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Rick Pitino’s Knicks were way ahead of the NBA curve
Two months ago, college basketball guru Dick Vitale lobbied on his Twitter account for Rick Pitino to land the Knicks job. Iona got there first. Despite Pitino’s baggage from an NCAA-related FBI investigation, a Knicks redux wouldn’t have been such an oddball choice. After all, Pitino was ahead of his time in the NBA when...
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Health care workers protest lack of equipment
Health care workers at NYC hospitals are reusing the same N95 masks — which are meant for one-time use — for five days.
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Why black Americans are moving to Africa
Monique John wasn’t sure what to expect when she stepped off the plane in her new home: the West African nation of Liberia. “It was very rundown looking,” the Brooklyn-born 28-year-old recalled of her first glimpse of the capital, Monrovia, nearly three years ago. “But my feeling as I was walking along the city’s main...
3 More National Parks Close to Prevent Coronavirus Spread
The news comes just days after several other well-known parks such as Yellowstone and Grand Teton closed their gates
Trump says he might lock down New York as coronavirus death count tops 2,000
President Donald Trump said on Saturday he might prohibit travel in and out of the New York area to limit the spread of the coronavirus from its U.S. epicenter, as the number of cases crossed 2,000 nationwide.
Popular NYC dive bar doing virtual happy hour amid coronavirus quarantine
New York City, which has become an epicenter of the coronavirus pandemic, is a ghost town now, locked down and empty. But that won’t stop the cool kids of Downtown Manhattan who never go more north than 14th Street from having a party. The party now is just online.
Bill Plaschke voted nation's best large-publication sports columnist
The Times' Bill Plaschke has been named the nation's top large-publication sports columnist for 2019, Associated Press Sports Editors said Saturday.
Trump speaks at Virginia Navy ship departing for New York aid
President Trump spoke before the departure of the Navy hospital ship the USNS Comfort to New York, the state hardest hit so far by the coronavirus pandemic. Watch his remarks.
Orange County coronavirus cases jump past 400 with 4 deaths
Coronavirus: Orange County cases jump to 403 with 4 deaths
South African soldiers fire rubber bullets to enforce social distancing
South African soldiers trying to slow the spread of the coronavirus fired rubber bullets at hundreds of grocery shoppers in Johannesburg to keep them a safe distance apart, photos taken Saturday show. The soldiers were deployed to a Shoprite in the Yeoville neighborhood, where a crowd of a few hundred had gathered outside the store,...
Column: The Rec Room: Perry Wallace Jr.'s resolve against racism is a story worth reading
'Strong Inside: Perry Wallace and the Collision of Race and Sports in the South' is an intimate look at the first black basketball player in the SEC.
Coronavirus stimulus check scams are out to swindle you out of $1,200: What you need to know
FBI, states warn Americans that phone calls, texts or emails asking for personal or financial information to get $1,200 federal payment are not legit.
New York lawmakers eye distance voting amid coronavirus pandemic
Welcome to distance legislating. The COVID-19 pandemic is allowing state lawmakers to practice what only weeks ago would have been a pipe dream: deliberating and possibly voting on the state budget and other bills from the comfort of their homes instead of schlepping to Albany. Maybe they’ll wear pajamas instead of formal attire. With four...
New York to Release 1,100 Low-Level Parole Violators, as Worries Over Prison System's Vulnerability to COVID-19 Mount
Any number of transgressions, from further criminal acts to simple oversights, can land an individual serving parole back in prison.
WHO Reviews "Available" Evidence On Coronavirus Transmission Through Air
A scientific brief from the World Health Organization says "current evidence" points to infectious respiratory droplets passed in "close contact" situations, but some say it's too soon to be sure
America Needs Plasma From COVID-19 Survivors Now
Editor’s Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here. Tatiana Prowell knew it was a long shot, but she didn’t know what else to do. Her brother-in-law’s father, the man she knew affectionately as “Papa Doc,” was in the ICU with COVID-19, and things were not looking good. “HELP!,” she tweeted late on Wednesday night: She needed to find someone who had recovered from COVID-19, and then ask for their blood.The day before Prowell tweeted her plea, the Food and Drug Administration began allowing doctors to use plasma, the yellow fluid in which blood cells are suspended, as a Hail Mary to treat very ill COVID-19 patients. The idea of using plasma from survivors, also known as convalescent-plasma therapy, dates back to the late 19th century. Doctors have transfused the blood of recovered patients into those still sick with the 1918 flu, measles, polio, chickenpox, SARS, and Ebola—to varying degrees of success. Given the dearth of treatments for COVID-19, convalescent plasma has gained new prominence. The blood of survivors, the thinking goes, contains proteins called antibodies that can neutralize the coronavirus. Early data from very small numbers of COVID-19 patients in China show some promise. But the first hurdle is finding the recovered patients who can give plasma.“We can’t go to that warehouse and get the 100 bottles on the shelf,” says Liise-anne Pirofski, the chief of the infectious-disease department at the Montefiore Medicine Center, in New York. So doctors, scientists, blood banks, and government agencies have begun mobilizing to collect, distribute, and study plasma from COVID-19 survivors. The advantage of plasma is that you don’t need to develop a vaccine or treatment from scratch. But in these early days of the pandemic, when the number of recovered and confirmed patients is still relatively small, finding them will take time. The irony is that the bigger the pandemic gets, the easier finding donors will be.[Read: America’s hospitals have never experienced anything like this]Prowell, who had been following the prospects of convalescent plasma closely because she is also a doctor at Johns Hopkins University, was overwhelmed—in a good way—by the response to her tweet. She got hundreds of replies from people who offered to donate or knew someone who might. “That’s very powerful, but it’s obviously not the right way to do this at scale,” she told me. “We’re going to have millions of cases.” The family is still looking for a donor who fits all the criteria.The way to do this at scale is a national network that connects donors, patients, and their doctors. Such an effort began in late February, when Arturo Casadevall, an immunologist at Johns Hopkins, published an op-ed in The Wall Street Journal suggesting the use of convalescent plasma for COVID-19. He started connecting interested doctors, virologists, immunologists, and blood-banking experts, who all came together to launch the National COVID-19 Convalescent Plasma Project.The movement has gained traction. This week, New York announced that it would be the first state to try convalescent-plasma therapy, and the New York Blood Center, a major blood bank, began collecting plasma from people who have recovered from COVID-19.For now, this plasma is going to hospitals in New York, which are using it on a case-by-case basis. A spokesperson at Mount Sinai told me that the hospital expects to transfuse its first patient this weekend. Mount Sinai’s call for donors got thousands of responses, which an army of medical students is now sifting through.A single plasma donation from a COVID-19 survivor could go to multiple patients. Donating plasma is similar to donating whole blood, except the red blood cells are separated out by a machine and returned to the donor. “We can do two to three people from one donor,” says Bruce Sachais, the chief medical officer at the New York Blood Center. But the majority of these interested donors will not be suitable for one reason or another: The criteria, set by the FDA, suggest that donors should have had no symptoms for at least 14 days. They should have had a lab test confirming COVID-19, which is hard to get now and was even harder to get when the donors would have first gotten sick, several weeks ago. And, as with normal blood donation, patients and donors have to be matched by blood type. Prowell, for example, is looking for someone who is A-positive or AB-positive for her relative.Finding enough donors is also key to clinical trials that can more systematically study convalescent-plasma therapy for COVID-19. Soon, the New York Blood Center plans to send out plasma for clinical trials at several hospitals, such as Johns Hopkins, the Mayo Clinic, and Montefiore Medical Center. To help find the right donors for the trials, Shmuel Shoham, an infectious-disease doctor who is involved in the Johns Hopkins trial, told me he leaned on a friend who is an organizer in the Orthodox Jewish community. Orthodox Jews in New York were at the center of an early coronavirus outbreak in the area, which means those who have recovered could become donors right now.Michael J. Joyner, a doctor at the Mayo Clinic, likened this phase to the “craft brewing” of convalescent-plasma therapy. It’s available at only a few academic centers, and doctors are reliant on personal connections to recruit donors. Getting to the “national-brewery model,” he says, requires involving bigger players. The FDA could help identify donors, and a network of national blood banks could send COVID-19 plasma to hospitals in small cities and towns. Eventually, pharmaceutical companies might be interested in pooling and purifying plasma down to a concentrated dose of antibodies—at which point convalescent plasma truly would be a standardized product you pull off the shelf.[Read: How blood-plasma companies target the poorest Americans]All of this, of course, is contingent on plasma actually working against COVID-19. The clinical trials that are planned in the U.S. will focus on patients who are less ill—ideally those not in the ICU. Some evidence suggests that the antibodies in plasma are useful early on in the immune response, but less so once a patient has reached the stage of organ failure that requires hospitalization. No one knows why, Pirofski told me, but one reason could be that antibodies help prevent the virus from spreading from the nose and throat into the lungs.At Mayo and Montefiore, the trials will be focused on people early into their infections. The Johns Hopkins trial will enroll people who have been exposed to COVID-19—maybe because a family member tested positive—but who do not yet have symptoms. If plasma can lessen the severity of COVID-19, it could be key to alleviating the strain on hospitals. “The idea is if we give this to people who have respiratory symptoms like cough and chest pain, maybe they won’t require supplemental oxygen, won’t require intubation,” Pirofski said.“Papa Doc” has gotten slightly better in the days since Prowell tweeted for help. But he’s still sedated and on a ventilator; no visitors are allowed, due to the risk of infection. “That is so emotionally excruciating,” says Jason Constantine, Prowell’s brother-in-law. His father doesn’t know that they are trying to find him a plasma donor or that hundreds of strangers have taken an interest in him. But they are still looking for the right stranger who might be able to help.
Thaddeus Moss: 5 things to know about the 2020 NFL Draft prospect
Thaddeus Moss is a college tight end for the LSU Tigers who is looking to make the jump to the pros.
Breaking down the Giants’ NFL free agency haul
With the bulk of free agency in the books around the NFL, and certainly for the Giants, it is a good time to sit back and assess what general manager Dave Gettleman did and why, and where the players he added eventually will fit in. Following Saturday’s signing of former Jets tight end Eric Tomlinson,...
UN donates 250K face masks to NYC health care workers
With five pallets of boxes stacked behind him, Mayor Bill de Blasio thanked the United Nations Saturday for a donation of 250,000 masks for city health care workers. The donation came in response to the mayor’s appeal for of supplies to help in the onslaught of COVID-19. New York City remains the epicenter of the...
Former 'All My Children' star John Callahan dies at 66 after suffering a stroke
John Callahan was known for playing the role of Edmund Gray on "All My Children." He died Saturday morning after suffering a stroke.
A Navy ship is headed to New York to help hospitals strained by coronavirus patients
President Trump, with Defense Secretary Mark Esper, speaks during the departure ceremony for the hospital ship USNS Comfort in Norfolk, Virginia on March 28, 2020. | Jim Watson/AFP via Getty Images Trump saw off the USNS Comfort off Saturday — it will house patients in New York to free up beds for Covid-19 patients. President Donald Trump sent a Navy hospital ship — the USNS Comfort — to New York City Saturday afternoon, in order to help hospitals overburdened by coronavirus patients. Speaking at Virginia’s Naval Station Norfolk, Trump said the ship will arrive in New York City on Monday. The hospital ship was “rushed through” scheduled maintenance in four days, according to Trump, and will augment healthcare efforts in New York, where more than 23,000 Covid-19 cases have been confirmed and 517 people have died, as of March 28. During his remarks, Trump also suggested that the severity of New York’s Covid-19 outbreak could lead him to placing the state — along with its neighbors New Jersey and Connecticut — under quarantine, something that, as Vox’s Ian Millhiser has explained, is within the federal government’s power. The president did not definitively say whether he would take this step, only stating that he plans to make an announcement about the potential quarantine “one way or the other fairly soon.” And Trump also did not give details about what a quarantine for those states would look like, but said quarantine measures would not apply to people passing through those states. As of March 28, the state of New York has more than 52,000 confirmed coronavirus cases; New Jersey has 8,825, and Connecticut has about 1,300 cases. New York state has the largest proportion — almost 50 percent — of confirmed coronavirus cases in the country, and at least 728 people have died of Covid-19-related causes as of March 28. More than 500 of those deaths have been within New York City. This high confirmed case count is why the Comfort is so badly needed in New York — as Caroline Hopkins has reported for Vox, New York Gov. Andrew Cuomo has said he believes the state will continue to see increases in confirmed cases for the next three weeks. And hospitals in the state are already overwhelmed: A resident at Columbia/New York-Presbyterian Hospital said her hospital’s intensive care unit (ICU) was at capacity due to coronavirus patients as of March 25, and a number of hospitals, Hopkins wrote, have begun to create plans governing which Covid-19 patients receive care and which will not. The Comfort’s role will be to provide emergency care for those will non-Covid-19 related illnesses in order to open up ICU beds for people infected with the coronavirus. And it is expected to begin receiving patients on Tuesday. “We are here for you, we are fighting for you, and we are with you all the way and we always will be,” Trump said, addressing New Yorkers. Trump also said the Comfort’s sister ship, the USNS Mercy, was deployed on the west coast to support Los Angeles residents, and would offer them 1,000 medical beds, a medical lab and a pharmacy, among other medical functions. The US is badly in need of more hospital beds The United States reached a grim milestone on Thursday when it was announced that there are more active coronavirus cases here than any other nation in the world. That announcement comes in the wake of ramped up testing measures, although diagnostic tests are still in short supply — something that could be remedied in part by a new, rapid coronavirus test recently approved by the Food and Drug Administration. Patients and doctors have also faced a growing shortage of emergency equipment, such as face masks and ventilators, and people with non-virus-related medical needs may be at risk of exposure to the virus simply by entering a hospital, medical officials have said. In the face of overwhelmed hospitals, local and state officials have implemented their own partial quarantine or isolation measures, closing schools, entertainment establishments and restaurants, and barring large gatherings. Many governors are beginning to order travelers from hard-hit areas, particularly New York and New Jersey, to self-isolate for fourteen days upon arrival elsewhere. But as Vox’s Dylan Scott has explained, “even the most aggressive mitigation strategies — general social distancing, quarantines, closing schools — will not be enough to prevent US hospitals from being overwhelmed eventually unless we commit to such drastic measures until a vaccine becomes available,” a process that could take up to 18 months. As Zeeshan Aleem has written for Vox: USA Today said that its most “conservative” analysis based on data from the American Hospital Association, US Census, CDC, and World Health Organization found that “there could be almost six seriously ill patients for every existing hospital bed.” But that estimate, which assumes an infection rate similar to ordinary infection rates of the flu, is based on the idea that all hospital beds would be empty. In reality, two-thirds are generally full. With that occupancy rate taken into account, there would be 17 patients per open bed. The Comfort and Mercy won’t solve this problem by themselves, but will certainly help in California and New York, both of which are among the states that have been hit hardest thus far by the coronavirus. And, as Trump mentioned Saturday, there are other things the military can do in order to alleviate pressure on hospitals across the country, promising, “We are marshaling the full power of the American nation — economic, scientific, medical and military — to vanquish the virus, and we will do that.” In particular, the president touted the four field hospitals the US Army Corps of Engineers and FEMA have built in New York, California, and Illinois. More of such hospitals could be needed in the days to come.
UFC’s Jon Jones says coronavirus ‘stir-crazy’ led to DWI arrest
Jon Jones said he was getting “stir-crazy” at home during the coronavirus pandemic, which led him to getting behind the wheel and ultimately being arrested Thursday morning in Albuquerque, NM. The UFC light heavyweight champion told cops he had a drink of vodka earlier in the day before he was charged with DWI, negligent use...
New Jersey mayor urges rich people to give to poor amid coronavirus
Mayor Robert Jackson's call came with his announcement that the township has donated $20,000 to a local soup kitchen and pledges to match individual contributions by another $20,000, reported.
Eight great bottles of wine under $20 to get you through COVID-19
Just because you’re stuck home alone during happy hour doesn’t mean you have to break the bank for a drink.
Mom sues Manhattan smoke shop after vaping son gets sick
Jason Flanders never listened to his mom’s warnings about vaping — until the Manhattan teen landed in the intensive care unit. “I was super sick,” he recalled. “I was in the hospital for 17 days.” Jason had been vaping since he was 15, but his age didn’t matter to the smoke shop in Chelsea where...
The voice of the first talking G.I. Joe action figure is a true American hero
Bill Corsair is the voice of the first talking G.I. Joe doll, a SAG award winner and a Guinness World Record holder. But the title that the Manhattanite is proudest of: Army veteran. Corsair, 79, went to Vietnam in January 1969 as part of the fabled First Cavalry Division. He came back 10 months later...
Four Big Questions About the $2 Trillion Relief Deal
Democrats decided to play ball to get what they wanted on policy. But how are all those ideas going to work?
Virtual playdates
It's ⌛ for screen time
Colorado Avalanche hit with another coronavirus player case
The Colorado Avalanche announced Saturday that a second unidentified player had tested positive for the coronavirus. According to the team’s statement, the Avalanche were advised of the positive test for COVID-19 on Friday night. The player is in self-isolation and his health will be monitored by team medical staff. “All other Avalanche players, staff and...
Locals livid over ‘rigged’ development in Flushing Creek, Queens
A $2 billion development along toxic Flushing Creek will pollute the neighborhood with gentrification, critics say. Affordable housing activists, unions and mom-and-pop shops have packed public hearings on the waterfront proposal, pushing back against more luxury apartments and designer stores. And as livid as they are about the revitalization, they are just as angry about...
Michigan Gov. Gretchen Whitmer announces arrival of 112,000 N95 masks in state
Michigan Governor Gretchen Whitmer posted a video on Saturday, telling residents to be safe amid the coronavirus outbreak and that she had good news about the state's preparedness.
Trump Considering “Enforceable” Quarantine of New York, New Jersey, Connecticut
Experts say it is unclear whether the president even has the authority to order residents of a state not to travel.
Rich and famous get COVID-19 test but average people can’t
If you’re rich and famous, there’s a much better chance that you’ll land an elusive COVID-19 test. If you’re an average Joe, well, good luck. “It’s the wild, wild West out there,” Dr. Edward Goldberg, a Manhattan internist said. “There’s very little unified messaging and when that happens, the rich and privileged jump the line....
You’ll never guess what Robert Pattinson smells like
The star said he wasn’t always a sex symbol, recalling that when he auditioned for “Twilight” he looked like, “a baby with a wig on..."
Tom Coburn, the Senate’s “Dr. No,” has died at 72
Sen. Tom Coburn, in 2013. | Bill Clark/CQ Roll Call via Getty Images The former Oklahoma senator’s political career was defined by his refusal to support wasteful government spending. Thomas Coburn, Oklahoma politician and physician, died Saturday after a years-long battle with cancer. He was 72. Coburn, a Republican who served in the House of Representatives and the Senate, was best known as a staunch fiscal conservative who hated and highlighted excess government spending. He refused to support bills that included what he saw as an abuse of taxpayer money, rarely backing down from those convictions even when they went against his own party, and did everything in his power to block them. He became known as “Dr. No,” a moniker he earned up until the very end of his tenure, when he blocked one bill to fund suicide prevention programs for military veterans and another to renew the Terrorism Insurance Program, which would bail out insurance companies if they were unable to pay a flood of claims following a 9/11-like terrorist attack (both bills were passed a few weeks later, after Coburn left office). “I am not a go-along, get-along guy if I think it is the wrong way to go,” Coburn told the New York Times in 2008. “I am O.K. taking the consternation of my colleagues. I take my oath seriously.” Transparency was part of Coburn’s campaign against government waste. In 2006, he worked with John McCain and two Democratic senators — Tom Carper and Barack Obama — on the Federal Funding Accountability and Transparency Act, which created a public online database of entities that received government funds. That database can be found at He also put out an annual “Wastebook” listing of what he judged to be the 100 most wasteful uses of taxpayer money. Coburn was also Dr. No when it came to gay rights, abortion, stem cell research, affirmative action, and global warming, voting and/or speaking out against such progressive policies throughout his political career. He voted for a congressional amendment banning same-sex marriage in 2006 and was a self-professed “global warming denier.” He was against abortion except in cases where the life of the mother was in danger — in fact, according to the Oklahoman, he had performed two procedures as an obstetrician. Coburn was born in Wyoming on March 14, 1948, and grew up in Muskogee, Oklahoma. After college, he worked for his father’s ophthalmic equipment company for several years, then went to medical school. He graduated in 1983 and opened up his own family and obstetrics practice, where he said he delivered more than 4,000 babies. He continued to see patients while serving as a representative and a senator, either at cost or free of charge to get around conflict of interest rules. He was also a Southern Baptist church deacon. A political outsider, Coburn ran for Congress in 1994 and was an unlikely winner. A proponent of term limits who decried career politicians, he said he would only serve for three terms and refused to seek re-election in 2001. In 2004, not thrilled with the Republicans vying for an open Senate seat, he entered the race. He served from 2005 until 2015. He ended his second term two years early after his prostate cancer, for which he was treated in 2011, returned — though he insisted his health was not why he stepped down. This was Coburn’s fourth bout with cancer; he also had melanoma in 1975 and colon cancer in 2003. In one of his last speeches on the Senate floor, Coburn defended the sometimes lonely crusade that defined his political career. “The most important number in the Senate is one,” Coburn said. “One senator. That’s how it was set up. That’s how our founders designed it. And with that comes tremendous amounts of responsibility, because the Senate has a set of rules — or at least, did — that gives each individual member the power to advance, change, or stop legislation.” Coburn is survived by his wife, three daughters, and nine grandchildren.
NJ gov slams 47-person 'corona party' after earlier warning against gatherings: 'This is not a game'
You don’t have a right to party in New Jersey, according to Democratic Gov. Phil Murphy – at least during the deadly coronavirus pandemic.
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LAPD preparing scenarios in which many officers are out sick from coronavirus
So far, 22 people who work for the Los Angeles Police Department have tested positive for the coronavirus.
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Coronavirus Tales: Delivery driver has sweet connections with customers
With restaurants open only for delivery and take-out, delivery services are keeping New Yorkers fed. DoorDash driver D’Shea Grant, who is 41 and lives in Queens, has seen the crisis bring out the best in people. I deliver meals in Brooklyn and Queens, and I am logging more miles than ever. Since this all started,...
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New York gets hospital ship, possible quarantine
US President Donald Trump floated the idea of a quarantine as early as Saturday affecting residents of New York, New Jersey and Connecticut for a short time to stop the spread of coronavirus from reaching states with fewer infections. (March 28)       
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The coronavirus may hit rural America later — and harder 
Downtown Fairbanks, Alaska along Second Avenue on March 27, just before the state government announced a shelter-in-place order and nonessential travel ban within the state. | Sean McDermott for Vox Rural communities “tend to be older, with more chronic illness,” making people more at risk of severe Covid-19. FAIRBANKS, Alaska — Early this week, Kodiak Island, part of an archipelago in southwest Alaska, issued a “hunker down” proclamation, asking residents to stay at home as much as possible. In the Covid-19 pandemic, the remote island, known for its brown bear population, might seem well-positioned — travel on or off the island is limited to the water or air. But Elise Pletnikoff, a family physician and the medical director of the Kodiak Area Native Association, says the same physical remoteness which may help protect rural communities from infection will become a liability if — and, more likely, when — the novel coronavirus arrives. “Our capacity will be the limiting factor,” she says, “meaning not just equipment, but also staff.” Her organization provides care for 5,000 patients on Kodiak; while there is a hospital on the island, it has limited resources for critical care and usually flies patients needing that kind of medical attention to Anchorage. But Pletnikoff says when Covid-19 cases surge, “we’re worried about how busy everyone will be.” Many small communities around the United States don’t have a full-time doctor — and in Alaska, many aren’t connected by road. Instead, they rely on community health aides, a physician who visits a few days out of the month, and either commercial or medevac flights to larger urban centers during emergencies. Already because of the outbreak, health workers are forced to disrupt this limited care even further, transitioning to telemedicine when possible. “We’ve stopped traveling to remote villages to reduce exposure,” Pletnikoff says, and staff currently in each village are staying, “until … we don’t know when.” Even though small towns like these may be thousands of miles from Covid-19 hotspots like New York City and New Orleans, there’s good reason for the 60 million Americans in rural areas to worry. A new map of confirmed cases and deaths nationwide from the University of Chicago’s Center for Spatial Data Science shows a disturbing trend: University of Chicago’s Center for Spatial Data Science This US Covid-19 Atlas shows growing outbreaks of the coronavirus in rural areas. While New York state still has the highest per capita rate — 1,995 cases per million people as of March 26 — there are also significant clusters of Covid-19 in rural areas in the Midwest and South, including Arkansas, Mississippi, Georgia, and South Carolina. Every US Health and Human Services region also has shown a sharp uptick in non-flu-related influenza-type illness. On Friday, Alaska reported 85 cases and its first Covid-19-related death. Shana Theobald, another doctor on Kodiak Island, explains the grim calculus for her state: Given that experts from the CDC estimate 40 to 70 percent of the state’s 737,500 people may eventually contract Covid-19, at least 295,000 Alaskans could get sick. Based on initial reports, 20 percent, or 59,000 people, will need hospital care. Alaska only has 1,500 general hospital beds. And even if as few as five percent of Covid-19 patients become critically ill (a conservative estimate), that’s a minimum of 14,750 people needing ICU beds. And Theobald estimates that Alaska only has around 200. If that many people get sick over the next one to three months, only one in 25 people who need intensive care will be able to get it. Even if you halved the number of Alaskans infected with Covid-19 to 20 percent, the system will still be over capacity — by thousands of people. It’s these kinds of equations that make epidemiologists particularly concerned about rural America. “If we believe that the way seasonal flu spreads through the country is likely similar to Covid-19, the rural eruptions tend to be later and briefer, but more impactful than in big urban areas,” said Roger Ray, a retired neurologist, physician executive, and physician consulting director with The Chartis Group. Sean McDermott for Vox A moose-antler arch along the Chena River in downtown Fairbanks, on March 27, 2020. Far apart, but far from safe Remote Alaska is an extreme example of rural health care, but even in the state’s comparatively large urban centers — like Fairbanks, the second largest city— physicians are worried. “Today I’ve been at the office for 12 hours on the phone or video conferencing, doing everything I can to keep my patients from the ER or urgent care clinics,” says Jenny Lessner, a family doctor in Fairbanks. She’s had many patients she suspects of having Covid-19, but says due to limited testing availability, “we have no idea how many people in this town have Covid right now. We’re walking in the dark.” In what has become a familiar refrain, Lessner’s clinic currently has four doctors, 16 masks, and thousands of patients. She and other doctors in the state recently put together a petition asking the state to institute a travel ban and shelter in place order. On Friday, state officials ordered shelter at home, closure of all nonessential businesses, and a ban on nonessential travel between communities in Alaska, effective Saturday. In rural areas, social distancing can be the normal way of life, delaying the arrival and spread of disease. But once people get sick, “I am absolutely concerned about capacity,” says Ray. Overall, rural communities “tend to be older, with more chronic illness,” he adds, making people more at risk of severe disease. This includes millions of Americans with heart disease, diabetes, and asthma — all risk factors for the novel coronavirus. I wouldn’t leave people in rural communities thinking they’re safe Various models predict slightly different rates of Covid-19 transmission, but Robert Siegel, a professor of immunology and microbiology at Stanford University, says they all “dramatically illustrate the importance of intervening early and hard, in terms of saving lives.” Density of population has been closely linked to transmission, he says, “but I wouldn’t leave people in rural communities thinking they’re safe.” He adds, “If they don’t do anything, the virus will arrive there — it might arrive slower, but it will arrive.” You can see detailed projects for transmission rates around the country at CovidActNow, a prediction tool created by a team of data scientists, epidemiologists, and public health officials to help people understand how Covid-19 will affect their area. It predicts that, with the current amount of limited action some states are taking to curtail transmission, Kansas will have more sick people than hospital beds by April 16 and Oklahoma by April 19 — in short, even states with low population densities will soon be overwhelmed. Leo Nissola, an immunologist at the Parker Institute for Cancer Immunotherapy, who was not involved in the design, says, “When I look at that model, I trust the data and the source.” Nissola agrees rural communities might not ever see rates of Covid-19 as high as New York City, but is concerned about their underlying vulnerabilities. More than half of counties in America have no hospital ICU beds, posing a particular risk for the more than 7 million people over the age of 60 living in those places, who are at higher risk of severe cases of Covid-19. In February, The Chartis Group released a study showing that more than 450 rural hospitals are vulnerable to closure. “If you’re vulnerable enough to risk losing the ability of making payroll, how valuable can you be to the community in crisis?” Ray asks. The delay in transmission may be longer in some places than others. Data from Johns Hopkins University suggests that rural areas with popular tourist destinations — like Blaine County, Idaho, home to Sun Valley — actually already have the highest rates of cases outside of New York City and its surrounding areas. Courtesy of Lt. Robbin Preston/Navajo Department of Corrections Sergeant Sharyl Chief sorts food with a volunteer from the Navajo Department of Corrections to send to elders and immunocompromised in the Chilchinbeto community in Arizona. “A different country”: fighting the virus on Native American reservations Ethel Branch, a former attorney general for the Navajo Nation, says that underlying inequalities in rural areas exacerbate these risks as well. “When I was growing up on the Nation as a little kid, I always felt like I lived in a different country,” she says. “A third of the Nation doesn’t have running water, a third don’t have access to electricity.” Many families live in multigenerational homes, increasing elders’ risk of infection, and risk factors like diabetes and asthma are common. The unemployment rate, before Covid-19, was 42 percent. In a pandemic, says Joseph Ravenell, a professor of population health at NYU Langone Health, “More vulnerable populations are more susceptible to having worse outcomes.” Last weekend, Branch set up a GoFundMe to buy supplies for elders who might not be able to stock up to prepare. When buying food for her mother, who lives on the reservation, she says, “I encountered shelves that were empty, really long lines. I thought about how disappointing it would be to spend so much gas money and not even be able to purchase what you need, and have to come back again” — also increasing the risk of infection. Over three-quarters of the reservation’s population have some level of food insecurity; the average resident drives three hours to buy food. Branch has, so far, raised over $162,000, which she is allocating based on risk. “We have help request forms for people to fill out so we can identify the highest risk folks,” for food distribution, she says. As of March 27, the Navajo Department of Health reports 92 positive Covid-19 cases in the Navajo Nation. But there, as elsewhere, testing has been limited. Health clinics and hospitals are being forced to turn patients without Covid-19 away, or delay their treatment The ability to manage crises is also unequal in cities versus rural areas, says Aaron Clark-Ginsberg, a qualitative social scientist who researches disasters at RAND Corporation, the nonpartisan policy research group. Big urban health departments usually have teams whose full-time job is to manage large incidents, but “in rural cases, it’s often a part-time person already pressed and doing other things,” he says. Many health departments do have disaster plans on file, Clark-Ginsberg says, but “they can be fantasy documents, paper plans that don’t necessarily match the capacity, and that first responders wouldn’t be able to put into practice.” And the surge of Covid-19 patients is not the only health impact the pandemic will have. “Inevitably, the health care system will have to shift toward Covid-19 patients, and there will be knock-on effects,” Clark-Ginsberg says. In Fairbanks, Lessner says Covid-19 has already hurt patients with other health concerns. She describes helping the spouse of a patient with very advanced Alzheimer’s find an assisted living facility. Over the past several months, she says, “we’ve been calling, trying to figure out Medicaid, and we finally had a plan with all the boxes checked.” But this week, the facility announced it was no longer admitting new patients because of Covid-19. “Now this poor guy is at home with his spouse, who we knew was too much for him to care for,” she says. “Instead of a full-time care facility, he’s just got me on the phone.” She pauses. “What do I tell him?” She adds that her clinic has rescheduled or delayed important preventive care for other health conditions, like mammograms, colonoscopies, screening bloodwork, and more. “None of these screenings are considered urgent but they are critical, particularly from a public health perspective, to prevent or detect cancers, high cholesterol, diabetes, etc.,” she says. On Kodiak, Pletnikoff says she’s very worried about hospital physicians “needing to care for newborns in addition to any surge of Covid-19 patients,” as the same hospital staff there manages standard inpatients, ICU patients, and OB and pediatric patients. Sean McDermott for Vox Traffic along Cushman Street in Fairbanks. Alaska’s first death from the novel coronavirus was reported Friday. There’s no denying that currently, the projections all look pretty grim. But one thing the CovidActNow model illustrates is the power of social distancing measures. Already, rural communities have been taking steps to minimize their risk. Checkpoints for the annual Iditarod dog sled race in Alaska, normally held in rural villages along the route, moved to remote locations outside of town to discourage visitors — and potential infection sources. Many people traveling with the race usually sleep in local schools, says Sarah Manriquez, a photographer who traveled with the dog teams to document the race this March — schools some of the villages also decided to close. Prior to Friday’s shelter-in-place order, Alaska’s hospitals were predicted to be overloaded by May 14 — spiking to almost six times the hospital capacity by early June. Three months of shelter-in-place would move that date beyond the model’s range of prediction. Any extra time that social distancing buys is critical to manufacture or procure much-needed supplies, or innovate new solutions. As Craig Smith, the surgeon-in-chief of Columbia University, wrote in a memo sent last week to his colleagues, “The next month or two is a horror to imagine if we’re underestimating the threat. So what can we do? Load the sled, check the traces, feed Balto, and mush on. Our cargo must reach Nome.” Lois Parshley is a freelance investigative journalist and the 2019-2020 Snedden Chair of Journalism at the University of Alaska Fairbanks. Follow her Covid-19 reporting on Twitter @loisparshley.
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