Tiger at New York’s Bronx Zoo tests positive for coronavirus

By Nathan Layne

(Reuters) – A tiger at the Bronx Zoo in New York City has tested positive for the respiratory disease caused by the novel coronavirus, in the first known case of a human infecting an animal and making it sick, the zoo’s chief veterinarian said on Sunday.

Nadia, the 4-year-old Malayan tiger that tested positive, was screened for the COVID-19 disease after developing a dry cough along with three other tigers and three lions, the Wildlife Conservation Society, which manages the zoo, said in a statement. All of the cats are expected to recover, it said.

The virus that causes COVID-19 is believed to have spread from animals to humans, and a handful of animals have tested positive in Hong Kong.

But officials believe this is a unique case because Nadia became sick after exposure to an asymptomatic zoo employee, Paul Calle, chief veterinarian at the Bronx Zoo, told Reuters. Calle said they did not know which employee infected the tiger.

“This is the first time that any of us know of anywhere in the world that a person infected the animal and the animal got sick,” Calle said, adding that they planned to share the findings with other zoos and institutions. “Hopefully we will all have a better understanding as a result.”

While the other tigers and lions were also exhibiting symptoms, the zoo decided to test only Nadia because she was the sickest and had started to lose her appetite, and they did not want to subject all the cats to anesthesia, Calle said.

“The tigers and lions weren’t terribly sick,” he said.

Nadia underwent X-rays, an ultrasound and blood tests to try to figure out what was ailing her. They decided to test for COVID-19 given the surge in cases in New York City, the epicenter of the outbreak in the United States.

The first tiger at the zoo, which has been shut since mid-March, began showing signs of illness on March 27, according to the U.S. Department of Agriculture National Veterinary Services Laboratories, which performed the test.

(Reporting by Nathan Layne in Wilton, Connecticut; Editing by Daniel Wallis)

Your COVID-19 questions, answered

There is a lot of misinformation circulating about the coronavirus, so we took to Instagram, Twitter and Reddit to see what questions have been bugging you, our readers.Below are answers from several healthcare experts who have been following the outbreak. Please note that there is much we still don’t know about the new virus, and you should reach out to your own healthcare provider with any personal health concerns.

LIVING UNDER LOCKDOWN

What are good ways to maintain your mental health?

I would recommend the following:

1. Maintain a normal schedule if possible

2. Exercise (go for walk or run, do an online video)

3. Maintain social connections via FaceTime, Skype or phone calls

4. Limit time spent on the Internet and connected to the news

5. Have “virtual” dates with family and friends.

— Dr. Krutika Kuppalli, infectious disease researcher

Here’s how it’s affecting young minds  and how millennials are adjusting to isolation.

How long will the U.S. really have to be on lockdown to successfully flatten the curve?

We’re still learning on a daily basis what the case count looks like in the U.S. We also need to consider that there could be a resurgence of cases once public health measures are loosened up.

— Dr. Krutika Kuppalli, infectious disease researcher

I defer to the epidemiologists here, but National Institute of Allergy and Infectious Diseases Director Anthony Fauci recently said that he’s confident in a range of four to six weeks to 3 months.

— Dr. Angela Rasmussen, virologist at Columbia University

Do I actually need to wear a mask?

The WHO advises that if you’re healthy, you need to wear a mask only when caring for an infected person or if you’re coughing, sneezing or showing symptoms. More here

TRANSMISSION

Is it fair to assume every American will be exposed to the coronavirus this year?

No, which is one of the reasons we have these current public health measures in place. We are trying to prevent further onward transmission of the disease.

— Dr. Krutika Kuppalli, infectious disease researcher

Almost 100,000 cases have been reported in the U.S. and its territories, according to a Reuters tally of state and local government sources, mapped .

Is the coronavirus airborne in normal settings and if so, for how long?

According to our knowledge, it does not stay in the air in normal settings. Most evidence directs us to droplet transmission. Airborne precautions are required only for healthcare workers when undertaking aerosol producing procedures such as bronchoscopy/intubation.

— Dr. Muge Cevik, infectious diseases researcher at the University of St. Andrews

Is there potential exposure in elevators?

Coronavirus guidelines by the CDC are based on the fact that the virus is transmitted primarily via respiratory droplets, like a cough or sneeze. In droplet form, it’s airborne for a few seconds, but is only able to travel a short distance. In elevators, social distancing measures should be implemented with a max number of people inside at a time.

— Infectious Diseases Society of America

How worried should we be about fomite transmission?

We are still learning about fomite transmission. We know from an article in the New England Journal of Medicine that the virus is viable up to four hours on copper, 24 hours on cardboard, and two to three days on plastic and stainless steel.

— Dr. Krutika Kuppalli, infectious disease researcher

Can you spread the virus if you’re asymptomatic?

Yes, but it isn’t the main driver of transmission. This is also why it is extremely important to ensure you have washed hands before touching your face.

— Dr. Krutika Kuppalli, infectious disease researcher

What’s the typical timeline of symptoms?

From the time of exposure to symptoms it may take on average three to six days, which may be longer/shorter in some patients. Typically it starts with fever, dry cough, myalgia and flu-like illness, then progresses to shortness of breath and pneumonia in some patients.

— Dr. Muge Cevik, infectious diseases researcher at the University of St. Andrews

Is it possible that an infected person only has a mild cold before recovering?

Yes. The most common symptoms a person will have are fever, dry cough and muscle aches/fatigue.

— Dr. Krutika Kuppalli, infectious disease researcher

Should people be more concerned about eye protection?

We certainly use face shields to protect our eyes when in contact with patients.

— Dr. Isaac Bogoch, infectious disease researcher and scientist

Does getting vaccines increase your risk?

Getting any vaccines would not increase your risk for COVID-19. We’re recommending getting needed vaccines. We want people to get their influenza vaccines so they don’t end up with the flu and in the hospital.

— Dr. Krutika Kuppalli, infectious disease researcher

Do people have a natural immunity to this virus?

I am not aware of “natural immunity” since it is a new virus. We might find as serology testing is rolled out that people have been exposed and developed antibodies without having symptoms.

— Dr. Krutika Kuppalli, infectious disease researcher

Is it possible to get reinfected?

We’re not sure how immunity works or how long it lasts. The best guess is that people who are infected are likely to be protected over the short-to-medium term. We don’t know about longer yet.

— Dr. Eric Rubin, editor-in-chief, New England Journal of Medicine

There are a handful of cases of possible “reinfection” in recovered patients. But most scientists believe those are more likely to have been relapses.

TREATMENT

Is there a team working on an antibody test for the virus? If so, when might it be ready?

There are teams working on serological tests. Rolling out on a population scale will be an essential part of the long-term answer, but we need to get through the next month.

— Bill Hanage, associate professor at the Harvard T. H. Chan School of Public Health

When will a vaccine be ready?

Vaccine trials may take as long as 12 months. There are multiple clinical trials looking at different treatment options, but we currently don’t know whether this combination is effective and safe for patients.

— Dr. Muge Cevik, infectious diseases researcher at the University of St. Andrews

Scientists in Singapore are trying to fast-track the process.

What impact will warmer weather have on the spread?

I have yet to see convincing evidence on this, one way or the other. We are all hoping transmission will slow down with warmer weather in the northern hemisphere, and that warmer countries will be spared the worst. Not enough data yet to conclude.

— Dr. Suerie Moon, director of research at the Global Health Centre

Here’s what we know about seasonal features of disease outbreaks.

I’ve seen several news sources report that experts from Johns Hopkins and other medical colleges are saying the virus can become less deadly as it spreads. Can you explain this phenomenon?

Yes, one theory for why many viruses become weaker over time is that viruses that kill their host don’t get very far. This pattern of weakening is seen with flu viruses, and many others, but not all. We’re not there yet with the current outbreak. Whether it’s weaker three or 10 years from now doesn’t change anything about today’s situation.

— Christine Soares, medical editor at Reuters

(Reporting by Lauren Young, Jenna Zucker, Beatrix Lockwood, Nancy Lapid, Christine Soares)

Loss of taste and smell key COVID-19 symptoms, app study finds

By Kate Kelland

LONDON (Reuters) – Losing your sense of smell and taste may be the best way to tell if you have COVID-19, according to a study of data collected via a symptom tracker app developed by scientists in Britain and the United States to help monitor the coronavirus pandemic.

Almost 60% of patients who were subsequently confirmed as positive for COVID-19 had reported losing their sense of smell and taste, data analysed by the researchers showed.

That compared with 18% of those who tested negative.

These results, which were posted online but not peer-reviewed, were much stronger in predicting a positive COVID-19 diagnosis than self-reported fever, researchers at King’s College London said.

The app, which the researchers say could help slow the outbreak and identify more swiftly those at risk of contracting COVID-19, can be downloaded via the URL covid.joinzoe.com.

If enough people participate in sharing their symptoms, the scientists said, the app could also provide healthcare systems with critically valuable information.

“This app-based study is a way to find out where the COVID-19 hot spots are, new symptoms to look out for, and might be used as a planning tool to target quarantines, send ventilators and provide real-time data to plan for future outbreaks,” said Andrew Chan, a professor of medicine at Harvard Medical School in the United States who is co-leading the study.

Of 1.5 million app users between March 24 and March 29, 26% reported one or more symptoms through the app. Of these, 1,702 also reported having been tested for COVID-19, with 579 positive results and 1,123 negative results.

MATHEMATICAL MODEL

Using all the data collected, the research team developed a mathematical model to identify which combination of symptoms – ranging from loss of smell and taste, to fever, persistent cough, fatigue, diarrhoea, abdominal pain and loss of appetite -was most accurate in predicting COVID-19 infection.

“When combined with other symptoms, people with loss of smell and taste appear to be three times more likely to have contracted COVID-19 according to our data, and should therefore self-isolate for seven days to reduce the spread of the disease,” said Tim Spector, a King’s professor who led the study.

Trish Greenhalgh, a professor of primary care health sciences at Britain’s Oxford University and who is not involved in the study, said it was the first to demonstrate scientifically and in a large population sample that loss of smell is a characteristic feature of COVID-19.

Spector’s team applied their findings to the more than 400,000 people reporting symptoms via the app who had not yet had a COVID-19 test, and found that almost 13% of them are likely to be infected.

This would suggest that some 50,000 people in Britain may have as yet unconfirmed COVID-19 infections, Spector said.

(Reporting by Kate Kelland, editing by Grant McCool and Gareth Jones)

Residents take coronavirus surveillance into their own hands

By Thin Lei Win and Beh Lih Yi

ROME/KUALA LUMPUR (Thomson Reuters Foundation) – A week after Malaysia ordered a partial lockdown to slow the spread of the coronavirus, construction supervisor Hafi Nazhan saw residents in his affluent Kuala Lumpur neighbourhood jogging outside.

He took photos of people flouting the stay-at-home order and published them on Twitter, receiving hundreds of shares. Hafi’s followers informed the police, who subsequently arrested 11 joggers in his neighbourhood.

They were charged with violating the movement restriction order and each fined 1,000 ringgit ($230) in court.

“I was upset some people did not take this stay-at-home order seriously. These are well-educated people,” Hafi, 26, told the Thomson Reuters Foundation, adding that police were spurred into taking action after his tweets went viral.

As governments around the world urge citizens to stay indoors to contain the deadly virus, concerned communities are taking surveillance matters into their own hands, reporting alleged breaches of quarantine and questioning anyone they deem suspicious.

The respiratory disease – which emerged in China late last year – has infected roughly 1.2 million people and killed about 65,000, according to a global tally by Johns Hopkins University.

In Singapore, a Facebook post by a man sharing a photo of himself enjoying a bowl of bak kut teh – pork rib soup – in a restaurant when he should be self-quarantining at home was so widely circulated that officials stepped in.

Singapore’s law minister ordered an investigation and the immigration authorities told local media the man was likely to be charged, although they did not respond to requests seeking comment.

In New Zealand, which is under a one-month shutdown, a police website set up to allow residents to report their neighbours who break isolation rules crashed hours after going live.

The website has received about 14,000 reports in less than a week since its March 29 launch, New Zealand police said in an email. They reportedly include people playing frisbee and holding parties.

In Italy, which has been under lockdown for weeks, fraying tempers have led to people being insulted from balconies or photographed and put on social media.

In Spain, locals have also begun posting videos of people going for a run, walking in the park, riding a bike – all prohibited activities – on social media.

HEALTH VS. PRIVACY

Such tip-offs and videos have sparked a debate over digital ethics with some arguing that normal privacy rules do not apply in a health emergency because the information is in the public interest.

“When we are all threatened with the risk of catching a lethal, incurable disease I see no reason why individuals should not report their legitimate concerns to the authorities,” said David Watts, former privacy commissioner for Australia’s Victoria state.

“There is not much point having privacy rights when you are dead,” added Watts, who now teaches information law and policy at Melbourne-based La Trobe University.

For David Lindsay, law professor at the University of Technology Sydney, privacy is “not an absolute right and must always be balanced against other rights and interests”.

“The balance struck obviously depends upon circumstances, and a global pandemic is an extreme event,” he said.

Still, both Watts and Lindsay said the balance between privacy and surveillance should be reset when the pandemic is over.

Others, like Joseph Cannataci, the United Nations special rapporteur on the right to privacy, fear surveillance measures ranging from facial recognition to phone tracking could outlast the current crisis.

“Dictatorships and authoritarian societies often start in the face of a threat,” he told the Thomson Reuters Foundation this week.

STIGMA AND FEAR

Community surveillance could also end up being used “in a malicious way, particularly to replicate prejudice or bias”, warned Raman Jit Singh Chima, Asia policy director at digital rights group Access Now.

“Often the people who might be reported on will be the least privileged, or might be belong to, in the case of India, lower caste communities or people who have to work outside,” he said.

Human rights experts worry that the tens of thousands of migrant workers who returned to Myanmar after a shutdown in neighbouring Thailand’s left them jobless will come under intense scrutiny.

In a village in central Myanmar, locals would not allow a young man who returned from Thailand to stay in his home, said Khin Zaw Win, a Yangon-based political analyst.

Foreigners have also been targeted on social media, with a Facebook video showing agitated residents in a neighbourhood in Mandalay, Myanmar’s second largest city, who described barging into a building after seeing Chinese visitors coughing.

Filmed Tuesday night, it has received more than 1 million views and 10,000 shares.

“The public is being very sensitive at the moment … when the key in this kind of situation is that you should help each other,” said Khin Zaw Win.

“Some of it have to do with the narrative that (coronavirus) was brought here from abroad. I think the panic is even scarier than the virus,” he added.

Myanmar so far has about 20 confirmed cases of the virus, with the health ministry warning of a “major outbreak” after the return of migrant workers from Thailand.

Officials have also reminded the public that failure to report people suspected of being infected could lead to jail sentences of up to a month.

“From the point of view of public health, surveillance and tracking is essential. The faster and the more effectively you can enforce it, the better,” said Sid Naing, Myanmar country director for health charity Marie Stopes International.

“But it should not be done in a way that breeds hatred and fear. It should be done based on understanding and support,” he said.

“At the moment, the state cannot provide full surveillance so people started doing it themselves because they are terrified … but there are stigma and discrimination behind the fear and those are the problems.”

(Reporting By Thin Lei Win @thinink and Beh Lih Yi @behlihyi, additional reporting from Sophie Davies in Barcelona, editing by Zoe Tabary. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)

Factbox: Latest on the spread of the coronavirus around the world

(Reuters) – Global cases of the new coronavirus have passed 1 million and more than 64,000 people have died, a Reuters tally showed on Sunday, in a pandemic that has hammered the world economy.

DEATHS AND INFECTIONS

* Reuters tally of reported cases and deaths.

* For an interactive graphic tracking the global spread, open here.

* U.S.-focused tracker with state-by-state and county map, open here.

EUROPE

* Parisians have been warned not to succumb to the tempting sunny spring weather and to remain indoors to help fight the spread of the coronavirus that has killed 7,560 in France.

* Italy’s health minister outlined plans on Sunday for broader testing and beefed-up health services as part of a package of measures that would follow a future easing of the country’s lockdown.

* Britain will have to impose further restrictions on outdoor exercise if people flout lockdown rules, Health Secretary Matt Hancock said.

* Queen Elizabeth will call on Britons to take on the challenge and disruption caused by the outbreak with good-humored resolve when she makes an extremely rare address to rally the nation on Sunday.

* The rate of new infections and deaths in Spain slowed again on Sunday as the country, suffering from one of the world’s worst outbreaks of the pandemic, began its fourth week under a near-total lockdown.

* Pope Francis marked a surreal Palm Sunday in an empty St. Peter’s Basilica, urging people living through the pandemic not to be so concerned with what they lack but how they can ease the suffering of others.

AMERICAS

* President Donald Trump told Americans to brace for a big spike in coronavirus fatalities in the coming days, as the country faces what he called the toughest two weeks of the pandemic.

* More than 306,000 people have tested positive in the United States and over 8,300 have died, according to a Reuters tally.

* The number of crew on the USS Theodore Roosevelt aircraft carrier who have tested positive for the coronavirus has risen 13% in the past 24 hours to 155, the Navy said on Saturday, in the wake of the firing of the carrier’s captain.

* Brazil’s lower house of Congress approved a constitutional amendment for a “war budget” to separate coronavirus-related spending from the government’s main budget and shield the economy as the country surpassed 10,000 confirmed cases.

ASIA

* Mainland China reported 30 new coronavirus cases on Saturday, up from 19 a day earlier as the number of cases involving travelers from abroad as well as local transmissions increased, highlighting the difficulty in stamping out the outbreak.

* India is restricting the export of most diagnostic testing kits, as coronavirus cases topped 3,350 on Sunday. The country has imposed a three-week nationwide lockdown to slow the spread of the disease.

* Australian health officials said they were cautiously optimistic about the slowing spread of the coronavirus but warned social distancing restrictions are to stay in place for months.

MIDDLE EAST AND AFRICA

* Dubai imposed a two-week lockdown and Saudi Arabia sealed off parts of the Red Sea city of Jeddah as Gulf states tightened measures in big cities to contain the spread of the coronavirus.

* Egyptian President Abdel Fattah al-Sisi postponed the launch of mega-projects including the Grand Egyptian Museum and moving civil servants to a planned new capital city to 2021 from 2020 due to the coronavirus outbreak, the presidency said.

ECONOMIC FALLOUT

* The job losses suffered in March as the U.S. economy shut down were widespread but still were disproportionately felt in a handful of employment sectors and by women, the young and the less educated.

* The pandemic has brought the global economy to a standstill and plunged the world into a recession that will be “way worse” than the global financial crisis a decade ago, the head of the International Monetary Fund said on Friday.

* Global stock markets sank on Friday following more signs that the pandemic would take a massive toll on economic growth. [MKTS/GLOB]

(Compiled by Frances Kerry)

U.S. braces for ‘hardest, saddest’ week as virus deaths surpass 9,000

(Reuters) – The United States enters one of the most critical weeks so far in the coronavirus crisis with the death toll exploding in New York, Michigan and Louisiana and some governors calling for a national order to stay at home.

New York, the hardest-hit state, reported on Sunday that there were nearly 600 new deaths for a total of 4,159 deaths and 122,000 total cases.

Bodies of victims of COVID-19, the flu-like respiratory disease caused by the coronavirus, were stacked in bright orange bags inside a makeshift morgue outside the Wyckoff Heights Medical Center in Brooklyn, according to photos provided to Reuters.

New York Governor Andrew Cuomo said new hospitalizations had fallen by 50% and, for the first time in at least a week, deaths had fallen slightly from the prior day, when they rose by 630.

But he cautioned that it was not yet clear whether the crisis in the state was reaching a plateau.

“The coronavirus is truly vicious and effective at what the virus does,” Cuomo told a daily briefing. “It’s an effective killer.”

U.S. Surgeon General Jerome Adams warned on Fox News Sunday that hard times were ahead but “there is a light at the end of the tunnel if everyone does their part for the next 30 days.”

“This is going to be the hardest and the saddest week of most Americans’ lives, quite frankly. This is going to be our Pearl Harbor moment, our 9/11 moment, only it’s not going to be localized,” he said. “It’s going to be happening all over the country. And I want America to understand that.”

Places such as Pennsylvania, Colorado and Washington, D.C. are starting to see rising deaths. The White House coronavirus task force warned this is not the time to go to the grocery store or other public places.

Most states have ordered residents to stay home except for essential trips to slow the spread of the virus in the United States where over 321,000 people have tested positive and more than 9,100 have died, according to a Reuters tally.

However, a few churches were holding large gatherings on Palm Sunday, the beginning of Holy Week in Christian churches.

“We’re defying the rules because the commandment of God is to spread the Gospel,” said Tony Spell, pastor at the Life Tabernacle megachurch in a suburb of Baton Rouge, Louisiana. He has defied state orders against assembling in large groups and has already been hit with six misdemeanors.

Louisiana has become a hot spot for the virus, on Saturday reporting a jump in deaths to 409 and more than 12,000 cases.

Governor John Bel Edwards told CNN on Sunday that the state could run out of ventilators by Thursday.

White House medical experts have forecast that between 100,000 to 240,000 Americans could be killed in the pandemic, even if sweeping orders to stay home are followed.

President Donald Trump warned on Saturday that there were “very horrendous” days ahead.

Still, Wisconsin’s Republican-controlled legislature decided to hold in-person voting for its presidential primary on Tuesday, when Democratic-led Colorado will also go ahead with local elections.

Washington state Governor Jay Inslee, a Democrat, whose state recorded the country’s first confirmed COVID-19 infection but has since seen cases flatten after early action to shutter activity, said if other states do not also impose strict measures, the virus will simply circulate.

“It would be good to have a national stay-at-home order,” he told NBC News’ “Meet the Press” program. “Even if Washington gets on top of this fully, if another state doesn’t, it could come back and come across our borders two months from now.”

Republican Arkansas Governor Asa Hutchinson, however, defended his refusal to order statewide restrictions, saying the situation was being watched closely and that his more “targeted approach” was still slowing the spread of the virus.

“We will do more as we need to,” he told NBC.

Kate Lynn Blatt, 38, a property manager from rural Pottsville, Pennsylvania, said she was astounded that her state’s governor, Tom Wolf, waited until April 1 to issue a statewide stay-at-home order.

“We were shocked. I can’t believe Trump hasn’t issued a nationwide order and I still can’t believe there are states that are still open,” Blatt said.

(Reporting by Susan Heavey and Amanda Becker in Washington and Daniel Trotta; Writing by Lisa Shumaker; Editing by Daniel Wallis)

Latest on the spread of the coronavirus around the world

(Reuters) – Global cases of the new coronavirus have shot past 1 million with more than 54,000 fatalities, a Reuters tally showed on Friday, as death tolls soared in the United States and western Europe while the world economy nosedived.

DEATHS AND INFECTIONS

** Reported cases have surpassed 1.03 million globally and nearly 54,500 people have died, according to a Reuters tally.

** For an interactive graphic tracking the global spread, open https://tmsnrt.rs/3aIRuz7 in an external browser.

** U.S.-focused tracker with state-by-state and county map, open https://tmsnrt.rs/2w7hX9T in an external browser.

EUROPE

** Spain overtook Italy for the first time for the number of confirmed cases, but the overnight death toll fell from the previous day.

** Hospitals in Catalonia, Spain’s second worst-hit region, are at “maximum stress”, the regional leader said.

** Switzerland’s government boosted its powers to force firms to make more critical medical supplies.

** Scientific advisers to the Italian government said a reliable antibody blood test to find out who has already had the virus would give a better picture of Italy’s epidemic and could possibly be identified within days.

** The southerly region of Chechnya became the first in Russia to introduce a night curfew.

** Cases in Ireland’s nursing homes have increased four-fold in the space of a week.

** Britain’s prime minister, Boris Johnson, said on Friday he was remaining in isolation with mild symptoms, seven days after he was confirmed to be infected. Queen Elizabeth will make an extremely rare address to the nation on Sunday.

** A new hospital opened in London to provide thousands of extra beds, after being installed in a huge conference centre in just nine days. Britain’s health minister said the curve of deaths could peak on Easter Sunday.

** French high-school students have had their graduation exam, the “baccalaureat”, cancelled for first time since it was instituted two centuries ago under Napoleon.

** Poland is working on a smartphone app to help trace sufferers and mitigate the outbreak.

** Latvia reported its first death.

AMERICAS

** U.S. House Speaker Pelosi said that $350 billion in already-passed coronavirus spending was not enough for small businesses, and she wants more money in next bill being developed now in the Democrat-run House.

** New York state suffered its deadliest single day with 562 deaths, Governor Andrew Cuomo said.

** New York City hospitals and morgues struggled to treat the severely ill and bury the dead, and San Francisco secured 4,500 rooms in its now-empty hotels for the homeless.

** Two Dutch ocean liners stuck at sea due to an onboard outbreak were allowed to dock in Florida.

** Canada has recorded almost 12,000 cases and the daily death toll jumped by almost 20%.

** Brazil faces a tense few weeks, with supplies of medical and protective equipment running low and shipments from China not expected to arrive for another month.

** Mexico’s deputy health minister said there were no plans for border closures, as Mexico’s death toll jumped to 50 from 37.

ASIA AND THE PACIFIC

** The top official in the central Chinese city of Wuhan, where the virus was first identified, warned residents to stay vigilant and avoid going out, even as the latest data showed a decline in new cases in mainland China and no new infections in the city.

** Confusion reigned in some Hong Kong pubs and bars after authorities ordered a two-week closure, with many food outlets uncertain if the latest restrictions applied to them.

** The U.S. sounded the alarm about a surge in cases in Japan, adding to a chorus of prominent domestic voices who have called for more decisive action.

** Taiwan and the United States discussed how to get “closer coordination” between the island and the World Health Organization during the outbreak, drawing a rebuke from China.

** Kyrgyzstan reported its first death.

MIDDLE EAST AND AFRICA

** More than 2 million workers in Turkey have lost their jobs due to containment measures, the main opposition party said, as the government moved towards tightening curbs on movement.

** Israel locked down an ultra-Orthodox Jewish town badly affected by the virus.

** A United Nations official voiced concern over prisoners after reports of unrest in jails in countries including Iran, one of the worst hit in the world.

** Flight restrictions are hampering efforts to wipe out locust swarms threatening to devastate more crops in eastern Africa, the U.N. Food and Agriculture Organization said.

** Coronavirus has infected more than 3,000 people in sub-Saharan Africa and killed about 100, prompting some of the world’s poorest countries to shut land and sea borders.

** Norway called for more money to help the Palestinian Territories get through the pandemic.

ECONOMIC FALLOUT

** Global stock markets sank following more signs that the COVID-19 pandemic would take a massive toll on economic growth, while oil prices continued to rally on hopes of a cut to global supply.

** The global recession that economists polled by Reuters say is under way due to the coronavirus pandemic will be deeper than thought a few weeks ago, although most are clinging to hopes of a swift rebound.

** The impact of the coronavirus, and for some the oil market crash, are putting at least half a dozen countries at risk of having their debt downgraded to a ‘junk’ rating.

** The U.S. economy shed 701,000 jobs in March, ending a historic 113 straight months of employment growth.

** The Swiss government is doubling the size of its emergency loan scheme to $41 billion after being flooded by requests for help from businesses.

** Sri Lanka’s central bank cut its benchmark interest rates by a further 25 basis points, its second such reduction in three weeks.

** The head of Britain’s Society of Motor Manufacturers and Traders urged the government to support car suppliers, some of which were set to run out of money within weeks.

(Compiled by Sarah Morland and Milla Nissi; Editing by Tomasz Janowski, William Maclean, Sriraj Kalluvila, Nick Macfie and Kevin Liffey)

New York braces for COVID-19 onslaught as state’s dead nears 9/11 toll

By Maria Caspani and Nathan Layne

NEW YORK (Reuters) – New York state has recorded nearly 500 coronavirus-related deaths in a single day, bringing the statewide total to nearly 3,000, or about the same number killed in the Sept. 11, 2001 attacks, Governor Andrew Cuomo said on Friday.

New York City has mere days to prepare for the worst of the novel coronavirus onslaught, the city’s mayor Bill de Blasio said and pleaded for federal government help to end a shortage of medical staff and ventilators.

The city has suffered more than a quarter of U.S. deaths in the outbreak.

“I think somehow in Washington, there’s an assumption (that) there’s weeks to prepare,” de Blasio said on MSNBC. “There’s not weeks anymore. It is days now.”

Emergency Medical Technicians transport a patient into Bronx-Lebanon Hospital during the outbreak of the coronavirus disease (COVID-19) in the Bronx borough of New York City, New York, U.S., April 2, 2020. REUTERS/Brendan Mcdermid

New York state recorded 2,935 fatalities over 24 hours, up from 2,373 a day earlier, Cuomo said. It was the “highest single increase in the number of deaths since we started,” he said.

The Sept. 11 attacks killed nearly 3,000 people, the majority of them at New York City’s World Trade Center.

De Blasio is asking for 1,000 nurses, 150 doctors and 300 respiratory therapists as the number of COVID-19 cases in the city is expected to rise sharply next week.

New York City has yet to receive a resupply for the up to 3,000 ventilators needed by next week, de Blasio said, urging President Donald Trump to mobilize medical personnel from the U.S. military.

“They are not mobilized for action,” de Blasio, a Democrat, told WNYC radio. “The president has to give that order right now.” Trump is a Republican.

More than 25% of the 6,058 U.S. coronavirus deaths tallied by Johns Hopkins University as of Friday morning were in New York City. Infections in the United States totaling 240,000 account for about 24% of the more than 1 million cases worldwide.

“We all know New York is bad but we know the worst is yet to come,” said Naila Shereen, an internal medicine specialist who rotates through various hospitals in New York.

New statistics on Friday confirmed that hundreds of thousands of Americans had lost their jobs because of the pandemic, although economists say the real figure is far more than that because huge swathes of the U.S. economy began shutting down last month to avoid spreading the virus.

‘BLOODLETTING’

U.S. employers cut 701,000 jobs last month, ending a record 113 straight months of employment growth, the Labor Department said. In the last two weeks, nearly 10 million workers have filed for jobless benefits.

“What we are watching in real time is the greatest bloodletting in the American labor market since the Great Depression,” said Joe Brusuelas, chief economist at RSM in Austin, Texas.

While the economic pain is spread across the country, New York is bearing the brunt of the grim march of the coronavirus in terms of cases, sickness and death. The virus causes the flu-like respiratory illness COVID-19 for which there is no vaccine.

“It’s very painful. You see your friends and people you work with, they’re getting sick,” Thomas Riley, a nurse in New York City who recovered after testing positive for the coronavirus, told CNN on Friday.

He said medical staff had very little protective equipment.

“It feels like we’re in a war, we’re soldiers in a war and we’re being sent out without camouflage, without Kevlar. We have no defenses against this and they’re giving us very little,” Riley said.

Cuomo said on Thursday his state’s apex – or the worst point – of the crisis would likely be on the “shorter end” of a projected range of seven to 30 days ahead. Most of the state’s coronavirus-related hospitalizations have been in the New York City area.

There are more than 102,863 coronavirus cases in New York state, up from 92,381 a day earlier, Cuomo said.

Anthony Fauci, a doctor and leading member of Trump’s coronavirus task force, said social distancing is beginning to work even though the United States is still far from over the worst.

“There’s no doubt…the mitigation activities, the physical separation that we’re doing clearly is having a positive impact. You don’t see it dramatically yet… but there’s no doubt that’s its having an effect,” Fauci told Fox News.

“It’s going to get worse – much worse – before it gets better… but it will turn around,” said Fauci, director of the National Institute of Allergy and Infectious Diseases.

He said Americans should cover their face in public but remain isolated as much as possible, adding that face masks must be reserved for medical personnel battling the highly-infectious disease. “This is…an addition to the physical separation, not as a substitute,” Fauci said.

On Thursday, the Trump administration appeared ready to join local officials in advising Americans to wear face coverings in public to help curb the spread of the virus.

Deborah Birx, another member of Trump’s coronavirus task force, said the U.S. Centers for Disease Control and Prevention (CDC) would in coming days add a recommendation on masks to guidelines on protective measures.

New York City’s de Blasio and Los Angeles Mayor Eric Garcetti have both urged residents to cover their faces when near others in public, even if they have no symptoms.

(Reporting by Maria Caspani and Nathan Layne; Additional reporting by Peter Szekely, Lucia Mutikani, Lisa Lambert, Susan Heavey, Steve Holland and Dan Whitcomb; Writing by Alistair Bell; Editing by Frank McGurty and Howard Goller)

Special Report: How the COVID-19 lockdown will take its own toll on health

By M.B. Pell and Benjamin Lesser

NEW YORK (Reuters) – It’s the most dramatic government intervention into our lives since World War II. To fight the coronavirus outbreak, governments across the globe have closed schools, travel and businesses big and small. Many observers have fretted about the economic costs of throwing millions of people out of work and millions of students out of school.

Now, three weeks after the United States and other countries took sweeping suppression steps that could last months or more, some public health specialists are exploring a different consequence of the mass shutdown: the thousands of deaths likely to arise unrelated to the disease itself.

The longer the suppression lasts, history shows, the worse such outcomes will be. A surge of unemployment in 1982 cut the life spans of Americans by a collective two to three million years, researchers found. During the last recession, from 2007-2009, the bleak job market helped spike suicide rates in the United States and Europe, claiming the lives of 10,000 more people than prior to the downturn. This time, such effects could be even deeper in the weeks, months and years ahead if, as many business and political leaders are warning, the economy crashes and unemployment skyrockets to historic levels.

Already, there are reports that isolation measures are triggering more domestic violence in some areas. Prolonged school closings are preventing special needs children from receiving treatment and could presage a rise in dropouts and delinquency. Public health centers will lose funding, causing a decline in their services and the health of their communities. A surge in unemployment to 20% – a forecast now common in Western economies – could cause an additional 20,000 suicides in Europe and the United States among those out of work or entering a near-empty job market.

None of this is to downplay the chilling death toll COVID-19 threatens, or to suggest governments shouldn’t aggressively respond to the crisis.

A recent report by researchers from Imperial College London helped set the global lockdown in motion, contending that coronavirus could kill 2 million Americans and 500,000 people in Great Britain unless governments rapidly deployed severe social distancing measures. To truly work, the report said, the suppression effort would need to last, perhaps in an on-again, off-again fashion, for up to 18 months.

In the United States, the White House this week said the final toll could rise to 240,000 dead. States have responded to the dire warnings, and the escalating number of cases revealed each day, by extending stay-at-home shutdowns.

The medical battle against COVID-19 is developing so rapidly that no one knows how it will play out or what the final casualty count will be. But researchers say history shows that responses to a deep and long economic shock, coupled with social distancing, will trigger health impacts of their own, over the short, mid and long term.

Here is a look at some.

SHORT TERM CONSEQUENCES

Domestic Violence

Trapped at home with their abusers, some domestic violence victims are already experiencing more frequent and extreme violence, said Katie Ray-Jones, the chief executive officer of the National Domestic Violence Hotline.

Domestic violence programs across the country have cited increases in calls for help, news accounts reported – from Cincinnati to Nashville, Portland, Salt Lake City and statewide in Virginia and Arizona. The YWCA of Northern New Jersey, in another example, told Reuters its domestic violence calls have risen up to 24%.

“There are special populations that are going to have impacts that go way beyond COVID-19,” said Ray-Jones, citing domestic violence victims as one.

Vulnerable Students

Students, parents and teachers all face challenges adjusting to remote learning, as schools nationwide have been closed and online learning has begun.

Some experts are concerned that students at home, especially those living in unstable environments or poverty, will miss more assignments. High school students who miss at least three days a month are seven times more likely to drop out before graduating and, as a result, live nine years less than their peers, according to a Robert Wood Johnson Foundation report.

Among the most vulnerable: the more than 6 million special education students across the United States. Without rigorous schooling and therapy, these students face a lifetime of challenges.

Special needs students “benefit the most from highly structured and customized special education,” said Sharon Vaughn, executive director of the The Meadows Center for Preventing Educational Risk at the University of Texas. “This means that they are the group that are most likely to be significantly impacted by not attending school both in the short and long term.”

In New Jersey, Matawan’s Megan Gutierrez has been overwhelmed with teaching and therapy duties for her two nonverbal autistic sons, eight and 10. She’s worried the boys, who normally work with a team of therapists and teachers, will regress. “For me, keeping those communications skills is huge, because if they don’t, that can lead to behavioral issues where they get frustrated because they can’t communicate,” Gutierrez said.

MEDIUM TERM CONSEQUENCES

Soaring Suicides

In Europe and the United States, suicide rates rise about 1% for every one percentage point increase in unemployment, according to research published by lead author Aaron Reeves from Oxford University. During the last recession, when the unemployment in the United States peaked at 10%, the suicide rate jumped, resulting in 4,750 more deaths. If the unemployment rate increases to 20%, the toll could well rise.

“Sadly, I think there is a good chance we could see twice as many suicides over the next 24 months than we saw during the early part of the last recession,” Reeves told Reuters. That would be about 20,000 additional dead by suicide in the United States and Europe.

Less than three weeks after extreme suppression measures began in the United States, unemployment claims rose by nearly 10 million. Treasury Secretary Steven Mnuchin warned the rate could reach 20% and Federal Reserve economists predicted as high as 32%. Europe faces similarly dire forecasts.

Some researchers caution that suicide rates might not spike so high. The conventional wisdom is that more people will kill themselves amid skyrocketing unemployment, but communities could rally around a national effort to defeat COVID-19 and the rates may not rise, said Anne Case, who researches health economics at Princeton University. “Suicide is hard to predict even in the absence of a crisis of Biblical proportions,” Case said.

This week, the Air Force Academy in Colorado Springs, Colorado, relaxed its strict social isolation policies after the apparent suicides of two cadet seniors in late March, The Gazette, a Colorado Springs newspaper, reported. While juniors, sophomores and freshmen had been sent home, the college seniors were kept isolated in dorms, and some had complained of a prison-like setting. Now, the seniors will be able to leave campus for drive-thru food and congregate in small groups per state guidelines.

Public Health Crippled

Local health departments run programs that treat chronic diseases such as diabetes. They also help prevent childhood lead poisoning and stem the spread of the flu, tuberculosis and rabies. A severe loss of property and sales tax revenue following a wave of business failures will likely cripple these health departments, said Adriane Casalotti, chief of government affairs with the National Association of County and City Health Officials, a nonprofit focused on public health.

After the 2008 recession, local health departments in the U.S. lost 23,000 positions as more than half experienced budget cuts. While it’s become popular to warn against placing economic concerns over health, Casalotti said that, on the front lines of public health, the two are inexorably linked. “What are you going to do when you have no tax base to pull from?” she asked.

Carol Moehrle, director of a public health department that serves five counties in northern Idaho, said her office lost about 40 of its 90 employees amid the last recession. The department had to cut a family planning program that provided birth control to women below the poverty line and a program that tested for and treated sexually transmitted diseases. She worries a depression will cause more harm.

“I honestly don’t think we could be much leaner and still be viable, which is a scary thing to think about,” Moehrle said.

LONG TERM CONSEQUENCES

Job-loss Mortality

Rises in unemployment during large recessions can set in motion a domino effect of reduced income, additional stress and unhealthy lifestyles. Those setbacks in income and health often mean people die earlier, said Till von Wachter, a University of California Los Angeles professor who researches the impact of job loss. Von Wachter said his research of past surges in unemployment suggests displaced workers could lose, on average, a year and a half of lifespan. If the jobless rate rises to 20%, this could translate into 48 million years of lost human life.

Von Wachter cites measures he believes could mitigate the effects of unemployment. The Coronavirus Aid, Relief, and Economic Security Act approved by the White House last week includes emergency loans to businesses and a short-time compensation program that could encourage employers to keep employees on the payroll.

Young People Suffer

Young adults entering the job market during the coronavirus suppression may pay an especially high price over the long term.

First-time job hunters seeking work during periods of high unemployment live shorter and unhealthier lives, research shows. An extended freeze of the economy could shorten the lifespan of 6.4 million Americans entering the job market by an average of about two years, said Hannes Schwandt, a health economics researcher at Northwestern University, who conducted the study with von Wachter. This would be 12.8 million years of life lost.

Thousands of college graduates will enter a job market at a time global business is frozen. Jason Gustave, a senior at William Paterson University in New Jersey who will be the first in his family to graduate from college, had a job in physical therapy lined up. Now his licensure exam is postponed and the earliest he could start work is September.

“It all depends on where the economy goes,” he said. “Is there a position still available?”

WHAT COMES NEXT

In the weeks ahead, a clearer picture of the disease’s devastation will come into focus, and governments and health specialists will base their fatality estimates on a stronger factual grounding.

As they do, some public health experts say, the government should weigh the costs of the suppression measures taken and consider recalibrating, if necessary.

Dr. Jay Bhattacharya, who researches health policy at Stanford University, said he worries governments worldwide have not yet fully considered the long term health impacts of the impending economic calamity. The coronavirus can kill, he said, but a global depression will, as well. Bhattacharya is among those urging government leaders to carefully consider the complete shutdown of businesses and schools.

“Depressions are deadly for people, poor people especially,” he said.

(Reporting in New York by M.B. Pell and Benjamin Lesser. Data editing by Janet Roberts. Editing by Ronnie Greene)

Sweden’s liberal pandemic strategy questioned as Stockholm death toll mounts

By Johan Ahlander and Philip O’Connor

STOCKHOLM (Reuters) – A spike in novel coronavirus infections and deaths in Stockholm has raised questions about Sweden’s decision to fight the outbreak without resorting to the lockdowns that have left much of Europe at a standstill.

Governments across Europe have closed schools and taken draconian measures to limit exposure to possible carriers with Germany for example enforcing bans on more than two people meeting in public.

Among Sweden’s Nordic neighbours, Denmark has closed its borders and shut its schools, as has Norway, while Finland has isolated its main urban region.

Yet Swedes are able to go to restaurants, get a haircut and send their children to school even as the number of confirmed cases and deaths have mounted, above all in Stockholm which accounts for more than half the fatalities.

An analysis of smartphone location data showed that while visits to public places has fallen steeply in most European countries, Sweden is bucking the trend.

But Sweden’s liberal approach, which aims to minimise disruption to social and economic life, is coming under fire as the epidemic spreads in the capital.

“We don’t have a choice, we have to close Stockholm right now,” Cecilia Soderberg-Naucler, Professor of Microbial Pathogenesis at the Karolinska Institute, told Reuters.

She is one of around 2,300 academics who signed an open letter to the government at the end of last month calling for tougher measures to protect the healthcare system.

“We must establish control over the situation, we cannot head in to a situation where we get complete chaos. No one has tried this route, so why should we test it first in Sweden, without informed consent?” she said.

Sweden reported 612 new cases on Friday, bringing the total to around 6,000. The death toll has reached 333, with fatalities now running at about 25-30 a day, according to the Swedish Health Agency.

A STORM IN STOCKHOLM

There are growing signs the virus is spreading at elderly care homes, again mainly in the capital, where some staff at hospitals and nursing homes have publicly warned of a lack of protective equipment such as masks.

Facing what a local official has called “a storm” of COVID-19 cases, Stockholm has opened a field hospital at a convention complex south of the city centre and called on anyone with medical training to help care for the sick.

At a news conference this week centre-left Prime Minister Stefan Lofven fielded questions over whether the rising number of cases at Sweden’s nursing homes was evidence of a failing strategy.

“I don’t think it is a sign of that. This is what things look like around Europe,” he said. “We have said all along that things will get worse before they get better.”

Sweden has focused on isolating and treating the sick rather than closing down swathes of society.

Gatherings of more than 50 people have been banned, high schools and universities have moved teaching online and people have been told not to take unnecessary trips, all quite low-key measures in a European context.

The public face of Sweden’s pandemic fight, Health Agency Chief Epidemiologist Anders Tegnell, only months ago a little known civil servant but now rivalling the prime minister for publicity, has questioned how effectively lockdowns can be enforced over time.

“It is important to have a policy that can be sustained over a longer period, meaning staying home if you are sick, which is our message,” said Tegnell, who has received both threats and fan mail over the country’s handling of the crisis.

“Locking people up at home won’t work in the longer term,” he said. “Sooner or later people are going to go out anyway.”

(Additional reporting by Simon Johnson; Editing by Niklas Pollard and Giles Elgood)