Latinos in Some States Have Seen Higher Rates of Infection

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Credit…Ruth Fremson/The New York Times

Epidemiologists around the country are examining more and more evidence that the coronavirus is impacting Latinos, especially in certain states and communities, with particular force.

Other groups, including African-Americans, also have been hard hit. But for doctors like Eva Galvez, who works as a family physician for a network of clinics in northwestern Oregon, the disparity for Latinos has become alarming. In tests of low-income patients over the past several weeks, she said, Latinos were 20 times as likely as other patients to have the virus.

Oregon is just one of many states where Latinos are showing a disproportionate level of impact. In Iowa, Latinos account for more than 20 percent of coronavirus cases though they are only 6 percent of the population. Latinos in Washington State make up 13 percent of the population but 31 percent of cases. In Florida, Hispanics are just over a quarter of the population but account for two of every five virus cases where the patient’s ethnicity is known.

Public health experts say Latinos may be more vulnerable to the virus as a result of the same factors that have put minorities at risk across the country. Many have low-paying service jobs that require them to work through the pandemic, interacting with the public. A large number also lack access to health care, which contributes to higher rates of diabetes and other conditions that can worsen infections. But the virus has not discriminated: its effects, experts said, had been seen among both immigrants and Latinos from multigenerational American families

In Latino communities with a longer history in the United States — like those in Arizona, California, New Mexico and Texas — the differences are narrower, at least according to the official data reported by the states. Experts say one reason is that places with more established Latino communities have a wider spectrum of professional and middle-class families with more wealth, who can work from home or take advantage of other options for weathering the pandemic.

Now, though, officials worry that those disparities could grow as the annual harvest season begins this month and seasonal farmworkers flood into states already seeing large differences in infection rates. In Oregon, officials are scrambling to enact far-ranging changes to work rules and living conditions for migrant workers, fearing that without them the virus could sweep through the 160,000 workers who typically toil in the fields, eat and bunk in proximity.

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President Trump’s go-to defense of his early response to the coronavirus is his decision to close down travel from China, the virus’s original center, and then from ravaged Europe.

But those hasty decisions led to exoduses of American citizens, packed airports and, according to a new congressional report, very few rigorous screenings for passengers who could have been bringing the virus home with them.

Medical officials on contract from the Department of Homeland Security checked the temperatures of just 10 percent of the more than 250,000 travelers who got some screening when they arrived at U.S. airports from travel-restricted countries during a 10-week span from January to March, according to a report released Thursday by the House Oversight and Reform Committee. The finding raised questions about one of the centerpieces of Mr. Trump’s argument that his administration responded aggressively to contain the outbreak.

If customs officers noticed symptoms in travelers returning from restricted countries, they were told to refer them to federal or local medical officials at the airport for more screening.

But officials from the Countering Weapons of Mass Destruction Office, which is part of the Homeland Security agency, told the committee that the informal policy was to check one of every 10 passengers because they “don’t want to slow things down,” according to the report.

And they said that just under 1,500 arriving passengers were passed along for more rigorous screening by officials with the Centers for Disease Control and Prevention between Jan. 17 and March 29.

Credit…Gregg Vigliotti for The New York Times

One patient was found dead in bed, 12 hours after falling on a wet floor and sustaining a head injury. Sick residents who were awaiting the results of coronavirus tests shared rooms with healthy residents. Since March, at least 53 have died after testing positive.

The report, released on Thursday by the Centers for Medicare and Medicaid Services, offers the first detailed glimpse into how the pandemic has ravaged nursing homes across the country.

It was released on the same day that members of the National Guard arrived in Andover, N.J., to assist at the nursing home, a 543-bed facility that has been chronically short of staff members and masks and has over the past two years received poor grades from federal and state inspectors.

Nursing homes have been hit particularly hard by the outbreak. A tally by The Times found that more than 118,000 residents and staff members at nursing homes and other long-term care facilities have contracted the virus, and more than 19,600 have died.

But a separate Times investigation also found that, when the pandemic struck, a majority of the nation’s nursing homes were losing money, some were falling into disrepair, and others were struggling to attract new occupants.

Their troubled state was years in the making. Decades of ownership by private equity and other private investment firms left many nursing homes with staggering bills and razor-thin margins, while competition from home care attendants and assisted-living facilities further gutted their business. Even so, many of their owners still found creative ways to wring profits out of them, according to an analysis of federal and state data.

Credit…Doug Mills/The New York Times

President Trump said on Thursday that he and Vice President Mike Pence, as well as the White House staff, would be tested every day for the coronavirus after a military aide who has had contact with the president was found to have the virus.

Asked by reporters about the aide, whom a senior administration official described as a personal valet to the president, Mr. Trump played down the matter. “I’ve had very little contact, personal contact, with this gentleman,” he said. But he added that he and other officials and staff members at the White House would be tested more frequently.

A White House spokesman said that Mr. Trump and Mr. Pence had both tested negative for the virus since their exposure to the aide. But the episode raised new questions about how well-protected Mr. Trump and other top officials are as they work at the White House, typically without wearing masks.

The president has said that the White House uses a test kit made by Abbott, which can return results on the spot in as little as five minutes. But health professionals have warned that the Abbott test kit produces less reliable results than those shipped to labs but which can take days.

The military aide’s illness was first reported by CNN, and was made public the day before eight World War II veterans — each older than 95, an age group at high statistical risk for serious illness from the coronavirus — were scheduled to take part in a photo-op at the White House and an event at the World War II Memorial nearby to celebrate the 75th anniversary on Friday of the German surrender, known as V-E Day.

The event will include an opportunity for the veterans to take pictures at the White House with the secretaries of defense and state; the first lady, Melania Trump; and the president, according to a schedule prepared by the Greatest Generations Foundation, which organized the event.

Credit…Marian Carrasquero for The New York Times

Tensions are flaring in black and Hispanic neighborhoods in New York over the enforcement of social distancing rules, leading some prominent elected officials to charge that the New York Police Department is engaging in a racist double standard as it struggles to shift to a public health role in the pandemic.

The arrests of black and Hispanic residents, several of them filmed and posted online, occurred on the same balmy days as other photographs showing police officers handing out masks to mostly white visitors at parks in Lower Manhattan, Williamsburg and Long Island City.

On Thursday, the Brooklyn district attorney’s office became the first prosecutor in the city to release statistics on social distancing enforcement. In the borough, the police arrested 40 people for social distancing violations from March 17 through May 4, the district attorney’s office said.

Of those arrested, 35 people were black, four were Hispanic and one was white. More than a third of the arrests were made in the predominantly black neighborhood of Brownsville, while no one was arrested in the more white neighborhood of Park Slope.

The tension over the enforcement of social distancing measures came as New York City’s mayor said on Thursday that the city might begin limiting entry to some parks to prevent overcrowding as the weather warms. He did not clarify which parks but said more details would be provided on Friday.

Credit…Stephanie Keith for The New York Times

With unemployment claims surpassing 33 million since March, the nation’s near-term economic outlook hinges on whether patchwork reopenings can mend the damage from the pandemic — and how soon.

Nearly 3.2 million Americans were added to state jobless rolls last week, the Labor Department said Thursday, and economists expect the monthly jobs report on Friday to put the April unemployment rate at 15 percent or higher — a Depression-era level.

But even a figure of that magnitude almost certainly understates the calamity. Officials in some states say more than a quarter of their work force is unemployed. And experts say it is impossible to calculate how many jobs might come back as states lift shelter-in-place rules.


Claims were filed in

the last seven weeks

Initial jobless claims, per week

Seasonally adjusted


Claims were filed in

the last seven weeks

Initial jobless claims, per week

Seasonally adjusted


Claims were filed in

the last seven weeks

Initial jobless claims, per week

Seasonally adjusted


Claims were filed in

the last seven weeks

Initial jobless claims, per week

Seasonally adjusted

Source: Department of Labor

By The New York Times

“We don’t know what normal is going to look like,” said Martha Gimbel, an economist and labor market expert at Schmidt Futures, a philanthropic initiative.

The biggest questions are how many workers will be willing to go back, how many businesses will have full-time jobs for them and how quickly customers will return to the shopping and spending habits that stoke the consumer-driven economy.

At the same time, many employers may not survive, particularly small ones, while others are likely to operate with reduced hours and staff members. Most Americans are uneasy about the moves to reopen, with 67 percent saying they would be uncomfortable going into a store and 78 percent saying they would be uncomfortable eating at a restaurant, according to a survey that The Washington Post and the University of Maryland released this week.

Credit…Lynne Sladky/Associated Press

Frontier Airlines on Thursday became the first United States carrier to announce plans to take passengers’ temperatures before boarding commercial flights, the latest effort to make travel safer as parts of the American economy continue to reopen.

Beginning June 1, anyone with a temperature of 100.4 degrees or higher will be denied boarding, Frontier said.

The requirement came as several major transit agencies and facilities also announced measures to limit the spread of virus.

Amtrak said it would require passengers to wear face coverings in stations and on trains and buses starting Monday. The coverings can be removed only when passengers are eating in designated areas, in private rooms or when seated alone or with a companion in their own pair of seats, Amtrak said.

Some Los Angeles transportation workers had urged the agency to make face coverings mandatory as it prepared to restore bus and rail service. At least 58 agency employees or contractors, including 16 bus drivers, have tested test positive for the virus.

The agency said enforcement of the mask requirement would be “a work in progress.” It said it wanted to avoid putting its officers “in an untenable position where confrontations with riders escalate — as we’ve seen happen in other cities.”



How Does Antibody Testing Work? We Went Behind the Scenes to Find Out

Stanford Health Care gave us exclusive access to show how coronavirus antibody testing works. So we followed two caregivers and their blood, through the testing process.

As time goes on, more people are wondering, did I have coronavirus already. “I can help the next patient [INAUDIBLE].“.” Now, Stanford hospitals in northern California are giving their health care workers the answer with antibody testing for all. We were given exclusive access to follow two caregivers and their blood through the antibody testing process. “I do have a loved one at home, my mother, who is high risk. So I want to get tested just to make sure I’m O.K., and kind of maybe surprise her and say, I get to come see you.” First, they’re swabbed to make sure they’re not currently infected. “Oh my god.” And then they give a vial of blood for the antibody test. “There’s so many asymptomatic carriers around, and there’s so many people that may have had it or had mild symptoms, and not had known. If I have the antibodies and someone needs my plasma, I’d love to help out.” “Honestly, I’m hoping that comes back positive, that it’ll teach us a lot.” ”—the blood antibody test for the COVID-19 virus.” This blood test, also known as serology, will show if they had coronavirus in the past, and their immune system raised antibodies to fight it off. But it can’t predict if those antibodies will make them immune. What this and other reliable antibody tests can do is give us a better picture of how widespread coronavirus actually is. And they’re helping researchers design possible treatments and vaccines. “More widespread testing will help us to better understand more quickly what are the important variables, you know, who’s going to be protected, who’s not.” These are samples from the people we just met including, Heidi and Jamshid. Here, they’ll be spun to separate blood cells from plasma. Next, that plasma is taken to a different lab on campus for analysis. “You can see the robot is precisely putting in the right amount of each sample into the wells of the plate.” “There’s been great demand for the test. The lab is basically open 24 hours. The instruments have been running day and night.” Dr. Scott Boyd and his team developed this test, and now they’re ramping up quickly. They’ve just received a new shipment of robots called ELISA Instruments. Soon, the team hopes to process at least 4,000 samples a day. They use controls to validate their tests, so they know it works. The positive controls are from coronavirus patients at Stanford, and the negative are from healthy blood donors, taken before coronavirus jumped to humans. Out of 200 people, the results for a few may be inaccurate. But this kind of test is among the best we have. You can see the controls here in the left column of each assay plate. Once the plate finishes processing, you can see a yellow color in the patient samples that have antibodies. The darker the color, the more antibodies there are. “But just measuring the total quantity doesn’t tell you all the information you’d like to know. The question is, does somebody likely have immunity. The answers are not yet as clear.” Only some antibodies actually fight or neutralize the virus. So the next step for researchers is to identify those ones. Then, how much of those neutralizing antibodies are needed to block the virus and prevent re infection? “So we’re also now working on developing a neutralizing anybody test that would allow us to test a lot of patients in the hospital, and also health care workers.” That neutralizing antibody test, which Dr. Boyd hopes to have ready by the end of May, will give a better sense of who is actually immune. Remember Heidi from earlier? Well, we watched her sample go through the process. “Coronavirus.” And now her results are in. “Not detected.” All right, so what did the results say? “Negative. Negative COVID and negative serology, unfortunately. But it’s a good thing, right? It can still be good. Today’s really my only safe day, because I go back to work tomorrow. So I feel pretty safe that I can go over, see my mom without a mask. I don’t think she’s got the ability to survive a disease like this, so I’ve had to be very careful. I haven’t seen her face. She hasn’t seen my face without a mask on since like, the beginning of March. I’m negative.” “What?” “Yeah.” “Yay!” “You get to take your mask off, at least for today. Come out here.” “Oh my goodness. I’m so happy.” “I missed you.” “I missed you. Oh, I haven’t had a hug forever. Oh, I’m so happy. O.K. Bye bye, sweetheart. Bye bye.” “All right. Bye bye.” “Thank you.” Jamshid’s results are the same as Heidi’s “So I do not have the antibodies, which is great, because it means PPE works, which is fantastic. I’ve definitely been in multiple rooms with people with known COVID, and I’ve been wearing PPE. And I’m glad that I was at a place that I didn’t have to reuse or recycle my PPE.” Preliminary data is starting to show that Heidi and Jamshid’s negative antibody results are representative. “Hi, Romey.” In places like the Bay Area that haven’t been hard hit, only a small fraction of people are testing positive for antibodies. “You know, where I go to the grocery store, I get it. I go to work again, I get it. It’s out there, so I’m still going to take the same precautions. I’m going to still wear a mask.” But these tests are a first step towards understanding immunity. Just having antibodies is not a free pass. “Hopefully if someone’s positive, it doesn’t give a false sense of security. I still think that everybody needs to protect themselves just the way that we currently are.”

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Stanford Health Care gave us exclusive access to show how coronavirus antibody testing works. So we followed two caregivers and their blood, through the testing process.

A new study offers some hope in the fight against the coronavirus: Nearly everyone who has had the disease — regardless of age, sex or severity of illness — eventually makes antibodies.

Antibodies are immune molecules produced by the body to fight pathogens. Typically, these proteins confer protection against the invader.

Several countries, including the United States, are hoping that antibody tests — flawed though many may be — can help decide who is immune to the virus and can return to work. People who are immune could replace vulnerable individuals, especially in high-transmission settings, building in the population what researchers call shield immunity.

The new study also eased a worry that only some people — those who were severely ill, for example — might make antibodies. In fact, the level of antibodies did not differ by age or sex, the researchers found, and even people who had only mild symptoms produced a healthy amount.

“The question now becomes to what extent those are neutralizing antibodies, and whether that leads to protection from infection — all of which we should presume are yes,” said Sean Whelan, a virologist at Washington University in St. Louis.

Credit…Ruth Fremson/The New York Times

A copy of the C.D.C. guidance obtained by The New York Times includes sections for child care programs, schools and day camps, churches and other “communities of faith,” employers with vulnerable workers, restaurants and bars, and mass transit administrators. The recommendations include using disposable dishes and utensils at restaurants, closing every other row of seats in buses and subways while restricting transit routes between areas experiencing different infection levels, and separating children at school and camps into groups that should not mix throughout the day.

But White House and other administration officials rejected the recommendations over concerns that they were overly prescriptive, infringed on religious rights and risked further damaging an economy that Mr. Trump was banking on to recover quickly.

A spokesman for the C.D.C. said the guidance was still under discussion with the White House, and a revised version could be published soon.

The rejection of the guidelines is the latest confusing signal as the Trump administration struggles to balance Mr. Trump’s desire to reopen the country quickly against the advice of public health experts, who have counseled reopening methodically via steps tied to reduced rates of infection and expanded efforts to control the spread of the virus.

In more than half of the states that are easing restrictions, case counts are trending upward, positive test results are on the rise, or both, raising concerns among public health experts.

Hydroxychloroquine, the malaria drug frequently promoted by Mr. Trump, neither helped nor harmed coronavirus patients at NewYork-Presbyterian Columbia University Irving Medical Center in Manhattan, researchers reported.

As a result, the hospital is no longer recommending it as a treatment for its Covid-19 patients.

The authors of the report, in The New England Journal of Medicine, say the drug should be used only in controlled clinical trials where patients are picked at random to receive one treatment or another. Controlled trials, which are underway around the world, are the most reliable way of finding out whether a drug works.

In the last several weeks, federal agencies and medical societies have issued safety warnings about hydroxychloroquine and the closely related drug chloroquine. The Food and Drug Administration said last month that the drugs could cause dangerous heart rhythm abnormalities in coronavirus patients and should be used only in clinical trials or hospitals where patients can be closely monitored. The National Institute of Allergy and Infectious Diseases issued a similar warning, saying there was “insufficient data” to recommend the drugs.

The new study did not include information on tests of heart rhythm.

Hydroxychloroquine is approved to treat malaria and the autoimmune diseases lupus and rheumatoid arthritis. But anecdotal reports from China and France early in the epidemic suggested that it might also help fight the coronavirus. With no proven treatment, doctors around the world began using it in a desperate effort to save dying patients, and Mr. Trump suggested people should take it. But there is little evidence to support its continued use against the virus, and the French report was later discredited.

The pandemic has plunged California into a fiscal hole of historic proportions, state finance officials said Thursday, projecting an 18 percent unemployment rate through next summer and a staggering $54.3 billion state budget deficit.

The analysis released by the state’s Department of Finance, which advises Gov. Gavin Newsom, reversed earlier projections of record reserves and a $5.6 billion surplus and came as the state reeled from a collapsing economy, the nation’s fifth-highest virus death toll and the approach of a potentially devastating fire season.

Unemployment, the department said, would more than quadruple from the 3.9 percent rate California boasted at the start of the year, and tax revenues would be $41.2 billion less than originally forecast.

Expenses are also about to soar, the department said, with the pandemic alone expected to add some $13 billion in unplanned spending for the state’s virus response and increased caseloads for welfare and Medi-Cal, the state’s version of Medicaid.

Gov. Gretchen Whitmer of Michigan said Thursday that she would allow manufacturing workers — including those at the major auto companies — to go back to work beginning Monday.

The road test is a rite of passage for millions of American teenagers. But last month, Georgia waived that requirement for most drivers to help fight the spread of the virus. The state said this week that it had issued licenses to nearly 20,000 teenagers without requiring road tests.

“These teens held a permit for a year and a day and complied with all Georgia’s mandatory driver education requirements,” including 40 hours of supervised training behind the wheel, said Susan Sports, a spokeswoman for the state’s Department of Driver Services. They also had the consent of a parent or responsible adult.

Georgia is not the only state amending its licensing process. In Wisconsin, the Department of Transportation said in a statement on Tuesday that drivers under 18 who had successfully completed their required training and who had a parent or guardian’s endorsement would be able to get a probationary license without completing a road test. Texas has also modified its procedures for individuals with a learner’s license seeking a provisional license.

“There’s concern that with waiving the road test, states are permitting teens to achieve a license when they could possibly be benefiting from additional practice,” said Jeanette Casselano, a spokeswoman for AAA.

Credit…Matthew Hatcher/Getty Images

In the early days of the pandemic, Mike DeWine, the mild-mannered Republican governor of Ohio, gained a national profile for moving quickly to shut down his state while other leaders hesitated. The rates of infection in Ohio have stayed lower than elsewhere in the Midwest.

Mr. DeWine said on Thursday that barbershops, hair salons, day spas, nail salons and other services could reopen on May 15, when restaurants could begin serving diners outside. By May 21, he said, they could begin to offer dine-in service.

The intraparty warfare in Ohio is part of a growing rebellion by Republican legislators across the country against their governors — both Democratic and Republican — arguing that stay-at-home orders and nonessential business closures are smothering the economy and violating rights.

Republicans in Pennsylvania tried in late April to overturn the Democratic governor’s stay-at-home order. In Louisiana, Republicans voted to strip the governor of his administration’s ability to penalize businesses for violating such an order. In Wisconsin and Michigan, Republican lawmakers sued the governors outright.

And in Massachusetts, a federal judge on Thursday ruled that gun stores could reopen, a rebuke to the state’s Republican governor, who had ordered them to close.

Credit…Mark Black/ZUMA Wire/Alamy Live News

For three weeks, the Food and Drug Administration allowed the sale of several types of N95-style face masks for American health care workers despite evidence that the masks were not effective for blocking the virus.

Millions of the masks, produced in China, have been bought by or donated to American hospitals and distributed to others on the front line of the outbreak. But starting in mid-April, tests conducted by the C.D.C. revealed that some of the products did not meet medical standards for protection against the virus.

“The U.S. Food and Drug Administration is concerned that certain filtering facepiece respirators (respirators) from China may not provide consistent and adequate respiratory protection to health care personnel exposed to Covid-19,” the agency wrote in a letter to health care providers around the country.

N95 masks, many of which are also produced in China, provide better protection against coronavirus particles than cloth or surgical masks, and they are coveted by health care providers and emergency medical workers. On April 3, drastic shortages of the N95 masks led the F.D.A. to allow imports of similar masks, also from China.

Reporting was contributed by Emily Badger, Peter Baker, Alan Blinder, Nicholas Bogel-Burroughs, Jonah Engel Bromwich, Benedict Carey, Ben Casselman, Patricia Cohen, Keith Collins, Michael Cooper, Karen Crouse, Michael Crowley, Nicholas Fandos, Manny Fernandez, Matthew Futterman, Rick Gladstone, James Glanz, Matthew Goldstein, Abby Goodnough, Denise Grady, Maggie Haberman, Tiffany Hsu, Shawn Hubler, Miriam Jordan, Inyoung Kang, Sheila Kaplan, Lauren Leatherby, Michael Levenson, Apoorva Mandavilli, David Montgomery, Andy Newman, Richard A. Oppel Jr., Tariq Panja, Alicia Parlapiano, Linda Qiu, Campbell Robertson, Marc Santora, Michael D. Shear, Ashley Southall, Jennifer Steinhauer, Eileen Sullivan, Tracey Tully, Pete Wells and Carl Zimmer.

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