Archive for June 1st, 2020

Experts dispute reports that coronavirus is becoming less lethal – The Washington Post

June 1st, 2020

Alberto Zangrillo, head of San Raffaele Hospital in Milan, roiled the global public health community on Sunday when he told RAI, the national TV station, that “the virus clinically no longer exists in Italy,” with patients showing minute amounts of virus in nasal swabs. Zangrillo theorized in a follow-up interview with The Washington Post that something different may be occurring “in the interaction between the virus and the human airway receptors.”

He added, “We cannot demonstrate that the virus has mutated, but we cannot ignore that our clinical findings have dramatically improved.”

The comments, which received widespread attention following a Reuters report, prompted vigorous pushback from Michael Ryan, a top official with the World Health Organization, who said Monday during an online news conference that “we need to be exceptionally careful not to create a sense that all of a sudden the virus by its own volition has now decided to be less pathogenic. That is not the case at all.”

The consensus among other experts interviewed Monday is that the clinical findings in Italy likely do not reflect any change in the virus itself.

Zangrillo’s clinical observations are more likely a reflection of the fact that with the peak of the outbreak long past, there is less virus in circulation, and people may be less likely to be exposed to high doses of it. In addition, only severely sick people were likely to be tested early on, compared with the situation now when even those with mild symptoms are more likely to get swabbed, experts said.

The pandemic is evolving rapidly, with the rate of new cases declining in some hard-hit areas of the world, including northern Italy and New York City, while rising dramatically in Brazil, Peru and India. The virus, however, is mutating at a slow rate, experts say.

Some strains of the virus have become more dominant, but there is no firm evidence yet that any of them are more contagious or deadly, according to scientists who have reviewed recent genetic studies.

Vaughn Cooper, an infectious-disease expert at the University of Pittsburgh School of Medicine, said the new coronavirus mutates slowly compared with influenza and other microbes, and its genetic changes appear to be “mostly inconsequential.”

“I believe it’s safe to say that the differences that doctors are reporting in Italy are entirely due to changes to medical treatment and in human behavior, which limit transmission and numbers of new infections initiated by large inocula — a larger dose of virus appears to be worse — rather than changes in the virus itself,” he said.

All viruses evolve over time, and many infectious-disease experts think the novel coronavirus will eventually become less lethal to human beings, joining four other coronaviruses in causing common colds. But there is no solid evidence so far that it has changed significantly in the five months since it was first recognized among patients in Wuhan, China.

“The virus hasn’t lost function on the time scale of two months,” said Andrew Noymer, an epidemiologist at the University of California at Irvine. “Loss of function is something I expect over a time scale of years.”

In the United States, the pandemic has taken on a patchwork pattern, with much of the Northeast seeing marked improvement. But some places in the South — Alabama, Texas and Virginia, for example — as well as Wisconsin, California and Washington state are showing increases in confirmed cases, according to the coronavirus tracker of Johns Hopkins University.

“Every place has a different epidemic, and it’s not because of the virus,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security.

Slight tweaks in the microbe’s genetic makeup appear in different places on the planet. Epidemiologists use those mutations to track the virus’s spread. Those changes are akin to stickers slapped on a well-traveled suitcase — markers of where the luggage has gone that don’t impart any functional change.

Researchers Harm van Bakel, Emilia Sordillo and Viviana Simon at the Icahn School of Medicine at Mount Sinai, who have been focusing on the genetics of the novel coronavirus, said in an interview that they had not seen a dip in viral load among patients in that hospital system since March, nor have they detected any major genetic changes in the virus in New York City.

People in the United States are collectively holding their breath, meanwhile, to see if there is an uptick in cases in response to the reopening of the economy, public gatherings over the Memorial Day holiday weekend and the eruption of protests against police violence in cities in recent days.

Nuzzo pointed out that it usually takes around five days, and up to 14 days, for an infection to result in symptoms, and then there is a further time lag before someone seeks a test and gets a result. There is also a lag between when symptoms begin and a person with a serious illness requires hospitalization. Thus it may be several weeks before the lessening of social distancing could result in a detectable change in the trajectory of a local epidemic, she said.

Compounding the uncertainty is the lack of a clear understanding of where and how the virus is spreading, because the country hasn’t done the extensive testing and contact tracing to know where or how infections have occurred.

“We never knew where the transmission was occurring in the United States. And still don’t know,” she said. “Is it risky to go to the grocery store?”

Caitlin Rivers, an epidemiologist and senior scholar at Johns Hopkins, noted that it is hard to tell to what degree people are practicing recommended safety measures, such as social distancing, in communities that have eased stay-at-home orders. She is most concerned about crowded institutions in which social distancing is difficult or impossible.

“I think we will continue to see explosive outbreaks connected to institutions,” Rivers said.

Of the 10 counties in the United States experiencing the greatest increase in their seven-day new case average from Friday, May 22, to Friday, May 29, at least nine have experienced outbreaks at a correctional facility, detention center, food processing center, or long-term-care facility.

“An outbreak starts at an institution, then it starts to move into the community,” Rivers said. “We can’t just say, ‘It’s there at that place, it’s irrelevant to the rest of us.’ That’s not true.”


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June 1st, 2020

Coronavirus in Oregon: One new death as known cases eclipse 4,300 –

June 1st, 2020

The Oregon Health Authority on Monday reported one new death from the novel coronavirus for a toll of 154 people as cases rose to 4,302.

The latest person to succumb to the disease was a 59-year-old man from Marion County, who tested positive last Friday and died the same day at Salem Hospital. He had underlying medical conditions, health officials said.

In the last 24 hours, the state reported 59 new confirmed and presumptive coronavirus cases.

They were in 14 of Oregon’s 36 counties: Clackamas (5), Deschutes (2), Jackson (1), Jefferson (11), Josephine (1), Lane (4), Lincoln (3), Linn (2), Marion (13), Morrow (1), Multnomah (6), Polk (2), Umatilla (4), Washington (4).

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Death toll: At least 154 people have died from the virus. They are from 12 counties — 59 people from Multnomah, 26 from Marion, 17 from Washington, 12 from Polk, 11 from Clackamas, nine from Linn, seven from Yamhill, five from Benton, three from Umatilla, three from Lane, one each from Josephine and Wasco.

Their ages ranged from 41 to 100. Among them, 89 men have died and 65 women have died. All but three had underlying medical conditions.

[Read about Oregon coronavirus deaths. Help us learn more.]

Senior care homes: Nearly six out of 10 coronavirus deaths in Oregon — at least 86 — are associated with a care center, a newsroom analysis of state data shows. About 550 to 600 senior care home residents, staff and close contacts from 66 nursing, assisted and retirement homes have contracted the coronavirus.

A federal report Monday said eight deaths were among workers at Oregon nursing homes.

County case totals: Eight counties — Multnomah, Marion, Washington, Clackamas, Deschutes, Linn, Umatilla and Polk — have reported 100 coronavirus cases or more. Gilliam and Wheeler still have reported none.

Here’s the overall count — confirmed and presumptive cases — by county: Baker (1), Benton (55), Clackamas (317), Clatsop (45), Columbia (16), Coos (31), Crook (6), Curry (7), Deschutes (127), Douglas (27), Grant (1), Harney (1), Hood River, (18), Jackson (67), Jefferson (44), Josephine (24), Klamath (44), Lake (2), Lane (77), Lincoln (15), Linn (117), Malheur (32), Marion (973), Morrow (12), Multnomah (1,171), Polk (100), Sherman (1), Tillamook (6), Umatilla (120), Union (6), Wallowa (2), Wasco (24), Washington (743) and Yamhill (70).

Testing: Another 2,415 people received coronavirus test results, up from the previous day’s 2,400, according to figures published on the health authority’s website.

So far, 131,508 Oregonians have been tested for the illness since the state confirmed its first case on Feb. 28.

Ages: Cases are so far spread relatively evenly among people in their 20s (16%), people in their 30s (17%), people in their 40s (17%) and people in their 50s (17%).

The breakdown: 0-9 (65), ages 10-19 (179), ages 20-29 (689), ages 30-39 (737), ages 40-49 (747), ages 50-59 (732), ages 60-69 (557), ages 70-79 (357), ages 80-plus (239).

Gender: Of the cases, 2,236 are among women, or 52%, and 2,063, or 48%, are among men. But more men have died: 89 compared to 65 women.

Hospitalizations: At least 790 of the state’s COVID-19 patients, or 18%, have been hospitalized at some point during their illness, according to the health authority. Currently, 50 people with confirmed coronavirus cases are hospitalized, including 19 in intensive care and 13 on ventilators.

Recoveries: At least 2,164 COVID-19 patients have recovered from the illness, the health authority said.

Here’s the list by county: Benton (36), Clackamas (168), Clatsop (7), Columbia (16), Coos (3), Crook (1), Curry (4), Deschutes (102), Douglas (25), Grant (1), Harney (1), Hood River (7), Jackson (52), Jefferson (22), Josephine (20), Klamath (37), Lane (61), Lincoln (8), Linn (73), Malheur (19), Marion (370), Morrow, (7), Multnomah (458), Polk (60), Sherman (1), Tillamook (6), Umatilla (101), Union (5), Wallowa (1), Wasco (15), Washington (473), Yamhill (40).

Nationwide: Confirmed coronavirus cases stood at more than 1.8 million. The death toll climbed past 105,000.

— Margaret Haberman, 503-221-8375

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Distancing Works, N95 Respirators Work Better – Medscape

June 1st, 2020

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s  Coronavirus Resource Center.

A study that claims to be the first review of all the available evidence of the effectiveness of physical distancing, face masks, and eye protection to prevent spread of COVID-19 and other respiratory diseases has quantified the effectiveness of these protective measures. The study found that greater physical distancing from an exposed person significantly reduces risk of transmission and that N95 masks, particularly for health care workers, are more effective than other face coverings.

The meta-analysis, published online in The Lancet (2020 Jun 2; S0140-6736(20)31142-9) also marks the first evaluation of these protective measures in both community and health care settings for COVID-19, the study authors stated.

“The risk for infection is highly dependent on distance to the individual infected and the type of face mask and eye protection worn,” wrote Derek K. Chu, MD, PhD, of McMaster University in Hamilton, Ont., and colleagues, reporting on behalf of the COVID-19 Systematic Urgent Review Group Effort, or SURGE.

The study reported that physical distancing of at least 1 meter, or about a yard, “seems to be strongly associated with a large protective effect,” but that distancing of 2 meters or about 6 feet could be more effective.

The study involved a systematic review of 172 observational studies across six continents that evaluated distance measures, face masks, and eye protection to prevent transmission between patients with confirmed or probable COVID-19, other severe acute respiratory syndrome (SARS) disease, and Middle East respiratory syndrome (MERS), and their family members, caregivers and health care workers up to May 3, 2020. The meta-analysis involved pooled estimates from 44 comparative studies with 25,697 participants, including seven studies of COVID-19 with 6,674 participants. None of the studies included in the meta-analysis were randomized clinical trials.

A subanalysis of 29 unadjusted and 9 adjusted studies found that the absolute risk of infection in proximity to an exposed individual was 12.8% at 1 m and 2.6% at 2 m. The risk remained constant even when the six COVID-19 studies in this subanalysis were isolated and regardless of being in a health care or non–health-care setting. Each meter of increased distance resulted in a doubling in the change in relative risk (= .041).

The study also identified what Dr. Chu and colleagues characterized as a “large reduction” in infection risk with the use of both N95 or similar respirators or face masks, with an adjusted risk of infection of 3.1% with a face covering vs. a 17.4% without. The researchers also found a stronger association in health care settings vs. non–health care settings, with a relative risk of 0.3 vs. 0.56, respectively (= .049). The protective effect of N95 or similar respirators was greater than other masks, with adjusted odds ratios of 0.04 vs. 0.33 (= .09).

Eye protection was found to reduce the risk of infection to 5.5% vs. 16% without eye protection.

The study also identified potential barriers to social distancing and use of masks and eye protection: discomfort, resource use “linked with potentially decreased equity,” less clear communication, and a perceived lack of empathy on the part of providers toward patients.

Dr. Chu and colleagues wrote that more “high-quality” research, including randomized trials of the optimal physical distance and evaluation of different mask types in non–health care settings “is urgently needed.” They added, “Policymakers at all levels should, therefore, strive to address equity implications for groups with currently limited access to face masks and eye protection.”

The goal of this study was to “inform WHO guidance documents,” the study noted. “Governments and the public health community can use our results to give clear advice for community settings and healthcare workers on these protective measures to reduce infection risk,” said study co-leader Holger Schünemann, MD, MSc, PhD, of McMaster University.

Prof. Raina MacIntyre, MBBS, PhD, head of the biosecurity research program at the Kirby Institute at the University of New South Wales in Sydney, who authored the comment that accompanied the article, said that this study provides evidence for stronger PPE guidelines.

“The Centers for Disease Control and Prevention initially recommended N95s for health workers treating COVID-19 patients, but later downgraded this to surgical masks and even cloth masks and bandannas when there was a supply shortage,” she said. “This study shows that N95s are superior masks and should prompt a review of guidelines that recommend anything less for health workers.”

Recommending anything less than N95 masks for health workers is like sending troops into battle “unarmed or with bows and arrows against a fully armed enemy,” she said. “We are not talking about a device that costs hundreds or thousands of dollars; a N95 costs less than a dollar to produce. All that is needed to address the supply shortage is political will.”

While the study has some shortcomings – namely that it didn’t provide a breakdown of positive tests among COVID-19 participants – it does provide important insight for physicians, Sachin Gupta, MD, a pulmonary and critical care specialist in San Francisco, said in an interview. “The strength of a meta-analysis is that you’re able to get a composite idea; that’s one up side to this,” he said. “They’re confirming what we knew: that distance matters; that more protective masks reduce risk of infection; and that eye protection has an important role.”

Dr. Chu and colleagues have no relevant financial relationships to disclose. One member of SURGE is participating in a clinical trial comparing medical masks and N95 respirators. The World Health Organization provided partial funding for the study.

SOURCE: Chu DK et al. Lancet. 2020 Jun 2; S0140-6736(20)31142-9.

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Sony Delays PS5 Reveal Event – The Daily Fix – IGN

June 1st, 2020

Apple fixes bug that could have given hackers full access to user accounts – Ars Technica

June 1st, 2020

Trump threatens military force against protesters across the U.S. – CTV News

June 1st, 2020

WASHINGTON — Wielding extraordinary federal authority, U.S. President Donald Trump threatened the nation’s governors on Monday that he would deploy the military to states if they did not stamp out violent protests over police brutality that have roiled the nation over the past week. His announcement came as police under federal command forced back peaceful demonstrators with tear gas so he could walk to a nearby church and pose with a Bible.

Trump’s bellicose rhetoric came as the nation braced for another round of violence at a time when the country is already buckling because of the coronavirus outbreak and the Depression-level unemployment it has caused. The president demanded an end to the heated protests in remarks from the White House Rose Garden and vowed to use more force to achieve that aim.

If governors throughout the country do not deploy the National Guard in sufficient numbers to “dominate the streets,” Trump said the U.S. military would step in to “quickly solve the problem for them.”

“We have the greatest country in the world,” the president declared. “We’re going to keep it safe.”

A military deployment by Trump to U.S. states would mark a stunning federal intervention not seen in modern American history. Yet the message Trump appeared to be sending with the brazen pushback of protesters outside the White House was that he sees few limits to what he is willing to do.

Some around the president likened the moment to 1968, when Richard Nixon ran as the law-and-order candidate in the aftermath of a summer of riots, capturing the White House. But despite his efforts to portray himself as a political outsider, Trump is an incumbent who risks being held responsible for the violence.

Minutes before Trump began speaking, police and National Guard soldiers began aggressively forcing back hundreds of peaceful protesters who had gathered in Lafayette Park, across the street from the White House, where they were chanting against police brutality and the Minneapolis death of George Floyd. As Trump spoke, tear gas canisters could be heard exploding.

Floyd died last week after he was pinned to the pavement by a police officer who put his knee on the handcuffed black man’s neck until he stopped breathing. His death set off protests that spread from Minneapolis across America. His brother Terrence pleaded with protesters on Monday to remain peaceful.

Five months before Election Day, the president made clear that he would stake his reelection efforts on convincing voters that his strong-arm approach was warranted to quell the most intense civil unrest since the 1960s. He made little effort to address the grievances of black Americans and others outraged by Floyd’s death and the scourge of police brutality, undermining what his campaign had hoped would be increased appeal to African American voters.

The scene in and around the White House on Monday night appeared to be carefully orchestrated. As the crowd of protesters grew, Attorney General William Barr arrived in Lafayette Park to look over at the demonstrations and the swarm of law enforcement.

The sudden shift in tactics against the protesters was initially a mystery. Then, after finishing his Rose Garden remarks, Trump emerged from the White House gates and walked through the park to St. John’s Church, where an office had been set on fire the previous night.

Trump, who rarely attends church, held up a Bible and gathered a group of advisers — all white — to pose for photos.

The moment was quickly decried by Trump’s critics, with New York Gov. Andrew Cuomo saying the president “used the military to push out a peaceful protest so he could have a photo op at a church.”

“It’s all just a reality TV show for this president,” he said on Twitter. “Shameful.”

Federal law permits presidents to dispatch the military into states to suppress an insurrection or if a state is defying federal law, legal experts said. But Trump’s statements also set up an immediate conflict with officials in New York and other states who asserted that the president does not have the unilateral right to send in troops against the will of local governments.

The country has been beset by angry demonstrations for the past week in some of the most widespread racial unrest in the U.S. since the 1960s. Spurred largely by Floyd’s death, protesters have taken to the streets to decry the killings of black people by police. Minneapolis Officer Derek Chauvin has been charged with murder, but protesters are demanding that three of his colleagues be prosecuted, too. All four were fired.

While most of the demonstrations have been peaceful, others have descended into violence, leaving neighbourhoods in shambles, stores ransacked, windows broken and cars burned, despite curfews around the country and the deployment of thousands of National Guard members in at least 15 states.

On Monday, demonstrations erupted from Philadelphia, where hundreds of protesters spilled onto a highway in the heart of the city, to Atlanta, where police fired tear gas at demonstrators, to Nashville, where more than 60 National Guard soldiers put down their riot shields at the request of peaceful protesters who had gathered in front of Tennessee’s state capitol to honour Floyd. Two people were killed during protests in the Chicago suburb of Cicero, authorities said, but provided no details. In Louisville, Kentucky, riot police firing tear gas scattered several hundred protesters from downtown, violently capping a day of mostly peaceful protests.

A vehicle plowed through a group of law enforcement officers at a demonstration in Buffalo, New York, injuring at least two. Video from the scene showed the vehicle accelerating through an intersection shortly after officers apparently tackled a protester and handcuffed him. The officers were hospitalized in stable condition, authorities said.

In New York City, where nightfall has brought widespread scenes of destruction, large crowds rallied peacefully in Times Square and Brooklyn during the day. Then, in early evening, looters rushed into a Nike store in Manhattan and protesters smashed storefront windows near Rockefeller Center. Video posted on social media showed some protesters arguing with people breaking windows, urging them to stop.

In Washington, protesters continued marching peacefully through Washington hours after being forced from Lafayette park and past the 7 p.m. curfew.

Eventually, within sight of the Capitol building, the marchers were turned back by law enforcement officers using tear gas, pellets and low-flying helicopters kicking up debris. As they dispersed, some protesters smashed windows at a nearby office building.

Earlier Monday, Trump told the nation’s governors in a video conference that they “look like fools” for not deploying even more National Guard troops. “Most of you are weak,” he said.

He added: “You’ve got to arrest people, you have to track people, you have to put them in jail for 10 years and you’ll never see this stuff again.”

Washington Gov. Jay Inslee, a Democrat, dismissed Trump’s comments as the “rantings of an insecure man trying to look strong after building his entire political career on racism.”

Former Vice-President Joe Biden, the Democratic presidential candidate, vowed to address institutional racism in his first 100 days in office. He met in person with black leaders in Delaware and also held a virtual meeting with big-city mayors.

Biden said hate emerges “when you have somebody in power who breathes oxygen into the hate.”

In Minneapolis, meanwhile, Floyd’s brother Terrence made an emotional plea for peace at the site where Floyd was arrested.

“Let’s switch it up, y’all. Let’s switch it up. Do this peacefully, please,” Terrence Floyd said as he urged people to use their power at the ballot box.

Also Monday, an autopsy commissioned for Floyd’s family found that he died of asphyxiation from neck and back compression, the family’s attorneys said.

Authorities in many cities have blamed the violence on outside agitators, though have provided little evidence to back that up.

But on Monday, federal authorities arrested a 28-year-old Illinois man saying he had posted self-recorded video on his Facebook page last week that showed him in Minneapolis handing out explosive devices and encouraging people to throw them at law enforcement officers.

More than 5,600 people nationwide have been arrested over the past week for such offences as stealing, blocking highways and breaking curfew, according to a count by The Associated Press.

Sullivan and Morrison reported from Minneapolis. Associated Press journalists across the U.S. contributed to this report.

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Six Months of Coronavirus: Here’s Some of What We’ve Learned – The New York Times

June 1st, 2020

We don’t really know when the novel coronavirus first began infecting people. But as we turn a page on our calendars into June, it is fair to say that Sars-Cov-2 has been with us now for a full six months.

At first, it had no name or true identity. Early in January, news reports referred to strange and threatening symptoms that had sickened dozens of people in a large Chinese city with which many people in the world were probably not familiar. After half a year, that large metropolis, Wuhan, is well-known, as is the coronavirus and the illness it causes, Covid-19.

In that time, many reporters and editors on the health and science desk at The New York Times have shifted our journalistic focus as we have sought to tell the story of the coronavirus pandemic. While much remains unknown and mysterious after six months, there are some things we’re pretty sure of. These are some of those insights.

Here are some things we think we know about coronavirus:


Credit…Jens Mortensen for The New York Times

Summer is almost here, states are reopening and new coronavirus cases are declining or, at least, holding steady in many parts of the United States. At least 100 scientific teams around the world are racing to develop a vaccine.

That’s about it for the good news.

The virus has shown no sign of going away: We will be in this pandemic era for the long haul, likely a year or more. The masks, the social distancing, the fretful hand-washing, the aching withdrawal from friends and family — those steps are still the best hope of staying well, and will be for some time to come.

“This virus just may become another endemic virus in our communities, and this virus may never go away,” Dr. Mike Ryan, the executive director of the World Health Organization’s health emergencies program, warned last month. Some scientists think that the longer we live with the virus, the milder its effects will become, but that remains to be seen.

Predictions that millions of doses of a vaccine may be available by the end of this year may be too rosy. No vaccine has ever been created that fast.

The disease would be less frightening if there were a treatment that could cure it or, at least, prevent severe illness. But there is not. Remdesivir, the eagerly awaited antiviral drug? “Modest” benefit is the highest mark experts give it.

Which brings us back to masks and social distancing, which have come to feel quite antisocial. If only we could go back to life the way it used to be.

We cannot. Not yet. There are just enough wild cards with this disease — perfectly healthy adults and children who inexplicably become very, very sick — that no one can afford to be cavalier about catching it. About 35 percent of infected people have no symptoms at all, so if they are out and about, they could unknowingly infect other people.

Enormous questions loom. Can workplaces be made safe? What about trains, subways, airplanes, school buses? How many people can work from home? When would it be safe to reopen schools? How do you get a 6-year-old with the attention span of a squirrel to socially distance?

The bottom line: Wear a mask, keep your distance. When the time comes in the fall, get a flu shot, to protect yourself from one respiratory disease you can avoid and to help keep emergency rooms and urgent care from being overwhelmed. Hope for a treatment, a cure, a vaccine. Be patient. We have to pace ourselves. If there’s such a thing as a disease marathon, this is it.

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Credit…Jens Mortensen for The New York Times

The debate over whether Americans should wear face masks to control coronavirus transmission has been settled. Although public health authorities gave confusing and often contradictory advice in the early months of the pandemic, most experts now agree that if everyone wears a mask, individuals protect one another.

Researchers know that even simple masks can effectively stop droplets spewing from an infected wearer’s nose or mouth. In a study published in April in Nature, scientists showed that when people who are infected with influenza, rhinovirus or a mild cold-causing coronavirus wore a mask, it blocked nearly 100 percent of the viral droplets they exhaled, as well as some tiny aerosol particles.

Still, mask wearing remains uneven in many parts of the United States. But governments and businesses are beginning to require, or at least recommend, that masks be worn in many public settings.

There is also growing evidence that some kinds of masks may protect you from other people’s germs. High-grade N95 masks are cleared by federal public health agencies because they filter out at least 95 percent of particles that are 0.3 microns in diameter when properly worn. One study showed that N95s were able to capture over 90 percent of viral particles, even if the particles were about one-fifth the size of a coronavirus. Other studies have shown that flat, blue surgical masks block between 50 to 80 percent of particles, whereas cloth masks block 10 to 30 percent of tiny particles.

“Wearing a mask is better than nothing,” said Dr. Robert Atmar, an infectious disease specialist at Baylor College of Medicine. Because the coronavirus typically infects people by entering their body through the mouth and nose, covering these areas can act as the first line of defense against the virus, he said.

Donning a face covering is also likely to prevent you from touching your face, which is another way the coronavirus can be transmitted from contaminated surfaces to unsuspecting individuals. And when combined with hand washing and other protective measures, such as social distancing, masks help reduce the transmission of disease, Dr. Atmar said.


Credit…Jens Mortensen for The New York Times

The United States knows how to fight wars. But, as the past few months have shown, the American response to pathogens can easily become a shambles — even though pathogens kill more Americans than many wars have.

We have no viral Pentagon. The Centers for Disease Control and Prevention is more of an F.B.I. for outbreak investigations than a war machine. For years — under both the Obama and Trump administrations — its leaders have had to seek clearance for almost every utterance.

Dr. Anthony S. Fauci, the most prominent of the doctors advising the coronavirus task force, is actually the head of a research institute, the National Institute for Allergy and Infectious Disease, rather than of the medical equivalent of a combat battalion.

The Surgeon General is essentially an admiral without a crew. He dispenses health warnings and recommendations, but the Public Health Services Commissioned Corps, which reports to him, are only about 6,500 strong, and many members have other jobs, often at the C.D.C.

Almost all the front-line troops — the contact tracers, the laboratory technicians, the epidemiologists, the staff in state and city hospitals — are paid by state and local health departments whose budgets have shriveled for years. These soldiers are led by 50 commanders, in the form of governors, and with that many in charge, it is amazing that any response moves forward.

The rest of the response is in the hands of thousands of private militias — hospitals, insurers, doctors, nurses, respiratory technicians, pharmacists and so on, all of whom have individual employers. Within limits, they can do what they want. When they cannot get something they need from overseasthey are largely powerless without federal logistical help.

As war does to defeated nations, pandemics expose the weaknesses of their systems. Our patchwork and uncoordinated response has produced more than 100,000 deaths; surely we can do better.

“The superpowers have their priorities all wrong,” Dr. Michael Ryan, the head of the W.H.O.’s emergencies program, said recently.

“They spend billions on missiles and submarines, and on fighting terrorism, and pennies on viruses. You can start peace talks with your enemy. You can change your policies to lessen the threat of terrorism. But you cannot negotiate with a virus, and we know that new threats are coming along every year.”


The federal government has spent hundreds of billions of dollars and promised to spend more than $2 trillion to address the coronavirus pandemic.

Of that money, $2 billion has gone to helping companies develop new vaccines, expanding testing capacity nationwide and shoring up the economic fallout since the beginning of March. (Even more could be on the way, but how much and when is unclear.)

The vast majority of this spending has been aimed at blunting the economic pain of small businesses shutting down and people losing their jobs or being furloughed. Congress also provided additional money for Medicaid and other social programs.

Hospitals, community health centers and other providers have been allocated $175 billion to cover the cost of caring for patients with Covid-19 and for the visits, procedures and surgeries that were canceled because of the pandemic. In the latest bill, $25 billion was targeted for coronavirus testing.

Many experts say more funding is needed, but there is ample controversy over how the money already allocated is being spent and which entities are getting funds. Various groups like the Committee for a Responsible Federal Budget are tracking the spending. By that organization’s calculation, roughly $1.6 trillion has already been disbursed or committed. The Federal Reserve has also provided more than $2 trillion in emergency lending, asset purchases and other activities, it said.


The landscape for testing looks far better than it did in the early days of the outbreak, when a botched rollout of coronavirus tests failed to detect the spread of the virus in the United States.

Today, hundreds of thousands of tests a day are being conducted in the United States, and in some areas it is so widely available that public health officials have complained they do not have enough takers. In Los Angeles, where testing is free to everyone, a drive-through site at Dodgers Stadium can process 6,000 people a day.

The range of tests available is also expanding. Tests that once required a health care worker to insert a swab through the nose to the back of the throat can now be done with a swipe inside the nose, or by spitting into a cup. A handful of companies now sell at-home test kits, and a test from Abbott can detect the virus in as little as five minutes.

In addition to the tests that detect active infections, Americans can also get tested for antibodies to the virus, which shows whether they have ever been infected, and could help give a better picture for how widely the coronavirus has spread in communities.

But despite this progress, the United States still has a long way to go. Public health experts say that anywhere from 900,000 tests to millions a day will be needed to screen hospital patients, nursing home residents and employees returning to work.

And even as testing is abundant in some areas, it is still hard to come by in others. Shortages of key supplies needed to run the tests — such as swabs and chemical reagents — have persisted. The federal government has effectively delegated oversight to the states, creating a patchwork of policies and putting states in competition with one another. Even tracking the number of tests conducted has proved difficult, after the C.D.C. and several states began lumping tests for the virus as well as antibodies together, to the bafflement of epidemiologists trying to track active infections, which the antibody tests do not show.


The idea is simplicity itself: If enough of the population has antibodies to the novel coronavirus, the virus will hit too many dead ends to continue infecting people. That is herd immunity.

That is the great hope for a vaccine. But it may not happen, even if a vaccine becomes available, as experience with flu vaccines shows.

Dr. Paul Offit of Children’s Hospital of Philadelphia and the University of Pennsylvania noted that while vaccines eliminated measles, rubella and smallpox and almost eliminated polio in the United States, vaccines against influenza and whooping cough have not stopped outbreaks. (With some parents declining measles vaccines, the disease is coming back.)

Influenza and whooping cough have spread, even after enough people in a community have been vaccinated to, in theory, stop the diseases. That’s because the antibodies that protect people against viruses infecting mucosal surfaces like the lining of the nose tend to be short-lived.

Vaccines against respiratory diseases are, at best, modestly effective, agreed Dr. Arnold Monto of the University of Michigan,

Since the coronavirus usually starts by infecting the respiratory system, Dr. Monto suspects that a Covid-19 vaccine would have a similar effect to a flu vaccine — it will reduce the incidence of the disease and make it less severe on average, but it will not make Covid-19 go away.

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  • Frequently Asked Questions and Advice

    Updated June 1, 2020

    • How do we start exercising again without hurting ourselves after months of lockdown?

      Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.

    • My state is reopening. Is it safe to go out?

      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • How many people have lost their jobs due to coronavirus in the U.S.?

      More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • How can I help?

      Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.

He would like the virus to disappear, of course, but a vaccine that reduces the disease’s spread and severity is a lot better than nothing.

“As an older person, what I want is not to end up on a respirator,” Dr. Monto said.


Credit…Jens Mortensen for The New York Times

Covid-19 is a viral respiratory illness. Many early descriptions of symptoms focused on patients being short of breath and eventually being placed on ventilators. But the virus does not confine its assault to the lungs, and doctors have identified a number of symptoms and syndromes associated with it.

In some patients, the virus propels the immune system into overdrive, causing the lungs to fill with fluid and damaging multiple organs, including the brain, heart, kidneys and liver.

The first symptoms of an infection are usually a cough and shortness of breath. But in April the C.D.C. added to the list of early signs sore throat, fever, chills and muscle aches. Gastrointestinal upset, such as diarrhea and nausea, has also been observed.

Another telltale sign of infection may be a sudden, profound diminution of one’s sense of smell and taste. Teenagers and young adults in some cases have developed painful red and purple lesions on the fingers and toes, but few other serious symptoms.

Severe disease leads to pneumonia and acute respiratory distress syndrome. The blood oxygen levels plummet, and patients may get supplemental oxygen or be placed on a machine, called a ventilator, to help them breathe.

But even without lung impairment, the disease can cause injury to the kidneys, heart or liver. Critically ill patients are prone to developing dangerous blood clots in the legs and the lungs. In rare cases, the disease triggers ischemic strokes that block the arteries supplying blood to the brain, or brain impairments, such as altered mental status or encephalopathy.

Death can result from heart failure, kidney failure, multiple organ failure, respiratory distress or shock.


Credit…Jens Mortensen for The New York Times

The news, when it was reported, added a frightening twist to the threat from the coronavirus: A study in March in The New England Journal of Medicine found that under laboratory conditions, the virus can survive for up to three days on some surfaces, such as plastic and steel, and on cardboard for up to 24 hours.

Other studies reported finding the virus on air vents in hospital rooms and on computer mice, sickbed handrails and doorknobs.

Many people grew worried that by touching a surface that had been covered in droplets by an infected person, and then touching their own mouth, nose or eyes, they then would contract the virus.

You should still wear a mask, avoid touching your face in public and keep washing your hands. But none of these studies tested for live virus, only for traces of its genetic material. Other scientists commenting on these studies said virus on these surfaces might degrade more quickly. The Centers for Disease Control and Prevention has said since March that contaminated surfaces are “not thought to be the main way” the virus spreads.

The main driver of infection is thought to be directly inhaling droplets released when an infected person sneezes, coughs, sings or talks. The C.D.C. recently made changes to its website to make this message even more explicit.


In February, three experts on viruses published an editorial in a journal headlined “We Shouldn’t Worry When a Virus Mutates During Outbreaks.”

But worry we did. As the coronavirus pandemic swept the planet, headlines and tweets poured forth that the new coronavirus was undergoing dangerous mutations.

Many of these worries were based on a misunderstanding of what it means when a virus mutates. When an infected cell produces new viruses, it sometimes makes mistakes in copying the viral genes. Those mistakes are mutations, and it turns out that most are bad for the viruses, getting in the way of their ability to hijack our cells.

The viruses that do manage to spread to new hosts have mutations, too. But those mutations often don’t have any significant effect. The alterations they bring to a virus’s genes don’t lead to any change in how the virus works.

Scientists have identified harmless new mutations in different lineages of the new coronavirus. These lineages are not dangerous new strains.

Some of these lineages have come to be the most common version of the coronavirus in some countries. Again, that doesn’t mean that they’ve got some evolutionary edge. There’s a very common phenomenon in nature called the founder effect: Whatever mutations happen to be common in the founders of a new population will end up common in their descendants.

It is possible for viruses to gain mutations that do affect the way they work. The new coronavirus will be no different. But the only way to know if a new mutation is significant or not is to carry out research. It will take a lot of evidence to reject the more likely hypothesis: that a new mutation has no importance at all.

Fortunately, it doesn’t look like coronaviruses will be picking up these new mutations very quickly. Compared with other viruses, scientists have found, the new coronavirus has a relatively slow rate of new mutations.

That’s a big relief for vaccine makers. Influenza viruses mutate so quickly that people need to get a new flu shot each year to stay protected. H.I.V. has so much genetic diversity that an effective vaccine against it has yet to be found. The new coronavirus poses immense challenges to vaccine makers, but most of them have to do with manufacturing billions of doses in a matter of months.

We have enough worries when it comes to Covid-19; no need to add needless ones to the list.


Credit…Jens Mortensen for The New York Times

The hot and humid weather of summer will not stop the pandemic. More sunlight and humidity may slow down its spread, but we probably won’t know by how much. Other factors, like reduced travel, increased personal distance, closed schools, canceled gatherings and mask-wearing, have effects that would outweigh the influence of the weather.

A few things are known about conditions that do or do not favor the virus. The ultraviolet rays in sunlight help destroy the virus on surfaces and some studies have shown a small effect from humidity. It seems to last longest on hard surfaces like plastic and metal. It won’t survive in pool or lake or seawater. Wind disperses it. Risk of transmission is lower outdoors than indoors.

A wooden bench under a bright sun at a breezy beach is a better bet than a metal and plastic recliner on the shady side of the pool. But if someone infected sits near you and coughs, or talks a lot or sings, it doesn’t really matter where you’re sitting and how nice a day it is.

“The virus doesn’t need favorable conditions,” said Peter Juni, an epidemiologist at the University of Toronto. It has a world population with no immunity waiting to be infected. Bring on the sun; the novel coronavirus will survive.

Air conditioning may blow the virus right to your restaurant table.

On Memorial Day, many people in the United States gathered in congenial closeness in lovely weather without masks. If any of them were infected and breathing, they probably infected someone else. The same will be true on July 4. Even if the weather is glorious.


George Floyd protests: Trump says he will deploy military if states don’t mobilize National Guard –

June 1st, 2020

U.S. President Donald Trump says he will be deploying the military to handle George Floyd protesters if states don’t mobilize their National Guard units.

Trump, who said the measures go into effect immediately, has yet to actually deploy the American military to any states as of yet.

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READ MORE: Trump urges crackdown on George Floyd protests, tells governors to get ‘tougher’

Whether he can do so legally as a means to quell protests and whether such demonstrations constitute acts of terrorism, however, also remains to be seen.

The American Civil War-era Posse Comitatus Act prohibits federal troops from executing domestic law enforcement measures such as making arrests or searching people.

4:22George Floyd protests: Trump says he will deploy military if governors can’t quell violent protests

George Floyd protests: Trump says he will deploy military if governors can’t quell violent protests

The president can, however, invoke the Insurrection Act in extreme cases.

The act — also from the 1800s — could essentially allow the deployment of active-duty military personnel or National Guard members in a state for use in law enforcement.

During his address, Trump urged mayors and governors to establish an “overwhelming law enforcement presence until the violence has been quelled.”

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“A number of state and local governments have failed to take necessary action to safeguard their residents,” he said.

“If a city or state refuses to take the actions that are necessary to defend the life and property of their residents, then I will deploy the United States military and quickly solve the problem for them.”

Trump said his administration was already in the process of dispatching “thousands and thousands of heavily armed soldiers, military personnel and law enforcement officers” to put an end to the protests.

2:21George Floyd protests: Trump issues warning with strict 7 p.m. curfew in Washington, D.C

George Floyd protests: Trump issues warning with strict 7 p.m. curfew in Washington, D.C

He added that a 7 p.m. curfew would be “strictly enforced” within Washington D.C. as well, promising lengthy jail sentences and severe criminal penalties for anyone caught breaking the law.

READ MORE: ‘This ain’t the way’: Protester pleads for violence to stop in powerful video

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According to The Associated Press, between 600 and 800 National Guard members from five states were now being sent to assist the U.S. capital, citing senior defence officials.

Trump also criticized Antifa, lumping the left-leaning, anti-fascist movement together with other “organizers of this terror” he claimed were “leading investigators” of the violence unfolding across the U.S.

On Sunday, Trump declared that he would be classifying Antifa as a terrorist organization.

2:21George Floyd protests: Trump issues warning with strict 7 p.m. curfew in Washington, D.C

George Floyd protests: Trump issues warning with strict 7 p.m. curfew in Washington, D.C

Currently, the U.S. does not have any laws in place to designate domestic groups as a terrorist entities — only foreign organizations could be classified as such.

Just minutes before Trump began speaking at the White House Rose Garden, National Guard members and police aggressively forced back peaceful protesters that were gathered in Lafayette Park.

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Loud noises heard in the background prior to Trump’s address seemed to be those of police helicopters and the firing of tear gas or flashbangs.

READ MORE: Kentucky police chief fired after Black restaurant owner killed amid police gunfire

After finishing his remarks, Trump later emerged from the front gates and walked through the park — which had been cleared of demonstrators — to St. John’s Church.

He later posed for photos — Bible in hand — alongside a group of advisers.

Earlier on Monday, Trump had mocked the nation’s governors as “weak,” demanding that they enforce tougher crackdowns and more arrests in their states amid another night of violent protest in several American cities.

“Most of you are weak,” Trump said, according to some of the local leaders. “You have to arrest people.”

Trump, who spoke to the governors on video teleconference alongside a handful of law enforcement and national security officials, said that they would “have to get much tougher.”

1:24George Floyd death: White House calls on governors to deploy National Guard

George Floyd death: White House calls on governors to deploy National Guard

The protests, which were sparked by the killing of George Floyd — a Black man who died after being suffocated by a white Minneapolis police officer — have now entered their second week.

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Several of the peaceful demonstrations have turned violent in many U.S. cities, with looters and rioters taking advantage of the chaos.

With files from The Associated Press

© 2020 Global News, a division of Corus Entertainment Inc.

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