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Coronavirus clue? Most cases aboard U.S. aircraft carrier are symptom-free

By Phil Stewart and Idrees Ali

WASHINGTON (Reuters) – Sweeping testing of the entire crew of the coronavirus-stricken U.S. aircraft carrier Theodore Roosevelt may have revealed a clue about the pandemic: The majority of the positive cases so far are among sailors who are asymptomatic, officials say.

The possibility that the coronavirus spreads in a mostly stealthy mode among a population of largely young, healthy people showing no symptoms could have major implications for U.S. policy-makers, who are considering how and when to reopen the economy.

It also renews questions about the extent to which U.S. testing of just the people suspected of being infected is actually capturing the spread of the virus in the United States and around the world.

The Navy’s testing of the entire 4,800-member crew of the aircraft carrier – which is about 94% complete – was an extraordinary move in a headline-grabbing case that has already led to the firing of the carrier’s captain and the resignation of the Navy’s top civilian official.

Roughly 60 percent of the over 600 sailors who tested positive so far have not shown symptoms of COVID-19, the potentially lethal respiratory disease caused by the coronavirus, the Navy says. The service did not speculate about how many might later develop symptoms or remain asymptomatic.

“With regard to COVID-19, we’re learning that stealth in the form of asymptomatic transmission is this adversary’s secret power,” said Rear Admiral Bruce Gillingham, surgeon general of the Navy.

The figure is higher than the 25% to 50% range offered on April 5 by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a member of President Donald Trump’s coronavirus task force.

‘DISCONCERTING’ DATA FOR PENTAGON

Defense Secretary Mark Esper, speaking in a television interview on Thursday, said the number of asymptomatic cases from the carrier was “disconcerting.”

“It has revealed a new dynamic of this virus: that it can be carried by normal, healthy people who have no idea whatsoever that they are carrying it,” Esper told NBC’s “Today” morning show.

Such data present challenges to the Pentagon, which is deployed around the world, sometimes in confined environments like submarines, ships and aircraft.

Testing the entire military is not yet feasible, given still-limited testing capacity, officials say, and detecting enough cases without tests is impossible if most cases are asymptomatic.

The U.S. coronavirus death toll – the highest in the world – surged past 31,000 on Thursday after doubling in a week.

It also claimed the life of a sailor from the Theodore Roosevelt this week. Five other members of the crew are hospitalized.

NUMBERS UNKNOWN

Still, the case of the Theodore Roosevelt offers a case study for researchers about how the virus spreads asymptomatically in a confined environment among mostly younger adults.

That cohort has been somewhat underrepresented in the epidemiological data so far, said William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center.

“The findings are of enormous interest because the proportion of people who are asymptomatic is just simply not known,” Schaffner said, when asked about the Navy’s data.

Vice Admiral Phillip Sawyer, a deputy chief of naval operations at the center of the Navy’s coronavirus response efforts, presented the 60% figure in a call with a small group of reporters on Wednesday.

But he declined to speculate about the implications.

“I don’t know if we’re proving something different,” Sawyer said.

“I do agree that we are providing some data that some other organizations might not have.”

(Reporting by Phil Stewart and Idrees Ali; Editing by Mary Milliken and Jonathan Oatis)

Your COVID-19 questions, answered

There is a lot of misinformation circulating about the coronavirus, so we took to Instagram, Twitter and Reddit to see what questions have been bugging you, our readers.Below are answers from several healthcare experts who have been following the outbreak. Please note that there is much we still don’t know about the new virus, and you should reach out to your own healthcare provider with any personal health concerns.

LIVING UNDER LOCKDOWN

What are good ways to maintain your mental health?

I would recommend the following:

1. Maintain a normal schedule if possible

2. Exercise (go for walk or run, do an online video)

3. Maintain social connections via FaceTime, Skype or phone calls

4. Limit time spent on the Internet and connected to the news

5. Have “virtual” dates with family and friends.

— Dr. Krutika Kuppalli, infectious disease researcher

Here’s how it’s affecting young minds  and how millennials are adjusting to isolation.

How long will the U.S. really have to be on lockdown to successfully flatten the curve?

We’re still learning on a daily basis what the case count looks like in the U.S. We also need to consider that there could be a resurgence of cases once public health measures are loosened up.

— Dr. Krutika Kuppalli, infectious disease researcher

I defer to the epidemiologists here, but National Institute of Allergy and Infectious Diseases Director Anthony Fauci recently said that he’s confident in a range of four to six weeks to 3 months.

— Dr. Angela Rasmussen, virologist at Columbia University

Do I actually need to wear a mask?

The WHO advises that if you’re healthy, you need to wear a mask only when caring for an infected person or if you’re coughing, sneezing or showing symptoms. More here

TRANSMISSION

Is it fair to assume every American will be exposed to the coronavirus this year?

No, which is one of the reasons we have these current public health measures in place. We are trying to prevent further onward transmission of the disease.

— Dr. Krutika Kuppalli, infectious disease researcher

Almost 100,000 cases have been reported in the U.S. and its territories, according to a Reuters tally of state and local government sources, mapped .

Is the coronavirus airborne in normal settings and if so, for how long?

According to our knowledge, it does not stay in the air in normal settings. Most evidence directs us to droplet transmission. Airborne precautions are required only for healthcare workers when undertaking aerosol producing procedures such as bronchoscopy/intubation.

— Dr. Muge Cevik, infectious diseases researcher at the University of St. Andrews

Is there potential exposure in elevators?

Coronavirus guidelines by the CDC are based on the fact that the virus is transmitted primarily via respiratory droplets, like a cough or sneeze. In droplet form, it’s airborne for a few seconds, but is only able to travel a short distance. In elevators, social distancing measures should be implemented with a max number of people inside at a time.

— Infectious Diseases Society of America

How worried should we be about fomite transmission?

We are still learning about fomite transmission. We know from an article in the New England Journal of Medicine that the virus is viable up to four hours on copper, 24 hours on cardboard, and two to three days on plastic and stainless steel.

— Dr. Krutika Kuppalli, infectious disease researcher

Can you spread the virus if you’re asymptomatic?

Yes, but it isn’t the main driver of transmission. This is also why it is extremely important to ensure you have washed hands before touching your face.

— Dr. Krutika Kuppalli, infectious disease researcher

What’s the typical timeline of symptoms?

From the time of exposure to symptoms it may take on average three to six days, which may be longer/shorter in some patients. Typically it starts with fever, dry cough, myalgia and flu-like illness, then progresses to shortness of breath and pneumonia in some patients.

— Dr. Muge Cevik, infectious diseases researcher at the University of St. Andrews

Is it possible that an infected person only has a mild cold before recovering?

Yes. The most common symptoms a person will have are fever, dry cough and muscle aches/fatigue.

— Dr. Krutika Kuppalli, infectious disease researcher

Should people be more concerned about eye protection?

We certainly use face shields to protect our eyes when in contact with patients.

— Dr. Isaac Bogoch, infectious disease researcher and scientist

Does getting vaccines increase your risk?

Getting any vaccines would not increase your risk for COVID-19. We’re recommending getting needed vaccines. We want people to get their influenza vaccines so they don’t end up with the flu and in the hospital.

— Dr. Krutika Kuppalli, infectious disease researcher

Do people have a natural immunity to this virus?

I am not aware of “natural immunity” since it is a new virus. We might find as serology testing is rolled out that people have been exposed and developed antibodies without having symptoms.

— Dr. Krutika Kuppalli, infectious disease researcher

Is it possible to get reinfected?

We’re not sure how immunity works or how long it lasts. The best guess is that people who are infected are likely to be protected over the short-to-medium term. We don’t know about longer yet.

— Dr. Eric Rubin, editor-in-chief, New England Journal of Medicine

There are a handful of cases of possible “reinfection” in recovered patients. But most scientists believe those are more likely to have been relapses.

TREATMENT

Is there a team working on an antibody test for the virus? If so, when might it be ready?

There are teams working on serological tests. Rolling out on a population scale will be an essential part of the long-term answer, but we need to get through the next month.

— Bill Hanage, associate professor at the Harvard T. H. Chan School of Public Health

When will a vaccine be ready?

Vaccine trials may take as long as 12 months. There are multiple clinical trials looking at different treatment options, but we currently don’t know whether this combination is effective and safe for patients.

— Dr. Muge Cevik, infectious diseases researcher at the University of St. Andrews

Scientists in Singapore are trying to fast-track the process.

What impact will warmer weather have on the spread?

I have yet to see convincing evidence on this, one way or the other. We are all hoping transmission will slow down with warmer weather in the northern hemisphere, and that warmer countries will be spared the worst. Not enough data yet to conclude.

— Dr. Suerie Moon, director of research at the Global Health Centre

Here’s what we know about seasonal features of disease outbreaks.

I’ve seen several news sources report that experts from Johns Hopkins and other medical colleges are saying the virus can become less deadly as it spreads. Can you explain this phenomenon?

Yes, one theory for why many viruses become weaker over time is that viruses that kill their host don’t get very far. This pattern of weakening is seen with flu viruses, and many others, but not all. We’re not there yet with the current outbreak. Whether it’s weaker three or 10 years from now doesn’t change anything about today’s situation.

— Christine Soares, medical editor at Reuters

(Reporting by Lauren Young, Jenna Zucker, Beatrix Lockwood, Nancy Lapid, Christine Soares)

Supreme Court nominee steers clear of Trump criticism

Supreme Court nominee Brett Kavanaugh testifies while White House Counsel Don McGahn (right) listens during the third day of his confirmation hearing before the Senate Judiciary Committee on Capitol Hill in Washington, U.S., September 6, 2018. REUTERS/Alex Wroblewski

By Lawrence Hurley and Amanda Becker

WASHINGTON (Reuters) – U.S. Supreme Court nominee Brett Kavanaugh stressed on Thursday that he believes the judiciary has broad authority to check the power of the White House, but refused to criticize the man who selected him, President Donald Trump.

In a second day of testimony, Kavanaugh declined to comment on Trump’s criticism of the judiciary or offer praise of the president’s character.

Democrats at Kavanaugh’s Senate confirmation hearing also pressed the conservative federal appeals court judge over newly released emails highlighting his views on abortion and racial issues after a partisan fight over the public release of the documents.

The documents released on Thursday dated from Kavanaugh’s service in the White House under Republican President George W. Bush more than a decade ago. Democrats had objected to an earlier decision by the Senate Judiciary Committee’s Republican leadership not to make the emails public.

The third day of the confirmation hearing again was repeatedly interrupted by protesters hostile to Kavanaugh. The nominee, enduring back-to-back days of lengthy questioning, remained in good humor, making no gaffes that were likely to derail his confirmation in a Senate narrowly controlled by Trump’s fellow Republicans, despite the efforts of Democrats opposed to him.

Some liberals have expressed concern Kavanaugh could be a rubber stamp for Trump and protect him from lawsuits and investigations.

Asked by Democratic Senator Cory Booker whether he was picked because of an expectation of loyalty to Trump, Kavanaugh responded: “My only loyalty is to the Constitution. I’m an independent judge.”

Kavanaugh refused to say whether he had “the greatest respect” for Trump, a phrase Booker said he had used when describing Bush.

JUDICIAL AUTHORITY

Democratic Senator Dick Durbin said Kavanaugh’s nomination comes at a time when Trump poses a threat to America’s rule of law and is facing an ongoing special counsel investigation. Kavanaugh said his 12 years as a judge demonstrated he was unafraid “to invalidate executive power when it violates the law.”

Kavanaugh had declined on Wednesday to answer whether a president would have to respond to a court’s subpoena, saying he could be asked to rule on the matter. But under questioning by Durbin on the scope of presidential power, Kavanaugh underscored judicial authority.

“When a court order requires a president to do something or prohibits a president from doing something under the Constitution or laws of the United States, under our constitutional system, that is the final word,” Kavanaugh said.

Kavanaugh, probed again on his views on a 1974 Supreme Court ruling against President Richard Nixon requiring recordings made in the Oval Office to be given to prosecutors, said the case was correctly decided. He called it “a moment of judicial independence where I think the court came together” in a unanimous decision.

Kavanaugh declined to answer questions on how that case could be applied relating to the investigation by Special Counsel Robert Mueller into potential collusion between Trump’s 2016 presidential campaign and Russia.

He also repeated his refusal to comment on whether he would recuse himself if a case involving the Mueller investigation or other issues relating to Trump’s conduct came before him.

If confirmed, Kavanaugh is seen as likely to tilt the top U.S. court even further to the right. That prospect worries Democrats and heartens Republicans on volatile issues including abortion, gun rights, gay rights, the death penalty, religious liberty and business regulation.

The committee considering Kavanaugh’s nomination will hear from outside witnesses on Friday before the hearing wraps up. Republicans hope the full Senate can vote on the nomination close to the time the Supreme Court’s new term starts on Oct 1.

‘SETTLED LAW’

In a 2003 email released on Thursday, Kavanaugh suggested striking a line from a draft opinion piece that had stated: “It is widely accepted by legal scholars across the board that Roe v. Wade and its progeny are the settled law of the land,” saying that the Supreme Court could overturn it.

Asked about that document, Kavanaugh said he suggested the change because he thought the draft language was overstating the thinking of legal scholars at the time. He again declined to say whether the landmark 1973 ruling that legalized abortion nationwide, Roe v. Wade, was correctly decided, although he indicated – as he did on Wednesday – that it was a decision that merited respect as “an important precedent of the Supreme Court.”

The hearing opened with Democrats complaining that various documents had not already been made public by the committee’s Republican leaders. They were released by the committee minutes later.

Booker called the process used by the committee to decide which documents to make public “a bit of sham,” a characterization rejected by the panel’s Republican chairman, Chuck Grassley. Booker said he was willing to face possible punishment under Senate rules by releasing the documents himself, although Republicans said they had already agreed to release them.

Trump picked Kavanaugh, 53, to replace Justice Anthony Kennedy, who announced his retirement in June.

(Reporting by Lawrence Hurley and Amanda Becker; Editing by Will Dunham and Peter Cooney)

No apology, no resignation: pressure grows on Greek government over fire deaths

Aristides Katsaros' burnt house is seen following a wildfire in the village of Mati, near Athens, Greece, July 27, 2018. REUTERS/Costas Baltas

By Angeliki Koutantou

MATI, Greece (Reuters) – Greece’s opposition accused the government on Friday of arrogance and an utter failure to protect lives in responding to a devastating wildfire as questions remained unanswered over how at least 86 people died in the town of Mati.

Survivors of one of the worst Greek disasters in living memory already heckled a government minister when he visited the scene less than 30 km (17 miles) east of Athens on Thursday.

But on Friday an official three days of mourning declared by Prime Minister Alexis Tsipras ended, and his opponents immediately went on the offensive.

The main opposition New Democracy party criticized a government news conference on Thursday night where not one word of apology was heard. “This government has just added unbridled cheek to its abject failure in protecting lives and people’s property,” said New Democracy spokeswoman Maria Spyraki.

Civil Protection Minister Nikos Toskas told the news conference that the government suspected arson was behind Monday night’s blaze, which trapped dozens of people in their cars trying to escape a wall of flames.

The left-led government defended itself, saying there had been no time to evacuate people because the blaze spread very quickly.

But pressure is growing on the government, which is trailing New Democracy in opinion polls, as the death toll was expected to rise further and the questions on how people got trapped piled up.

Tsipras has not been seen in public since Tuesday when he declared the three days of national mourning for the dead. A cabinet meeting was scheduled for 1400 GMT on Friday.

Politicians’ criticism reflected anger among the survivors. “They left us alone to burn like mice,” Chryssa, one of the survivors in Mati, told Skai television. “No one came here to apologize, to submit his resignation, no one.”

Toskas said he had offered his resignation but Tsipras rejected it. “A day after the tragedy, mainly to have my conscience clear and not because of mistakes, I offered my resignation to the prime minister, who told me it’s a time to fight,” Toskas told reporters on Thursday.

Fofi Gennimata, who leads the socialist PASOK party, said the government carried a huge political responsibility.

“Why didn’t they protect the people by implementing on time the available plan for an organized and coordinated evacuation in the areas that were threatened?” she said. “They have confessed they let people burn helplessly.”

ONE-OFF PAYMENTS

The government has announced a long list of relief measures including a one-off 10,000 euro ($11,600) payment for families of the victims. Their spouses and near relatives were also offered public sector jobs. But many felt that was not enough to ease the pain and wanted authorities to assume responsibility for the scale of the devastation.

About 300 firefighters and volunteers were still combing the area on Friday for dozens still missing. More than 500 homes were destroyed, and the fire brigade said some closed-up homes had not yet been checked.

Haphazard and unlicensed building, a feature of many areas across Greece, was also blamed. Many routes to the beach were walled off.

Mortuary staff in Athens, shocked at the sight of burnt bodies including children, were expected to conclude post-mortems later on Friday after relatives of victims provided information and blood samples which could assist identifications.

The fire broke out on Monday at 4:57 p.m. and spread rapidly through Mati, which is popular with local tourists.

Firefighters described a rapid change in the direction of the wind, which also picked up speed, and some suggested the thick covering of pine trees and a mood of panic were a deadly combination that would have been hard to combat.

(Additional reporting by Michele Kambas; editing by David Stamp)

Trump administration approves tougher visa vetting, including social media checks

A U.S. Customs and Border Protection arm patch and badge

By Yeganeh Torbati

WASHINGTON (Reuters) – The Trump administration has rolled out a new questionnaire for U.S. visa applicants worldwide that asks for social media handles for the last five years and biographical information going back 15 years.

The new questions, part of an effort to tighten vetting of would-be visitors to the United States, was approved on May 23 by the Office of Management and Budget despite criticism from a range of education officials and academic groups during a public comment period.

Critics argued that the new questions would be overly burdensome, lead to long delays in processing and discourage international students and scientists from coming to the United States.

Under the new procedures, consular officials can request all prior passport numbers, five years’ worth of social media handles, email addresses and phone numbers and 15 years of biographical information including addresses, employment and travel history.

Officials will request the additional information when they determine “that such information is required to confirm identity or conduct more rigorous national security vetting,” a State Department official said on Wednesday.

The State Department said earlier the tighter vetting would apply to visa applicants “who have been determined to warrant additional scrutiny in connection with terrorism or other national security-related visa ineligibilities.”

President Donald Trump has vowed to increase national security and border protections, proposing to give more money to the military and make Mexico pay to build a wall along the southern U.S. border.

He has tried to implement a temporary travel ban on people from six Muslim-majority nations that a U.S. appeals court refused to reinstate, calling it discriminatory and setting the stage for a showdown in the Supreme Court.

The Office of Management and Budget granted emergency approval for the new questions for six months, rather than the usual three years.

While the new questions are voluntary, the form says failure to provide the information may delay or prevent the processing of an individual visa application.

Immigration lawyers and advocates say the request for 15 years of detailed biographical information, as well as the expectation that applicants remember all their social media handles, is likely to catch applicants who make innocent mistakes or do not remember all the information requested.

The new questions grant “arbitrary power” to consular officials to determine who gets a visa with no effective check on their decisions, said Babak Yousefzadeh, a San Francisco-based attorney and president of the Iranian American Bar Association.

“The United States has one of the most stringent visa application processes in the world,” Yousefzadeh said. “The need for tightening the application process further is really unknown and unclear.”

(Editing by Sue Horton and Lisa Shumaker)