A4 FRIDAY, JULY 31, 2020
Tracking an Outbreak
YAverage daily cases per 100,000 people
in the past week16 Few or
no cases32 48Hot Spots in the United States
THE NEW YORK TIMESAs of Thursday evening, more than 4 ,488,000 people across every state, plus Washington, D.C., and four U.S. territories, have tested positive for the
coronavirus, according to a New York Times database. More than 152,100 people with the virus have died in the United States.Nev.Ga.Miss.Conn.N.C.IowaN.D.Kan.Te x a sR.I.Mass.Ark.UtahMont.S.C.Mich.Calif.Wis.N.M.Ill.Fla.Wyo.N.Y.Ind.Minn.
Ore.MaineAlaskaTenn.Pa.Md.Ariz.Wash.N.H.HawaiiMo.Del.
W. Va.N.J.IdahoD.C.OhioKy.Okla.La.Ala.Vt.Neb.S.D.Minn.Colo.
Va.Puerto RicoSources: State and local health agencies. The map shows the share of population with a new reported case over the last week. Parts of a county with a
population density lower than 10 people per square mile are not shaded. Data for Rhode Island is shown at the state level because county level data is
infrequently reported. Data is as of July 30, 2020, at 5 p.m., Eastern.Another grim avalanche of figures served to confirm what many —
on the glum Main Streets of the United States if not on Wall Street
— already knew: The economic wreckage wrought by the coro-
navirus pandemic was unprecedented in its speed and scope. Gross
domestic product, the broadest measure of goods and services
produced, plunged 9.5 percent over April, May and June, the equiva-
lent of a 32.9 percent annual rate of decline, enough to wipe away
five years of economic growth. The figures would have been worse
without trillions of dollars in government aid.
The G.D.P. figures suggested that the chances of a “V-shaped
recovery” — the rapid rebound that President Trump and his eco-
nomic advisers had been counting on — were dimming. The figures
amounted to a three-month snapshot of the economy. A look back at
just last week suggests that the trends are continuing to go in the
wrong direction: Another 1.43 million people filed new state unem-
ployment claims, about 10,000 more than during the previous week.
Last week was the 19th in a row in which claims exceeded one mil-
lion, an unheard-of figure before the coronavirus pandemic.
“We’re still in a desperate situation,” said Diane Swonk, the chief
economist at the accounting firm Grant Thornton in Chicago, who
noted that weekly claims had been in the 200,000 range before the
pandemic. “Everyone wants to keep putting on rose-colored glasses,
but it’s blinding us to the reality of the situation and what we have to
deal with.”
Mr. Trump, at a White House news conference on Thursday,
again predicted that the economy would recover quickly. He said it
was “not going to take very long.”
Unlike past downturns, this one was a result of deliberate deci-
sions by governors and mayors to all but suspend economic activi-
ty: “Not a viable strategy for any country,” the president said, but
one aimed at flattening the curve. “And we’ve done that.” Congress
also pumped trillions of dollars into the economy to sustain house-
holds and limit long-term damage, and that succeeded — at first.
But the economy appears to have slowed in the last few weeks
as different indicators — case counts covering much of the country
— have moved in the wrong direction. As the United States death
toll passed 150,000 this week, more than any other nation in the
world, three states — Arizona, California and Mississippi — set
records for the most deaths they have reported in a single day. A
fourth, Florida, set death records three days in a row this week,
hitting its latest record, 253, on Thursday.
In Washington, the last-ditch effort to extend enhanced unem-
ployment benefits fizzled as the Senate on Thursday dissolved into
partisan bickering. Without action by Friday, the benefits will lapse,
leaving millions of Americans in limbo.
‘People Should Wear the Mask’
To wear a mask or not to wear a mask? That is the tension that
continued on Thursday, with the commissioner of the Food and
Drug Administration rebutting an assertion made by Representa-
tive Louie Gohmert, who announced on Wednesday that he had
tested positive for the coronavirus. Mr. Gohmert, a Republican from
Texas who often pointedly shunned wearing a mask in the Capitol,
said he believed that the pathogen had gotten into a mask he was
wearing when he adjusted it on his face.
On Thursday, the F.D.A. commissioner, Dr. Stephen M. Hahn,
said that “we don’t have any medical evidence that that’s the case.”
“What our data show is people should wear the mask” when
social distancing is not possible, Dr. Hahn said on the NBC News
program “Today.” In any case, masks are now mandated on the
House floor and in House office buildings. Speaker Nancy Pelosi
announced the requirement after Mr. Gohmert had disclosed his test
results.
Dr. Deborah L. Birx, the Trump administration’s coronavirus
response coordinator, made a wider plea for mask-wearing, calling
on state and local officials to make masks a must. “We believe if the
governors and mayors of every locality right now would mandate
masks for their communities and every American would wear a
mask, and socially distance and not congregate in large settings
where you can’t socially distance or wear a mask, that we can really
get control of this virus,” she told the Fox News program “Fox and
Friends.”
Dr. Birx said there was “still a very serious pandemic” in the
South, although she said that the virus was “moving up” to states in
the Midwest and the Northwest. She named 13 states where case
counts have risen.
Herman Cain Dies at 74
Herman Cain, the former chief executive of Godfather’s Pizza
who sought the Republican presidential nomination in 2012, died.
Mr. Cain, 74, had been hospitalized with complications from the
coronavirus since the beginning of July.
Mr. Cain attended President Trump’s rally last month in Tulsa,
Okla. Mr. Cain said in a video on his website after the rally that he
had worn a mask while around others at the event. But he also
posted photographs on social media that showed him without a
mask and surrounded by people. The statement on his Twitter ac-
count in early July announcing that he had tested positive said there
was “no way of knowing for sure how or where Mr. Cain contracted
the coronavirus.” The top health official in Tulsa said two and a half
weeks after the June 20 rally that a surge of cases in the Tulsa area
was probably connected to the event.
By JAMES BARRONCoronavirus Update
Coronavirus Update wraps up the day’s developments with infor-
mation from across the virus report.Economic Cost: Quarterly G.D.P. Falls 9.5%
Masks Now Mandatory on U.S. House Floor
Birx Warns South Still in ‘Serious Pandemic’
New Coronavirus Cases Announced Daily in U.S.
THE NEW YORK TIMESMarch 1 July 30
Note: Thursday’s total is incomplete because some states report cases
after press time. Data is as of July 30, 2020, at 5 p.m. Eastern.
Sources: State and local health agencies; hospitals; C.D.C.
As of Thursday evening, more than 4,488,000 people across every
state, plus Washington, D.C., and four U.S. territories, have tested
positive for the virus, according to a New York Times database.
New cases7-day
average60,30,It has been a comforting refrain
in the national conversation about
reopening schools: Young chil-
dren are mostly spared by the co-
ronavirus and don’t seem to
spread it to others, at least not
very often.
But on Thursday, a study intro-
duced an unwelcome wrinkle into
this smooth narrative.
Infected children have at least
as much of the coronavirus in their
noses and throats as infected
adults, according to the research.
Indeed, children younger than age
5 may host up to 100 times as much
of the virus in the upper respira-
tory tract as adults, the authors
found.
That measurement does not
necessarily prove children are
passing the virus to others. Still,
the findings should influence the
debate over reopening schools,
several experts said.
“The school situation is so com-
plicated — there are many nu-
ances beyond just the scientific
one,” said Dr. Taylor Heald-Sar-
gent, a pediatric infectious dis-
eases expert at the Ann and
Robert H. Lurie Children’s Hospi-
tal of Chicago, who led the study,
published in JAMA Pediatrics.
“But one takeaway from this is
that we can’t assume that just be-
cause kids aren’t getting sick, or
very sick, that they don’t have the
virus.”
The study is not without cav-
eats: It was small, and did not
specify the participants’ race or
sex, or whether they had underly-
ing conditions. The tests looked for
viral RNA, genetic pieces of the co-
ronavirus, rather than the live vi-
rus itself. (Its genetic material is
RNA, not DNA.)
Still, experts were alarmed to
learn that young children may
carry significant amounts of the
coronavirus.
“I’ve heard lots of people say-
ing, ‘Well, kids aren’t susceptible,
kids don’t get infected.’ And this
clearly shows that’s not true,” said
Stacey Schultz-Cherry, a virolo-
gist at St. Jude Children’s Re-
search Hospital.
“I think this is an important, re-
ally important, first step in under-
standing the role that kids are
playing in transmission.”
Jason Kindrachuk, a virologist
at the University of Manitoba,
said: “Now that we’re rolling into
the end of July and looking at try-
ing to open up schools the next
month, this really needs to be con-
sidered.”
The standard diagnostic test
amplifies the virus’s genetic ma-
terial in cycles, with the signal
growing brighter each round. The
more virus present in the swab ini-
tially, the fewer cycles needed for a
clear result.
Dr. Heald-Sargent, who has a re-
search interest in coronaviruses,
began noticing that children’s
tests were coming back with low
“cycle thresholds,” or C.T.s, sug-
gesting that their samples were
teeming with the virus.Intrigued, she called the hospi-
tal lab on a Sunday and asked to
look back at test results for the
past several weeks. “It wasn’t
even something we had set out to
look for,” she said.
She and her colleagues ana-
lyzed samples collected with naso-
pharyngeal swabs between March
23 and April 27 at drive-through
testing sites in Chicago and from
people who came to the hospital
for any reason, including symp-
toms of Covid-19.
They looked at swabs taken
from 145 people: 46 children
younger than age 5; 51 children
aged 5 to 17; and 48 adults aged 18
to 65. To forestall criticisms that
really ill children would be ex-pected to have a lot of the virus,
the team excluded children who
needed oxygen support. Most of
the children in the study reported
only a fever or cough, Dr. Heald-
Sargent said.
To compare the groups fairly,
the team included only children
and adults who had mild to moder-
ate symptoms and for whom they
had information about when
symptoms began. Dr. Heald-Sar-
gent left out people who didn’t
have symptoms and who did not
remember when they had started
to feel ill, as well as those who had
symptoms for more than a week
before the testing.
The results confirmed Dr.
Heald-Sargent’s hunch: Older
children and adults had similar
C.T.s, with a median of about 11 andranging up to 17. But children
younger than age 5 had signifi-
cantly lower C.T.s of about 6.5. The
upper limit of the range in these
children was a C.T. of 12, however
— still comparable to those of old-
er children and adults.
“It definitely shows that kids do
have levels of virus similar to and
maybe even higher than adults,”
Dr. Heald-Sargent said. “It would-
n’t be surprising if they were able
to shed” the virus and spread it to
others.
The results are consistent with
those from a German study of 47
infected children between the
ages 1 and 11, which showed that
children who did not have symp-
toms had viral loads as high as
adults’, or higher. And a recent
study from France found that
asymptomatic children had C.T.
values similar to those of children
with symptoms.
C.T. values are a reasonable
proxy for the amount of coro-
navirus present, said Dr. Kin-
drachuk, who relied on this metric
during the Ebola outbreaks in
West Africa.
Still, he and others said that ide-
ally researchers would grow infec-
tious virus from samples, rather
than test only for the virus’s RNA.
“I suspect that it probably will
translate into meaning that there
is more actual virus there as well,
but we can’t say that without see-
ing the data,” said Juliet Morrison,
a virologist at the University of
California, Riverside.
Some RNA viruses multiply
quickly and are prone to genetic
errors that render the virus in-
capable of infecting cells. Some
RNA detected in children may rep-
resent these “defective” viruses:
“We need to understand how
much of that is actually infectious
virus,” Dr. Schultz-Cherry said.
(The researchers said they did
not have access to the type of high-security lab required to grow in-
fectious coronavirus, but other
teams have cultivated virus from
children’s samples.)
The experts all emphasized that
the findings at least indicate that
children can be infected. Those
who harbor a lot of virus may
spread it to others in their house-
holds, or to teachers and other
school staff members when
schools reopen.
Many school districts are plan-
ning to protect students and staff
members by implementing physi-
cal distancing, cloth face cover-
ings and hand hygiene. But it’s un-
clear how well staff members and
teachers can keep young children
from getting too close to others, Dr.
Kindrachuk said.
“Frankly, I just haven’t seen a
lot of discussion about how that as-
pect is going to be controlled,” he
said.
Observations from schools in
several countries have suggested
that, at least in places with mild
outbreaks and preventive meas-
ures in place, children do not seem
to spread the coronavirus to oth-
ers efficiently.
Strong immune responses in
children could limit both how
much virus they can spread to oth-
ers and for how long. The chil-
dren’s overall health, underlying
conditions such as obesity or dia-
betes, and sex may also influence
the ability to transmit the virus.
Some experts have suggested
that children may transmit less vi-
rus because of their smaller lung
capacity, height or other physical
aspects.
Dr. Morrison dismissed those
suggestions. The virus is shed
from the upper respiratory tract,
not the lungs, she noted.
“We are going to be reopening
day care and elementary schools,”
she said. If these results hold up,
“then yeah, I’d be worried.”PEDIATRIC STUDYChildren May Carry the Virus at High Levels
By APOORVA MANDAVILLIUndergoing a nasal swab at a mobile clinic at the Walker Temple A.M.E. Church in Los Angeles.MARIO TAMA/GETTY IMAGESFindings that should
influence the debate
on reopening schools,
some experts say.
BD