MUST READ CORONAVIRUS UPDATES FROM WASHINGTON POST

A stark contrast in the coronavirus mortality rates in South Korea and Iran shows how critical a government’s response can be in determining whether the disease is stymied or spread. Public health experts say they want to ensure the U.S. outcome turns out more like the former.

“Will we take the tough actions to mitigate spread, or will we let this spread like the flu?” said Scott Gottlieb, former head of the Food and Drug Administration. “I think we will end up somewhere in between: not helpless like Iran, but not as aggressive and swift as South Korea.”

South Korea managed to dramatically arrest the spread. It’s conducting more tests per person than any other country in the world, with about 15,000 people getting tested every day. The government has set up dozens of drive-through testing centers. South Korean officials aggressively informed the public about how to respond, including with cellphone alerts notifying people of new cases near them.

The country has reported 7,800 cases, but just 66 deaths — a relatively low mortality rate under 1 percent. Its daily growth in new cases also appears to be slowing. But it’s a different story in Iran, a country with 80 million people where cases are surging and several top officials — including two dozen members of parliament and a vice president — have been infected.

As neighboring countries canceled flights and alerted medical personnel, Iranian officials said little in public about the virus. They didn’t announce the disease’s arrival in the country until Feb. 19, when officials said two people had already died.

The country’s Health Ministry claims that about 10,000 have been infected and 429 have died. But mass graves — confirmed by videos, satellite images and other open-source data — could mean Iran has suffered more deaths than its government has let on.

During an interview on “CBS This Morning,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the widespread disruption to everyday American life from the coronavirus is unlike anything the nation has experienced in his 36 years on the job.

“There have been an awful lot of challenges,” Fauci said, noting the HIV/AIDS crisis in the 1980s and the H1N1 influenza pandemic in 2009. “With regard to disruption of everyday life, we have not seen that before, but we’ve not had this kind of a situation before.”

With H1N1, also known as the swine flu, Fauci said there was less mass panic because unlike the new coronavirus, it was an influenza virus.

“We were familiar with what influenza does. We were familiar with its seasonal capability,” Fauci said. “Right now there are a lot of unknowns and I think that’s the thing that’s frightening people.”

Sign up for our Coronavirus Updates newsletter to track the outbreak. All stories linked within the newsletter are free to access.

Scientists studying the novel coronavirus are quickly uncovering features that allow it to infect and sicken human beings.

The coronavirus can be shed by people even before they develop symptoms. That pre-symptomatic transmission has helped it become a stealth contagion. The coronavirus may take many days — up to 14 — before an infection flares into symptoms, and although most people recover without a serious illness, this is not a bug that comes and goes quickly.

The virus lurks in the body even after people feel better. A new study in the Lancet, based on research in China, found that the median length of time the virus remains in the respiratory tract of a patient after symptoms begin is 20 days. Among patients who survived the disease, the virus continued to be shed for between eight and 37 days.

This coronavirus can establish itself in the upper respiratory tract, said Vincent Munster, chief of the Virus Ecology Section of Rocky Mountain Laboratories, a facility in Hamilton, Mont., that is part of the National Institute of Allergy and Infectious Diseases. That enables the virus to spread more easily through coughing and sneezing, and stands in contrast to another coronavirus that Munster’s laboratory has studied — MERS, which tends to infect cells in the lower respiratory tract, he said.

Munster and his colleagues have conducted experiments showing that at least some coronavirus can potentially remain viable — capable of infecting a person — for up to 24 hours on cardboard and up to three days on plastic and stainless steel.

During a CNN town hall program on the coronavirus Thursday night, Anthony Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases, addressed whether it is safe to open a package delivered by mail: “I think if you start thinking about money and mail and things like that, you can almost sort of immobilize yourself, which I don’t think is a good idea.”

Read more here.

Sign up for our Coronavirus Updates newsletter to track the outbreak. All stories linked within the newsletter are free to access.

As coronavirus infections mount, the federal government is preparing for an unprecedented experiment in remote working that brings with it a slew of digital dangers.

The Trump administration is ordering hundreds of thousands of federal employees to be prepared to telework full time if the virus spread worsens, as my colleague Lisa Rein reports. And it’s far from clear government technologists are prepared to handle that strain.

If U.S. adversaries, such as Russia or Iran, creep inside government computer networks, they could disrupt efforts to mitigate the virus by stopping or slowing down communications. They could also sow chaos by sending phony alerts about the virus to the government workforce or the public.

Federal agencies are trying to get ahead of any problems as telework is being encouraged, though not mandated at this point. The Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency is working entirely remotely today to stress-test whether the agency will be up to the job “if CISA-wide telework becomes necessary in response to the outbreak,” spokeswoman Sara Sendek said.

But the government has never attempted to work remotely on anywhere near this scale before. At DHS alone, as many as 240,000 workers could be asked to work remotely; the CISA test alone involves 3,500 people.

Read more here.

But to understand why experts are so alarmed and what may be coming next, the public needs to start paying attention to a whole other set of numbers: How many ventilators do we have in this country? How many hospital beds? How many doctors and nurses? And most importantly, how many sick people can they all treat at the same time?

Consider the ventilators. For those severely ill with a respiratory disease like Covid-19, ventilators are a matter of life and death because they allow patients to breathe when they cannot on their own. In a report, last month, the Center for Health Security at Johns Hopkins estimated American has a total of 160,000 ventilators available for patient care.

A planning study run by the federal government in 2005 estimated that if America were struck with a moderate pandemic like the 1957 influenza, the country would need more than 64,000 ventilators. If we were struck with a severe pandemic like the 1918 Spanish flu, we would need more than 740,000 ventilators — many times more than are available.

South Korea, which has seen success mitigating its large outbreak, has more than 12 hospital beds per 1,000 people. China, where hospitals in Hubei were quickly overrun, has 4.3 beds per 1,000. Italy, a developed country with a reasonably decent health system, has seen its hospitals overwhelmed and has 3.2 beds per 1,000.

Read more here.