospitals in Houston are operating in a very different environment now compared with during New York’s peak in the spring, when federal, state and local leaders agreed to a national pause.

Here in Texas, political leaders have been at odds with one another, and residents sharply disagree about the danger the virus poses and what precautions are necessary. At some Houston hospitals, visitors and patients have refused to wear masks, creating conflicts with security guards at entrances.

As the Fourth of July holiday approached, Methodist spent hundreds of thousands of dollars on a public information campaign — including full-page ads wrapped around a local newspaper, social media efforts and billboards. “Stay Safe and Stay Home This July 4th,” the signs say. Methodist also sent a text message to about 10,000 patients providing safety tips. In response, the hospital system received some angry phone calls and texts. “How about you stay at home and quit telling me what to do,” was how one hospital official described them.

The economy in Texas remains open, with only bars shuttered, but Gov. Greg Abbott on Thursday issued an order requiring Texans to wear face coverings in public after long opposing such a mandate.

“There is a glimmer of some optimism,” Dr. Boom told the health system’s physicians this past week, reporting that county testing figures showed some signs of improvement.

Many hospitals in New York during the earlier crisis essentially became all-Covid units and endured billions of dollars in losses.

But Methodist and some other private Houston institutions are trying to operate differently now after taking a financial beating from shutting down elective surgeries and procedures this spring.

With safety protocols and expansion plans in place, they are trying to maintain as many services as possible for as long as possible while contending with the flood of coronavirus cases. “No one’s ever done that before,” Dr. Boom said. “We were seeing all the harm from patients delaying care.”

Doctors and nurses have combed through lists of surgical patients, choosing whom to delay. The easiest surgeries to maintain are those that do not require a hospital stay, like treatment for cataracts. Some surgeons who used to keep patients overnight after knee and hip replacements are now allowing them to leave the same day.

Credit…Erin Schaff/The New York Times

The most agonizing decisions concern the hospital’s robust transplant program, in part because its recipients often require a stay in intensive care. Dr. A. Osama Gaber, the program’s director, spoke with a dialysis patient whose kidney transplant had been postponed from March. “She was in tears,” he said. “She almost wanted me to swear to her we’re not going to put her off again.” For now the surgeons plan to continue cautiously.

A key strategy to maintain services is increasing what hospital officials call throughput — discharging patients as quickly as is safely possible. Yet it is not always clear who is ready to leave. Alexander Nelson-Fryar, a 25-year-old treated for coronavirus pneumonia at Methodist, was discharged from the hospital this past week. Hours after he left, he said, he began laboring to breathe and an ambulance sped him back to Methodist. By the end of the week, he was in intensive care receiving a high dose of pressurized oxygen.

As cases began rising in New York, some overwhelmed emergency departments sent home coronavirus patients only to see them return gravely ill or die. “We realized there was no way of predicting which direction a patient would go,” said Dr. de Souza, the emergency department director in Brooklyn. As a result, she said, she came to believe that any patient aside from those with the mildest symptoms should be admitted to the hospital or otherwise monitored.

But doctors in Houston are tightening criteria for admission. Dr. Bakshy, the Methodist emergency room doctor, who trained at Bellevue and Mount Sinai in New York, said that he was conferring with his former colleagues.

“We all have questions about who truly needs to be hospitalized versus not,” he said. “If we had unlimited resources, of course we’d bring people in just to make sure they’re OK.”

Now, he said, a patient has to have low oxygen levels or serious underlying conditions “to really justify coming into the hospital,” although exceptions can be made.

Credit…Erin Schaff/The New York Times

Another challenge in New York and Houston has been determining who is infected and needs to be isolated from others. Nearly 40 percent of all emergency room patients at Methodist are now testing positive; some of them lack symptoms.

Because test results are sometimes delayed by more than a day, Dr. Bakshy and his colleagues have had to make their best guesses as to whether someone should be admitted to a ward for coronavirus patients.

Hospitals in New York tended to move patients within their own systems to level loads. In Houston, the wealthier institutions have joined together to aid those least able to expand capacity.

This past week, Methodist sent a team to a nearby public hospital to accept transfer patients. Top officials from Methodist and the other flagship hospitals that make up the Texas Medical Center, normally competitors, consult regularly by phone. They have been coordinating for days with the county’s already overwhelmed safety-net system, Harris Health, taking in its patients. The private institutions have also agreed to take turns, with others in the state, accepting patients from rural hospitals.

One morning this past week, Molly Tipps, a registered nurse, brought some medications to an older patient at the Methodist ward outside Houston. “I have the dexamethasone for your lungs,” she told the patient, Dee Morton. Preliminary results of a large study, released last month but not yet peer-reviewed, showed that the drug, a common steroid, saved lives among those who were critically ill with Covid-19 or required oxygen.

Ms. Morton, 79, said she was confident she would recover. “I’m going to make it to 80,” she said. A much lower proportion of patients have been dying from the virus locally and nationally than they were several months ago.

The ward where Ms. Morton is being treated is inside a long-term acute-care facility and is known as the Highly Infectious Disease Unit. Created to treat Ebola several years ago, it now serves as a safety valve for the Methodist system. It takes in coronavirus patients who are improving but for various reasons — from lacking housing to living in a nursing home that will not accommodate them — cannot go home. In Ms. Morton’s case, she was too weak, and after transferring to the unit, some signs of infection, including a fever, rebounded.

Credit…Erin Schaff/The New York Times

At Methodist’s flagship hospital in central Houston, Rosa V. Hernandez, 72, a patient in the intensive care unit, has pneumonia so severe that if she had fallen sick several months ago, she would probably have been put on a ventilator and made unconscious.

But doctors, based on the experiences of physicians in New York and elsewhere, are avoiding ventilators when possible and are maintaining Ms. Hernandez on a high flow of oxygen through a nasal tube. She is on the maximum setting, but can talk to the clinical team and exchange text messages with her daughter, who is also a Methodist inpatient with the coronavirus.

“I took it seriously,” Ms. Hernandez said of the virus. But she joined a small party of eight people for her granddaughter’s birthday, a decision she now described with regret. “Just a birthday cake. What’s a birthday cake without health?”

She is getting remdesivir, an antiviral that was tested in clinical trials in New York and Houston, among other cities, and a new experimental drug.

Methodist was part of two remdesivir trials. But because the research has ended, it and other hospitals now depend on allotments of the drug from the state. As virus cases increased, the supplies ran short, said Katherine Perez, an infectious-disease specialist at the hospital. “In Houston, every hospital that’s gotten the drug, everyone’s just kind of used it up,” she said.

The hospital received 1,000 vials, its largest batch ever, a little over a week ago. Within four days, all the patients who could be treated with it had been selected, and pharmacists were awaiting another shipment.

A new chance to test remdesivir in a clinical trial in combination with another drug may provide some relief. As cases rise, Methodist researchers are being flooded with offers to participate in studies, with about 10 to 12 new opportunities a week being vetted centrally. Without solid research, “your option is to do a bunch of unproven, potentially harmful, potentially futile, interventions to very sick people who are depending on you,” said Dr. H. Dirk Sostman, president of Methodist’s academic medicine institute.

Dr. Boom, the Methodist chief executive, said if he could preserve one thing from the New York experience in March, it would be how the country came together as it had in previous disasters.

Credit…Erin Schaff/The New York Times

When cases began rising again in Texas, hospital officials here spent close to a month trying to educate the public about the risks of contagion. “It didn’t work,” Dr. Boom said.

“How do you get the message out there when certain people just don’t hear it and then you’re dealing with quarantine fatigue and it’s summer and I’m done with school and I just believe I’m 20 and I’m invincible?” he asked. “We told everybody this is all about the sick, vulnerable population, which was the truth, but they heard the message of ‘Well, therefore I’m fine.’ And now we’re doing the re-education on that.”

But even some of Methodist’s physicians, like many Texans, take issue with measures promoted by most public health experts. “A lot of the masks that people are wearing in public don’t do very much,” said Dr. Beau Briese, director of international emergency medicine, contradicting studies that point to a substantial benefit with universal face coverings.

Credit…Erin Schaff/The New York Times

Dr. Briese, 41, believes the soundest approach is to keep opening businesses but have the population at highest risk, including older people, stay apart from the broader public. Some of Methodist’s patients find even those measures objectionable.

One patient on Dr. Bakshy’s emergency room shift, Genevieve McCall, 96, came to the hospital with a satchel full of nightgowns because her legs had swollen, a sign of worsening heart failure. Dr. Bakshy asked about any exposure to the coronavirus. She said her caregiver had been out since the previous day with a fever and a sore throat.

Born five years after the 1918 flu, Ms. McCall, a retired nurse, said that until the coronavirus, she told people she thought she had seen everything. “I question a lot of things,” she said of the safety restrictions. “They’ve been too tight about it. And every time that there is a little bit of a spike, then we’re restricted more.”

Credit…Erin Schaff/The New York Times

Ms. McCall, who tested negative for the virus, according to a daughter, added: “This is a political year. I think that politics has a lot to do with the way this has been handled. And I think it’s been mishandled.”

She said that it was difficult to be stuck in her apartment in an independent-living complex that was prohibiting visitors, canceling many activities and delivering meals to rooms instead of serving them in the dining room. “It’s very depressing,” she said. “Until this afternoon, when my daughter walked in the door to come and pick me up and bring me here, I had not been able to see her or touch her for three months, more.”

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

In West Texas, Lingering Distrust in Public Health Measures as Virus Spreads

LUBBOCK, Texas — For a while, it seemed that the coronavirus had spared West Texas. Cases were low. Few had died. Concern through the spring was focused on getting businesses running again.

By mid-June, the Texas Tech football team returned to campus. Local baseball tournaments resumed. Hotels filled up.

Then people started getting sick.

In Lubbock, a burnt-tan city of 250,000 with a rollicking college bar scene, more people tested positive for the virus in the last three weeks than in the previous three months combined. On the day Gov. Greg Abbott began to swiftly reopen the state, two months ago, the city recorded eight positive tests for the virus. On Wednesday, there were 184.

The sudden jump, concentrated among those in their 20s, reflected a sharp and uncontrolled rise in the virus that has hit Texas harder than many other places in the country. Unlike the early weeks of the pandemic, when infections were concentrated in the state’s mainly liberal cities, the virus has now reached into the deep-red regions of the state that have resisted aggressive public health regulation.

Yet for many conservatives, even those with the virus now at their door, the resurgence has not changed opinions so much as hardened them.

For those Texans, trust in government is gone, if it was there to begin with, and that includes some of the state’s top leaders. On Tuesday, Lt. Gov. Dan Patrick of Texas declared himself tired of Dr. Anthony Fauci, the nation’s top infectious disease doctor. “I don’t need his advice anymore,” Mr. Patrick said.

That sentiment was echoed outside a popular, newly opened hamburger restaurant in Wolfforth, Texas, just outside Lubbock, where even Mr. Abbott, a Republican, came under harsh criticism. “It seems like he’s been influenced by Fauci and the left,” said Mark Stewart, who sat with his wife and children and several other families at a gathering for locals who home school.

None in the 18-person group, which squeezed around several outside tables, wore masks or made an attempt to stay distant. “This is the first time we’ve met each other and we don’t care,” said Mr. Stewart’s wife, Tamera, adding that other people might take precautions when they are together and stay far apart. “Texas has all kinds. But we’re done with all that.”

Such attitudes present a daunting challenge for local leaders trying to contain a resurgent outbreak, especially in solidly Republican areas, where mandatory public health measures can generate swift opposition.

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Updated 2020-07-04T20:10:10.349Z

And they could complicate an order by the governor, issued late Thursday, requiring Texans to wear face coverings in public, with few exceptions, or be fined up to $250. The order applies to counties with more than 20 positive cases, in other words, most of the state.

It is the sort of requirement that Lubbock’s conservative mayor, Dan Pope, an eighth-generation Texan, sought to avoid imposing himself, opting instead to urge compliance from his avowedly independent-minded constituents.

“My approach all along has been one of personal responsibility,” Mr. Pope said in an interview from a ground-floor conference room in the city’s new municipal building. He said that he would enforce the governor’s mask order nevertheless.

The mayor, who wore a black Lubbock-branded face mask, was working out of the conference room, rather than his 11th-floor office, because his adult daughter who lives in town had recently tested positive for the coronavirus. His younger brother had also been infected, he said.

“I’m clean as far as our health department goes, I just think in an abundance of caution — I don’t want to be the guy,” Mr. Pope said. “I’m asking our people to act this way. Why wouldn’t I act that same way?”

That message is commonly heard from conservatives in Texas as they seek to balance public health concerns against worries that an aggressive government response could result in a backlash. Mandates have come to be associated with demands from leaders of the state’s largely Democratic cities.

ImageWestlake Legal Group 03virus-lubbock02-articleLarge In West Texas, Lingering Distrust in Public Health Measures as Virus Spreads Texas Tech University Texas Masks Lubbock (Tex) Coronavirus Reopenings Coronavirus (2019-nCoV) Abbott, Gregory W (1957- )
Credit…Dylan Cole for The New York Times

In the Houston area, the top county executive, Lina Hidalgo, has called for a new and stricter stay-at-home order. Several other county leaders from major metropolitan areas, all Democrats, have also urged Governor Abbott to grant them the power to impose local lockdowns. He has so far refused.

But that has not won Mr. Abbott support on the right. Instead, many conservatives have strongly criticized the steps that Mr. Abbott has taken — such as closing bars and limiting restaurant service, as well as the mask requirement — in response to the huge increase in cases.

“There’s a lot of frustration that the governor is not giving our nation a contrasted worldview to that of California or New York,” said Luke Macias, a conservative Republican political consultant in Texas who said that Mr. Abbott had not offered a conservative vision of how to deal with the crisis. “With Abbott, he’s tried to have his cake and eat it too; he wants to not protect your individual liberty and then say he is.”

Before Mr. Abbott’s latest order, mayors in West Texas had blocked efforts to require residents to wear masks while inside stores, in some cases linking their opposition to disgust with leaders in Austin and Washington.

“Free Americans, and free Texans, must not allow a fractious, divided and politically motivated body of values lightweights to dictate day-to-day living,” Mayor Patrick Payton of Midland said at a news conference on Wednesday.

Gabrielle Ellison was elated to hear that message. Ms. Ellison is the owner of Big Daddy Zane’s, a bar in Odessa that attracted national attention in May after it joined with other businesses in Texas and, aided by men carrying assault rifles, reopened in defiance of state restrictions.

Ms. Ellison said she was defying the state’s order again and keeping her bar open. She has joined a statewide lawsuit over the governor’s closures.

“To me that is a life-and-death situation,” she said. “I can’t feed my family. My bartenders can’t feed their families.”

If anything, she said, the aggressive growth of coronavirus cases in Odessa made her more confident in reopening. “It has affected it in a more positive way,” she said. “We’re having people survive,” she said, adding, “Let’s just let this run its course.”

In Lubbock, the shutdown of bars left a usually bustling strip near the Texas Tech campus devoid of all activity on Wednesday evening, even as parking lots filled outside gyms elsewhere in town. Several local bars have said they would not reopen.

The city is deep in Trump country — the president won here with 66 percent of the vote — but it is also a college town. Household income is below average for the state, the mayor observed, while the number of people with college degrees is above.

“We’re some of the nicest people in the entire world,” said Jason Corley, a conservative who beat a more moderate Republican to become a Lubbock county commissioner. “But as soon as you make demands and tell them they’re going to do something, you get a different response: You don’t get to tell me what to do.”

Credit…Dylan Cole for The New York Times

About a third of the city’s residents are Hispanic, according to census figures, and that community has seen about a third of the city’s total coronavirus cases. Officials said they could not yet provide a demographic breakdown of the recent wave of cases, which have now totaled more than 1,700 since June 15.

While many residents expressed confidence that they would not be infected, others were more concerned.

Michael Machuca, 29, said he worried about the virus spreading among staff in the warehouse where he works. “The whole night shift didn’t show up one day,” he said, as he and his 6-year-old son were casting for bass in a local park.

The focus on bars came in part from what was learned about the outbreak by the city’s contact tracers in their interviews with young infected people, said Katherine Wells, the city’s director of public health.

Still, it has been a challenge to get people to self-quarantine, she said. And the virus has since spread more broadly into the community, cropping up again in at least one nursing home.

The return of the virus to nursing homes has been particularly demoralizing: The majority of the city’s 52 deaths have occurred in those facilities, but city leaders believed they had blunted that part of the early outbreak by the end of April.

While the campus of Texas Tech remains closed, many student athletes returned for practice in the middle of June. On the football team alone, 23 players and staff tested positive for the virus, a school spokesman said, adding that all had recovered.

“When the governor opened the bars, the floodgates opened,” said Latrelle Joy, a City Council member. “Now we’re in a position where he’s closed those bars, but we’ve got spread in the community.”

With the closures, gatherings had shifted from bars to pool parties by day, and house parties at night, officials said. Cases have now been traced to those gatherings.

Despite the surge in infections among young people, before the new mask order this week, many chose not to wear a mask. Or let it slip their minds.

“I left mine in the car,” said Ambroshia Pollard, 29, as she emerged from a grocery store with her mother and month-old daughter. Still, she said, she took the virus seriously. “My brother’s friend got it. He’s young, 21,” Ms. Pollard said. “I feel like it’s real and people should be more conscious. Us too, we should have masks.”

But many of their fellow shoppers also came and went without them, as did diners at a Braum’s Ice Cream and Burger restaurant in Wolfforth, and drinkers at the Brewery LBK in downtown Lubbock. There, groups of friends gathered around beers and cigarettes on the patio and argued about the utility of the governor’s mask order shortly after it came out.

Not a mask in sight.

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Leaders Re-examine U.S. Reopenings as Coronavirus Cases Soar

MIAMI — As coronavirus cases surge across much of the United States, leaders are urgently rethinking their strategies to curb the spread, which the nation’s top infectious disease expert said on Friday were “not working.”

For the first time, some governors are backtracking on reopening their states, issuing new restrictions for parts of the economy that had resumed.

Leaders in Texas and Florida abruptly set new restrictions on bars, a reversal that appeared unthinkable just days ago. And Gov. Gavin Newsom of California told rural Imperial County, where hospitals have been overwhelmed with patients, that it must reinstate a stay-at-home order, the most restrictive of requirements.

Florida, Utah and South Carolina hit daily highs on Friday for reported new cases, but even leaders outside of the new hot zones in the South and West expressed mounting anxiety.

“This is a very dangerous time,” Gov. Mike DeWine of Ohio said in an interview on Friday, as cases were trending steadily upward in his state after appearing to be under control for more than a month. “I think what is happening in Texas and Florida and several other states should be a warning to everyone.”

“We have to be very careful,” he said.

The stock market responded badly, with the S&P 500 dropping 2.4 percent. Losses accelerated after the Texas announcement, adding to investors’ concerns that the virus continued to be a threat to the economy.

The shifting assessments of the nation’s handling of the virus stretched to the highest levels of the federal government, where Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, made clear that the standard approach to controlling infectious diseases — testing sick people, isolating them and tracing their contacts — was not working. The failure, he said, was in part because some infected Americans are asymptomatic and unknowingly spreading the virus but also because some people exposed to the virus are reluctant to self-quarantine or have no place to do so.

In a brief interview on Friday, he said officials were having “intense discussions” about a possible shift to “pool testing,” in which samples from many people are tested at once in an effort to quickly find and isolate the infected.

Dr. Fauci also issued an urgent warning that while coronavirus infections were spiking mostly in the South, those outbreaks could spread to other regions.

Even in the face of the alarming news, the White House continued to praise its own efforts.

“We have made truly remarkable progress in moving our nation forward,” Vice President Mike Pence said at what has become a rare public briefing by the coronavirus task force in Washington. “We’ve all seen the encouraging news as we open up.”

Mr. Pence did not wear a mask, although the health officials around him did.

ImageWestlake Legal Group merlin_173952390_7120147d-b458-4d7f-8de8-f98c62d4e89c-articleLarge Leaders Re-examine U.S. Reopenings as Coronavirus Cases Soar United States Texas Florida Coronavirus Reopenings Coronavirus (2019-nCoV) California Bars and Nightclubs
Credit…Eve Edelheit for The New York Times

The renewed sense of urgency comes as the United States confronts a new, treacherous phase of the pandemic, no longer defined by a crisis concentrated in New York City, but by rising cases in many cities and states. Alabama, Alaska, California, Georgia, Idaho, Missouri, Nevada, Oklahoma and Texas also reported their highest single-day totals of new known cases this week, and the United States set records for daily new cases on both Wednesday and Thursday. By Friday, new daily cases were rising in 29 states.

From Miami to Los Angeles, mayors were contemplating slowing or reversing their plans to return cities to public life. On Friday, San Francisco announced it was delaying plans to reopen zoos, museums, hair salons, tattoo parlors and other businesses on Monday, citing a spike in new cases. “Our numbers are still low but rising rapidly,” Mayor London Breed wrote on Twitter, adding, “I know people are anxious to reopen — I am too. But we can’t jeopardize the progress we’ve made.”

In Miami, officials were considering whether to revert to some of the limits they had set months ago. “We’re in a far more precarious position than we were a month ago,” Mayor Francis Suarez said.

The decisions in Texas and Florida to revert to stronger restrictions on Friday represented the strongest acknowledgment yet that reopening had not gone as planned in two of the nation’s most populous states, where only days ago their Republican governors were adamantly resisting calls to close back down.

On Thursday, Gov. Greg Abbott of Texas placed the state’s reopening on pause, while remaining firm that going “backward” and closing down businesses was “the last thing we want to do.”

But by Friday, he did just that, ordering bars closed and telling restaurants to limit themselves to 50 percent capacity rather than 75 percent.

“It is clear that the rise in cases is largely driven by certain types of activities, including Texans congregating in bars,” Mr. Abbott said in a statement, adding that he hoped the new restrictions would be “as limited in duration as possible.”

Eight weeks ago, Mr. Abbott started a phased-in reopening of Texas, when the state had reported about 29,000 cases and more than 800 deaths. Bars had been allowed to open since late May.

New cases and hospitalizations have increased significantly in recent days in Houston, San Antonio and other large cities. By Friday, Texas had more than 130,000 known coronavirus cases and more than 2,300 deaths, and the leader of the third-largest county in America — Harris County, which is home to Houston — had deemed the region to be on a code-red coronavirus threat level.

“We find ourselves careening toward a catastrophic and unsustainable situation,” the top elected official in Harris County, Lina Hidalgo, said at a news conference. She said the current hospitalization rate was on pace to overwhelm the hospital system “in the near future.”

Credit…Bryan Denton for The New York Times

In Florida, the speed of the virus’s growth was dizzying: State officials reported 8,942 new coronavirus cases on Friday, by far outpacing its earlier single-day record of 5,508 cases, which had been set on Wednesday.

Officials announced limits on bars, immediately banning alcohol consumption on the premises. Bars can still sell food if they are licensed to do so, but their facilities must remain at 50 percent capacity.

The return to stricter limits left local officials worried whether residents would follow the rules, especially now, months into the crisis.


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  • Frequently Asked Questions and Advice

    Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


“People are tired of being in a stay-at-home environment, and they’re not going to be compliant,” said Carlos Migoya, president and chief executive of the public Jackson Health System in Miami. “You can’t put the genie back in the bottle. We’ve got to deal with it being in the environment.”

Pete Boland, who co-owns the Galley, a restaurant and bar in St. Petersburg, Fla., was sorting through the details of Florida’s latest order on Friday to determine what the rules will be for establishments that also serve food.

He had just reopened on Wednesday, following a professional deep cleaning after some employees fell ill with the virus.

“I don’t know if we can continue to do this: open, closing, open, closing,” he said. “You have people who desire to socialize and to earn and to live and to have some fun in this crazy world.”

In Arizona, Gov. Doug Ducey has held out on setting new limits in his state, even as cases there surged past 66,000, with an average of 2,750 new cases per day. He warned this week that hospitals were likely to hit surge capacity soon but he has remained opposed to backtracking on reopening.

“This is not another executive order to enforce, and it’s not about closing businesses,” he said this week. “This is about public education and personal responsibility.”

Credit…Adriana Zehbrauskas for The New York Times

Still, shutting down businesses again in Arizona is not out of the question, Daniel Ruiz, the state’s chief operating officer, said in an interview on Friday.

“We want to treat that like a last resort,” Mr. Ruiz said. “It’s a tool in the toolbox, but it’s something that we’re going to use very judiciously.”

California, which had the first stay-at-home order in the nation this spring, has surpassed 200,000 cases, and on Friday, Mr. Newsom announced new restrictions on Imperial County, which has the state’s highest rate of infection. The county has exceeded its hospital capacity so severely that some 500 patients have had to be moved to beds elsewhere, and hospitals as far away as the Bay Area have been seeing Imperial County patients.

“This disease does not take a summer vacation,” said Mr. Newsom, noting that at least 15 of California’s 58 counties were being monitored closely as the virus surges.

In Los Angeles County, health officials estimate that every 400th person may currently be infected. Mayor Eric Garcetti of Los Angeles said he planned to wait three to five days before deciding whether to pull back on the city’s reopening.

“We’re not in the red zone but we’re in the yellow zone,” the mayor said in an interview on Friday.

From case counts to hospitalizations, he said, the city’s metrics are moving in the wrong direction, in part because of a patchwork of responses in neighboring areas.

Mr. Garcetti said he would like health officials in the state, the county and the surrounding region to come to a consensus strategy.

“If you don’t move together, there’s no point in being the lone holdout,” he said. “If you don’t have an entire region working together, who cares if you keep your gyms closed?”

Patricia Mazzei reported from Miami, Sarah Mervosh from Pittsburgh and Shawn Hubler from Sacramento. Contributing reporting were Nicholas Bogel-Burroughs and Giulia McDonnell Nieto del Rio from New York, Julie Bosman from Chicago, Manny Fernandez from Houston, Frances Robles from Miami, Michael D. Shear and Sheryl Gay Stolberg from Washington, and Dave Montgomery from Austin, Texas.

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New Numbers Showing Coronavirus Spread Intrude on a White House in Denial

WASHINGTON — In the past week, President Trump hosted an indoor campaign rally for thousands of cheering, unmasked supporters even as a deadly virus spread throughout the country. He began easing up on restrictions that had been in place at the White House since Washington instituted a stay-at-home order in response to the coronavirus in March, and he invited the president of Poland to a day of meetings. Then, on Thursday, he flew to Wisconsin to brag about an economic recovery that he said was just around the corner.

But by Friday, it was impossible to fully ignore the fact that the pandemic the White House has for weeks insisted was winding down has done just the opposite.

The rising numbers in Texas, Florida and Arizona made that clear, as well as the reality that those are all states where the president and his Republican allies had urged people to return to normal.

In a reflection of a growing sense of anxiety over the new numbers, Vice President Mike Pence and members of the coronavirus task force held a public briefing for the first time in two months. But ever loyal to Mr. Trump’s desire for good news, Mr. Pence tried to tiptoe around the statistics that Dr. Deborah L. Birx, the task force coordinator, pointed to, showing surging cases and hospitalizations in Florida, Texas, Arizona and other states.

“We have made a truly remarkable progress in moving our nation forward,” the vice president said. “We’ve all seen the encouraging news as we open up,” he added, dismissing any suggestion that the outbreaks across the South should prompt a return to the shutdowns that Mr. Trump so badly wants to be over. “The reality is we’re in a much better place.”

Refusing to wear a mask even as the health officials next to him did, Mr. Pence described the recent outbreaks across the country as little more than the product of increased testing among younger, more healthy Americans who should be less likely to get seriously ill from the coronavirus even as they spread it to others.

“Very encouraging news,” he said.

But Mr. Pence’s comments came against the backdrop of a very different message from Dr. Birx and Dr. Anthony S. Fauci, the nation’s top infectious disease expert, who warned of a broken testing system and said the outbreaks could engulf the country.

“If we don’t extinguish the outbreak, sooner or later, even ones that are doing well are going to be vulnerable to the spread,” he warned. “So we need to take that into account because we are all in it together. And the only way we’re going to end it is by ending it together.”

ImageWestlake Legal Group merlin_173956896_2def4fed-28e7-431d-8785-64b3b5526ba6-articleLarge New Numbers Showing Coronavirus Spread Intrude on a White House in Denial United States Politics and Government Tulsa (Okla) Trump, Donald J Texas Presidential Election of 2020 Pence, Mike Florida Fauci, Anthony S Disease Rates Coronavirus Reopenings Coronavirus (2019-nCoV) Birx, Deborah L Arizona
Credit…Michael A. McCoy for The New York Times

The return of the televised task force news conference — at which reporters were limited to only a handful of questions — revived the deep disconnect between Washington and the states where local officials spent Friday sounding the alarm and, in some cases, halting the reopening that Mr. Trump has so often encouraged.

In Florida, Gov. Ron DeSantis, a Republican who has resisted rolling back the economic reopening, banned drinking in bars after saying that patrons were not abiding by social distancing rules. In Texas, Gov. Greg Abbott, also a Republican, went further, ordering all bars closed in the state. And Judge Lina Hidalgo of Harris County, the largest county in Texas, reimposed stay-at-home orders on Friday, calling the rise in cases there “a catastrophic and unsustainable situation.”

Taken together, it was grim news about a pandemic that is still a threat to the public’s health, the nation’s economy and the president’s political future.

At a time when his poll numbers now call into question whether he can win a second term in November, Mr. Trump faces the prospect that his efforts to boost the economy by shrugging off the virus have backfired. Rather than head into the summer with a country on the mend, the president will be forced to explain how his response to the coronavirus contributed to a resurgence of it that may force some Americans back into a painful shutdown.

And yet Mr. Trump made no appearance at the task force briefing to demonstrate concern. Instead, an hour after it was over, the president addressed a panel of industry officials, political allies and White House economic advisers for a self-congratulatory session about how successful the economic recovery has been.

In taking his victory lap, Mr. Trump made no mention of the increase in cases around the country, underscoring a message that he posted on Twitter late Thursday night: “Our Economy is roaring back and will NOT be shut down. ‘Embers’ or flare ups will be put out, as necessary!”

All spring, Mr. Trump expressed his impatience and annoyance with the social distancing measures that various states, and his own aides, were taking.

He showed some concern when his personal valet, who serves his food, was diagnosed with the coronavirus and Mr. Pence’s press secretary tested positive. But since then, Mr. Trump has maintained a posture of denial and dismissiveness.

Credit…Callaghan O’Hare for The New York Times

He has been enabled by a handful of advisers, some of whom share his desire to focus on the economy and some of whom are afraid of the president’s reaction if they press him too hard about the public health crisis unfolding once again in large chunks of the country.

The White House chief of staff, Mark Meadows, has been among the chief proponents of keeping the administration’s public health experts largely out of sight, according to several senior administration officials.

But he is not alone. Even though they are aware that Mr. Trump’s mishandling of the virus presents a threat to his re-election, his campaign advisers agreed to his demand for the rally last Saturday at an arena in Tulsa, Okla., hoping the adulation he would receive there would snap the president out of a funk he has been in for months.

But at least eight staff members — including two Secret Service agents — tested positive for the virus before the rally, which was lightly attended and attracted none of the overflow crowd that Mr. Trump’s advisers had promised. Since then, dozens of campaign aides who were in Oklahoma for the event have been told to quarantine.

His advisers are now trying to figure out how to give Mr. Trump the traveling road show he wants while acknowledging the widespread fears about the coronavirus and allowing for proper health measures. At the same time, the White House has stopped employing the health checks it had been using for several weeks, like temperature checks for people entering the complex.

One of the states where the cases are rising drastically is Florida, where Mr. Trump insisted the Republican National Convention at the end of August be relocated to meet his desire for a large-scale event free of social distancing measures. As of now, Republicans hope to put on a show celebrating Mr. Trump, the first lady and Mr. Pence with three nights of crowds as large as 12,000 people in Jacksonville.

Some of the president’s political allies have signaled in recent days that they intend to take the threat of the virus more seriously.

Speaking to a group of health care workers in Morehead, Ky., Senator Mitch McConnell, Republican of Kentucky and the majority leader, held up a simple face mask.

“Until we find a vaccine, these are really important,” the senator said. “This is not as complicated as a ventilator. This is a way to indicate that you want to protect others. We all need during this period until we find a vaccine to think of us as protecting not only ourselves but others.”

And Representative Liz Cheney, Republican of Wyoming, had a not-so-subtle message for Mr. Pence in a tweet she posted not long after the vice president refused to wear a mask during the task force briefing on Friday. Her tweet included a picture of her father, former Vice President Dick Cheney.

“Dick Cheney says WEAR A MASK,” she wrote, adding the hashtag: #realmenwearmasks.

But if anything, Mr. Trump, Mr. Pence and the rest of the senior members of the administration have seemed determined in the past 24 hours to embrace a previrus political reality — even if the medical facts contradict it.

On Thursday night, the Trump administration asked the Supreme Court to overturn the Affordable Care Act, a move that, if successful, would bring a permanent end to the health insurance program popularly known as Obamacare and wipe out coverage for as many as 23 million Americans.

In an 82-page brief, the administration joined Republican officials in Texas and 17 other states in arguing that in 2017, Congress, then controlled by Republicans, had rendered the law unconstitutional when it zeroed out the tax penalty for not buying insurance — the so-called individual mandate.

The president’s argument is sure to reignite Washington’s bitter political debate over access to affordable health care even as the accelerating pandemic has left millions of unemployed Americans without employer-provided health coverage.

Sheryl Stolberg contributed reporting.

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As Virus Surges, Younger People Account for ‘Disturbing’ Number of Cases

CHICAGO — Younger people are making up a growing percentage of new coronavirus cases in cities and states where the virus is now surging, a trend that has alarmed public health officials and prompted renewed pleas for masks and social distancing.

In Arizona, where drive-up sites are overwhelmed by people seeking coronavirus tests, people ages 20 to 44 account for nearly half of all cases. In Florida, which breaks records for new cases nearly every day, the median age of residents testing positive for the virus has dropped to 35, down from 65 in March.

And in Texas, where the governor paused the reopening process on Thursday as hospitals grow increasingly crowded, young people now account for the majority of new cases in several urban centers. In Cameron County, which includes Brownsville and the tourist town of South Padre Island, people under 40 make up more than half of newly reported cases.

“What is clear is that the proportion of people who are younger appears to have dramatically changed,” said Joseph McCormick, a professor of epidemiology at UTHealth School of Public Health in Brownsville. “It’s really quite disturbing.”

The pattern is drawing notice from mayors, governors and public health officials, and comes as a worrisome sign for cities and institutions as they look to the fall. The rise in cases among younger people could complicate the plans of leaders who are eager to open schools and universities, resume athletic events and return to normal life and a fully functioning economy.

The increases could reflect a simple reality: Since many states have reopened bars, restaurants and offices, the coronavirus has been allowed to spread more widely across communities, including to more young people. But people in their 20s and 30s are also more likely to go out socializing, experts say, raising concerns that asymptomatic young people are helping to spread the virus to more vulnerable Americans at a time when cases are surging dangerously in the South and the West.

Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, said on Thursday that younger people have helped fuel the increase in known coronavirus infections — and that in the past, many of those infections went undiagnosed.

“Our best estimate right now is that for every case that was reported, there actually were 10 other infections,” he said.

No single answer fully accounts for the surge of cases among young people, who are less likely to be hospitalized or die from the coronavirus than older people.

“Is it the governor’s reopening? Is it Memorial Day? Is it the George Floyd demonstrations? Is it going to the beach?” said Eric Boerwinkle, dean of the UTHealth School of Public Health in Houston. “We don’t really know, but it is probably all of those things that are contributing.”

The United States recorded 36,975 new cases on Wednesday, a new high point in daily cases as the country confronted a new stage of the crisis two months after the previous high in late April. The resurgence is most immediately threatening states that reopened relatively early in the South and the West. Alabama, Florida, Oklahoma, South Carolina and Texas all reported their highest single-day totals this week, as did Montana and Utah, and cases were rising in 29 states on Thursday.

Adriana Carter, 21, is among the newly infected.

For many weeks this spring, she said, she took steps to limit her exposure, eating many of her meals at her apartment in San Marcos, Texas, and wearing a mask when going in and out of stores. At the one Black Lives Matter protest she attended, most people were in masks.

But after a particularly long week of juggling online summer classes and her job at an eye clinic, Ms. Carter took a risk one Saturday night in early June and met a friend at the Square, a popular bar district downtown. Though they were careful to avoid the most crowded spots, they chose not to wear masks as they sipped drinks inside and endured the hot Texas weather.

Days later, her friend woke up feeling ill. Both tested positive for the virus.

“We were told we could go out to bars,” she said, adding that she had been careful to quarantine since she learned that she had been exposed. “It’s very unusual for anyone in their 20s to stay at home all the time — not giving any excuses or anything, but I just think we are all just trying to do the best we can.”

The new cases among young people may appear to be a departure from the early days of the pandemic when infections in nursing homes were spiraling out of control, and the virus appeared at higher rates among older people in New York City.

Experts cautioned that the seemingly new prevalence among young people may be, in part, a reflection of more widely available testing. But the growing numbers of people hospitalized in states like North Carolina and Texas also suggest increased transmission of the virus.

Even now, people younger than 50 are being hospitalized at a far lower rate than people older than that, according to C.D.C. data.

While the effect of the coronavirus on younger people “may not be highly associated with hospitalization and death,” Dr. Redfield said, “they do act as a transmission connector for individuals that could in fact be at a higher risk.”

In Florida, which has emerged as a particularly concerning hot spot, reopened bars have been a source of contagion among young people. The state shut down the Knight’s Pub, a popular bar near the University of Central Florida in Orlando, after 28 patrons and 13 employees were infected.

In Miami-Dade County, the number of known coronavirus cases among 18- to 34-year-olds increased fivefold in a month, to more than 1,000, Mayor Carlos Gimenez said this week.

“They’re thinking they’re invincible,” he said, adding that many of the infected have no symptoms.

They are at higher risk, though, if they are overweight or have diabetes or other medical conditions, he said. About a third of the coronavirus patients at the public Jackson Health System were from that age group, and about half had a high body mass index, Mr. Gimenez said.

Gov. Ron DeSantis described “a real explosion in new cases” among younger people. “Part of that is just natural,” he said. “You kind of go and you want to be doing things. You want to be out and about. The folks who are older and would be more vulnerable are being a bit more careful.”

In fact, some experts believe that a decision by older people to stay home and exercise caution to avoid the virus may, in part, help explain why young people appear to be an increasing portion of new cases.

ImageWestlake Legal Group merlin_173920437_0c7f16c1-5d96-4261-83be-3c5e34a66929-articleLarge As Virus Surges, Younger People Account for ‘Disturbing’ Number of Cases United States Texas Florida Coronavirus Reopenings Coronavirus (2019-nCoV) Arizona
Credit…Callaghan O’Hare for The New York Times

In Dallas County, people between the ages of 18 and 40 have made up 52 percent of newly reported cases since the beginning of June, a jump from the 38 percent that young people represented in March, according to county data.

At the same time, older people have begun to represent a smaller portion of the total number of people who test positive for the virus. In June, people over 65 have made up 8 percent of new confirmed cases in Dallas County, down from 16 percent in March.


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  • Frequently Asked Questions and Advice

    Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


The situation is particularly unsettling in Hays County, home to Texas State University in San Marcos. Coronavirus cases have surged since the beginning of June, to 2,100 this week, from 371 at the start of the month. People in their 20s now make up more than half of all known cases, officials said.

In Arizona, rising infections have set many people on edge, including some residents in their 20s and 30s.

In Arcadia, Ariz., Ian Bartczak, who is 31, said he did not feel comfortable dining out at restaurants and was dismayed to see crowds of young people squeezing onto patios and bars on a commercial strip near his home.

“It goes back to, what is a want and what is a need?” said Mr. Bartczak, who works for an education technology company. “Did you have to go to a big swimming party or El Hefe nightclub with your friends?”

His point of view has created awkwardness with some friends, he said. He has turned down invitations to go out for sushi, and been puzzled by friends who chose to visit casinos.

“It’s affected some of my relationships because I won’t see them or get kind of angry,” he said. “How are you not willing to help the old lady behind you who could have a poor immune system? Or help lower our cases so we can increase our economy?”

In Phoenix, Michael Donoghue, an investment analyst who is 33, said he felt comfortable going out — carefully — since he is single, healthy, lives alone and takes care to avoid close contact with people who might be at risk, like his 91-year-old grandmother.

Only once since restrictions were lifted in that state has he felt uncomfortable while out, he said. A bar he visited with friends in Scottsdale was crowded.

“It just felt like, should we be doing this right now?” he said.

The resurgence of the virus has echoes of its earliest days in the United States, as places like California and Washington State, which saw some of the country’s first outbreaks, were seeing new upticks.

In King County, Wash., which includes Seattle, people in their 20s and 30s make up about 45 percent of new coronavirus cases — a number that was 25 percent in March, according to Dr. Judith A. Malmgren, an epidemiologist in Seattle.

She believes the real percentage is even larger than what is being measured because younger people are less likely to be symptomatic. That said, she warned that the risk of infecting other people was serious.

“Just because you’re in an age group that is less likely to die from coronavirus,” she said, “does not mean that you live alone.”

Julie Bosman reported from Chicago, and Sarah Mervosh from Pittsburgh. Patricia Mazzei contributed reporting from Miami, and Mitch Smith from Chicago.

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

Texas Pauses Reopening as Virus Cases Soar Across the South and West

Westlake Legal Group texas-pauses-reopening-as-virus-cases-soar-across-the-south-and-west Texas Pauses Reopening as Virus Cases Soar Across the South and West Texas States (US) Coronavirus Reopenings Coronavirus (2019-nCoV) Abbott, Gregory W (1957- )

HOUSTON — Just 55 days after reopening Texas restaurants and other businesses, Gov. Greg Abbott on Thursday hit the pause button, stopping additional phases of the state’s reopening as new coronavirus cases and hospitalizations soared and as the Republican governor struggled to pull off the seemingly impossible task of keeping both the state open and the virus under control.

The announcement by Mr. Abbott — which allows the many shopping malls, restaurants, bars, gyms and other businesses already open to continue operating — was an abrupt turnaround and came as a growing number of states paused reopenings amid rising case counts.

The latest developments call into question any suggestion that the worst of the pandemic has passed in the United States, as rising outbreaks in the South and the West threaten to upend months of social distancing meant to help keep the virus at bay.

The nation recorded a new high point with 36,975 new cases on Wednesday, nearly two months after many states began to reopen with the hope of salvaging the economy and the livelihoods of millions of Americans. Alabama, Missouri, Montana and Utah all hit new daily case records on Thursday.

Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, said on Thursday that the number of people in the United States who have been infected with the coronavirus is actually about 10 times higher than the 2.3 million cases that have been reported. “We probably recognized about 10 percent of the outbreak,” Dr. Redfield said in a call with reporters.

Dr. Redfield added that between 5 and 8 percent of Americans have been infected to date.

As cases climbed in more than half the states on Thursday, the Labor Department reported that nearly 1.5 million workers filed new unemployment claims last week, the 14th week in a row that the figure has topped one million. And the outlook for the economy remained grim: More than 19 million people were still collecting state unemployment insurance, down slightly from 25 million in early May.

In a juxtaposition that reflects how far — and how little — the country has come in controlling the virus, Mr. Abbott’s announcement in Texas arrived on the same day that Mayor Bill de Blasio of New York City declared the city on track to enter the next phase of reopening on July 6, allowing indoor dining and personal care services, like manicures, to resume with social distancing.

ImageWestlake Legal Group merlin_173900463_72745db6-c0d3-4022-a4ea-bbd312563645-articleLarge Texas Pauses Reopening as Virus Cases Soar Across the South and West Texas States (US) Coronavirus Reopenings Coronavirus (2019-nCoV) Abbott, Gregory W (1957- )
Credit…Erin Trieb for The New York Times

Only two months ago, it was Texas that was allowing restaurants to reopen, while Mr. de Blasio was pleading with residents to resist the impulse to gather outdoors.

Now, Texas and several other states with rising cases are scrambling. In North Carolina, Gov. Roy Cooper, a Democrat, this week paused further reopenings for three weeks and ordered residents to wear masks in public. In Nevada, Gov. Steve Sisolak, a Democrat, said that “any discussion of entering Phase 3 will be tabled.”

And in Florida, Gov. Ron DeSantis, a Republican who has been defiantly against shutting his state back down, said he did not intend to move to the next phase of reopening. “We never anticipated necessarily doing anything different in terms of the next phase at this point anyways,” he said on Thursday in Tampa. “We are where we are.”

The worrying surge of cases has proved to be a test for states that decided reopening early was a necessary risk in order to save jobs.

“It hasn’t worked out as they planned,” said Kent Smetters, the director of the Penn Wharton Budget Model at the University of Pennsylvania, which is analyzing the impact of government policies on coronavirus deaths and the economy. “By reopening, they have seen cases go up, and they have made a lot of people scared” to visit restaurants and other businesses, he said, adding that “people’s confidence is the key driver in this.”

The situation is perhaps most urgent in Texas, the nation’s second-largest state, which was under one of the shortest stay-at-home orders when Mr. Abbott decided to reopen the state in phases on May 1.

The virus has since spread rapidly in Houston, San Antonio, Austin, Dallas and other large cities in all regions of the state. Total known cases have topped 100,000, and on Wednesday, the state recorded its most new cases in a single day, with more than 6,200 new infections.

“The governor’s plan was always predicated on a very high rate of voluntary compliance with things like wearing masks and socially distancing,” said Mayor Eric Johnson of Dallas, a Democrat, who has been pushing for a statewide mask policy. “I think what we’re seeing is that was a miscalculation.”

Mr. Abbott’s response to the increase in cases has been contradictory, and he has been criticized by both Democrats and Republicans over his handling of the stay-at-home order and mask requirements. In recent weeks, he has declared the state open for business, but has also said that Texans should stay home. He has said Texans should wear masks, but he has refused to issue a statewide mandate. His pausing of the reopening was viewed as yet another half-measure by his critics, some of whom called on him to roll back the reopening entirely, a move the governor suggested on Thursday that he opposed.

“We are focused on strategies that slow the spread of this virus while also allowing Texans to continue earning a paycheck to support their families,” Mr. Abbott said on Thursday. “The last thing we want to do as a state is go backward and close down businesses.”

Mr. Abbott called the pausing of the reopening “temporary” but did not indicate when he would resume the process. Bars now operate at 50 percent capacity, while restaurants operate at 75 percent capacity. Yet in many ways, the state feels fully reopened. Beaches and shops in Galveston have been packed. Malls from Houston to the border city of McAllen are busy throughout the day. Diners eat indoors and outdoors at restaurants in San Antonio, Austin and Houston.

But the decision to reopen the state has been fraught for some business owners, including Omar YeeFoon, who owns Shoals Sound & Service, a cocktail bar in Dallas. “We were open for four days, and the cases just started going up and up,” he said. Mr. YeeFoon, 43, added that he thought reopening too quickly had also harmed business. “People are starting to get more and more scared. Less people want to go out.”

Hospitalizations are on the rise across Texas, including hard-hit Houston, where the Texas Medical Center reported a steep increase in patients over the last 10 days. Mr. Abbott, under pressure as the numbers soared, took another step to get the virus under control on Thursday, stopping all elective surgeries at hospitals in the counties containing Houston, San Antonio, Dallas and Austin, in order to free up capacity for Covid-19 patients.


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  • Frequently Asked Questions and Advice

    Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


The growing concern in Texas reflected a nation increasingly on edge, as a quieting of the pandemic in New York City and other epicenters gives way to an unfurling crisis in many other cities and states.

Credit…Mark Felix for The New York Times

Florida has reported more than 10,000 new coronavirus cases over the past two days, bringing its total to 114,018. Orange County, home to Orlando, is averaging 353 new cases per day, compared to an average of 73 two weeks ago. And in Miami-Dade, which has reopened more slowly than the rest of the state, Mayor Carlos Gimenez said that for now all plans to move forward are on pause.

“We’re not opening up bars,” he said on Wednesday. “We’re not opening up nightclubs. That’s just asking for trouble.”

Even California, which issued the first stay-at-home order in the nation and has had a gradual reopening, is struggling with climbing case counts. Gov. Gavin Newsom, a Democrat, said that the state had boosted its testing — there was an average of 88,000 tests across California over the past week — but the percentage of positive tests had also increased to 5.6 percent on average over the past seven days. About 34 percent of available intensive care unit beds were full on Thursday, up slightly from the day before.

Cases have also been growing ominously in South Carolina, which was among the last states to issue a stay-at-home order and also among the first to begin opening up in late April. The upswing intensified in recent days, with more than 1,000 confirmed cases in a day reported for the first time on June 19.

By Thursday, the State Department of Health and Environmental Control reported that 1,106 new confirmed cases had been diagnosed, along with eight more deaths, bringing the statewide totals to 28,962 cases and 691 confirmed deaths.

“That is undeniable, it’s a huge jump, and I think we all know the reason why,” said Knox H. White, the mayor of Greenville, S.C., which was among several cities that have passed mask ordinances in recent days. “It’s because we’ve all been a little lax on social distancing the past several weeks.”

State lawmakers also passed legislation this week for spending $1.2 billion in federal aid on ramping up Covid-19 testing and restocking on personal protective equipment, as well as financial relief for hospitals, state agencies and local governments.

“When I open a newspaper, almost every day there are death notices of people who I know — who I have worked with — who are no longer here,” Gilda Cobb-Hunter, a Democratic state representative, said on the House floor this week, noting that many were essential workers.

“Here in South Carolina, we aren’t even at the peak of the first wave,” she added. “It scares me to think of what this state will be like in September.”

Manny Fernandez reported from Houston and Sarah Mervosh from Pittsburgh. Contributing reporting were Rick Rojas from Atlanta, Patricia Mazzei from Miami, Sheila Kaplan from Washington, David Montgomery from Austin, Jill Cowan from Los Angeles and Mitch Smith from Chicago.

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

Still Reeling From Oil Plunge, Texas Faces New Threat: Surge in Virus Cases

HOUSTON — Things were looking up for Texas in recent weeks. Oil prices had managed an impressive rebound, more than doubling to just above $40 a barrel. Restaurants and small businesses were opening up in Houston, Dallas and elsewhere. And tens of thousands of people were getting back to work.

But a recent surge in coronavirus cases in the state is messing up that neat recovery story. Small businesses that had just reopened are closing again and oil prices have slid below $40 a barrel after weeks of gains. Energy executives say they remain optimistic, but some analysts are worried about the Texas economy, which would be the world’s 10th biggest if the state were a country.

Since businesses began reopening in early May, after a four-week statewide stay-at-home order by Gov. Greg Abbott that was only loosely enforced in some areas, optimism spread that the coronavirus pandemic was under control. People returned to their dentist offices, gyms and hair salons, and bars began doing brisk business, especially in the oil production hub of West Texas.

Many residents of the state, which last backed a Democratic presidential candidate in 1976, considered mask wearing a form of opposition to President Trump. And many business owners were reluctant to force their customers to cover their faces or stay apart.

But starting just after Memorial Day, Texas began to report a rise in coronavirus cases, a trend that has accelerated over the last 10 days. The state has recorded 130,000 cases, and nearly 3,000 deaths. Hospitalizations are on the rise.

Fears of the disease spread as grocery stores and restaurants reported that employees were getting sick, and Apple this week closed seven stores in Houston again. Other large retail chains like J.C. Penney, Ikea and Nordstrom said on Thursday that they were monitoring the situation but were keeping their Texas stores open.

Restaurant reservations on OpenTable have been dropping in recent days. Data from another online platform, the Home Base scheduling app, showed total hours worked by employees at small businesses were rising until June 22, but then stalled as the week progressed, according to analysts at the Federal Reserve Bank of Dallas.

Credit…Erin Trieb for The New York Times
Credit…David J. Phillip/Associated Press

“Certainly we’re concerned,” said Keith R. Phillips, an assistant vice president at the bank. “Staffing levels are beginning to flatten and decline and we’re hearing from our contacts that businesses that had sent workers home and brought them back are now sending them back home.”

On Thursday, Governor Abbott issued an executive order suspending elective surgery in four populous counties to ensure that hospitals have the space to care for coronavirus patients. He also paused further business reopenings.

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Updated 2020-06-25T22:06:53.076Z

William Presta, a barbershop owner in the Houston suburb of Bellaire, closed on March 22 and reopened on May 12. Business was going well until this week when demand suddenly dried up, he said, so he has decided to close the shop next week and take a vacation.

“I’m just being conscious and smart and trying to keep out of harm’s way,” he said.

Texans are accustomed to a gyrating economy that has long soared and tanked along with oil and natural gas prices. There have been four steep oil downturns in the last four decades. In the 1980s, for example, a sharp drop in oil prices devastated the state’s energy companies and banks. Three out of every four petroleum worker lost their jobs.

Over the years the state economy has diversified, with medical centers mushrooming in Houston and Dallas, and Austin becoming a technology hub. But energy remains a critical part of the state’s economy. The shale fracking revolution has made Texas the leader of a national energy boom and fueled an expansion of petrochemical plants and natural gas export terminals.

At the start of the year, Texas oil and gas companies appeared to be doing OK. The U.S. benchmark oil price hovered around $60 a barrel. When the pandemic took hold, and Russia and Saudi Arabia briefly flooded the market with oil, the price dropped to $20 a barrel in March, and then, in a first, briefly dropped to more than $37 below zero.

Oil companies shut down wells and stopped new drilling except when companies were legally obligated to employ rigs under contract.

More than 26,000 Texas oil workers — roughly one in four — lost their jobs in April, according to state employment data. That was the largest single month of oil and gas layoffs. But the impacts were far greater, rippling across the state, hurting businesses that serve the energy industry and its workers. Regional banks, many of which have large oil-company loan portfolios, are being strained, and investments in pipelines are being delayed.

The drop in oil prices and the spread of the coronavirus dealt a double punch and 1.3 million Texans lost their jobs in April.

ImageWestlake Legal Group merlin_171818520_4dd10895-d502-4cfd-8366-35b650d2b18b-articleLarge Still Reeling From Oil Plunge, Texas Faces New Threat: Surge in Virus Cases Texas Oil (Petroleum) and Gasoline natural gas Labor and Jobs Houston (Tex) Economic Conditions and Trends Coronavirus Reopenings Coronavirus (2019-nCoV) Abbott, Gregory W (1957- )
Credit…Bronte Wittpenn for The New York Times

But oil prices recovered faster than most analysts had expected as producers in the United States, Saudi Arabia, Russia and other countries cut back production. And as many states opened up their economies, gasoline demand started climbing. National average prices at the pump for regular gasoline have increased roughly 10 percent, or 20 cents a gallon, over the last month, according to the AAA motor club.


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  • Frequently Asked Questions and Advice

    Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


Texas added 237,800 jobs in May, a monthly record, as businesses reopened and oil companies slowly began sending workers into the field to revive shale wells. At nearly $40 barrel, oil is now expensive enough for producers to reopen some wells they had shut.

“The near-term situation in oil markets is undeniably severe, but it is a temporary aberration stemming from an unprecedented health issue,” said Ray Perryman, an economic consultant in Waco.

But despite his overall optimism, Mr. Perryman remains cautious because of the recent surge in coronavirus infections, which he said should have been avoided. “The spike is higher than necessary due to lack of adherence to safety recommendations and is becoming alarming,” he said. “You can’t fix the economy if you don’t get to a sustainable place on the health crisis.”

The Texas oil industry is marked by wildcatters who wear optimism on their sleeves whatever the oil price, in part because low oil prices typically stimulate demand, which in turn pushes prices back up. But the current crisis is fundamentally different because the pandemic has kept demand suppressed even at low prices. Demand for jet fuel, for example, is still subdued because airlines are flying far fewer flights than they normally do this time of the year.

Energy executives say that at $40 a barrel, the U.S. oil price is not high enough for them to hire more workers and drill more wells. They say the price needs to approach $50 a barrel, but few experts expect that to happen until the pandemic is largely under control or an effective vaccine is widely available.

“I’m optimistic to a point,” said Scott D. Sheffield, chief executive of Pioneer Natural Resources, a leading Texas oil company. “If the infection numbers don’t level back, it’s going to be a tough decision for the governor as to whether or not to put back in place ‘shelter in place,’ which would be an economic disaster for the state.”

Even if the governor does not issue another stay-at-home order, many businesses could decide they have no choice but to shut down because they cannot afford to pay employees with few or no customers coming in the door. Some say closing again would be devastating but not doing so could be, too.

Mithu and Shammi Malik had been hoping to open Musaafer, a new Indian restaurant in Houston three years in the making, in March. Instead, the married couple had to wait until May 18 because of state and local public health restrictions. Roughly two weeks after they opened, a few of their employees tested positive for the virus, forcing them to shut down again.

The couple decided to give it another shot, and reopened on June 12, and are now nervously monitoring the rise in coronavirus cases and wondering if they will be forced to close their doors yet again.

“You can’t ignore that Covid itself is spreading quickly,” Mr. Malik said. “We are very much aware that cases are going up.”

Sophia June contributed reporting from New York, and Gillian Friedman from Salt Lake City.

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Virus Cases Are Soaring in Texas. But Closing Down Again Is a ‘Last Option.’

Westlake Legal Group virus-cases-are-soaring-in-texas-but-closing-down-again-is-a-last-option Virus Cases Are Soaring in Texas. But Closing Down Again Is a ‘Last Option.’ Texas Houston (Tex) Disease Rates Coronavirus Reopenings Coronavirus (2019-nCoV) Abbott, Gregory W (1957- )

HOUSTON — The coronavirus has been testing America’s governors. Few are being squeezed harder than Gov. Greg Abbott of Texas.

Mr. Abbott, the governor of the country’s largest Republican-controlled state, reopened Texas in May, eager to be part of President Trump’s push to restart the economy sooner rather than later. But the reopening has backfired, creating the makings of a political and public health disaster that is putting the lives of Texans at risk, adding ammunition to Mr. Abbott’s long-running war with the Democrats who run the state’s biggest cities and drawing unusually sharp criticism from fellow Republicans.

As millions of Texans have emerged from weeks of isolation and headed to shopping malls, movie theaters and beaches, the governor, faced with an alarming number of new cases, did an abrupt about-face this week and urged people to go back home.

He imposed restrictions on outdoor gatherings of more than 100 people and has cleared the way for local authorities to require face masks in businesses — after earlier opposing attempts by local officials to require everyone in their cities to wear masks in public.

These were the latest in a series of contradictory moves by the governor that have proved confusing and frustrating to many Texans.

For weeks, Mr. Abbott had reassured Texans that the virus was largely under control. “Covid-19, while dangerous, while still growing in the state of Texas, is not as severe as it is in some other states,” he told reporters in April.

But as the state began to rapidly reopen, and people returned to restaurants, bars, malls, hair salons and gyms, the numbers — and the governor’s tone and policy responses — have changed.

New cases, hospitalizations and the percentage of positive tests have been on the rise for weeks, indicators that the coronavirus is spreading rapidly. Since late May, the average number of newly reported cases each day has more than doubled to about 3,500, up from 1,500. That is not just the result of more testing: The percentage of tests coming back positive has soared from 4.5 percent to about 9 percent. Hospitalizations are also on the rise.

Texas has surpassed more than 100,000 cases, joining a small club of only six other states to do so — New York, California, New Jersey, Illinois, Massachusetts and Florida. On Wednesday, Texas hit another milestone, recording more new cases in a single day than it has since the start of the pandemic — 5,551 new infections.

Wednesday brought another turnabout. Texas had previously ordered all air travelers arriving from New York, with its then-booming number of cases, to quarantine for 14 days. But on Wednesday, Gov. Andrew M. Cuomo of New York turned the tables and announced that travelers from Texas and eight other hard-hit states would have to quarantine there.

The sudden reversal has left Mr. Abbott with few good options and an array of critics from both parties — some of them the leaders of the state’s largely Democratic major cities, who have complained that the state reopened too quickly and tied their hands when they wanted to impose virus-control measures of their own.

“The governor opens up our economy and says, ‘OK, you guys go back to work,’ and we expect nothing to happen?” said Ruben Becerra, a Democrat and the county executive in Hays County, southwest of Austin, where total confirmed cases have surged from 353 on June 1 to more than 2,100 on Wednesday.

Mr. Abbott is by no means alone. Other states led by Republican governors have struggled to balance their reopenings with the spread of the virus, while navigating the politics of mask-wearing and issues of state versus local control.

In Arizona, the handling of the pandemic by Gov. Doug Ducey, a Republican, has come under intense criticism by Democratic leaders in Arizona’s largest cities. Mr. Ducey had resisted allowing mayors to make mask-wearing mandatory in their cities. But under pressure over a surge in cases, Mr. Ducey allowed mayors to implement their own measures.

On Wednesday, Florida saw a record number of new coronavirus cases, but Gov. Ron DeSantis, a Republican, gave no indication that the state would roll back its reopening, urging people instead to avoid crowds and closed spaces with poor ventilation.

Texas, though, is facing a challenge of both politics and numbers. If local trends persist, Houston could become the hardest-hit city in the country, rivaling the situation in Brazil, Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, warned this week on Twitter.

Dr. Hotez, one of the state’s leading experts on contagious diseases and vaccine development, said in an interview on Wednesday that the Houston, San Antonio, Austin and Dallas-Fort Worth metropolitan regions “are facing a dire public health emergency.”

The governor should require face masks and tougher social distancing measures in those four regions immediately, he said. “We have to take action before the end of this week,” he said. “If we don’t do something, there’s nothing to stop this thing going up the ceiling.”

ImageWestlake Legal Group merlin_173888412_60337a61-9747-4298-8112-c7df0158c07b-articleLarge Virus Cases Are Soaring in Texas. But Closing Down Again Is a ‘Last Option.’ Texas Houston (Tex) Disease Rates Coronavirus Reopenings Coronavirus (2019-nCoV) Abbott, Gregory W (1957- )
Credit…Mark Felix for The New York Times

Dr. Hotez and other public health experts, along with several local elected officials, have blamed the uptick in the virus on Mr. Abbott’s decision to speedily reopen the state. They said businesses were allowed to resume operations before the state had enough testing, contact tracing and other resources in place.

The results surfaced immediately in cities around the state.

San Antonio’s Bexar County had 93 patients in county hospitals on June 1, 20 of them on ventilators; by Tuesday, those numbers had jumped to 518 hospitalized, with 79 on ventilators.

“As we opened up Texas, everybody became very complacent and were not wearing face masks,” said Nelson W. Wolff, a Democrat who serves as the top elected official in Bexar County. “Then you have the president running around and not wearing one, and the governor only recommending it, not enforcing it, and so I think people got mixed signals, and we have seen it spread exponentially.”

Mr. Abbott, a former Texas attorney general now in his second term, has been praised for his calm and swift handling of Hurricane Harvey, mass shootings and other large-scale disasters. But he has also been criticized, even by some in his own party, for too often following the lead of the state’s second-in-command, Lt. Gov. Dan Patrick, an outspoken arch-conservative who made national headlines for saying he and other grandparents were willing accept the threat to their own lives if that is what it took to reopen the country.

Mr. Abbott, his aides and his supporters defended his response to Covid-19 and said Texas can both reopen its economy and maintain public health.

“People must know the facts,” Mr. Abbott told KTVT in Fort Worth on Tuesday. “The facts are that Covid-19 is expanding far faster and far wider than at any time during the pandemic in Texas. That is why we are having to take additional measures.”


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  • Frequently Asked Questions and Advice

    Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


But the governor has had to carefully navigate the state’s complicated politics in trying to control the virus.

The phased opening-up has fueled a backlash among some conservatives, who resist wearing masks in public and say the state needs to go even further. (Bars now operate at 50 percent capacity, while restaurants operate at 75 percent capacity.)

In just one example of the politics at play, the Texas Democratic Party held an online-only convention recently, while the Republican Party is planning an in-person convention in Houston in July.

Credit…Ilana Panich-Linsman for The New York Times

Mr. Abbott has leaned on conservative, pro-business, small-government themes, but has also sent conflicting messages.

The governor initially resisted calls to issue a stay-at-home order, as other states had done, before issuing an executive order in early April. But even that led to a flurry of confusion, when he said at a news conference that it did not amount to a stay-at-home order. The next day, he released a video message clarifying that it did.

The order lasted 28 days, one of the shortest stay-at-home orders in the country.

Since businesses began reopening in early May, Mr. Abbott has gone head-to-head with the mostly Democratic mayors in the state’s largest cities, who have begged for more power to impose tougher restrictions. At first, Mr. Abbott’s approach was to let local officials handle the response. Then he shifted course, issuing an executive order that made it clear the state’s coronavirus rules nullified local ones. His stance shifted again in recent days when he allowed cities and counties to require businesses to have customers and employees wear masks and to fine business owners who did not comply.

Democratic critics who had been fighting for more local control said the governor’s turnabout came too late. Some Republicans saw Mr. Abbott’s move as throwing business owners under the bus.

“Business owners will become a de facto law enforcement arm, but the only tool they will have to enforce the mask requirement is to refuse to sell to their customers and to kick them out of their store,” State Senator Bob Hall, a Republican from East Texas, wrote in a posting online. “Who knew the flame of Texas Liberty would be extinguished, by the stroke of a pen, without a shot fired?”

In Galveston, a beach city southeast of Houston, Mayor James D. Yarbrough ordered mandatory face masks for all businesses starting on Tuesday. The number of people who tested positive rose to more than 300 this week from about 50 at the end of May.

The city has seen packed beaches and crowds in restaurants, bars and souvenir shops.

“There is no social distance — there are minimal masks,” said Mr. Yarbrough, a Democrat. “We are seeing a lot more younger people, what we call day trippers,” he said. “They come to spend the day and leave their trash and Covid and go on back.”

Manny Fernandez reported from Houston, Neil MacFarquhar from New York and Sarah Mervosh from Pittsburgh. Contributing reporting were David Montgomery from Austin, Simon Romero from Albuquerque and Patricia Mazzei from Miami.

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Public Health Experts Reject President’s View of Fading Pandemic

Westlake Legal Group merlin_173632221_62c15d16-03b4-4fef-ab12-f474c98b6af6-facebookJumbo Public Health Experts Reject President’s View of Fading Pandemic your-feed-healthcare Wolf, Chad F. University of Minnesota Tulsa (Okla) Trump, Donald J Texas south carolina Oklahoma Masks johns hopkins university Homeland Security Department Harvard University Gottlieb, Scott (1972- ) Florida Coronavirus Reopenings Coronavirus (2019-nCoV) Centers for Disease Control and Prevention Arizona

Public health experts warned on Sunday that the coronavirus pandemic is not going away anytime soon. They directly contradicted President Trump’s promise that the disease that has infected more than two million Americans would “fade away” and his remarks that disparaged the value of evidence from coronavirus tests.

A day after President Trump told a largely maskless audience at an indoor rally in Tulsa, Okla., that he had asked to “slow down the testing” because it inevitably increased the number of confirmed coronavirus cases, infectious disease experts countered that the latest rise of infections in the United States is real, the country’s response to the pandemic is not working and rallies like the president’s risk becoming major spreading events.

Dr. Tom Inglesby, the director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, said on “Fox News Sunday” that the spikes in confirmed cases in many states in the South and West are not simply a result of increased testing. Data show that the percentage of tests that are positive is increasing, he said, and in some states is accompanied by increased hospitalizations. In states like Arizona, Texas, North and South Carolina and Florida, he said, “That’s a real rise.”

On “Face the Nation” on CBS, Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, said, “We’re seeing the positivity rates go up. That’s a clear indication there is now community spread underway, and this isn’t just a function of testing more.”

And Dr. Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, repeated his call for a national plan to respond to the pandemic, calling the existing patchwork of state-by-state policy “disjointed.”

In an interview on NBC’s “Meet the Press,” Dr. Osterholm noted, “We’re at 70 percent of the number of cases today that we were at the very height of the pandemic cases in early April.”

He said that although his center had put out a report in April showing different possible waves and troughs of infection as the pandemic progressed, he had changed his thinking: “I don’t see this slowing down for the summer or into the fall.”

“I think this is more like a forest fire,” he said. “I think that wherever there’s wood to burn, this fire is going to burn it.”

The experts mainly urged greater use of proven interventions to slow the spread of disease, like hand-washing, mask-wearing and maintaining social distancing when out in public.

When asked whether states should consider reversing the levels of reopening, Dr. Inglesby did not recommend a return to lockdown.

“Each state has a different story,” he said, adding that “leaders should be encouraging people to use the tools we know work.”

He said indoor gatherings like the president’s rally were a concern, as were outdoor demonstrations like the mass protests against police brutality, but to a lesser degree. “We know from what we’ve seen so far in the last few months,” said Dr. Inglesby, “that outdoors is less of a risk than indoors and that mask use has a major impact.”

The Centers for Disease Control and Prevention, he noted, has advised that “the highest-risk gatherings are those that are large indoors, where people can’t stay apart from each other more than six feet, and where people travel from out of town. And this rally met all of those criteria.”

He and other public health specialists expressed concerns about the potential for a significant spreading event. Oklahoma has a rapidly rising infection rate, although its absolute numbers are still small. It had a record number of cases — 450 — and the last five days have been the highest the state has recorded. Deaths in that state have been in the single digits since the end of April.

U.S. cases are up 15 percent in the past two weeks, with at least 2.2 million confirmed infections since the start of the pandemic and cases on the rise in 22 states.

Earlier in the week, Mr. Trump told Sean Hannity on Fox News that the virus will disappear. “It’s going to fade away,” he said.


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  • Frequently Asked Questions and Advice

    Updated June 16, 2020

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • Will protests set off a second viral wave of coronavirus?

      Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

    • My state is reopening. Is it safe to go out?

      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


Dr. Ashish Jha, director of the Harvard Global Health Institute, said on CNN, “Not only is it not fading out — this will be with us for at least another 12 months, and that’s the most optimistic scenario for having a vaccine.”

Dr. Jah also responded to the president’s comments on testing. Peter Navarro, President Trump’s trade adviser, said on “State of the Union” on CNN, that the president’s comment about testing was “tongue-in- cheek.” “This is unfortunately not a joke,” Dr. Jha said. He mentioned families who had lost relatives in nursing homes and Americans who had not been able to get tests.

Chad F. Wolf, acting secretary of Homeland Security, appearing on NBC’s news program, defended the precautions taken at the Trump rally as meeting C.D.C. guidelines, since masks were offered and social distancing was voluntary. He also said the administration was trying to get the country “up and running” in a safe way.

“And I think we’re doing a great job at that,” he said.

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

Coronavirus Lockdowns: Businesses Turn to Armed Defiance

SHEPHERD, Texas — When Jamie Williams decided to reopen her East Texas tattoo studio last week in defiance of the state’s coronavirus restrictions, she asked Philip Archibald for help. He showed up with his dog Zeus, his friends and his AR-15 semiautomatic rifle.

Mr. Archibald established an armed perimeter in the parking lot outside Crash-N-Burn Tattoo, secured by five men with military-style rifles, tactical shotguns, camouflage vests and walkie-talkies. One of them already had a large tattoo of his own. “We the People,” it said.

“I think it should be a business’s right if they want to close or open,” said Mr. Archibald, a 29-year-old online fitness trainer from the Dallas area who lately has made it his personal mission to help Texas business owners challenge government orders to keep their doors shut during the coronavirus pandemic. “What is coming to arrest a person who is opening their business according to their constitutional rights? That’s confrontation.”

Call it the armed reopening.

While Gov. Greg Abbott this month allowed a wide range of malls, restaurants and other businesses to reopen after a coronavirus lockdown, bars, salons, tattoo parlors and other enterprises where social distancing is more difficult were ordered to remain closed for a longer period.

In at least a half dozen cases around the state in recent days, frustrated small-business owners have turned to heavily armed, militia-style protesters like Mr. Archibald’s group to serve as reopening security squads.

The showy displays of local firepower are creating a dilemma for the authorities, who face public demands for enforcement of social distancing guidelines, but also strong pushback from conservatives in some parts of the state who are convinced that the restrictions go too far.

The broader political split came out into the open this week, when the Republican attorney general, Ken Paxton, issued a warning to three Democratic-led cities — Austin, San Antonio and Dallas — that their local Covid-19 restrictions were illegal under the statewide reopening order issued by Governor Abbott, also a Republican.

The armed gatherings are in some ways a Texas thing — a combination of longstanding antigovernment and pro-gun movements in an independent state where “Come and Take It” flags are commonplace and amateur warriors patrol the southern border with Mexico.

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Around the state, groups of rifle-carrying demonstrators have volunteered their services to small-business owners, and have taken to social media to urge people to defy the authorities where necessary and reopen with armed support.

Friday’s reopening at Crash-N-Burn in the town of Shepherd unfolded quietly, except for Zeus. In the span of a few hours, the shop had 10 tattoo and piercing customers.

In recent days, Mr. Archibald has also brought his firearms to the illicit reopenings of a handful of bars, gyms and other businesses around the state. Days before the reopening in Shepherd, Mr. Archibald helped organize a protest outside an illegally reopened bar in the West Texas city of Odessa. That one ended with the authorities rolling up in an armored vehicle and arresting several of Mr. Archibald’s armed friends, along with the bar owner.

Mr. Archibald also lent his services at the Dallas hair salon whose owner, Shelley Luther, was jailed for defying the authorities and became a national icon to conservatives opposed to state lockdowns.

Following the confrontations in Odessa and Dallas, police officials and local leaders have found themselves in a bind, especially after the governor spoke out on behalf of the Dallas salon owner and helped get her released by easing the punishment for violating his remaining lockdown orders.

“Why put forth to law enforcement to enforce these orders if you’re not going to have the backbone to stand up and back up what you’ve ordered?” the county sheriff who led the raid on Big Daddy Zane’s bar in Odessa, Mike Griffis, told The Odessa American.

The armed protesters are a varied lot scattered around the state, some of them with long-established groups, others forming new ones or acting as lone operators. J.P. Campbell, 45, a military veteran with the group Freedom Fighters of Texas, met Mr. Archibald face to face for the first time only during last week’s action at Crash-N-Burn.

“It’s not for looks,” Mr. Campbell said as he stood guard with a shotgun draped across his chest. “We’re willing to die.”

The groups walk a thin line between civil disobedience and political street theater in a way that has caused a split within the anti-lockdown movement, some of whose proponents oppose such brazen challenges to the authorities.

Gun control supporters have their own concerns about such tactics.

“People are nervous enough as it is, and then to see people walking around with AR-15s in public places, gathered together like that, is unnerving and upsetting,” said Ed Scruggs, the board president of the group Texas Gun Sense. “The entire goal is intimidation and attention.”

ImageWestlake Legal Group merlin_172190709_4a1c7449-afc8-4ee0-8334-0882a9734142-articleLarge Coronavirus Lockdowns: Businesses Turn to Armed Defiance Texas Second Amendment (US Constitution) Open Carry Texas Luther, Shelley (Dallas, Tex, Salon Owner) firearms Demonstrations, Protests and Riots Coronavirus (2019-nCoV) Abbott, Gregory W (1957- )
Credit…Eli Hartman/Odessa American, via Associated Press

Some of the protesters say they are merely engaging in marketing — drawing attention to businesses so that their reopening attracts more customers — while others say they are part of a grass-roots rebellion against oppressive government.

“We go out there because we want peace, but we prepare for war,” said C.J. Grisham, 46, a retired Army sergeant whose gun rights group Open Carry Texas helped the arrested owner of the bar in Odessa get a lawyer. “I hope this never happens, but at some point guns are going to have to cease to be a show of force and be a response to force,” he said.

Outrage followed the Odessa arrests. Sheriff Griffis of Ector County has received numerous threats. Bomb technicians were summoned to his house to inspect his pickup truck after one threat.

Mr. Archibald, who had publicly called for Mr. Griffis to step down and for protesters to rally outside the sheriff’s house, said he had no involvement in any threatening messages. “I have no control over those threats,” he said. “I think a lot of that is just coming from people who have been angry at him and angry about police brutality for a long time.”

The Odessa arrests and the jailing and release of Ms. Luther have energized the protesters and put them in the spotlight. Mr. Archibald said he planned to travel soon to California and New Jersey to help businesses reopen there — though he said he would go unarmed.

“We aren’t going to take any heat because I personally don’t know the California laws,” he said. “Texas is way more lenient.”

Handguns are regulated under Texas law — a state-issued license is required to carry a handgun in a concealed or unconcealed manner. But the carrying of bigger weapons — rifles, shotguns and other firearms known as long guns — is largely unregulated, and no licenses are required to carry long guns out in the open. According to state law, a person can carry a rifle in a public place as long as they do not display it “in a manner calculated to alarm.”

And this being Texas, the alarm threshold is rather high.

The top elected official in San Jacinto County, which includes Shepherd, said he had no objections to the reopening of Crash-N-Burn, particularly after the governor’s apparent acquiescence in the Dallas salon case.

“The powers that be came to their senses and said, ‘Look, you can’t do this,’ so the same thing’s going to apply to a tattoo shop,” the official, County Judge Fritz Faulkner, 61, a Republican, said. “Now my personal opinion is if a barbershop can open, I don’t know why a tattoo shop couldn’t open.”

Barbershops and hair salons were allowed by the state to reopen last week with restrictions. Critics of the lockdown orders, including conservative activists and some local officials, believe that the governor’s orders are so vaguely written that it is also legal for bars and tattoo studios to reopen, fueling the armed protesters’ belief that they are in the right.

Mr. Abbott’s executive order states only that people “shall avoid” visiting those establishments.

“The language is so open-ended, broad and subject to interpretation that it’s causing a lot of confusion amongst people who are trying to live under the order,” said Jared Woodfill, a conservative activist and Houston lawyer who has sued Mr. Abbott claiming that the lockdown orders violate both the Texas and U.S. Constitutions, among other laws.

At Crash-N-Burn on Friday, the owner, Ms. Williams, 35, said she had been scared about the potential pushback from law enforcement if she reopened, but had decided to try because she had lost between $6,000 and $10,000 after being closed for weeks.

Ms. Williams said she was inspired by the actions of Ms. Luther in Dallas and felt a peace of mind knowing the armed men were there in the parking lot.

“I had a feeling that finally somebody had my back,” Ms. Williams said. “And it’s really sad that citizens are having my back as opposed to my government.”

Manny Fernandez reported from Shepherd, and David Montgomery from Austin.

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