Coronavirus Live Updates: Fear of Racial Bias During Medical Care

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Medical bias may add to the outsize impact of Covid-19 on African-Americans.

The coronavirus has left many people struggling to make sense of the seemingly random terror it inflicts. But for many black families in America, mourning coronavirus deaths brings an added burden, as they wonder whether racial bias may have played a role.

Decades of research shows that black patients in the United States receive inferior medical care compared with white patients. Many families, social scientists and public health experts now fear that racial bias may be contributing to the disproportionately high rate at which Covid-19 is killing African-Americans.

African-American patients enter the health care system with distinct disadvantages, experts say. There is less access to quality health care in many black communities, research shows. And black people are more likely to have diabetes, hypertension and other underlying conditions that make Covid-19 particularly fatal.

The National Medical Association, the country’s largest professional organization representing black doctors, is calling on federal health agencies to study the role bias may have played in the testing and treatment of African-Americans for Covid-19.

Its president, Dr. Oliver Brooks, said, “I think what we will find is race is a factor.”

There may be a hot spot at 1600 Pennsylvania Ave.

Credit…Anna Moneymaker/The New York Times

The Trump administration is racing to contain an outbreak of Covid-19 inside the White House, as some senior officials believe that the disease is already spreading rapidly through the warren of cramped offices that make up the three floors of the West Wing.

Three top officials leading the government’s response effort have begun two weeks of self-quarantine after the announcement of positive tests by two members of the White House staff — one of President Trump’s personal valets and Katie Miller, the spokeswoman for Vice President Mike Pence.

The officials in quarantine are Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases; Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention; and Dr. Stephen Hahn, the commissioner of the Food and Drug Administration.

Others who came into contact with Ms. Miller and the valet are continuing to report for duty at the White House.

“It is scary to go to work,” Kevin Hassett, a top economic adviser to the president, said on the CBS program “Face the Nation” on Sunday.

Mr. Hassett said he sometimes wears a mask in the White House, but he conceded that “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”

He added: “It’s a small, crowded place. It’s, you know, it’s a little bit risky. But you have to do it because you have to serve your country.”

Dr. Fauci was scheduled to testify at a Senate committee hearing on Tuesday; he and other witnesses will now appear by videoconference instead of in person, according to the office of the committee chairman, Senator Lamar Alexander of Tennessee.

The discovery of the two infected staff members has prompted the White House to step up its procedures to combat the coronavirus, including daily tests for some senior staff, increased use of masks and more rigorous screening of people entering the complex.

The concern about an outbreak at the White House — and the swift testing and contact tracing being done to contain it — underscores the broader challenge facing Americans as Mr. Trump urges them to begin returning to their own workplaces. Public health officials continue to warn that the virus is still ravaging communities across the country and that precautions are still needed.

Mr. Trump himself continues to reject guidance from the C.D.C. to wear a mask when meeting with groups of people. But a senior administration official said the president was spooked that his valet, who is among those who serve him food, had not been wearing a mask. Mr. Trump was annoyed to learn that Ms. Miller had tested positive, and has been growing irritated with people who get too close to him, the official said.

Carnage in the job market could get much worse.

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President Trump’s top economic advisers are bracing for the unemployment rate to climb above 20 percent in the coming months, as the coronavirus pandemic continues to stifle economic activity and wipe out jobs.

The unemployment rate leapt to 14.7 percent in April, the Labor Department reported on Friday — the highest level since the Great Depression — as lawmakers debate the next round of stimulus measures to buttress the cratering economy. Congress has already pumped trillions of dollars into the economy in the hope of propping up businesses and stabilizing financial markets, but the job losses show little sign of abating.

Treasury Secretary Steven Mnuchin said on Sunday that the jobs figures would get worse before they got better. He said the real unemployment rate — including people who are underemployed as well as those entirely without work — could soon approach 25 percent.

“There are very, very large numbers,” Mr. Mnuchin said on “Fox News Sunday.”

The White House is encouraging governors to begin reopening their states safely but quickly. Mr. Mnuchin suggested that not reopening could cause “permanent” economic damage, ultimately posing a greater risk to the country than reopening.

“Unlike the Great Depression, where you had economic issues that led to this, we closed down the economy,” he said.

White House officials are considering proposals for another economic relief package, which they hope will include a payroll tax cut and provisions to protect businesses from liability for bringing employees back to work. But Mr. Mnuchin said more legislation was not imminent.

Kevin Hassett, a White House economic adviser, said on the CNN program “State of the Union” that the Trump administration was watching to see what effect the first reopenings have in energizing the economy.

“We think that we have a moment — the luxury of a moment — to learn what’s going on,” Mr. Hassett said, “so that the next step can be prudent.”

Even so, Mr. Hassett predicted that the jobless rate could hit 20 percent next month, and he suggested that restrictions may have to be reimposed if coronavirus cases picked back up.

Despite the White House’s hopes, it appears increasingly likely that the labor market will take a considerable time to recover.

Neel Kashkari, the president of the Federal Reserve Bank of Minneapolis, said Sunday on the ABC program “This Week” that “if this goes on for a long period of time,” outbreaks, lockdowns and returns to work would continue in phases over “a year or two.”

“The worst is yet to come on the job front, unfortunately,” Mr. Kashkari said, adding: “To solve the economy, we must solve the virus. Let’s never lose sight of that fact.”

Ready to rock? Travis McCready is, but Arkansas is wary.

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Being first is often a good thing, but the opening this week of what could be the first major concert in the United States since the pandemic prompted the cancellation of live events is turning into a fraught affair.

While the world’s big touring acts remain on hiatus or confined to sporadic online performances, Travis McCready, a country-rock singer, is set to take the stage on Friday for an intimate acoustic live performance at a venue in Fort Smith, Ark.

The performance, though modest, is attracting outsize attention, not only because it is testing whether people are ready to return in numbers to listen to live music but also because it is challenging the restrictions the governor put on such performances.

Gov. Asa Hutchinson has said indoor venues such as theaters, arenas and stadiums can reopen on May 18 as long as they limit their audiences to fewer than 50 people. The venue, Temple Live, a former Masonic Temple, is saying the show will be held three days earlier, with more than four times that number of fans allowed in — 229 in the 1,100-seat theater.

Promoters have emphasized that masks will be mandatory and social distancing enforced, and they have suggested it is discriminatory for the government to have set more lenient restrictions on church gatherings than on concert venues.

“The virus does not know if it’s in a body in church or high school or a music venue,” said Mike Brown, a representative for Temple Live. “Not that I have anything against church, but if you can go to a church and it’s a public assembly, there is no difference. How is it OK for one group to have a public meeting and it’s not OK for a music venue to have the same opportunity?”

The governor, however, is not backing down.

“As advertised, this concert does not comply with our Department of Health directives for indoor entertainment venues,” Governor Hutchinson said in an emailed statement.

After Obama blasts Trump’s pandemic response, aides suggest more is to come.

Credit…Vincent Thian/Associated Press

Former President Barack Obama thinks that President Trump is doing a poor job of handling the coronavirus pandemic, and that he represents a historic threat to constitutional democracy. But the former president has been so unwilling to call out his successor publicly that his staff has begun referring to Mr. Trump as “He-Who-Must-Not-Be-Named,” a half-joking reference to the arch-villain Voldemort in the “Harry Potter” novels.

Even so, Mr. Obama launched arguably his most scathing attack on Mr. Trump’s White House since he left office, lashing the president’s handling of the pandemic as “a chaotic mess” during a group call with 3,000 of his former White House and campaign aides.

In remarks that were later leaked to the news media, Mr. Obama seemed most infuriated by the Justice Department’s decision to drop charges against Mr. Trump’s former national security adviser, Michael T. Flynn.

“There is no precedent that anybody can find for somebody who has been charged with perjury just getting off scot-free,” Mr. Obama said on the call, according to a participant.

Mr. Obama’s team publicly pointed to his fiery endorsement of Joseph R. Biden Jr., his vice president and the presumptive Democratic nominee, and his sharp attacks on Mr. Trump (sometimes by name), to suggest that his latest remarks were part of a long pattern. Privately, though, the aides acknowledged that they were nothing of the sort.

Mr. Obama is deeply anxious about the election, and is worried about the incumbency advantage that Mr. Trump has. He is seeking to even the playing field a bit by throwing his considerable weight around, four people close to him said, adding that Mr. Obama plans to do so again when opportunities arise.

Mr. Trump has issued a torrent of defensive Twitter messages in the past two days on several sore subjects, including the Flynn matter. On Sunday, he lashed back at Mr. Obama, calling his administration’s handling of the H1N1 flu pandemic in 2009 a “disaster.”

A partisan battle has erupted over aid for the pandemic-hit Postal Service.

Credit…Gabriela Bhaskar for The New York Times

The United States Postal Service employs more people than any government entity outside the military, and for many Americans, it’s the most familiar face of the federal government.

Postal leaders and their allies have made unusually blunt appeals for support, running advertisements recently on President Trump’s favorite Fox News programs and laying out an urgent account of how the pandemic has had a “devastating effect” on the U.S. mail service.

Without a financial rescue from Congress, they have warned, the Postal Service, which normally runs without needing any tax money, could run out of cash as soon as late September, raising the specter of bankruptcy and an interruption in regular mail delivery.

Republicans and Democrats nearly reached a deal for a multibillion-dollar bailout in the last coronavirus rescue package in late March. But since then, the two sides have diverged sharply over whether to provide a lifeline.

President Trump and his Treasury secretary, Steven Mnuchin, have largely viewed the agency’s worsening bottom line as a problem of its own making. “The Postal Service is a joke,” Mr. Trump declared recently, announcing that he would not support any additional financial support for the agency unless it quintupled the rates it charges to deliver parcels.

Democrats, for their part, have positioned themselves as protectors of the agency. In the House, they are preparing to introduce a relief bill that would give the agency much of what it has sought, including $25 billion in cash and some debt relief.

“We have to fight for the post office,” Speaker Nancy Pelosi said last week.

Parents of newborns share advice on Mother’s Day.

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What It’s Like to Give Birth in the Middle of a Pandemic

Poonam Sharma Mathis documented her experience having a baby in New York City, just as hospitalizations and deaths from the coronavirus were starting to rise.

“Hi, Poonam.” “Hi. Nice to meet you. My contractions are about 15 minutes apart. And I’m about to get pulled into an O.R. at Cornell to have a C-section. Like any minute now, they’re going to come pull me through that door. And I’m gloved-up and masked-up. And my husband’s all suited-up. He’s literally in a hazmat suit.” Doctor: “Dad, do you want to grab those shoes and throw them?” “They’re pulling me in. I have to go. Thank you. My name is Poonam Sharma Mathis. My husband is Kris Mathis. We have a 4½-year-old, Pierce Mathis.” “I need some Monday motivation, Pierce.” “My first birth was pretty uneventful. The baby came out, we made eye contact and then I closed my eyes, and I woke up in the recovery room. Everybody was kissing him and hugging him. And I felt like the community and the village that he’s so blessed to be a part of was there. I grew up with a lot of extended family and a lot of love. We’d been wanting a girl in this generation so badly. So when we found out we were having a girl, we were just grateful. I was 37 weeks pregnant when they started to issue stay-at-home orders. OK, so I am officially scared. I’m having contractions this morning. I am not a hypochondriac. I’m not somebody who’s really prone to general mass hysteria. But we are — I’m breathless. We are dealing with something we don’t understand.” Kris: “Only a couple of days prior to our birth, they had been saying no partners, no spouses. I was probably one of the first spouses that was allowed into the hospital. I was walking, and it was like, do not touch anything. Make sure your mask is on. Put the booties over your shoes.” “My husband could catch it right now. Right? He could bring it home, and give it to my son who’s 4 and a half. And there’s a thought about going home with my daughter, and then just immediately quarantining myself and my daughter.” Doctor: “All right, Mom, are you ready?” “Do you want to open your eyes for me? No? Her name is Asha: 7 pounds, 11 ounces. They put her skin on my chest. But I had a mask on, so I wasn’t breathing on her. Daddy is cuddling with her.” “It’s weird. She opened her eyes right when she was born — really wide. And then I haven’t seen her eyes since. She didn’t like what she saw or something. Our expectations were that I probably wasn’t going to be there anyway. So just being there for the delivery and seeing the baby, meeting the baby, it was a really exciting thing for me.” “You realize you have to do a father-daughter dance, and give her away one day?” “But then immediately after the birth, I had to say goodbye.” “Say, good night.” “Sweet dreams.” “It’s 11:30 at night. I’m in my room. I just breastfed. [Asha crying] I wore a mask, and I threw up. The only good news is they let her stay in my room because babies are not being kept in the nursery right now. They’re being kept with the mom. The next step is that we are waiting for news of my coronavirus status. Based on that result, they’ll decide how much interaction I’ll be having with her, for her own safety. So now we wait. I just want to kiss her. It was really exciting to find out that we tested negative, because that meant I could kiss her head. But it’s definitely different delivering and recovering in a hospital during coronavirus, and it hit me yesterday. Yesterday was the worst day of physical pain in my life. I genuinely thought I might die. This is one of the most intense surgeries you can have, is a C-section. But if you have any air bubbles that go into your stomach when they cut you open, which is normal, those air bubbles don’t come out right away. Then they float around your body, I guess, and they feel like knives stabbing you from the inside until they come out. And they don’t want to come out. It is so traumatic being here without somebody to advocate for you when things go wrong, because there’s too much going on. They are overwhelmed. I’m pushing the call button to get care, and they don’t come right away. And last time I gave birth here, four and a half years ago, they did everything right away because they were able to. I was in so much pain for so long, and waiting for my medication for so long, that I was throwing up. I threw up eight times from pain. It feels like I was in a horror movie where they chopped somebody up, but then the person escapes and is running to safety. And that’s a ridiculous thing to say. We have the best health care. We’re in the best city. But that’s how it feels. I just want to get her home as soon as possible. And hopefully then I’m able to walk and stand, and do something to help my husband take care of these kids. Thursday at around 1:30, my husband and son came and picked us up. She was so excited to meet you she didn’t know what to do.” “Asha.” “I haven’t left the upstairs from Thursday till now. It’s Monday morning. There’s so much family that’s just waiting, itching to rush in and be with us. And who knows if that will happen before she’s 3 months old.” “One toe is kind of curving.” “Yeah.” “Will she wrap her finger around your finger if you put it in there?” Poonam: “She’s like a little animal, huh?” “You’re going to be such a good big brother.” Poonam: “Mm-hmm. I’m just grateful that she’s healthy. I’m grateful that so far, my husband and myself and my son are healthy. I look at her eyes, and I do believe that the eyes show something even from birth. Whenever she does open her eyes, she just looks and she’s just laser-focused. And it’s not a curious focus. It’s like — like she knows she needs to be calm right now or something. I had a great aunt who always said that if she could come back, she’d come back as my daughter. So maybe that’s her, I hope. If so, nothing’s going to keep her down.”

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Poonam Sharma Mathis documented her experience having a baby in New York City, just as hospitalizations and deaths from the coronavirus were starting to rise.

People who have babies coming soon are having to make gut-wrenching decisions: Is a home birth less risky? Who will take care of any other children if your partner is with you at the hospital? Should you allow visitors to help with the laundry, or struggle to do it yourself to limit your exposure to others?

More than 800 expectant parents told The New York Times about how they are coping with giving birth during the pandemic. Most said they were riddled with anxiety as their birth plans had to change.

Five women who have just given birth, some at home and others in hospitals, shared their stories and offered advice for new parents: Connect with people. Try to laugh. Trust your own judgment.

“I’m grieving the postpartum that I could have had,” said Carly Buxton, 35, a market researcher in Virginia, who delivered her second child. “I had such high hopes for how I wanted to call on my village of support this time around. But instead, it’s all FaceTime kisses and waves through glass porch doors.”

As a postpartum doula herself, she recommends building virtual support networks anyway, even though it doesn’t feel the same during social distancing.

When will this end?

Credit…Werner Forman/Universal Images Group, via Getty Images

When will the Covid-19 pandemic end? And how?

According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes.

“When people ask, ‘When will this end?’ they are asking about the social ending,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins.

In other words, an end can occur not because a disease has been vanquished but because people grow tired of panic mode and learn to live with a disease.

Endings “are very, very messy,” said Dora Vargha, a historian at the University of Exeter. “Looking back, we have a weak narrative. For whom does the epidemic end, and who gets to say?”

As an Iowa meat plant reopens, questions of workers’ health and the food supply.

Credit…Daniel Acker for The New York Times

On April 10, Tony Thompson, the sheriff for Black Hawk County in Iowa, visited the giant Tyson Foods pork plant in Waterloo. What he saw, he said, “shook me to the core.”

Workers, many of them immigrants, were crowded elbow to elbow as they broke down hog carcasses zipping by on a conveyor belt. The few who had face coverings wore a motley assortment of bandannas, painters’ masks or even sleep masks stretched around their mouths. Some had masks hanging around their necks.

Five days later, the plant was closed. Tyson said the reason was “worker absenteeism.” As of last week, the county health department had recorded 1,031 coronavirus infections among Tyson employees — more than a third of the work force. Some are on ventilators. Three have died, according to Tyson.

But the plant — Tyson’s largest pork operation in the United States, responsible for almost 4 percent of the nation’s pork supply — didn’t stay closed for long.

As meat shortages hit U.S. grocery stores and fast-food restaurants, political pressure built to reopen plants that had shut down because of virus outbreaks. An executive order by President Trump declared the meat supply “critical infrastructure” and shielded the companies from certain liability.

New safety precautions have been added at the Tyson plant, and now the question is this: Will America’s appetite for meat be sated without sickening armies of low-wage workers, and their communities, in new waves of infection?

Ohio’s governor threatens a veto if legislators try to force the state to reopen.

Gov. Mike DeWine of Ohio, who is facing an open revolt among fellow Republicans, said he would veto a bill by state legislators that would limit his administration’s ability to issue a stay-at-home order lasting more than two weeks.

“I’ve made it clear to the legislature that if that reached us, and I don’t think it will, but I would veto that,” he said on “Fox News Sunday.”

Mr. DeWine took aggressive steps in the early days of the virus to reduce transmissions but the state, which has seen its new cases and deaths stabilize, is still not meeting the federal government’s recommendations for reopening.

“We are really at a plateau with hospitalizations, we are at a plateau with deaths, and we are at a plateau in regard to new cases,” he said. “We wish we were going down — we’re not.”

Ohio has more than 23,000 cases and a growing hot spot at a prison in Marion. Still, with more than 1.1 million Ohio workers filing for unemployment over the past two months, Mr. DeWine is under pressure to get the state back to work.

With software rather than professors monitoring exams, a worry over privacy.

Credit…Rozette Rago for The New York Times

As a college semester like no other winds down, with bedrooms replacing classrooms as testing sites, professors are no longer able to keep a close eye out for cheat sheets and wandering eyes.

Into the havoc have come digital proctoring services, which, after years in tech’s niches, are suddenly monitoring hundreds of thousands of students taking millions of at-home exams in myriad time zones.

Privacy advocates are sounding alarms. Investors are taking note. And students are fueling demand with their own testing — of boundaries.

Yet while academic integrity is not a new concern in remote learning — in surveys, about one in three students say they have cheated in online tests, about the same as the proportion who admit to cheating offline — it’s not just students who are now cringing at the online monitoring.

“There has to be a better way,” said Sue Escobar, a professor of criminal justice at California State University, Sacramento. She said she would not use a webcam option that the university added last month to its online testing software, a step that she called “invasive.”

“Sure, we want to minimize cheating,” she said, “but how far do you go?”

Elon Musk has harsh words for California.

Credit…Brendan Smialowski/Agence France-Presse — Getty Images

Elon Musk, the Tesla chief executive, clashed with health officials in California on Saturday over the reopening of the company’s factory in Fremont, with Mr. Musk pushing for an immediate return and the county’s government seeking a delay of about a week.

In a series of tweets, Mr. Musk said he would move the company’s headquarters out of California to Texas or Nevada. Tesla also took its fight to federal court, filing a lawsuit against Alameda County on Saturday. The company said “the county’s position left us no choice but to take legal action to ensure that Tesla and its employees can get back to work.”

The actions came a day after county health officials told Tesla that it was not yet allowed to resume production of electric vehicles in Fremont because of fears that the coronavirus could spread among the company’s workers. Manufacturers have been allowed to restart work in other parts of the state that have had less severe outbreaks.

Tesla, which noted that it was “the last major carmaker remaining in California, and the largest manufacturing employer in the state with more than 10,000 employees at our Fremont factory and 20,000 statewide” — outlined in a blog post its rationale for pushing to reopen, and detailed on how it plans to proceed.

“Frankly, this is the final straw,” Mr. Musk said on Twitter. “Tesla will now move its HQ and future programs to Texas/Nevada immediately. If we even retain Fremont manufacturing activity at all, it will depend on how Tesla is treated in the future.”

Why reopening New York City is so difficult.

Credit…Brittainy Newman/The New York Times

The factors that made New York City the U.S. epicenter of the pandemic — its density, tourism and dependence on mass transit — complicate a return to any semblance of normalcy.

States like Colorado, Georgia and Texas have let stay-at-home orders lapse and businesses like nail salons and retail stores reopen, and New York State is anticipating a partial reopening this month, mostly in rural areas. But the city is far from meeting the public health metrics necessary to reopen, from available critical-care beds to new hospital admissions for the virus.

The virus has killed more than 19,000 people in New York City, a death toll that exceeds those in all but a small number of countries, or in California, Illinois, Massachusetts, Michigan and Texas combined. While the outbreak is receding in the city, more than 1,000 new positive cases were reported on at least three days last week, for a total that now tops 181,000.

The key to reopening is containing the virus, and that will take a vast infrastructure of testing and contact tracing unlike anything the United States has ever seen, public health experts say.

How long might it take to restart New York City’s economy?

Said Gov. Andrew M. Cuomo last week: “Nobody can tell you.”

Motoko Fujishiro Huthwaite, last of the ‘Monuments Women,’ dies at 92.

Credit…via Monuments Men Foundation

Motoko Fujishiro Huthwaite, part of a team of 345 people from 14 countries — collectively known as the Monuments Men and Monuments Women — who preserved cultural treasures and artworks during and after World War II, died on Monday in Taylor, Mich., outside Detroit. She was 92.

Robert M. Edsel, founder and chairman of the Monuments Men Foundation, said the cause was complications of the coronavirus.

Ms. Huthwaite was the last of the Monuments Women, who originally numbered 27. Richard M. Barancik is the last of the 318 Monuments Men.

They were immortalized in a 2014 movie, “The Monuments Men,” directed by George Clooney and starring him and Matt Damon. The movie was based on the 2009 book of the same title by Mr. Edsel and Bret Witter. Mr. Edsel is now writing a book on the Monuments Women.

During the war, a small, special force of American and British art historians, museum directors, curators and others started out steering Allied bombers away from cultural targets in Europe and overseeing temporary repairs when damage occurred. Their numbers grew, and after the war they tracked down more than five million objects stolen by Nazi Germany and returned them to the countries from which they came.

In the Pacific theater, their mission was chiefly to assess damage to cultural treasures, prevent looting and return stolen objects. In the course of their work they came across many works of art that no one from the West had ever seen.

This required a tremendous amount of inventorying and record keeping, which was where Ms. Huthwaite came in.

Getting the whole family to move more.

It’s easy to be stationary when there’s nowhere to go, and children tend not to respond well to formal workouts. Here are some ideas to help the whole family — from the youngest to the oldest — get up and move a bit more, without it feeling like work.

Coronavirus updates from our correspondents around the globe.

Reporting was contributed by Nicholas Bogel-Burroughs, Neal E. Boudette, Graham Bowley, Audra D. S. Burch, Emily Cochrane, Michael Corkery, Michael Crowley, Melina Delkic, John Eligon, Reid J. Epstein, Tess Felder, Emily Flitter, J. David Goodman, Maggie Haberman, Rebecca Halleck, Shawn Hubler, Gina Kolata, Sharon LaFraniere, Michael Levenson, Ben Protess, Alan Rappeport, Michael Rothfeld, Michael D. Shear, Shreeya Sinha, Jeanna Smialek, Mitch Smith, Sheryl Gay Stolberg, Ana Swanson, Jim Tankersley, Katie Thomas, Glenn Thrush and David Yaffe-Bellany.

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