Pentagon eyes Chicago, Michigan, Florida, Louisiana as coronavirus spreads

By Phil Stewart and Idrees Ali

WASHINGTON (Reuters) – The U.S. military is watching coronavirus infection trends in Chicago, Michigan, Florida and Louisiana with concern as it weighs where else it may need to deploy, after boosting aid to New York, California and Washington, a top general said on Friday.

Air Force General John Hyten, vice chairman of the Joint Chiefs of Staff, said the military was doing its own analysis as well as looking at data on infections compiled elsewhere in the government.

“There’s a certain number of places where we have concerns and they’re: Chicago, Michigan, Florida, Louisiana,” Hyten told a group of reporters, when asked where field hospitals could head next.

“Those are the areas that we’re looking at and trying to figure out where to go next.”

Confirmed coronavirus cases in the United States reached 100,040 on Friday, the highest number in the world, a Reuters tally showed.

The Army Corps of Engineers said on Friday it was aiming to provide facilities for 3,000 people with the coronavirus at Chicago’s McCormick Place convention center by April 24 for about $75 million.

Lieutenant General Todd Semonite, the Corps’ commander, said the Corps was looking at potentially converting 114 facilities in the United States into hospitals.

Asked about Hyten’s remarks, Semonite said he continued to be concerned about Michigan, Florida and Louisiana and had spoken with the governor of Louisiana. He said there could be a high demand for medical resources in Florida because of the aging population and added the Corps was developing options for the state.

STRAINS ON MILITARY

The military is already deploying field hospitals to Seattle and New York. A Navy hospital ship arrived on Friday in Los Angeles and another one is expected to reach New York City on Monday, where Hyten said the city was still dredging the harbor to allow the massive ship to dock.

Each ship has a capacity of about 1,000 beds and would not treat coronavirus patients, instead taking pressure off overwhelmed civilian hospitals.

But Hyten cautioned that the U.S. military only had limited medical capacity in the United States and, at some point, it would have to tap the reserve forces — while guarding against drawing medical staff away from civilian facilities.

President Donald Trump on Friday signed an executive order authorizing the Pentagon and Department of Homeland Security to call up reservists.

“We made a decision about five or six years ago that we would downsize our military (health care) capabilities in the United States … to only really focus on our deployed requirements,” Hyten said.

He estimated that the military only had 1,329 adult hospital beds staffed at any one time in the United States.

“We’re digging into the active duty force really heavily,” he said. “So the next thing that we’re going to need is to look into the reserves.”

(Reporting by Phil Stewart and Idrees Ali; Editing by Daniel Wallis)

Grief in a pandemic: Holding a dying mother’s hand with a latex glove

By Deborah Bloom and Nathan Layne

KIRKLAND, Wash. (Reuters) – Doug Briggs put on a surgical gown, blue gloves and a powered respirator with a hood. He headed into the hospital room to see his mother – to tell her goodbye.

Briggs took his phone, sealed in a Ziplock bag, into the hospital room and cued up his mother’s favorite songs. He put it next to her ear and noticed her wiggle, ever so slightly, to the music.

“She knew I was there,” Briggs recalled, smiling.

Between songs by Barbara Streisand and the Beatles, Briggs conference-called his aunts to let them speak to their sister one last time. “I love you, and I’m sorry I’m not there with you. I hope the medicine they’re giving you is making you more comfortable,” said Meri Dreyfuss, one of her sisters.

Somewhere between “Stand by Me” and “Here, There, and Everywhere,” Barbara Dreyfuss passed away – her hand in her son’s, clad in latex. It would be two days before doctors confirmed that she had succumbed to COVID-19, the disease caused by the coronavirus.

Doug Briggs is pictured outside of the Life Care Center of Kirkland, where his mother, Barbara Dreyfus, was a resident, contracted coronavirus disease (COVID-19), and later died in a hospital, in Kirkland, Washington, U.S., March 16, 2020. REUTERS/David Ryder

Dreyfuss, 75, was the eighth U.S. patient to die in a pandemic that has now killed more than 1,200 nationally and nearly 25,000 worldwide. She was among three dozen deaths linked to the Life Care nursing home in Kirkland, Washington, the site of one of the first and deadliest U.S. outbreaks. (For interactive graphics tracking coronavirus in the United States and worldwide, click https://tmsnrt.rs/2Uj9ry0 and https://tmsnrt.rs/3akNaFr )

Dreyfuss’s final hours illustrate the heartrending choices now facing families who are forced to strike a balance between staying safe and comforting their sick or dying loved ones. Some have been cut off from all contact with parents or spouses who die in isolation, while others have strained to provide comfort or to say their final goodbyes through windows or over the phone.

Just three days before his mother died, Briggs had been making weekend plans with her. Now, in his grief, he found himself glued to news reports and frustrated by the mixed messages and slow response from local, state and federal officials.

“You find out all these things, of what they knew when,” Briggs said.

Officials from Life Care Centers of America have said the facility responded the best it could to one of the worst crises ever to hit an eldercare facility, with many staffers stretched to the brink as others were sidelined with symptoms of the virus. As the first U.S. site hit with a major outbreak, the center had few protocols for a response and little help from the outside amid national shortages of test kits and other supplies.

‘NOT FEELING TOO GOOD’

A flower child of the 1960’s, Dreyfuss lived a life characterized by art and activism. After marrying her high school sweetheart and giving birth to their son, she pursued a degree in women’s studies at Cal State Long Beach, where she marched for women’s equality and abortion rights.

Furious over President Gerald Ford’s pardoning of former president Richard Nixon in 1974, Dreyfuss took to her typewriter and penned an angry letter to Ford. “Today is my son’s 9th birthday,” she wrote of a young Briggs. “I do not feel like celebrating.”

By the time she arrived at the Life Care Center in May 2019, years of health issues had dimmed some of that spark, her son said. Fibromyalgia and plantar fasciitis restricted her to a walker or a wheelchair, and chronic obstructive pulmonary disease required her to have a constant flow of oxygen.

When her son visited on Feb. 25, he brought a grocery bag of her favorites, including diet A&W root beer. She awoke from a nap and smiled at him, but hinted at her discomfort.

“Hi Doug,” she said. “I’m not feeling too good.”

Still, Dreyfuss talked about an upcoming visit with her sisters – the movies she wanted to see, the restaurants she wanted to try. The mother and son then had only a vague awareness of the deadly virus then ravaging China.

In hindsight, Briggs realized he had witnessed the first signs of her distress. His mother was using more oxygen than usual, her breathing was more strained.

At the time, staff at the nursing home believed they were handling a flu outbreak and were unaware the coronavirus had started to take hold, a spokesman has said.

‘A TINY FOOTNOTE’

Two days later, Briggs dropped by to see his mom. She felt congested, and staff were going to X-ray her lungs for fluid. Briggs, 54, still saw no red flags, and continued to discuss weekend plans with his mother.

“I hope we can finally watch that new Mr. Rogers movie,” she told him, referring to the film, A Beautiful Day in the Neighborhood.

Briggs hugged his mom before she was wheeled to the imaging room and drove for a quick meal. Soon after, he received a call from the nursing home. His mother was experiencing respiratory failure. She was on her way to the hospital. Doug rushed to nearby EvergreenHealth Medical Center. By then, she was unresponsive.

At the time, there were 59 U.S. cases of coronavirus, a number that has since soared to more than 85,000.

After hearing of her sister’s sudden hospitalization, Meri Dreyfuss remembered an earlier voicemail from Barbara: her distant voice, groaning for 30 seconds. When she had first heard it, she assumed Dreyfuss had called by accident, but now she realized her sister was in pain. “It haunts me that I didn’t pick up the phone,” she said.

Briggs spent close to 10 hours the next day in his mom’s hospital room. He wore a medical mask and anxiously watched her vital signs – especially the line tracking her oxygen saturation.

On his way out the door, a doctor took him aside to say they were testing her for the coronavirus. He remembered the difficulty reconciling the outbreak taking place on television – far away, in China – with what was happening in his mother’s hospital room.

In the Bay Area, Meri and Hillary Dreyfuss were packing their suitcases on Feb. 28 when Briggs telephoned. After the call, they decided that visiting their sister would pose too much danger of infection.

“I realized there was no way we were going to get on a plane at that point, because we couldn’t see her,” said the middle sister, Hillary. “And now, it seemed that we shouldn’t be seeing Doug, either.”

They canceled their flights. On Saturday, Feb. 29, Briggs learned his mother’s condition was deteriorating. Tough decisions loomed. Briggs and his aunts decided to prioritize making her comfortable over keeping her alive. Doctors gave her morphine to relax the heaviness in her lungs.

She died the next day.

Having emerged from a two-week quarantine, Briggs will soon retrieve his mother’s cremated remains. The family has been struggling with how to memorialize her life in such chaotic times.

“All the things that one would want to happen in the normal mourning process have been subsumed by this larger crisis,” said Hillary Dreyfuss. “It’s almost as though her death has become a tiny footnote in what’s going on.”

(Reporting by Deborah Bloom and Nathan Layne; Editing by Paul Thomasch and Brian Thevenot)

U.S. House approves $2.2 trillion coronavirus bill, sends to Trump

By David Morgan and Susan Cornwell

WASHINGTON (Reuters) – The U.S. House of Representatives on Friday approved a $2.2 trillion aid package – the largest in American history – to help individuals and companies cope with an economic downturn caused by the coronavirus outbreak and provide hospitals with urgently needed medical supplies.

The massive bill, also passed by the Republican-controlled Senate late on Wednesday, now goes to Republican President Donald Trump who is expected to promptly sign it into law.

Democrats and Republicans in the Democratic-led House approved the package on a voice vote, turning back a procedural challenge from Republican Representative Thomas Massie, who had sought to force a formal, recorded vote.

Massie, an independent-minded Republican who has repeatedly defied party leaders, said on Twitter that he thought the bill contained too much extraneous spending and gave too much power to the Federal Reserve. He did not speak on the House floor during the three-hour debate.

Trump called Massie a “third rate Grandstander” on Twitter and said he should be thrown out of the Republican Party.

“He just wants the publicity. He can’t stop it, only delay,” Trump wrote.

Other said he was putting lawmakers’ health at risk.

At least three members of Congress have tested positive for the coronavirus and more than two dozen have self-quarantined to limit its spread.

“Thomas Massie, this is disgusting. This is inhumane,” Democratic Representative Max Rose said on Fox News.

The rescue package – which would be the largest fiscal relief measure ever passed by Congress – will rush direct payments to Americans within three weeks if the House backs it and Trump signs it into law. It passed the Senate unanimously on Wednesday night.

The $2.2 trillion measure includes $500 billion to help hard-hit industries and $290 billion for payments of up to $3,000 to millions of families.

It will also provide $350 billion for small-business loans, $250 billion for expanded unemployment aid and at least $100 billion for hospitals and related health systems.

The rare but deep, bipartisan support in Congress underscored how seriously lawmakers are taking the global pandemic as Americans suffer and the medical system threatens to buckle.

The United States surpassed China and Italy on Thursday as the country with the most coronavirus cases. The number of U.S. cases passed 85,000, and the death toll exceeded 1,200.

The Labor Department on Thursday reported the number of Americans filing claims for unemployment benefits surged to 3.28 million, the highest level ever.

(Reporting by David Morgan, Lisa Lambert, Doina Chiacu, Richard Cowan, Susan Cornwell, Andy Sullivan and Patricia Zengerle; Writing by Andy Sullivan and Patricia Zengerle; Editing by Lincoln Feast and Jonathan Oatis)

Verses of Comfort and Hope from God’s Word

By Kami Klein

Romans 8:28 And we know that all things work together for good to them that love God, to them who are the called according to his purpose. (KJV)

We are living in a time of great worry and fear. There is not anyone on this planet that is not being affected by the COVID-19 coronavirus. It seems there are more questions than answers from the world but we, as Christians, know where our strength comes from. God’s Word encourages us, holds us and comforts our spirit. Now is the time to turn to the Bible and spend time with the Lord in deep gratitude and love. Though the world around us may be in turmoil, you can rest within the Holy Spirit.

1 Chronicles 16:11 Look to the LORD and his strength; seek his face always. (NIV)

Psalm 34:4 I sought the Lord, and he answered me; he delivered me from all my fears. (NIV)

John 14:27 Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid. (NIV)

Please remember that you are not alone. God is always with you! Reach out to others and give them the peace that comes from HIM! This is the time to show your faith and wisdom through your kindness and grace.

Joshua 1:9 Have I not commanded you: Be strong and courageous; do not be frightened or dismayed, for the Lord your God is with you wherever you go. (NIV)

Romans 8:38-39 For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, 39 neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord. (NIV)

John 16:33 “I told you these things so that you can have peace in me. In this world, you will have trouble, but be brave! I have defeated the world.”(NCV)

The world needs our faithful prayers. Pray for our healers, those who are out on the front lines. Pray for those who are sick, for those that are mourning their loved ones. Pray to bring joy to those around you. Pray for patience and discernment. Pray for our leaders! Pray for those that are in such fear but do not know the relief, the hope and love found in Jesus. We are prayer warriors. Now is the time to do battle!

Jeremiah 29:12 Then you will call on me and come and pray to me, and I will listen to you. (NIV)

1 John 5:14 This is the confidence we have in approaching God: that if we ask anything according to his will, he hears us. (NIV)

Ephesians 6:18 18 Pray in the Spirit at all times with all kinds of prayers, asking for everything you need. To do this you must always be ready and never give up. Always pray for all God’s people. (NCV)

We may all be in our homes but we can be a witness to the Power and Glory of God by our peace, by sharing a kind word and keeping a joyful attitude. Worry and stress are bad for our immune systems so stay healthy and have faith. Remember that what you fear the most is what you are trusting God with the least. Our Faith will always win!

Matthew 5:16 In the same way, you should be a light for other people. Live so that they will see the good things you do and will praise your Father in heaven. (NCV)

Factbox: Coronavirus cases reported at 13 of Amazon’s U.S. warehouses

Factbox: Coronavirus cases reported at 13 of Amazon’s U.S. warehouses
(Reuters) – Amazon.com Inc is at the front line of responding to outbreaks of the novel coronavirus in the United States, delivering essential goods while about half the population faces government stay-at-home orders.

However, news reports that a handful out of Amazon’s hundreds of thousands of U.S. warehouse workers have contracted the virus raise the potential of future site closures and operational disruptions at the world’s largest online retailer.

The following is a list of 13 company warehouses across the United States where one or more instances of COVID-19 have been reported. Amazon, which did not respond to Reuters requests that it confirm all the cases, said in a statement that it has taken preventive action and that workers’ health and safety is its top priority.

According to logistics consultancy MWPVL International Inc, Amazon has 519 facilities in its U.S. distribution infrastructure — including fulfillment centers, delivery stations and warehouses.

QUEENS, NEW YORK – On March 19, Amazon said it was temporarily closing delivery station DBK1 after an associate there tested positive for the virus. It was the first known case at an Amazon warehouse in the United States.

SHEPHERDSVILLE, KENTUCKY – Amazon said it shut a warehouse until April 1 at the direction of the state’s governor. Several workers at the site, known as SDF9, had contracted COVID-19. The facility handles apparel and footwear, according to MWPVL.

OKLAHOMA CITY, OKLAHOMA – A worker at Amazon’s OKC1 fulfillment center said until he had tested positive, he needed to keep working to pay his bills. “I hope I didn’t spread it,” he told local television station News 4.

BROWNSTOWN, ROMULUS and SHELBY CHARTER TOWNSHIP, MICHIGAN – Three facilities near Detroit have had cases of the virus, including an Amazon sortation center and two Amazon fulfillment centers , the company said in local media reports.

WALLINGFORD, CONNECTICUT – Amazon told local broadcaster WTNH last week  that it was supporting a now-quarantined individual at its facility here who had the coronavirus. The site has stayed open, the report said.

JOILET, ILLINOIS – A worker, who was last at a fulfillment center in this city southwest of Chicago on March 18 and now is in quarantine, caught the virus, Amazon said to the Herald-News.

KATY, TEXAS – Amazon told local news  that a management team member at a delivery station outside Houston had tested positive for the disease.

JACKSONVILLE, FLORIDA – A fulfillment center employee tested positive for the virus, Amazon told local news , which quoted an anonymous worker as saying the person was “upset, angry, scared — basically in fear for my safety, in my own immediate (family’s) safety.”

MORENO VALLEY, CALIFORNIA – Amazon notified employees at its “ONT8” fulfillment center that a worker had contracted COVID-19. Last at the facility on March 18, the person has since received medical care and has gone into quarantine, the Desert Sun reported.  The warehouse is continuing operations, the report said.

STATEN ISLAND, NEW YORK – CNN has reported  that a worker at a fulfillment center in New York City’s least-populated borough had the virus.

EDISON, NEW JERSEY – Local news reported  that an employee at the facility southwest of New York had tested positive for the virus.

(Reporting by Jeffrey Dastin in San Francisco; Editing by Leslie Adler)

Race for space to house vulnerable in coronavirus

By Zoe Tabary

LONDON (Thomson Reuters Foundation) – “Stay home” – that’s the message stretching from Italy to Iran as the world tries to contain coronavirus. But what if you’ve got no place to call home, or your house is out of bounds in the pandemic?

Some 1.8 billion people worldwide are homeless or live in inadequate housing, experts say, calling for urgent measures to ensure the most vulnerable get sanctuary in the outbreak.

Thousands more need a temporary place to live, either to stay close to crisis centres at the core of the coronavirus fightback or to keep housemates infection-free during weeks of lockdown.

Worldwide, the respiratory disease – which emerged last year in China – has infected more than 490,000 people and the death toll tops 22,000, according to Johns Hopkins University.

“Housing has become the front line defence against the coronavirus, said Leilani Farha, the U.N. Special Rapporteur on the right to adequate housing. “Home has rarely been more of a life or death situation.”

To that end, officials are scouring cities for vacant spaces or disused buildings to turn into makeshift homes.

From empty motels to festival halls, conference centres to cottages – buildings are being repurposed at breakneck speed, with the homeless a top priority.

“Housing, not handcuffs or forced congregate sheltering, for those experiencing homelessness, is the way to best ensure we all remain safer,” Eric Tars, of the U.S. National Law Center on Homelessness & Poverty, said in a statement.

SHELTER

In Italy, which has registered more than 7,500 deaths from the virus – it is the world’s worst hit country – some rail stations are doubling up as centres offering shelter and wash rooms.

Alessandro Radicchi, who runs the Binario 95 shelter in Rome’s central train station, said police were now routinely stopping homeless people, saying they could pay a fine for wandering the streets without proof of residence.

“You can imagine how a homeless person who feels alone during an ordinary time, now really feels there is no one,” Radicchi told the Thomson Reuters Foundation by phone.

The centre supports about 70 people daily but can only sleep 12, Radicchi said, adding that the Italian capital has more than 40,000 people living without adequate housing but only 1,000 beds in homeless shelters.

“We cannot host all of them. But we tell them, ‘when you go in the street, remember these things like keep the mask and don’t touch anything if you don’t have to’,” he explained.

Officials expect the crisis to have an outsized impact on the homeless, who often make do without sanitation or food, bed down in close quarters and suffer more underlying illnesses.

For the millions of poor and daily wage workers in India, the threat of hunger and a lack of shelter looms larger than that of the deadly coronavirus, which has prompted the government to lock down the country until mid-April.

Since the shutdown began on Wednesday night, homeless shelters have filled with migrant workers and labourers who have lost their livelihoods and so cannot afford food or a bed.

ISOLATION

In the Canadian city of Montreal, a former hospital is this week being transformed into an isolation facility for homeless people exhibiting symptoms of coronavirus.

Patients will be kept in individual rooms in a building that sits at the top of a hill, tested for the virus and quarantined should they test positive, said a spokesman for the regional health agency, with capacity that can go up to 150 beds.

In London, the government will open a temporary hospital at the cavernous ExCel exhibition centre in east London, installing ventilators and beds in what was once an Olympic sporting venue.

U.S. communities have taken things into their own hands.

In California, a collective of homeless people and others whose housing is insecure have occupied six vacant, state-owned homes in the Los Angeles area.

“Letting hundreds of homes sit empty during a pandemic poses a health hazard to those like us — those who lack stable housing,” the Reclaiming Our Homes collective wrote on Facebook.

JUST A BED

Cities are also scrambling to help hard-pressed healthcare staff – working flat out and often without transport networks – with well-placed home owners opening up their flats for free.

As the virus decimates tourism, hotels and holiday lets are also sitting empty, prompting rental company Airbnb to open pages in Italy and France to connect medics with hosts.

“Doctors and nurses were requested to move from one city to another to support hospitals with exploding intensive care units. It was our desire to support … these heroes,” said Airbnb’s general manager in Italy, Giacomo Trovato.

He said the firm would pay hosts a minimum rate of about 10 euros a night and cover cleaning and fees for up to two months.

More than 2,000 homeowners and 180 doctors and nurses signed up within days of the launch, he said by phone.

Europe’s largest hotel group Accor said on Tuesday it had created a platform to offer housing to medical staff, and would offer up to 2,000 beds in 40 hotels for the homeless.

Such measures will be even more pressing as the virus digs into poorer countries where densely populated slum neighbourhoods create ideal conditions for disease transmission.

“COVID-19 is likely to spread at an even faster rate in informal settlements than elsewhere and with more disastrous consequences,” Farha said via WhatsApp.

“A ‘stay at home’ policy fails to recognise the conditions in informal settlements that make staying at home just as deadly, if not more, than no policy at all,” she said.

(Reporting by Zoe Tabary @zoetabary in London, Thin Lei Win @thinkink in Rome, Umberto Bacchi @UmbertoBacchi in Tbilisi, Annie Banerji @anniebanerji in Delhi and Jillian Kestler-D’Amours @jkdamours in Montreal, editing by Lyndsay Griffiths. 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)

U.S. has most coronavirus cases in world, next wave aimed at Louisiana

By Maria Caspani and Daniel Trotta

NEW YORK (Reuters) – The number of U.S. coronavirus infections climbed above 82,000 on Thursday, surpassing the national tallies of China and Italy, as New York, New Orleans and other hot spots faced a surge in hospitalizations and looming shortages of supplies, staff and sick beds.

With medical facilities running low on ventilators and protective masks and hampered by limited diagnostic testing capacity, the U.S. death toll from COVID-19, the respiratory disease caused by the virus, rose beyond 1,200.

“Any scenario that is realistic will overwhelm the capacity of the healthcare system,” New York Governor Andrew Cuomo told a news conference. He described the state’s projected shortfall in ventilators – machines that support the respiration of people have cannot breathe on their own – as “astronomical.”

“It’s not like they have them sitting in the warehouse,” Cuomo added. “There is no stockpile available.”

At least one New York City hospital, New York-Presbyterian/Columbia University Medical Center in Manhattan, has begun a trial of sharing single ventilators between two patients.

While New York was the coronavirus epicenter in the United States this week, the next big wave of infections appeared headed for Louisiana, where demand for ventilators has already doubled. In New Orleans, the state’s biggest city, Mardi Gras celebrations late last month are believed to have fueled the outbreak.

Louisiana Governor John Bel Edwards said New Orleans would be out of ventilators by April 2 and potentially out of bed space by April 7 “if we don’t flatten the infection curve soon.”

“It’s not conjecture, it’s not some flimsy theory,” Edwards told a press conference. “This is what is going to happen.”

Nurse Tina Nguyen administers a nasal swab at a coronavirus testing site outside International Community Health Services in the Chinatown-International District during the coronavirus disease (COVID-19) outbreak in Seattle, Washington, U.S. March 26, 2020. REUTERS/Lindsey Wasson

About 80% of Louisiana’s intensive care patients are now on breathing machines, up from the normal rate of 30-40%, said Warner Thomas, chief executive of Ochsner Health System, the state’s hospital group.

Scarcities of protective masks, gloves, gowns and eyewear for doctors and nurses – reports abound of healthcare workers recycling old face masks, making their own or even using trash bags to shield themselves – have emerged as a national problem.

“Our nurses across the country do not have the personal protective equipment that is necessary to care for COVID patients, or any of their patients,” Bonnie Castillo, head of the largest U.S. nurses union, National Nurses United, told MSNBC.

In an ominous milestone for the United States as a whole, at least 82,153 people nationwide were infected as of Thursday, according to a Reuters tally from state and local public health agencies. China, where the global pandemic emerged late last year, had the second highest number of cases, 81,285, followed by Italy with 80,539.

At least 1,204 Americans have died from COVID-19, which has proven especially dangerous to the elderly and people with underlying chronic health conditions, Reuters’ tally showed.

MORE BEDS NEEDED

For New York state, Cuomo said a key goal was rapidly to expand the number of available hospital beds from 53,000 to 140,000.

New York hospitals were racing to comply with Cuomo’s directive to increase capacity by at least 50%. At Mount Sinai Hospital’s Upper East Side location, rooms were being constructed within an atrium to open up more space for beds.

At Elmhurst Hospital in New York’s borough of Queens, about a hundred people, many wearing masks with their hoods pulled up, lined up behind barriers outside the emergency room entrance, waiting to enter a tent to be screened for the coronavirus.

The city coroner’s office has posted refrigerated trucks outside Elmhurst and Bellevue Hospital to temporarily store bodies of the deceased.

Deborah White, vice chair of emergency medicine at Jack D. Weiler Hospital in the city’s Bronx borough, said 80% of its emergency room visits were patients with coronavirus-like symptoms.

A ventilator shortfall and surge in hospitalizations has already raised the prospect of rationing healthcare.

Asked about guidelines being drafted on how to allocate ventilators to patients in case of a shortage, New Jersey Governor Phil Murphy told reporters such bioethical discussions “haunted him” but were unavoidable.

Outside New York and New Orleans, other hot spots appeared to be emerging around the country, including Detroit.

Brandon Allen, 48, was buying groceries in Detroit for his 72-year-old mother, who has tested positive and was self-quarantining at home.

“It’s surreal,” Allen said. “People around me I know are dying. I know of a couple people who have died. I know a couple of people who are fighting for their lives. Everyday you hear of another person who has it.”

RECORD UNEMPLOYMENT CLAIMS

Desperate to slow virus transmissions by limiting physical contact among people, state and local governments have issued stay-at-home orders covering about half the U.S. population. A major side effect has been the strangulation of the economy, and a wave of layoffs.

The U.S. Labor Department reported Thursday the number of Americans filing claims for unemployment benefits last week soared to a record of nearly 3.28 million – almost five times the previous weekly peak of 695,000 during the 1982 recession.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said warmer weather may help tamp down the U.S. outbreak as summer approaches, though the virus could re-emerge in the winter.

“We hope we get a respite as we get into April, May and June,” Fauci said on WNYC public radio.

Washington state Governor Jay Inslee said he may extend a stay-at-home order tentatively set to expire April 6, encouraged by what he called a “very modest improvement” in the Seattle area.

Washington experienced the first major U.S. outbreak of COVID-19 and has been among the hardest-hit states. As of Thursday the state reported about 3,200 cases and 147 deaths.

In California’s Coachella Valley, a region rife with retirees who are especially vulnerable, 25 members of the state’s National Guard helped a non-profit distribute food to people stuck in their homes, as most of the regular volunteers are senior citizens.

More than 10,000 troops have been deployed in 50 states to provide humanitarian aid during the pandemic.

(Reporting by Maria Caspani in New York and Daniel Trotta in Milan; Additional reporting by Gabriella Borter, Catherine Koppel, Lucia Mutikani, Doina Chiacu, Susan Heavey, Nathan Layne, Lisa Lambert, Michael Martina, Rebecca Cook, Barbara Goldberg, Rich McKay and Dan Whitcomb; Writing by Will Dunham and Steve Gorman; Editing by Howard Goller, Bill Tarrant, Cynthia Osterman and Daniel Wallis)

Coronavirus tag: How the pandemic can affect young minds

By Kate Kelland

LONDON (Reuters) – It’s a bit like tag, except that you get tagged when someone coughs on you and that means you have the virus and have to go into isolation. If you come out and get tagged again, you die.

Child psychotherapists say playground games in the time of COVID-19 are becoming infused with words that many of the children playing them had never heard before: pandemic, isolation, lockdown.

So while the disease caused by the new coronavirus appears to produce relatively mild symptoms in many children, doctors and psychologists warn the impact of the outbreak and its anxiety-inducing spread may be far more traumatic.

“I’m worried we could develop a generation of children with health anxiety,” said Nikhil Chopra, a family doctor and father of two girls, aged 2 and 4, living in southern England.

His 4-year-old, normally playful and worry-free, he said, was coming home from school last week saying: “If we don’t wash our hands we could die.”

A psychotherapist who works with children in London said the games and playground talk among young children sharply reflect the new world.

Describing the coronavirus tag game, where “if you’re tagged you have to stand at one end of the playground in isolation, and if you come out and get tagged again, you die”, the therapist said fear and confusion were leading some kids to lash out.

“There’s quite a lot of ethnic diversity in the school I work in, and the Chinese children are being victimized and bullied – they are being told they’re “unclean” and “revolting” because “they eat dogs and snakes”. It’s so sad. The children are not bad, but their fear is so great that the only thing they can do is project it onto others to gain a sense of control.”

NERVOUS AND BRAVE

Across the Atlantic, 4-year-old Asher Henkoff says he’s fine when asked how the pandemic is affecting him: “I have my stuffed animals to keep me company, and I get to watch TV,” the Houston, Texas boy said, adding he feels “nerv-brave” – a mix of nervous and brave.

His mother, Alexandra Wax, says Asher has become uncharacteristically clingy, is asking non-stop questions about the new virus and has begun having accidents during the night – something he hasn’t done in years.

While some young minds will be resilient and enable those children to bounce back after the crisis, the risk for others, psychotherapists say, is that the anxiety they see around them now will impact their mental growth and future lives.

“Adults panicking is going to mean children panicking because they will be feeling very unsafe,” said Lucy Russell, a clinical psychologist in southern England and author of an online child mental health blog called “They are the Future”.

“I’m most worried not because of the distress I’m seeing in children right at this moment, but because of the distress I’m seeing in adults and how that will be transmitted to children.”

Russell and other mental health specialists such as Mary Calabrese, a Cambridge, Massachusetts-based child psychologist, say traumas like the global coronavirus pandemic can affect children particularly strongly.

Because their brains are still forming, trauma can cause the amygdala – the emotional part of the brain linked to fear and anxiety – to over-react at a time when its link to the frontal cortex – the thinking and more rational part of the brain – is not fully developed.

“The connections aren’t strong,” Russell said. “So young children tend to react emotionally to things – and the thinking, rational part of the brain can’t calm them down.”

Calming becomes a job for adults – parents, neighbors, teachers and friends – said Russell and Calabrese.

Acknowledging how hard this can be for parents and carers whose own lives are filled with anxiety and uncertainty, the specialists advise creating as much structure and predictability as possible to help children feel secure and safe.

And because children’s minds are geared toward problem-solving, they might also respond well to reassurance that focuses on what can be done to control the spread of the virus – like washing hands and staying inside.

“Validate their fears without making it worse,” Calabrese said. “You might want to say: ‘Let’s find out together what this means’. Pull it away from them personally, and say: ‘This is why we all owe it to each other to socially distance’.”

(Reporting and writing by Kate Kelland in London. Additional reporting by Nick Brown in New York; Editing by Janet Lawrence)

One ventilator, two patients: New York hospitals shift to crisis mode

By Jonathan Allen and Nick Brown

NEW YORK (Reuters) – At least one New York hospital has begun putting two patients on a single ventilator machine, an experimental crisis-mode protocol some doctors worry is too risky but others deemed necessary as the coronavirus outbreak strains medical resources.

The coronavirus causes a respiratory illness called COVID-19 that in severe cases can ravage the lungs. It has killed at least 281 people over a few weeks in New York City, which is struggling with one of the largest caseloads in the world at nearly 22,000 confirmed cases.

A tool of last resort that involves threading a tube down a patient’s windpipe, a mechanical ventilator can sustain a person who can no longer breathe unaided. The city only has a few thousand and is trying to find tens of thousands more.

Dr. Craig Smith, surgeon-in-chief at New York-Presbyterian/Columbia University Medical Center in Manhattan, wrote in a newsletter to staff that anesthesiology and intensive care teams had worked “day and night” to get the split-ventilation experiment going.

By Wednesday, he wrote, there were “two patients being carefully managed on one ventilator.”

New York Governor Andrew Cuomo, who says his staff is struggling to find enough machines on the market, has touted the adaptation as a potential life-saver. “It’s not ideal,” he told reporters, “but we believe it’s workable.”

The U.S. Food & Drug Administration, which regulates medical device manufacturers, gave emergency authorization on Tuesday allowing ventilators to be modified using a splitter tube to serve multiple COVID-19 patients, though manufacturers still must share safety information with regulators.

Some medical associations oppose the unproven method.

On Thursday, the Society of Critical Care Medicine, the American Association for Respiratory Care and four other practitioner groups issued a joint statement saying the practice “should not be attempted because it cannot be done safely with current equipment.”

It is difficult enough to fine-tune a ventilator to keep alive even one patient with acute respiratory distress syndrome (ARDS), the statement said; sharing it across multiple patients would worsen outcomes for all. They proposed doctors instead choose the one patient per ventilator deemed most likely to survive.

At Columbia, Smith noted that they could not split a ventilator across just any two COVID-19 patients, but were only pairing patients with sufficiently similar respiratory needs.

Across Manhattan, Mount Sinai Hospital told staff in an email that officials were “working to figure out” whether they could split ventilators. The hospital has ordered the necessary adapters, a nurse there said in an interview on condition of anonymity because she was not authorized to speak to reporters.

Experts at Columbia pointed to a 2006 study where researchers, using lung simulators, concluded that a single ventilator could sustain four adults in an emergency scenario.

One author of that study, Dr. Greg Neyman, cautioned against the application in COVID-19 cases in part because the lungs themselves are infected. If one patient’s lungs were deteriorating faster, he said, it could cause imbalances in the closed system. One patient could starve for oxygen while the other patient’s lungs would get increased pressure.

“Unless they were very very closely monitored, such a set up may end up doing more harm than good,” Neyman wrote in an email to Reuters.

(Reporting by Jonathan Allen and Nick Brown; Editing by David Gregorio)

House on edge ahead of $2.2 trillion coronavirus vote

By David Morgan and Richard Cowan

WASHINGTON (Reuters) – Armed with hand sanitizer and discouraged from using elevators, members of the U.S. House of Representatives aimed to quickly pass a sweeping $2.2 trillion coronavirus stimulus bill on Friday, though it was unclear if they would be forced to delay a day.

Leadership of the Democratic-controlled chamber and top Republicans aimed to pass the largest relief measure that Congress has ever taken up in a voice vote, one of the fastest methods the chamber has, and pass it on to Republican President Donald Trump for his signature.

There could be opposition. Republican Representative Thomas Massie said he opposed the bill, and was uncomfortable with the idea of allowing it to pass on a voice vote, rather than in a formal call recording how each House member voted, which could delay the vote until Saturday.

The Capitol has laid out special procedures because of the coronavirus to minimize the threat of infection. Members are barred from sitting next to one another and would be called from their offices alphabetically for the vote. They will be required to use hand sanitizer before entering the chamber and encouraged to take the stairs, rather than use elevators, to better maintain social distancing.

While most of the House’s 430 current members are in their home districts because of the coronavirus outbreak, several are expected to travel to Washington for a vote around 11 a.m. EDT(1500 GMT).

On a call with fellow Democrats on Thursday afternoon, Speaker Nancy Pelosi urged House members not to do anything to delay the unprecedented economic aid package the Republican-led Senate backed by a unanimous 96-0 vote on Wednesday night.

Treasury Secretary Steven Mnuchin, who helped craft the package, also urged lawmakers to pass it quickly.

“This is the time that we want to see the government and that states all come together and execute on the largest financial package in the history of time,” he said on Fox Business Network.

The rescue package – which would be the largest fiscal relief measure ever passed by Congress – will rush direct payments to Americans within three weeks if the House backs it and Trump signs it into law.

The $2.2 trillion measure includes $500 billion to help hard-hit industries and $290 billion for payments of up to $3,000 to millions of families.

The legislation will also provide $350 billion for small-business loans, $250 billion for expanded unemployment aid and at least $100 billion for hospitals and related health systems.

VOICE VOTE SOUGHT

The rare but deep, bipartisan support in Congress underscored how seriously lawmakers are taking the global pandemic as Americans suffer and the medical system threatens to buckle.

Pelosi said House leaders were planning to fast-track the rescue plan by passing it via a voice vote on Friday. She had said that if there were calls for a roll-call vote, lawmakers might be able to vote remotely as not all would be able to be in Washington.

It was unclear whether Massie would block the measure.

“I’m having a real hard time with this,” Massie, an outspoken fiscal conservative, said on 55KRC talk radio in Cincinnati.

Democratic Representative Dean Phillips asked Massie on Twitter to let his colleagues know if he intended to delay the bill’s passage “RIGHT NOW so we can book flights and expend about $200,000 in taxpayer money to counter your principled but terribly misguided stunt.”

The United States surpassed China and Italy on Thursday as the country with the most coronavirus cases. The number of U.S. cases passed 82,000, and the death toll reached almost 1,200.

The Labor Department reported the number of Americans filing claims for unemployment benefits surged to 3.28 million, the highest level ever.

(Reporting by David Morgan, Doina Chiacu, Richard Cowan, Susan Cornwell and Patricia Zengerle; writing by Patricia Zengerle and Andy Sullivan; editing by Lincoln Feast.)