Alarmed as COVID patients’ blood thickened, New York doctors try new treatments

By Jonathan Allen

NEW YORK (Reuters) – As the novel coronavirus spread through New York City in late March, doctors at Mount Sinai Hospital noticed something strange happening to patients’ blood.

Signs of blood thickening and clotting were being detected in different organs by doctors from different specialties. This would turn out to be one of the alarming ways the virus ravages the body, as doctors there and elsewhere were starting to realize.

At Mount Sinai, nephrologists noticed kidney dialysis catheters getting plugged with clots. Pulmonologists monitoring COVID-19 patients on mechanical ventilators could see portions of lungs were oddly bloodless. Neurosurgeons confronted a surge in their usual caseload of strokes due to blood clots, the age of victims skewing younger, with at least half testing positive for the virus.

“It’s very striking how much this disease causes clots to form,” Dr. J Mocco, a Mount Sinai neurosurgeon, said in an interview, describing how some doctors think COVID-19, the illness caused by the coronavirus, is more than a lung disease. In some cases, Mocco said, a stroke was a young patient’s first symptom of COVID-19.

As colleagues from various specialties pooled their observations, they developed a new treatment protocol. Patients now receive high doses of a blood-thinning drug even before any evidence of clotting appears.

“Maybe, just maybe, if you prevent the clotting, you can make the disease less severe,” said Dr. David Reich, the hospital president. The new protocol will not be used on certain high-risk patients because blood thinners can lead to bleeding in the brain and other organs.

“FUNNY YOU MENTIONED THAT”

In the three weeks beginning mid-March, Mocco saw 32 stroke patients with large blood blockages in the brain, double the usual number for that period.

Five were unusually young, under age 49, with no obvious risk factors for strokes, “which is crazy,” he said. “Very, very atypical.” The youngest was only 31.

At least half of the 32 patients would test positive for COVID-19, Mocco said.

Meanwhile, Dr. Hooman Poor, a Mount Sinai lung specialist, found himself working a late shift with 14 patients on ventilators. The ventilator readings were not what he expected.

The lungs did not seem stiff, as is common in pneumonia. Instead, it seemed blood was not circulating freely through the lungs to be aerated with each breath.

Poor ran into a kidney doctor that night, who remarked that dialysis catheters were often getting blocked with clots.

“And I said, ‘It’s funny that you mentioned that because I feel like all these patients have blood clots in their lungs,'” Poor recalled.

Reich, the hospital president, told Poor about the surge in strokes seen by Mocco and said the two doctors should team up, setting off days of discussions and meetings with the hospital’s department heads.

At 2:46 a.m. on Easter Sunday, Poor sent Mocco his first draft of what would become the new treatment protocol.

DOCTORS SHARE FINDINGS

As their wards began to overflow with COVID-19 patients, the Mount Sinai doctors read papers describing similar findings from doctors in China’s Hubei province and other hard-hit areas, and discussed them with their peers in phone calls and webinars.

Mocco called neurosurgeons he knows elsewhere in the country. At Philadelphia’s Thomas Jefferson University Hospital, Dr. Pascal Jabbour had begun to see a similar surge in strokes among people with COVID-19. The way his patients’ blood congealed reminded him of congenital conditions such as lupus, or certain cancers.

“I’ve never seen any other viruses causing that,” Jabbour said.

In Boston, the Beth Israel Deaconess Medical Center began a clinical trial earlier this month to see if tPA, an anti-clotting drug, could help severely sick COVID-19 patients.

Clotting can develop in anyone who gets very sick and spends long periods of time immobile on a ventilator, but doctors say the problem seemed to show up sooner in COVID-19 patients as a more direct consequence of the virus.

At Mount Sinai, patients in intensive care often receive the blood-thinning agent heparin in weaker prophylactic doses. Under the new protocol, higher doses of heparin normally used to dissolve clots will be given to patients before any clots are detected.

The treatment joins a growing toolbox at the hospital, where some patients are receiving the antibody-rich plasma of recovered COVID-19 patients or experimental antiviral drugs.

The American Society of Hematology, which has also noted the clotting, says in its guidance to physicians that the benefits of the blood-thinning therapy for COVID-19 patients not already showing signs of clotting are “currently unknown.”

“I certainly wouldn’t expect harps to play and angels to sing and people to just rip out their intravenous lines and waltz out of the hospital,” said Reich. “It’s likely going to be something where it just moderates the extent of the disease.”

(Reporting by Jonathan Allen in New York; Editing by Nancy Lapid, Ross Colvin and Aurora Ellis)

Georgia tests boundaries of life post-pandemic with ‘risky’ reopening

By Howard Schneider and Andy Sullivan

WASHINGTON (Reuters) – A handful of mostly southern U.S. states will begin loosening economic restrictions this week in the midst of a still virulent pandemic, providing a live-fire test of whether America’s communities can start to reopen without triggering a surge that may force them to close again.

The Republican governors of Georgia, South Carolina, Tennessee and Ohio all announced on Monday they would begin peeling back the curbs on commerce and social activity aimed at stopping the coronavirus outbreak over the next two weeks. Colorado’s Democratic governor said on Tuesday he would open retail stores on May 1.

Georgia has been hardest-hit of these states, with 19,000 cases and nearly 800 deaths, including a dense cluster in the state’s southwest. Amid a national debate over how to fight the virus while mitigating the deep economic toll, these moves are the first to test the borders of resuming “normal” life.

None of the states have met basic White House guidelines unveiled last week of two weeks of declining cases before a state should reopen. Most are weeks away from the timing suggested in modeling by the influential Institute for Health Metrics and Evaluation (IHME), based on the virus’s spread and social distancing.

With farmers, small business owners, and larger industries teetering on the edge, “I see the terrible impact on public health as well as the pocketbook,” Georgia Governor Brian Kemp said.

Stacey Abrams, Kemp’s Democratic rival in a closely fought gubernatorial race in 2018, warned of the dangers faced by lower-wage workers called back into businesses that may not follow the rules, serving customers who may not abide by them.

Around the country, the pandemic has taken a greater toll on poorer Americans and minorities. As of Monday, 412 of Georgia’s 774 COVID-19 fatalities were black, or more than 53% compared to the 31% black share of the state’s population.

“We’re not ready to return to normal,” Abrams told CBS’s “This Morning” on Tuesday. “We have people who are the most vulnerable and the least resilient being put on the front lines, contracting a disease that they cannot get treatment for.”

TATTOO PARLORS AND NAIL SALONS

Republican President Donald Trump, who has been eager to end a lockdown that has crushed the U.S. economy in an election year, has called for Democratic governors in big states to “liberate” their citizens from the stay-at-home orders.

In Georgia, where the growth in cases and deaths from the COVID-19 disease caused by the virus has slowed in recent days, Kemp said he would allow a broad swath of businesses from barbershops to tattoo parlors to reopen on Friday under enhanced rules for hygiene, distancing among employees, and use of masks.

The industries employ thousands in Georgia, but are not top contributors to the state’s overall GDP, which is led https://apps.bea.gov/regional/bearfacts/action.cfm by finance and insurance, followed by professional and business services. Retail stores and fast food chains are top employers.

Graphic: Georgia moves to reopen – https://fingfx.thomsonreuters.com/gfx/editorcharts/xlbpgadypqd/eikon.png

(See a graphic of Georgia’s economy https://reut.rs/3eBy40W.)

On Monday, movie theaters, restaurants and private clubs in the state will be allowed to open, with some restrictions. Bars, music clubs and amusement parks will remain closed for now.

Some questioned the wisdom of opening up service industries that operated with such high levels of human contact.

“Gyms, nail salons, bowling alleys, hair salons, tattoo parlors — it feels like they collected, you know, a list of the businesses that were most risky and decided to open those first,” Scott Gottlieb, former Food and Drug Administration commissioner, told CNBC on Tuesday.

“Unlike other businesses, these entities have been unable to manage inventory, deal with payroll, and take care of administrative items while we shelter in place,” Kemp said on Monday.

Georgia was one of the best-prepared U.S. states to weather an economic downturn before the COVID-19 crisis hit, Moody’s Analytics noted in an April report, with a “rainy day” balance of 10.9% of 2019 revenues on hand. Only six other states had more.

NEXT STEPS

With stepped-up testing and monitoring, “we will get Georgians back to work safely,” Kemp said.

Leaders of the other states offered similar rationales, arguing that caseloads had eased, testing and monitoring had expanded, and hospital capacity was now adequate to take what Kemp called a “small step forward” in resuming normal life.

Some health experts have suggested activity should remain restricted until near universal testing is available.

Death rates in Georgia, Colorado and Ohio are close to the national average, but their testing rates are among the lowest in the United States, according to a Reuters analysis.

Just 83,000 tests have been conducted so far on Georgia’s more than 10 million residents.

Graphic: Flying blind – https://fingfx.thomsonreuters.com/gfx/editorcharts/jznpnrgkplm/eikon.png

(See a graphic of state testing rates https://reut.rs/34Ui1Xv.)

“We’ve got to get more testing done before we make any public health decisions,” said Dr. Boris Lushniak, dean of the University of Maryland School of Public Health.

Opening is a gamble in a situation where much is still unknown about the virus’ presence in people who show no symptoms, incubation periods within the body, and transmissibility, health experts say.

Economists and epidemiologists who have studied past pandemics warn https://www.reuters.com/article/us-health-coronavirus-usa-reopen-analysi/the-u-s-weighs-the-grim-math-of-death-vs-the-economy-idUSKBN21H1B4 that reopening too quickly could both cause unnecessary deaths and cause worse damage to the economy over the long run.

Unknown as well is the public’s tolerance for potential exposure, critical in determining whether reopening at this point provides true economic relief or simply a pathway for the virus to surge – whether confidence, in other words, rises before the infection rate.

Guidelines issued by the IHME at the University of Washington as of Monday recommended Georgia keep restrictions in place until June 15, South Carolina until June 1, Tennessee and Colorado until May 25, and Ohio until May 18.

(Reporting by Howard Schneider and Andy Sullivan in Washington; Additional reporting by Heather Timmons in Washington and Ann Saphir in Berkeley, Calif.; Editing by Heather Timmons and Sonya Hepinstall)

In a first, Missouri sues China over coronavirus economic losses

By Jan Wolfe

(Reuters) – Missouri on Tuesday became the first U.S. state to sue the Chinese government over its handling of the coronavirus, saying that China’s response to the outbreak that originated in Wuhan city led to devastating economic losses in the state.

The civil lawsuit, filed in federal court by Missouri Attorney General Eric Schmitt, alleges negligence, among other claims. The complaint alleges Missouri and its residents have suffered possibly tens of billions of dollars in economic damages, and seeks cash compensation.

“The Chinese government lied to the world about the danger and contagious nature of COVID-19, silenced whistleblowers, and did little to stop the spread of the disease,” Schmitt, a Republican, said in a statement. “They must be held accountable for their actions.”

The lawsuit also accuses the Chinese government of making the pandemic worse by “hoarding” masks and other personal protective equipment (PPE).

U.S. President Donald Trump, also a Republican, initially lavished praise on China and his counterpart Xi Jinping for the official response to the outbreak, which has since spread to infect more than 2.5 million people worldwide. But he and other senior U.S. officials have also referred to it as the “Chinese virus” and in recent days have ramped up their rhetoric.

China is already facing similar lawsuits filed in U.S. courts on behalf of U.S. business owners.

International law experts told Reuters that efforts to hold China liable for the coronavirus in U.S. courts will likely fail.

A legal doctrine called sovereign immunity offers foreign governments broad protection from being sued in U.S. courts, said Tom Ginsburg, a professor of international law at the University of Chicago.

Ginsburg said he thought the recent flurry of lawsuits against China serve a political end for Republican leaders facing an election in November.

“We are seeing a lot of people on the political right focus on the China issue to cover up for the U.S. government’s own errors,” Ginsburg said.

Trump initially downplayed the seriousness of the coronavirus, which has killed more than 43,000 people in the United States out of nearly 800,000 cases as of Tuesday.

The outbreak has also forced state governors to declare stay-at-home orders that have shuttered businesses and social activities, leading a record 22 million people to seek unemployment benefits in the past month.

“If the United States wants to bring claims against China, it will have to do so in an international forum,” said Chimène Keitner, an international law professor at the University of California, Hastings College of the Law in San Francisco. “There is no civil jurisdiction over such claims in U.S. courts.”

(Reporting by Jan Wolfe; Editing by Sonya Hepinstall)

Global coronavirus cases pass 2.5 million as U.S. tally nears 800,000

(Reuters) – Global coronavirus infections surpassed 2.5 million on Tuesday, according to a Reuters tally, with U.S. cases surpassing 800,000.

The figure includes more than 170,000 deaths, two-thirds of which have been reported in Europe.

It took around 75 days for the first 500,000 cases to be reported, and just six days for the most recent half million to be registered.

The first 41 cases were confirmed on Jan. 10, just over three months ago, and new cases have accelerated to over 70,000 a day in April.

It compares to 3 million to 5 million cases of severe illness caused annually by seasonal influenza, according to World Health Organisation estimates.

While experts say actual cases of the new coronavirus are likely higher than current reports, the number still falls far short of the Spanish flu, which began in 1918 and infected an estimated 500 million people.

Despite the growing number of cases in the current pandemic, there are signs that the spread of the coronavirus is slowing with many countries exercising lockdown measures.

At the beginning of April, the total case figure grew at a rate of 8%-9% per day and this has since slowed to between 3%-4% per day in the past week.

More than 1.1 million cases have been reported in Europe, including almost 400,000 cases in Italy and Spain, where over 10% of reported cases have been fatal.

North America accounts for a third of all cases, though so far the region has reported lower death rates. In both the United States and Canada, 5% of reported cases have been fatal.

Cases in Latin America continue to grow faster than other regions, and topped 100,000 in the past 24 hours.

In China, where the virus is thought to have originated, daily new cases have dwindled to less than 20 a day over the past three days and no new deaths have been reported this week.

However, last week China raised its official death toll by 40%, adding another 1,290 fatalities which health authorities said were not reported earlier.

Currently, many countries continue to experience a shortage of testing resources, artificially lowering case numbers and excluding infections in nursing homes.

(Reporting by Cate Cadell in Beijing; Editing by Lisa Shumaker and Alistair Bell)

Corporate America seeks legal protection for when coronavirus lockdowns lift

By David Morgan

WASHINGTON (Reuters) – Major U.S. business lobbying groups are asking Congress to pass measures that would protect companies large and small from coronavirus-related lawsuits when states start to lift pandemic restrictions and businesses begin to reopen.

Their concerns have the ears of congressional Republicans, though it is far from clear if the idea has the Democratic support it would need to pass in the Democratic-controlled House of Representatives.

The U.S. Chamber of Commerce, National Association of Manufacturers (NAM) and National Federation of Independent Business (NFIB) are seeking temporary, legal and regulatory safe harbor legislation to curb liabilities for employers who follow official health and safety guidelines. The Business Roundtable, which represents corporate chief executives, is also exploring ways to limit coronavirus liabilities.

Businesses want to make sure that they are not held liable for policy decisions by government officials, should employees or customers contract COVID-19 once operations resume. They also want protection from litigation that could result from coronavirus-related disruptions to issues like wages and hours, leave and travel.

“These are practical things to reassure businesses that they can confidently move to implement a reopening,” Neil Bradley, the U.S. Chamber of Commerce chief policy officer, said in an interview.

The debate over when to ease restrictions intended to slow the spread of the COVID-19 respiratory disease, which has killed more than 40,000 Americans, has recently entered a more politically charged phase with Republican President Donald Trump voicing support for scattered street protests aimed at ending the restrictions.

Public health officials warn that doing so prematurely risks sending infection rates soaring and further taxing an overwhelmed healthcare system.

The idea of protecting businesses from being sued by workers or customers has already found support in some quarters on Capitol Hill.

“There’s been a lot of discussion among conservative Republicans,” U.S. Representative Mike Johnson, a Republican member of Trump’s congressional task force on the economy, told Reuters. “On the Republican side, I think there would be broad support, probably near-unanimous support.”

The path to bipartisan legislation remains unclear in the Senate and House.

Representative Bobby Scott, Democratic chairman of the House Education and Labor Committee, told Reuters that any legislation on employer liability would need to address the question of who is liable in cases of negligence.

“If you just want to immunize the business and stop there,” he said, “that’s not much of a conversation.”

Scott and other House Democrats introduced new legislation on Tuesday that would require employers to implement infectious disease exposure control plans to keep workers safe during the pandemic.

LIFE AND ‘LIVELIHOODS’

The coronavirus pandemic has upended American life, closing businesses, schools and churches, leading most states to ban social gatherings, and sickening more than 760,000 people. Its economic fallout has included throwing more than 20 million people out of work.

Undoing the economic devastation will require a regulatory and legal framework that recognizes the unprecedented risks to businesses, including essential businesses that have remained open throughout the health crisis, lobbyists argue.

“The nature and the contour of the problem that we’re facing here is starting to become much more evident to members of both parties. And I think there’s a growing understanding that we’re going to have to find a solution,” said Patrick Hedren, NAM’s vice president of litigation.

House Speaker Nancy Pelosi signaled over the weekend that upcoming “CARES 2” legislation would prepare the path ahead to support the lives and “livelihoods” of Americans, without providing details.

The Trump administration’s “Opening Up America Again” guidelines put the onus on employers to provide personal protective equipment (PPE) like masks and gloves to staff, test employees for symptoms, and trace infections.

At the same time, officials acknowledge the risk that economic activity could spread the virus and create deadly new hot zones of infection.

Business groups say there are ample precedents for congressional actions to safeguard businesses from liability, including legislation involving the anthrax attacks of 2001 and widespread Y2K fears in the 1990s that the arrival of the year 2000 would wreak havoc on computer systems.

The U.S. Chamber laid out a comprehensive return to work plan in an April 13 memo that advocates safe harbors to allow companies to implement temporary workplace policies and benefits, including the provision of PPE.

The protections would exempt PPE supplies and training from federal worker safety requirements and protect against litigation emanating from wage and hour issues, leave policy, travel restrictions, telework protocols and workers’ compensation.

The protections would not be available for companies guilty of gross negligence, recklessness or willful misconduct.

The U.S. Chamber’s recommendations, which run the gamut from medical liability for healthcare providers to securities litigation against publicly traded companies, are intended to cover the entire national business community.

(Reporting by David Morgan; Editing by Scott Malone, Rosalba O’Brien and Jonathan Oatis)

Coronavirus crisis stoking anti-Semitism worldwide: report

JERUSALEM (Reuters) – The coronavirus crisis is stirring anti-Semitism around the world, fuelled by centuries-old lies that Jews are spreading infection, researchers in Israel said on Monday.

The findings, in the annual report on Anti-Semitism Worldwide by the Kantor Center at Tel Aviv University, showed an 18% rise in anti-Semitic incidents in 2019 over the previous year.

In the first few months of 2020, far-right politicians in the United States and Europe and ultra-conservative pastors have seized upon the health crisis and its resulting economic hardship to foster hatred against Jews, the researchers said.

“Since the beginning of the COVID-19 pandemic, there has been a significant rise in accusations that Jews, as individuals and as a collective, are behind the spread of the virus or are directly profiting from it,” said Moshe Kantor, president of the European Jewish Congress.

“The language and imagery used clearly identifies a revival of the mediaeval ‘blood libels’ when Jews were accused of spreading disease, poisoning wells or controlling economies,” he said during the report’s release.

Kantor said that as unemployment soars due to lockdowns to contain the coronavirus, “more people may seek out scapegoats, spun for them by conspiracy theorists”.

He called on world leaders to address the problem of growing extremism “already at our door”.

Severe and violent incidents against Jews worldwide rose to 456 in 2019 from 387 in 2018, and seven Jews were killed in anti-Semitic attacks last year, the report found.

In 2019, 122 major violent incidents against Jews were reported in Britain, followed by 111 in the United States, 41 in France and Germany and 33 in Australia, according to the findings.

Kantor said there had been a consistent rise in anti-Semitism over the least few years, especially online, and in mainstream society, politics and media.

He said the increased use of social media during the health crisis could facilitate the spread of conspiracy theories, “providing simplistic answers for the growing anxiety among the general public”.

(Reporting by Jeffrey Heller; Editing by Mark Heinrich)

Congress feuds as deal still elusive on small business coronavirus aid

By Doina Chiacu and Susan Cornwell

WASHINGTON (Reuters) – U.S. Democrats and Republicans feuded on Monday over who was responsible for delay even as they worked on details of a possible $450 billion-plus deal to provide more aid to small businesses and hospitals hurt by the coronavirus pandemic.

“We could have been done yesterday, but the Democrats continue to hold up, even though we had agreed to all the numbers,” Representative Kevin McCarthy, House of Representatives minority leader, told Fox News.

President Donald Trump said on Sunday that Republicans were “close” to an agreement with Democrats, who have the majority in the House, and suggested there could be a resolution on Monday.

But there was no immediate deal on Monday morning, and the two parties took shots at one another over the holdup.

“How many more millions of (House Speaker Nancy) Pelosi’s layoffs will we have to endure before she will put people before politics?” McCarthy wrote on Twitter Monday.

Pelosi spokesman Drew Hammill shot back that Democrats, who have the majority in the House, have given notice that there could be floor action on a bill as soon as Wednesday.

The legislation “could pass by unanimous consent in the House tomorrow, but you cannot control your members who want a recorded vote,” Hammill said in comments aimed at McCarthy. “The delay will be on your end @GOPLeader.”

Representative Thomas Massie, a Republican, sought a recorded vote the last time the House passed a $2.3 trillion coronavirus relief package, and has warned he may seek to block future bills from passing without a roll call vote.

Pelosi on Twitter lamented the “staggering” coronavirus death toll numbers, which have crossed 40,000 in the United States.

Representative Lee Zeldin, a Republican member of the House, said on Fox News that a bipartisan deal was looking good that would include $310 billion for a small business aid program established last month as part of the $2.3 trillion coronavirus economic relief plan.

That fund, aimed at helping small businesses keep workers on their payrolls during the economic slowdown brought on by the pandemic, has already been exhausted.

Zeldin said there would be at least $50 billion more for a separate small business loan program under the deal still under negotiation. A Democratic source familiar with the talks has said this figure was more likely to be $60 billion.

“I believe that there is a deal coming,” Zeldin said.

The Democratic source, speaking on condition that he not be named, said some $60 billion of the $310 billion was likely to be set aside for minority and rural businesses.

The Democrats also sought more funds for state and local governments and hospitals, as well as food aid for the poor. Republicans have strongly resisted these proposals, although Trump said Sunday he favored more aid for state and local governments and said that could be done at a later date.

Republican Senator Bill Cassidy said aid for states and municipalities will not be included in the package now being negotiated. Cassidy, whose home state of Louisiana has been among those hit hardest by the pandemic, told reporters on a conference call that he thought it made sense because it will too early to assess the extent of the damage in various states.

“It’s not in this package,” he said.

(Reporting by Doina Chiacu, Susan Cornwell and Patricia Zengerle; Editing by Lisa Lambert, David Gregorio and Jonathan Oatis)

A grave concern: Coronavirus highlights burial plot shortages in cities

By Rina Chandran and Kim Harrisberg

BANGKOK/JOHANNESBURG (Thomson Reuters Foundation) – The coronavirus pandemic has exacerbated the problem of scarce burial space in cities, even as health concerns and tight budgets force more families to opt against traditional grave burials, land rights experts said on Monday.

As cities around the world have rapidly expanded in recent decades, urban cemeteries have filled up or been dug up to build roads and homes, leading to an increase in cremations.

“This trend will continue with urbanisation. COVID-19 may just cause us to think about this in the immediate term,” said Peter Davies, an associate professor at the department of earth and environmental sciences at Australia’s Macquarie University.

“There would be increasing pressure for cremations as a more cost- and space-effective, and possibly safer solution from a disease transmission perspective,” he told the Thomson Reuters Foundation.

Globally, there have been more than 2 million reported cases of the coronavirus, and more than 165,000 people have died, according to a Reuters tally.

Before the outbreak, in cities such as Singapore and Hong Kong where even columbaria for urns containing ashes have filled up, historians and conservationists moved to protect the last remaining cemeteries and safeguard their heritage and tradition.

In Britain, cities where burials are still the norm have proposed shared burial plots as space runs out.

The challenge facing city authorities now – to dispose of bodies quickly and safely – was brought to the fore when a New York City councilman said earlier this month that public parks may be used as temporary burial grounds.

City officials refuted the claim, but said some recent burials in a so-called potter’s field on Hart Island, which has been used since the 19th century for burying the poor or those with no known next of kin, included victims of the coronavirus.

In Ecuador, authorities are preparing an emergency burial ground on land donated by a private cemetery in Guayaquil, the country’s largest city, to address a shortage of burial plots.

COMMUNAL GRAVES

Cemeteries in South Africa have been asked to identify land for emergency burials, and consider “communal graves” for 20 bodies in the event of many coronavirus deaths, said Pepe Dass, chairman of the South African Cemeteries Association.

“South Africa has serious issues with access to land in metropolitan areas, but also in rural areas,” said Dass, adding that conservation and residential developments take precedence, not cemeteries because they are not considered sustainable.

“I definitely hope South Africa will become more sustainable in the way we think about burials. This is a wake up call.”

As the pandemic brings greater awareness of mortality and consideration of funerary practices, there is an opportunity to rethink how we care for the dead, said David Neustein, an architect in Sydney and an advocate of “natural burial”.

“It is the simplest, least energy-intensive alternative we have, and one that is highly compatible with environmental repair and regeneration,” he said of the process in which a body is simply put into the ground in designated areas, casket-free.

Neustein had earlier proposed a “burial belt”, where bodies are placed in the soil among newly planted vegetation near towns and cities. It would reforest cleared land and create “near-limitless” land for burial, he said.

“It can be implemented much more quickly than conventional cemeteries … and provide lasting green monuments to this terrible time,” he said.

(Additional reporting by Ellen Wulfhorst in New York; Editing by Michael Taylor. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)

‘Schools are survival’: U.S. coronavirus closures put homeless students at risk

By Carey L. Biron

WASHINGTON (Thomson Reuters Foundation) – For U.S. student Samantha Kinney, high school is about more than education: It has also given her a support network, a sense of accomplishment — and, at times, even access to daily necessities like food and hygiene products.

Kinney, 18, has dealt with homelessness and housing instability for years, including a time when she lived out of a car with her parents and dropped out of school altogether.

She currently lives with relatives in Kansas City, Missouri – having not seen her parents in a few years – and has restarted school, where she has found a surprisingly nurturing community.

“There were even times when families would ‘adopt’ me for Christmas, when they would buy me gifts before break,” Kinney told the Thomson Reuters Foundation by phone.

Now, the coronavirus pandemic has thrown that support system into flux.

Like most schools across the country, Kinney’s school is closed, probably through the end of the school year in June, leaving students in unstable housing situations without the everyday help they rely on, warn homelessness groups.

For many students, those closures have removed a key source of stability, safety, access to food and other resources, as well as the opportunity to gain the skills or a job that could secure their future.

“Schools are survival for children experiencing homelessness,” said Barbara Duffield, executive director of SchoolHouse Connection, a nonprofit that works on the issue nationally.

“Now that schools aren’t there, and the organizations that schools referred (homeless students) to are closing down or short-staffed, a lot of the most vulnerable populations are more likely to fall through the cracks,” she said.

Kinney is one of at least 1.5 million homeless public school students across the country, according to federal statistics released in January for the 2017-2018 school year, the latest available.

That figure is a record high, according to SchoolHouse Connection, up 11% in just a year, and includes a doubling of the number of students in “unsheltered” situations, such as living in cars or on the street.

Those who work with homeless students worry that the pandemic will have an outsized impact on many of them, now and into the future.

More than 90% of schools in the United States have been affected by closures to some degree due to the pandemic, according to trade publication Education Week.

So far, Kinney said she is coping with the changes. She has a computer and stable internet connection at her relatives’ house, and has stayed on top of her studies.

Still, the high school senior said she feels the disruption even more starkly than her peers, including the possible cancellation of landmark events such as prom and a formal graduation.

“I really wanted the satisfaction of being able to walk across that stage and being handed my diploma,” she said.

SOURCE OF STABILITY

Schools have long played a critical, but poorly recognized, role in helping homeless students in the United States, said social workers and activists.

As well as providing homeless students with an education, many public schools “offer other basic supports, including showers, laundry, and even clothing,” said Matt Smith of Washington state’s Homeless Student Stability Program.

But Dana Bailey, chief operating officer at nonprofit Homeless Youth Connection in Avondale, Arizona, said that homeless youths are more likely to drop out of school – and that the coronavirus outbreak has “turned our organization upside-down”.

In Arizona, schools started closing on March 16 for what was going to be two weeks, but has been extended to the rest of the school year.

During the first few weeks of the closure, Bailey and her colleagues focused on the immediate needs of the nearly 290 students they work with.

For students who usually get food through schools, the group dropped off groceries or gift cards that can be used for food and other supplies.

Then, as the schools prepared to start remote learning, Homeless Youth Connection began trying to source essentials like computers and internet hotspots for students who didn’t have them.

“Our students come into our program with no stability,” said Kayla McCullough, a program manager at the non-profit.

“They don’t have what we think of as a home, housing is temporary, food is unreliable and family members are overburdened by trauma caused by homelessness.”

Students who face problems at home are often safer at school, McCullough said.

“If there’s any danger at home, they get to escape that by going to school … It’s a light at the end of the tunnel for many,” she said.

Some community advocates say the public fear surrounding the pandemic is exacerbating homelessness issues, sometimes resulting in people being kicked out of their living situation.

“We’re starting to hear from (homeless) parents that there’s fear on the part of their hosts, (who are) saying, ‘You’ve been here for six months, and I’m too scared to have you’,” said Debra Albo-Steiger, a director at the Project UP-START homeless programme in Miami’s public school system.

DORMS SHUTTERED

School closures don’t affect only younger students: As colleges and universities across the country have shut classrooms and dorms, many have been confronted with students who have nowhere else to go.

Nearly half of college students are housing insecure, and 16% are homeless, according to Marissa Meyers, a researcher with the Hope Center for College, Community and Justice at Temple University in Philadelphia.

Amid the pandemic, “colleges and universities don’t know what to do — they’re paralyzed,” she said, with most seeing major holes opening in their budgets.

Colleges and universities are projecting a $23 billion decline in revenue next school year due to the coronavirus-related drop in enrolment, according to the American Council on Education industry group.

The federal government recently allotted $14 billion to struggling colleges and universities, half of which must be used to help students pay for things like food, housing, school materials and health care.

Some schools have found a way to keep some of their dorms open for students, at least temporarily.

Middle Tennessee State University spokesman Jimmy Hart said the school has made exceptions for those who can’t go anywhere else, including international students and those without reliable internet connections at home.

Berea College in Kentucky, which caters solely to low-income students, is also maintaining housing for about 150 students who could not vacate, according to president Lyle Roelofs.

“No student who had no home to go to or another viable option was asked to leave campus,” he said in emailed comments.

Yet Roelofs expressed concern about the longer-term effects of coronavirus-related closures, particularly for poor students.

“My larger fear is that … the extra curveballs they are facing as a result of the pandemic may seriously degrade their already discouraging prospects,” he said

That’s a sentiment expressed by many, at all levels of schooling.

“We know (the pandemic) isn’t just affecting health, but also our economy,” said Dana Bailey of Homeless Youth Connection.

Ahead of the next school year, she said, “we’re already anticipating a greater number of students needing our services”.

(Reporting by Carey L. Biron, Editing by Jumana Farouky and Zoe Tabary. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)

Protective gear, cellphone, video chats: How America’s clergy minister to COVID-19 patients

By Rich McKay

(Reuters) – Reverend Manuel Dorantes closed his eyes, took a breath to calm his fear and prayed when word came that Cardinal Blase Joseph Cupich had put out a call for volunteers.

Cupich, archbishop of the Roman Catholic Archdiocese of Chicago, needed two dozen young priests to take on the sacred duty of administering the last rites to those dying from the new and highly contagious coronavirus.

For the priests, like doctors, nurses and other frontline workers, it means putting their lives at risk to care for the sick in hospitals.

“I know the consequences,” said Dorantes, 36. “We are called to do this.”

Throughout history, priests and other clergy have risked their lives ministering to the dying through population-decimating plagues and on the battlefields of wars.

But in the face of COVID-19, which has killed more than 150,000 people worldwide and about 33,000 in the United States, the Vatican last month waived the requirement for in-person worship and sacraments, including a special dispensation for believers who cannot receive the last rites.

Many faiths and denominations in America have taken similar unprecedented actions, as the coronavirus has upended one of the most sacred duties of clergy of most major faiths – ministering to the dying and comforting the bereaved.

The disease has forced clergy to rely on technology. Cell phones or iPads are held at the bedsides of very ill patients by nurses and orderlies.

During funerals, they preach to empty pews during services shared using sites such as Zoom and FaceTime. Graveside prayers can be attended by the barest few, sometimes just three mourners.

For clergy, this is the new normal, said United Methodist Bishop Thomas Bickerton, a member of the denomination’s ruling council of bishops, which has halted in-person worship services.

JUMP SUITS AND MASKS

Rabbi David-Seth Kirshner, head rabbi at Temple Emanu-El in Closter, New Jersey, said many hospitals won’t allow bedside visits by anyone, including clergy.

“We don’t even bother to ask,” said Kirshner, 46, who leads a conservative congregation of about 800 families. “It’s too dangerous.”

But the rabbi asks nurses or orderlies to hold an iPad so patients can see it. They then pray together. “It’s very, very important that we at least offer that.”

Some burials that under Jewish tradition should be held within a day have to wait a week or more, the rabbi said, in places where cemeteries and funeral homes are beyond capacity.

One Muslim imam said many funeral homes in the United States are no longer allowing the Islamic ritual of washing the body before burial, for fear of spreading the disease.

“For the family it’s tough because they cannot mourn the same,” Daoud Nassimi, an imam in Washington D.C., told the online publication Middle East Eye.

About 3 million Americans identify as members of the Episcopalian Church, which is largely relying on video chats and phone calls by priests to make that last connection with those on the brink of death, according to Reverend Lorenzo Librija of the Episcopal Diocese of Los Angeles.

A few weeks ago, he came up with a plan to organize the effort. It is called “Dial-a-Priest” and is aimed at helping people who do not have a relationship with a local church, but still want to receive the last rites.

“We picked that name because it’s easy to remember and easy to Google,” said Librija.

His group has about 100 retired ministers who have volunteered to man telephones around the clock, ready to give the ritual ministration of death from the Book of Common Prayer.

The Archdiocese of Chicago, with its 24-member last rites team, is one of the few places in the nation where in-person visits to patients near death have continued in hospitals.

Dorantes, pastor of Chicago’s Saint Mary of the Lake parish, said he has conducted several bedside rituals since he volunteered in late March.

He and the other priests don protective jump suits and N95 respirator masks. Wearing gloves, they take a dab of blessed oil and make the sign of the cross on the patient’s forehead and hands using a Q-tip.

“Laying on of hands and anointing, this is the sacrament of the church, a visible sign of invisible grace,” he said. “I could see it in their eyes, incredible moments of grace.”

(Reporting by Rich McKay in Atlanta; Editing by Daniel Wallis)