Coronavirus thread for June

That’s not a defense for the bar, though.

The incompetence and political division in the US means that likely result in the US is to shut down the economy again* and live with more deaths for the forseeable future until medical advances catch up (wide availability of either an effective vaccine or treatment protocols that greatly reduce the risk of death and long term damage or disability).

*Even in the absence of government ordered shutdowns, fear of the virus will shut down the economy again. And the past government ordered shutdowns were not enough to bring R0 to enough below 1 for enough time to beat the virus – they only brought R0 to about 1, so relaxing them allows the virus to win again.

The lack of agreement means that personal choices will sabotage attempts by all points of view, resulting in a lose-lose result.

Shut down things to an even greater degree than before to force R0 below 1 long enough to beat the virus? Enough non-compliant people will sabotage that.

Open up everything to restore the economy? Enough people still do not want to get the virus, so they will limit their economic activity and sabotage that.

I feel like you and my hubby have been talking lol. He was on and on about the 7 day and 3 day rolling average.

Data club?! I discovered that our DOH has downloadable Excel spreadsheets with at least some data that I can slice and dice my way.

On the subject of temporary field hospitals, I have no first hand knowledge. But I saw the Army Corps of Engineers guy who was in charge of setting up the hospital in the convention center (the Javits Center?) In New York. This was a guy who knew exactly what he was doing. He spoke about negative air flow and cleaning and laundry. No doubt he had the patient bathroom situation under control as well. His name, if I remember correctly, was Simonte. And I thought while listening to him, “Can we make this guy the coronavirus czar?”

Did they even use the field hospitals and the boat? My impression was that this was theatre.

    In Houston the TMC ICU stats being quoted as the 97% full has 28% or so of that as covid pts. Only recently has elective surgery been addressed. The question to ask is what are those other pts in ICU for? Break that down for me. These are ICUs across different locations with different specialties. I feel for those pediatric ICU staff taking adult pts. That is going to hurt.  I don't know enough about MD Anderson not to ask how a cancer center would admit Covid ICU pts in the mix ? That is difficult PR.

I don’t entirely understand the “if you try to open the economy, you’ll wind up with both more deaths AND a destroyed economy” perspective. I get that peoples individual fear would mean that the economy would take a big hit either way. But…as we have seen, there are plenty of people willing to fill those bars and restaurants, and even to the extent that there aren’t, clearly there are businesses that couldn’t survive longer with my business, but can take the hit of diminished business. Again, it’s a balancing act, not an either or.

Do I agree with places opening up as fully as they have so soon? No. I think it is a major mistake. But let’s not pretend no one is benefitting meaningfully, or that other states behaving more cautiously aren’t also making their own compromises. Unless we were to shut down completely, we aren’t going to fully “beat” this disease by any but medical means. The question is how to live with it in the interim, and the answer to that isn’t, IMO, “do everything possible to minimize the number of direct fatalities,” which would mean totally shutting down society indefinitely.

Restaurants Across the Country Are Closing After Workers Test Positive for COVID-19

As states begin to allow restaurants to reopen, service industry workers are again at high risk of catching and spreading the novel coronavirus

by Elazar Sontag

Long blond wood tables and plastic blue chairs are marked with Xs in blue and yellow tape to mark where patrons should sit according to social distancing guidelines.
People are understandably tired of staring at the same four walls and eating the same four (or maybe five) dishes for months on end. And as restaurants reopen, diners have jumped at the chance to sit in a restaurant’s dining room, or on a patio, and eat something — anything — new. Not so fast, though, because the reopening experiment isn’t going great thus far.

As states and cities move from one stage of their reopening plan to the next, there’s a sense that the pandemic is over, or at the very least, has been subdued. On the contrary, cases have spiked in states that were too quick to lift restrictions on restaurants and other businesses where people congregate. Across the country, an ominous, costly cycle is playing out: A restaurant reopens, a case of COVID-19 is detected, the restaurant closes to sanitize, employees are tested, and the restaurant excitedly announces a reopening plan — again.

In California’s San Gabriel Valley, national bakery chain Nothing Bundt Cakes closed two locations this week, after employees tested positive with the virus. In Las Vegas, where many restaurants and casinos opened just days after restrictions were lifted, service employees at five restaurants have contracted COVID-19, forcing the businesses to shutter while they sanitize and test, and those are just the diagnosed, self-reported cases. In Dallas, Texas, the same scenario. Since April, as cases have risen in Atlanta, a growing number of restaurants have shuttered and reopened because employees have fallen ill.

Restaurants hoping for a renewed rush during the summer months in Orange County, California, which reopened for business in late May, are facing the same harsh reality. As the county’s case count grows, and debates rage over requiring residents to wear face coverings in public, several restaurants have temporarily closed because of sick employees. The list includes A Restaurant in Newport Beach, which posted on Instagram that they would be closing for two days to “deep-clean” and “sanitize.” They also noted they would be testing all staff. Two days later, the restaurant was open again, and another Instagram photo advertised a “sassy cocktail” and outdoor seating for “those who would like to dine al fresco.”

These reopenings come at a great cost to service workers, many of whom have to weigh the risk of sickness against that of losing their source of income. The restaurants that close to test and sanitize mostly reopen, but what happens when a restaurant has closed two, three, five times? How much disruption can an independent business take? How many employees must get sick before we acknowledge that “normal” isn’t in our near future?

https://www.eater.com/2020/6/23/21300929/stage-two-restaurants-are-closing-as-workers-test-positive-for-covid-19

Crowded bars contribute more to coronavirus spread than protests and vigils do

Demonstrations and bar visits — in Ada County, Idaho, two kinds of outings that illustrate how drastically different SARS-CoV-2 transmission can look in contrasting environments across the United States.

There was no spike of COVID-19 cases associated with a June 2 vigil of 5,000 people, who gathered in front of the Idaho Capitol in honor of black Americans killed by police or vigilante violence, the Idaho Press reported last week. The vigil took place outside, the majority of attendees wore face masks, and few people spoke outside of preselected speakers. All of these factors can contribute to lower transmission of viral droplets. Protests in which people shout may pose higher risk of transmission, but attendees of those demonstrations also tend to wear masks.

Contrast that with the conditions at crowded bars: speaking and drinking in close quarters, fewer masks, and inhibitions lowered by alcohol can all create a more effective path for virus transmission. In Ada County, a cluster of 69 coronavirus cases was linked to people who visited bars mostly located in downtown Boise, according to the Idaho Press.

Idaho’s Central District Health announced on Monday that Boise and the larger Ada County, which moved to the final stage of reopening on June 13, will be reverting to the previous stage of reopening, following a spike in coronavirus cases. As part of that return to the previous stage, bars and nightclubs will be closed.

https://www.eater.com/2020/6/24/21301793/idaho-protests-vigils-did-not-contribute-to-coronavirus-spike-but-bars-did

Latin America’s coronavirus crisis is only getting worse
Image without a caption
By
Ishaan Tharoor

In many parts of the world, authorities and experts are fretting over the onset of a coronavirus second wave. Yet in the Americas, there’s still no end in sight to the first. The virus is surging in various U.S. states, and the American death toll has eclipsed 120,000. On Thursday, the head of the Centers for Disease Control and Prevention said the real number of infected Americans is probably 10 times the 2.3 million official count.

But to the United States’ south, things are looking all the more concerning. Across Latin America, cases have tripled in the space of a month. The region, which is home to just 8 percent of the world’s population, accounted for about half of global coronavirus-related deaths in the past two weeks and surpassed the unfortunate milestone of 100,000 fatalities this week. According to a new projection by researchers, that figure could reach close to 400,000 by October.

The largest numbers are in Brazil and Mexico, the two most populous countries in the region. In both instances, governments in charge played down the scale of the threat and are desperately playing catch-up. Official counts of infections and coronavirus-linked deaths are probably lower than the actual numbers. Mass testing initiatives have struggled to get off the ground, while shutdown skeptics who suggested herd immunity could take root have little evidence to justify their optimism.

“We are doing something that no one else has done,” Pedro Hallal, a Brazilian epidemiologist, said to my colleagues. “We’re getting near the curve’s peak, and it’s like we are almost challenging the virus. ‘Let’s see how many people you can infect. We want to see how strong you are.’ Like this is a game of poker, and we’re all in.”

But it’s not just in Brazil and Mexico. Argentina, Chile, Colombia, Ecuador, Guatemala and Peru are each forecast to see more than 10,000 fatalities, according to Reuters. In Peru and Chile, political leaders who initially touted success in managing the pandemic now find their countries overrun by the virus and popular discontent mounting.

The situation in Chile, in particular, is striking: It is blessed with a more advanced health-care system than many of its neighbors, and officials suggested they could soon distribute the world’s first “immunity passport.” Two weeks ago, the health minister who proposed the initiative resigned as infections surged. Now, Chile’s deaths per capita dramatically surpass those of Brazil and the United States, and its official number of cases eclipses those of Italy and Iran — countries once considered epicenters of the pandemic.

As the country hunkers down for a quarantined winter, there is little to dispel the simmering popular discontent that saw mass protests over inequality paralyze the government last year. As is the case in much of the world, the spread of the virus has disproportionately affected the country’s poor and only underscored societal and economic divisions.

“Although it likes to think otherwise, Chile’s DNA code is very Latin American, and its cities are highly segregated,” Dante Contreras, an economist at the University of Chile, said to The Washington Post. “Part of the population lives in the First World and the rest in the Third World, yet we all live within a few kilometers of one another. … Both the social movement and pandemic have torn away a veil, revealing a very different country to the one that Chile’s elite had thought it lived in.”

That’s a recurring theme in Latin America’s coronavirus experience. The virus was carried into the region by the rich, jet-setting classes but has spread unabated among the poor, who live in circumstances that leave them profoundly vulnerable to the highly contagious virus. (Tiny Uruguay, with a small population and decades of robust public spending, including on health care, has bucked the trend.)

“The adherence of the population to social distancing measures is very different to Europe, where they don’t have so many poor people and they don’t have big slums,” said Jarbas Barbosa, assistant director at the Pan American Health Organization, to the Financial Times. “It’s very difficult to sustain these measures for a long time.”

“Nearly three-quarters of Mexico’s coronavirus fatalities have involved underlying conditions such as hypertension or diabetes,” wrote my colleague Mary Beth Sheridan. “As cheap, processed foods and sugary soft drinks have proliferated in recent decades, particularly in poor neighborhoods, obesity and other chronic illnesses have multiplied. Even before Mexico reported its first cases, epidemiologists were fearful about the virus’s effect on a country suffering a nutritional crisis.”

And on top of the public health calamity, there’s another imminent disaster. Experts fear that, as a consequence of pandemic shutdowns and slumping economies, tens of millions in the region will be pushed deeper into poverty, erasing multiple generations of social progress achieved in various countries. That may well have knock-on political effects once the pandemic passes and popular anger flares.

“Optimists think that the overriding lesson of covid-19 is that democratic governments, armed with science and openness, are doing a better job than populists, and that voters will reward them,” noted the Economist, referencing the disease caused by the coronavirus. “That may be so in richer parts of the world. In Latin America opposition to incumbents, whether populists or democrats, is more likely to be the trend.”

https://www.washingtonpost.com/world/2020/06/26/latin-america-coronavirus-crisis/

There are a couple good graphs in the link.

How Arizona ‘lost control of the epidemic’

By Jeremy Duda,
Isaac Stanley-Becker and
Chelsea Janes

PHOENIX — A drive-up testing site equipped for several hundred people in West Phoenix was swarmed on Saturday by about 1,000 people, leaving some baking in their cars for hours.

A nearby testing station has already reached capacity for this weekend, appointments vanishing within minutes. Hospitals are filling up. Restaurants are again shutting down, more than a month after Arizona reopened its economy under the mantra “Return Stronger.”

Arizona has emerged as an epicenter of the early summer coronavirus crisis as the outbreak has expanded, flaring across new parts of the country and, notably, infecting more young people.

Maricopa County, which includes Phoenix, is recording as many as 2,000 cases a day, “eclipsing the New York City boroughs even on their worst days,” warned a Wednesday brief by disease trackers at Children’s Hospital of Philadelphia, which observed, “Arizona has lost control of the epidemic.”

But physicians, public health experts, advocates and local officials say the crisis was predictable in Arizona, where local ordinances requiring masks were forbidden until Gov. Doug Ducey ® reversed course last week. State leaders did not take the necessary precautions or model safe behavior, these observers maintain, even in the face of compelling evidence and repeated pleas from authoritative voices.

“We have failed on so many levels,” said Dana Marie Kennedy, the Arizona director of AARP, who said her organization has yet to receive a response to four letters outlining concerns to the governor. She is working on a fifth.

Neither the governor’s office nor the state health department responded to requests for comment.

At critical junctures, blunders by top officials undermined faith in the data purportedly driving decision-making, according to experts monitoring Arizona’s response. And when forbearance was most required, as the state began to reopen despite continued community transmission, an abrupt and uniform approach — without transparent benchmarks or latitude for stricken areas to hold back — led large parts of the public to believe the pandemic was over.

And now, Arizona is facing more per capita cases than recorded by any country in Europe or even by hard-hit Brazil. Among states with at least 20 people hospitalized for covid-19, the disease caused by the coronavirus, no state has seen its rate of hospitalizations increase more rapidly since Memorial Day.

This week, Arizona reported not just a record single-day increase in new cases — with Tuesday’s tally reaching 3,591 — but also record use of inpatient beds and ventilators for suspected and confirmed cases. Public health experts warn that hospitals could be stretched so thin they may have to begin triaging patients by mid-July.

Soon, the only option might be “crisis standards of care,” said Will Humble, a former director of the Arizona Department of Health Services. “If you’re in a bed, normally they’ll keep you for a few days, but they’re going to send you home with oxygen.”

Ducey, speaking to reporters Thursday, said hospitals are “likely to hit surge capacity very soon.”

“This virus is everywhere,” the governor said.

The situation in Arizona — as President Trump this week paid his second visit in as many months to the state, which could be a battleground in November — has exemplified the march of the virus across the Sun Belt, where it has also thrashed Florida and Texas, creating conditions as dire as at any point during the pandemic. Texas Gov. Greg Abbott ® on Thursday paused his state’s reopening and ordered hospitals in four counties to postpone elective surgeries.

Physicians fear there is now less buy-in from a public weary of restrictions and polarized by a highly partisan response to the health crisis. In Southern states, some epidemiologists also are cautioning about what they are calling a “reverse summer effect,” with warm weather — once thought to interrupt the spread of the virus — driving residents into indoor spaces with recycled air.

“My level of frustration is high,” Kennedy of AARP said. “We could have stopped this.”

The last time she met with Ducey was March 11, Kennedy said, when she stood by his side as he declared a health emergency and promised to safeguard nursing homes and assisted-living facilities. He has failed to follow through on those efforts, she argued, saying testing of facility staffers has remained inadequate and equipment needs have gone unmet. Cara Christ, Ducey’s health director, has been absent as well, Kennedy said, pulling out of plans for a virtual town hall meeting with AARP members in April.

Now, a crisis that crashed down first on the state’s elderly population is increasingly taking hold among younger people.

The mean age of Arizonans killed by covid-19 fell from 78 on April 27 to 69 on June 14, according to data processed by a modeling team made up of experts at Arizona State University and the University of Arizona. The average age of patients testing positive for the virus dropped from 51 on April 5 to 39 by mid-June. While older individuals are known to be at greater risk from the virus, Arizona has three times as many positive tests among people age 20 to 44 as it does in any other age bracket, according to state data.

The state’s cases began rising dramatically about May 25, 10 days after Ducey allowed the state’s stay-at-home order to expire, said Joe K. Gerald, an associate professor and public health researcher at the University of Arizona who is part of the academic team providing models to the state health department.

Ross F. Goldberg, president of the Arizona Medical Association, said that “people thought it was back to normal times.”

That mistaken view has persisted, even as new cases mount.

“I have to see somebody sick, directly related to me or close to me, in order for it to become like reality,” said Joshua Kwiatkowski, strolling this week at an open-air shopping center in Tempe, Ariz. “So it hasn’t really, I guess, sank in.”

Kwiatkowski said he was not inclined to wear a mask unless required to do so — unless, as he put it, “an Uber driver is feeling some type of way or a store makes you wear it.”

continued…

Requirements designed to stanch the spread of the virus have expanded since Ducey changed course last week and allowed local governments to impose stricter rules on masks than the recommendations issued by the state. A petition urging him to mandate face coverings statewide gained signatures from more than 1,000 medical professionals. Ducey also shifted his stance toward businesses, directing them to develop policies in line with guidance from the Centers for Disease Control and Prevention, which had previously only been recommended.

“There will be enforcement, and they will be held accountable,” the governor said.

Numerous cities responded immediately with mask ordinances and emergency proclamations, including Scottsdale, where a tony neighborhood of bars and high-end boutiques had come to epitomize disregard for social distancing guidelines still technically in effect but largely unenforced. Photos and videos of packed businesses accumulated on social media as Ducey and other officials — frequently appearing themselves without masks — insisted most people were behaving responsibly.

The area, known as Old Town Scottsdale and ordinarily packed even on a weekday, fell quiet this week after the wave of new restrictions unleashed by Ducey’s about-face. Most businesses had only a smattering of customers, while some bars and restaurants had already closed their doors for the evening, despite banners hanging from their facades welcoming customers.

Still, resistance to health precautions remains pronounced. At an anti-mask rally Wednesday, a member of the Scottsdale City Council, Republican Guy Phillips, shouted the dying words of George Floyd — “I can’t breathe” — before ripping off his mask, enlisting a rallying cry of the nationwide protests against racial injustice to inveigh against face coverings that reduce airborne transmission of tiny droplets. Hours later, he issued an apology “to anyone who became offended.”

Phillips, who did not respond to an email seeking further comment, runs an air-conditioning business, and, according to his council biography, is a member of the Better Business Bureau, the Arizona Small Business Association and the North Scottsdale Chamber of Commerce, among other business groups.

At virtually every stage of the state’s pandemic response, the interests of business have held sway, said Nathan Laufer, the founder of the Heart and Vascular Center of Arizona, a medical practice with locations in Phoenix and nearby counties, and a former director of the state medical association.

Ducey is a former chief executive of Cold Stone Creamery. The head of the state’s restaurant association, Steve Chucri, is also a Republican supervisor in Maricopa County. He did not respond to requests for comment.

“It’s fine to be pro-business, but you have to be pro-citizen first,” Laufer said. The governor, in belatedly handing local authorities more control, is “playing catch-up,” he added, “but it’s too little, too late.”

Some residents noted that the Republican governor was following his party’s standard-bearer. “Hindsight’s 20/20, but yeah, it was a little late,” said Greg Cahill, loading his car with groceries outside a Costco at Phoenix’s Christown Spectrum mall. “I think he was a little slow. But he’s a conservative man and he wanted to do what Trump said.”

“It’s scary,” the 58-year-old said of the rising cases.

Protests were mounting at the state capitol over Ducey’s stay-at-home order. Lawmakers in his party were pledging to invalidate it. County sheriffs were refusing to enforce it.

And Trump, who was urging governors to jump-start their economies, was coming to Arizona to tour a Honeywell plant and to convene a discussion about issues facing Native Americans.

The day before the president’s visit, Ducey announced plans to accelerate the reopening of his state’s economy, lifting restrictions on salons and barbershops and allowing restaurants to resume dine-in service. A chart displaying the number of new cases, which did not show the 14-day decline recommended by White House guidelines, “really doesn’t tell you much,” Ducey said at his May 4 news conference.

That evening, the state ended its partnership with the university modeling team whose projections plainly showed a rising caseload in Arizona. It was resumed following an outcry.

Two days later, top health officials acknowledged having changed the testing count to include viral tests confirming an infection and serology tests determining the presence of coronavirus antibodies — a move with the potential to artificially lower the positivity rate touted by Ducey at his May 4 briefing.

“This is a good trajectory for Arizona,” he affirmed at the time.

Ducey’s original order reopening the state — and preventing local officials from setting their own rules despite mounting evidence about the benefits of masks and social distancing — was in keeping with a top-down approach to governance that critics say has characterized his tenure. In 2017, he signed a bill approved by the Republican-controlled legislature that allowed any state legislator to direct the Arizona attorney general to investigate a local regulation for a possible violation of state law. Consequences included potentially losing revenue from the state.

“The biggest challenge has been Governor Ducey tying the hands of mayors and county health departments,” said Regina Romero, the Democratic mayor of Tucson, who said she weighed an emergency proclamation mandating masks in mid-March but was advised against it by her city attorney. Her city’s budget is about $566 million, Romero said, more than a fifth of which comes from the state.

“There’s a real threat with money involved,” the mayor said.

Limited resources have also hampered the ability of the hardest-hit counties to conduct thorough contact tracing. Maricopa County shifted in the early weeks of the pandemic to what it called a “mediated” approach in which all sickened people are interviewed but are then made responsible for notifying their own contacts.

A spokesman for the county health department, Ron Coleman, confirmed this week the limited approach is still in use, even as cases soar.

Hugh Lytle, chief executive of Equality Health, said the willingness of people in Phoenix to wait for hours to be tested at the drive-in site organized by his medical group over the weekend has been a wake-up call.

State officials are taking note, he said, of the “overwhelming level of fear and anxiety that’s causing people to say it’s worth sitting in my car for a couple hours.”

https://www.washingtonpost.com/health/how-arizona-lost-control-of-the-epidemic/2020/06/25/f692a5a8-b658-11ea-aca5-ebb63d27e1ff_story.html

I Sent Checks to Dead People

$1.4 billion worth of stimulus checks was sent to more than 1 million dead Americans, a congressional watchdog said yesterday.

That happened partially because the Treasury’s Bureau of the Fiscal Service, which was in charge of sending out stimulus checks, didn’t have access to the Social Security Administration’s set of death records.

So who is this watchdog that would dare hold the government accountable? The Government Accountability Office (GAO), which released a 403-page report evaluating Washington’s response to the COVID-19 pandemic. The conclusion: room for improvement.

The GAO knocked the Small Business Administration for dragging its feet in complying with its investigation and for not addressing fraud risks stemming from the Paycheck Protection Program.

It also said the CDC’s initial COVID-19 tests had “accuracy and reliability issues” that hurt the U.S.’ early response.

Big picture: As the economic recovery takes shape (or doesn’t), there’s going to be an intensifying battle on Capitol Hill over the next stimulus package. The GAO will expect better oversight.

Here’s the 403-page report:

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

People in their 20s, 30s and 40s account for a growing proportion of the cases in many places, raising fears that asymptomatic young people are helping to fuel the virus’s spread.

By Julie Bosman and Sarah Mervosh

Updated June 26, 2020, 6:09 a.m. ET

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

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

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

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

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

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

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

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

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

Adriana Carter, 21, is among the newly infected.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

In King County, Wash., which includes Seattle, people in their 20s and 30s make up about 45 percent of new coronavirus cases — a number that was 25 percent in March…

https://www.nytimes.com/2020/06/25/us/coronavirus-cases-young-people.html

Almost one-third of black Americans know someone who died of covid-19, Post-Ipsos poll finds

Nearly 1 in 3 black Americans know someone personally who has died of covid-19, far exceeding their white counterparts, according to a Washington Post-Ipsos poll that underscores the coronavirus pandemic’s profoundly disparate impact.

The nationwide survey finds that 31 percent of black adults say they know someone firsthand who has been killed by the virus, compared with 17 percent of adults who are Hispanic and 9 percent who are white.

https://www.washingtonpost.com/health/almost-one-third-of-black-americans-know-someone-who-died-of-covid-19-survey-shows/2020/06/25/3ec1d4b2-b563-11ea-aca5-ebb63d27e1ff_story.html

My brother and family live in Chile. They were able to leave in mid-June and have been self-quarantining in the states and will stay with a relative for a couple of weeks. They haven’t been allowed to leave their house in Chile, even to walk the dog. They are coming to stay with me for 10 days before their jobs are saying they have to be back in Chile. Then if they do get stranded, they aren’t paying for hotels and Airbnbs and having to move every few days - I have room for them for however long it takes.

Your solution is?

The problem, I believe, is that those going out aren’t spending enough more to cover for those who aren’t. Couple that with higher expenses needed to open up with the new normal (more money for disposable items, more hand sanitizer, masks, shields, whatever) and any gov’t help from funds going away since they can now be open, and it doesn’t look good for many businesses.

Some businesses, of course, are doing extremely well (pool sales for one), but those doing well aren’t in the majority and that will continue to affect tax income everywhere with sales taxes making it tougher for localities to keep up spending too.

IF we could have opened up safely with masks, distancing, and cleanliness I think it might have worked because it seems to be working elsewhere, but not enough people are on board with trying to do it. Therefore there are more cases, there will likely be more deaths, more people will get scared, and the $$ coming in will fall over time instead of rising.

Deaths go up, economy goes down.

Unfortunately, there probably is no (societal) solution in the short term (before the needed medical advances occur).

In the meantime, individuals, households, and organizations can only do the best they can to protect their own health and finances*. For many on these forums (high income and wealth, whose biggest problem is the loss of their kids’ residential college experience), that may not be too difficult if they make the appropriate choices. But for many other Americans, it may require hard choices, if they have much of a choice at all.

*It is hard to protect your health if you have no money, and it is hard to protect your finances if you are sick and cannot work while running up medical bills.