‘We All Feel At Risk’: 100,000 People Dead From COVID-19 In The U.S.

A volunteer artist sets up a memorial in Brooklyn on May 20. Artists and volunteer organizers across New York City put up physical memorials throughout the five boroughs in connection with Naming the Lost to honor the lives lost to COVID-19. Erik McGregor/LightRocket via Getty Images hide caption

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Erik McGregor/LightRocket via Getty Images

A volunteer artist sets up a memorial in Brooklyn on May 20. Artists and volunteer organizers across New York City put up physical memorials throughout the five boroughs in connection with Naming the Lost to honor the lives lost to COVID-19.

Erik McGregor/LightRocket via Getty Images

The U.S. death toll from COVID-19 has reached a somber milestone: as of Wednesday afternoon, the highly infectious viral disease has taken more than 100,000 lives nationwide.

Soaring from two known coronavirus fatalities in February to more than 58,000 in April, the tally of U.S. deaths — in a country with fewer than 5% of the world’s inhabitants — now accounts for nearly one-third of all the known lives lost worldwide to the pandemic.

According to a mortality analysis by Johns Hopkins University’s Coronavirus Resource Center, about 6% of the nearly 1.7 million people who have tested positive for COVID-19 in the U.S. have now succumbed to the disease.

Public health experts say the coronavirus has exposed the vulnerability of a wide range of Americans and the shortcomings of a U.S. health care system faced with a deadly pandemic.

“What is different about this is, it is affecting all of us in a variety of ways, even if some of us are able to social distance in more effective ways than others,” says sociology professor Kathleen Cagney, who directs The University of Chicago’s Population Research Center. “But we all feel at risk.”

Even some who are well acquainted with earlier health scourges in the U.S. were caught off guard by this one.

“I think anybody who understands anything about infectious disease recognizes that we were going to sooner or later face something like this,” said John Barry, a professor at Tulane University School of Public Health And Tropical Medicine and author of “The Great Influenza: The Story Of The Deadliest Pandemic In History,” on NPR’s Fresh Air earlier this month. “But, you know, intellectually understanding it is one thing, and having it hit you is something quite different.”

Demographic disparities in deaths

People have died from the disease in all 50 states and most U.S. territories. But the impact has been felt unevenly. Demographic statistics that the CDC has posted of the first nearly 69,000 fatalities show some striking disparities:

— The disease has been far deadlier for males than females. For age groups up to 75 years old, about twice as many men and boys have been killed by COVID-19 as have women and girls.

— Older people have died in much greater numbers than those who are younger. Eighty percent of the known fatalities were at least 65 years old.

— Racial and ethnic disparities in who is dying have also become apparent, even while tracking data that has been compiled by Johns Hopkins is still incomplete.

In Alabama, for example, 44% of those killed by COVID-19 were black, in a state where fewer than 27% of its residents are African American. Similarly, while African Americans make up 14% of Michigan’s population, they account for 40% of that state’s COVID-19 fatalities.

Nurses and health care workers mourn and remember their colleagues who died during the outbreak of the novel coronavirus during a demonstration outside Mount Sinai Hospital in Manhattan on April 10. Johannes Eisele/AFP via Getty Images hide caption

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Johannes Eisele/AFP via Getty Images

Nurses and health care workers mourn and remember their colleagues who died during the outbreak of the novel coronavirus during a demonstration outside Mount Sinai Hospital in Manhattan on April 10.

Johannes Eisele/AFP via Getty Images

Native American communities have also been hit especially hard by the pandemic. In Arizona, Native Americans account for about 5% of the population but comprise nearly 17% of that state’s COVID-19 fatalities.

The University of Chicago’s Cagney said that differences in socioeconomic status — and thus the ability to practice social distancing — are contributing to COVID-19’s uneven lethal impact.

“If you look at the locations where people are disproportionately dying, they are in places that are lower income,” said Cagney. “They are places that likely have multiple residents in a single unit space. They are places where people rely on public transit and rely on services like big box locations where by entry alone you’re putting yourself at risk.”

The degree of devastation wrought by the pathogen has taken even some public health experts by surprise.

“Back in March, I did not think this would be possible — I was not expecting 100,000 deaths,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.

“I really believed we as a nation would have taken the decision to put in place social distancing and accepted the economic hardship that it’s creating, and that we would have stuck to it to get transmission down to a very low level,” he added.

A study done this month by a Columbia University research team suggests the number of coronavirus deaths in the U.S. could have been considerably lower had Americans been told sooner to stay home and maintain social distancing.

A “pre-print” version of the report — meaning it has yet to be peer reviewed — finds that “55% of reported deaths as of May 3, 2020 could have been avoided if the same control measures had been implemented just one week earlier.”

By that measure, the nationwide death toll on that date of 65,307 could have instead stood at 29,410 — meaning nearly 36,000 lives might have been saved.

“The lesson isn’t what this means for the next time we have a pandemic with a new virus,” says Jeffrey Shaman, one of the study’s co-authors. “The lesson is really what are we doing with this virus as we move forward that it isn’t going anywhere and that we still have to contend with it.”

Asked on Thursday about the Columbia University study, President Trump dismissed it as “just a political hit job.”

A roller coaster ride of presidential predictions

The number of Americans killed by the pandemic appears to be a sensitive subject for a president seeking reelection in November. His predictions have gone up and down several times.

“We have it totally under control. It’s one person coming in from China,” Trump told CNBC on Jan. 22, one day after the Centers for Disease Control and Prevention confirmed the first COVID-19 case in the U.S. “We have it under control. It’s going to be just fine.”

President Trump speaks to reporters after meeting with Senate Republicans at their weekly luncheon on Capitol Hill on May 19. Sen. John Barrasso, R-Wyo., and Senate Majority Leader Mitch McConnell are standing behind Trump. Patrick Semansky/AP hide caption

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Patrick Semansky/AP

President Trump speaks to reporters after meeting with Senate Republicans at their weekly luncheon on Capitol Hill on May 19. Sen. John Barrasso, R-Wyo., and Senate Majority Leader Mitch McConnell are standing behind Trump.

Patrick Semansky/AP

Five weeks later, on Feb. 27 — almost a month after the World Health Organization declared the COVID-19 outbreak a “public health emergency of international concern” — Trump continued to downplay the threat posed by the coronavirus.

“You have 15 people, and the 15 within a couple of days is going to be down to close to zero,” Trump declared at a White House coronavirus task force briefing. “That’s a pretty good job we’ve done.”

But the numbers kept rising. By the end of March, with the WHO having already declared a global pandemic, Johns Hopkins was reporting more than 188,000 confirmed coronavirus infections in the U.S. and some 5,500 deaths.

That was when Trump executed an abrupt U-turn in his effort to manage public expectations: for the first time, he broached the possibility that the pandemic — far from nearing zero — could indeed end up claiming 100,000 U.S. lives.

Speaking from the White House Rose Garden on March 29, Trump cited new mortality projections by Dr. Deborah Birx, response coordinator for the White House Coronavirus Task Force, and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. The two had predicted that if no preventive measures were taken, the pandemic could cause 2.2 million deaths in the U.S.; if such measures were taken, the toll could be between 100,000 and 200,000 deaths over an unspecified period of time.

“And so, if we can hold that down, as we’re saying, to 100,000 — that’s a horrible number — maybe even less, but to 100,000,” Trump said, “so we have between 100- and 200,000 — we all, together, have done a very good job.”

Three weeks later, amid mounting pressure from supporters to reopen the mostly quarantined economy, Trump was back to lowering public expectations about how many lives the pandemic might claim.

“One is too many. But we’re going toward 50- or 60,000 people,” Trump declared on April 20. “That’s at the lower — as you know, the low number was supposed to be 100,000 people. We — we could end up at 50 to 60.”

Trump appeared to be relying on one of the lowest of a dozen fatality estimates at the time, a range of 60,000 to 115,000 deaths modeled by the University of Washington’s IHME.

Family and friends lay flowers on the casket of Bishop Carl Williams Jr. at Hollywood Memorial Cemetery Park in Union, N.J., on May 21. Williams was the emeritus pastor of the Institutional International Ministries. Because of the coronavirus pandemic, only a few family members were permitted to attend the service in person; the church livestreamed the event. Seth Wenig/AP hide caption

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Seth Wenig/AP

Family and friends lay flowers on the casket of Bishop Carl Williams Jr. at Hollywood Memorial Cemetery Park in Union, N.J., on May 21. Williams was the emeritus pastor of the Institutional International Ministries. Because of the coronavirus pandemic, only a few family members were permitted to attend the service in person; the church livestreamed the event.

Seth Wenig/AP

But a week later, with social distancing measures being eased, the IHME practically doubled those projected numbers, forecasting that nearly 135,000 — and possibly as many as 242,890 — people would die by August in the U.S. from COVID-19.

IHME’s Murray says the earlier calculations had been made assuming every state would hold off on loosening social distancing measures until new infections had dropped to a very low level.

“But even before people started relaxing the mandates, people start changing their behavior as the national discussion about reopening the economy became pretty dominant,” says Murray, adding that his team realized keeping those mandates in place until early June “was just not going to happen. And so that’s what led to our major change in the modeling’s strategy and assumptions.”

Trump, for his part, once again raised his predictions about how many lives in the U.S. the pandemic would claim.

“I used to say 65,000,” he declared May 3 during a Fox News interview held at the Lincoln Memorial. “And now I’m saying 80 or 90, and it goes up and it goes up rapidly. But it’s still going to be, no matter how you look at it, at the very lower end of the plane.”

By mid-May, all of the dozen forecasting models for COVID-19 deaths in the U.S. tracked by the CDC surpassed Trump’s latest predictions.

“All forecast an increase in deaths in the coming weeks,” CDC Director Robert Redfield, in his first public comment on expected deaths, tweeted on May 15. Every one of those models, he added, predicted “a cumulative total exceeding 100,000 by June 1.”

Many more deaths expected — and funerals

With all 50 states now separately dropping some or all of their social distancing restrictions, health experts warn that the U.S. coronavirus death toll could climb much higher than the approximately 140,000 by August that many of them have been predicting.

A man sets a candle on a makeshift memorial outside the Otay Mesa Detention Center during a “Vigil for Carlos” event on May 9 in Otay Mesa, Calif. The vigil was held to commemorate Carlos Ernesto Escobar Mejia, who died of COVID-19 related symptoms while being held at the detention center. Sandy Huffaker/AFP via Getty Images hide caption

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Sandy Huffaker/AFP via Getty Images

A man sets a candle on a makeshift memorial outside the Otay Mesa Detention Center during a “Vigil for Carlos” event on May 9 in Otay Mesa, Calif. The vigil was held to commemorate Carlos Ernesto Escobar Mejia, who died of COVID-19 related symptoms while being held at the detention center.

Sandy Huffaker/AFP via Getty Images

“Now we’re almost getting the worst of both worlds — we’re getting the economic hardship and we’re relaxing,” said the IHME’s Murray. “And it seems either now or in the fall, we’re going to have a big second wave and we’ll be right back to dealing with pressure on the hospital system and dealing with, when is the peak surge coming?”

Columbia University’s Shaman said the U.S. has to keep suppressing the spread of COVID-19 while having an acceptable level of a functioning economy.

“That’s the hard problem we’re trying to address as we try to figure that out and we loosen restrictions,” said Shaman. “If we have these flare-ups, we have to be willing to immediately recognize them and tamp back down and not wait and not dither. And that goes both for communities that have experienced the virus already and those that have not experienced it as much.”

And there’s another challenge: Many of the 100,000 who have died have not yet had proper send-offs.

“It’s been stunning to me that we have had as much death as we’ve had, with as little attention to all those deaths,” said Ashish Jha, director of the Harvard Global Health Institute. “I think one of the reasons we’ve had so little attention to all of this is because we’ve not had the kind of public mourning that comes with mass casualties like this.”

Jha expects that as the U.S. opens up from its social isolation, those who have grieved privately will be holding postponed funerals, burials and other commemorations.

“I think the sort of the weight of this calamity is going to become much more apparent to people in the upcoming days and weeks,” Jha added. “So people are going to, I think, really come to grips with how awful these last couple of months have been.”

Establishing a stable health routine helps prepare for unexpected such as COVID-19 | Opinion

Andrea Willis, Guest Columnist Published 3:00 p.m. CT May 27, 2020

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Chief Physician Executive for Health First Dr. Jeffrey Stalnaker explains what to expect when returning to various doctor visits. Florida Today

Taking preventive steps in your health can help you or your loved ones, whether it be a new fight like COVID-19, or a familiar one like the flu.

During the COVID-19 pandemic, you may have put off our routine medical care. It may feel natural, as many of us have been following safety protocols and postponing non-essential appointments of all kinds over the past few months. But now more than ever, it’s important for all of us to get the preventive care we need — and easier since BlueCross and some other insurers are waiving some member costs and making telehealth resources more accessible. 

I often hear about people who haven’t managed health conditions like heart disease as well as they should. For example, a woman in her mid-60s with heart disease who may have been unable to make healthy lifestyle choices after her diagnosis, or hasn’t addressed the depression that may have resulted from it, or doesn’t take her medications as directed by her physician.  

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This can all lead to her immune system being compromised, and her being more at risk of complications from other illnesses, such as the novel coronavirus. 

That doesn’t mean falling ill from the coronavirus is the fault of anyone living with a chronic health condition. Even if someone is taking all the recommended steps, they could still have a harder time managing their health due to factors outside their control.  

Seeking to create better health routines

Minorities often serve in public-facing essential roles, and as a result, are less able to work from home. These communities face unique social challenges related to housing and food desserts. The coronavirus has disproportionately impacted those communities here in Tennessee (and across the country). 

When compared to white Americans, minorities often face higher rates of illness and worse health outcomes, whether from common ailments (such as heart disease) or a novel coronavirus like COVID-19. 

As of May 19,  African Americans in particular represent 21% of COVID-19 cases and roughly 31% of deaths across the state — despite comprising only 17% of the population.  

These disparities and what can result for certain communities amplify why preventive care and maintenance are so important.  

As a physician, I stress making your provider your partner in your care. They are committed to your health journey and can recommend and schedule routine preventive health screenings. You can also work with your PCP to build a medical support team. Have questions about healthy food choices when options are limited? Consult a dietitian who can identify resources in your area. Concerned about your mental health? Find a behavioral health care coordinator with whom you can share your feelings. 

And as many of us continue to stay home more than usual, make healthy lifestyle changes a family-and-friends affair. For example, you can plan meals as a family or create a fitness routine together. 

Taking preventive steps in your health can help you or your loved ones, whether it be a new fight like COVID-19, or a familiar one like the flu.

Whatever your path forward, BlueCross is committed to supporting you. We’ve made it easier for our members to get the care they need by waiving all cost-sharing for testing and treatment related to COVID-19.

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For challenged communities, we’re sharing information on COVID-19 testing, texting online resources to members who are high-risk and face social or health care disparities, and proactively contacting and emailing members who fall into certain susceptible categories to discuss safety precautions. 

We’re also helping you manage your chronic conditions by expanding access to in-network telehealth services permanently. This allows virtual visits from the comfort of your home.  

With proper management, you can still enjoy a healthy, fulfilling life. During these difficult times, resources to help you do so are available. 

Andrea D. Willis, MD, MPH, FAAP, is senior vice president and chief medical officer at BlueCross BlueShield of Tennessee. 

Read or Share this story: https://www.tennessean.com/story/opinion/2020/05/27/covid-19-reminder-keep-stable-health-routine/5267251002/

COVID-19 virus puts a spotlight on inequality and racism

(RNS) — While the coronavirus is an equal opportunity killer, the poor and people of color are disproportionately suffering and dying from COVID-19. These communities were least prepared to respond to the virus for reasons rooted in racism and inequality.

When the virus arrived, public health experts told us to protect ourselves by working from home, keeping social distance, isolating the sick and quarantining those who have come into contact with the sick. But all of these recommendations are easier for white, affluent suburbanites to follow. They have large homes they share only with family, and jobs that can be done online. Their financial reserves can cushion the impact of hard times.

Those who work in restaurants, grocery stores, warehouses, hotels, slaughterhouses, agriculture, factories, construction, nursing homes, retail stores, maintenance and cleaning cannot work from home. Security guards, maids, janitors, bus drivers, truck drivers, waiters, dishwashers, cooks, cashiers, farmworkers, delivery people and receptionists must show up for work if they are going to be paid.

Many of these workers survive from paycheck to paycheck with meager reserves to withstand the loss of their paychecks. About 1.8 million workers are paid the federal minimum wage ($7.25 per hour) or less, according to the U.S. Bureau of Labor Statistics. Nearly half (48%) of workers earn less than $15 an hour. In bad times, they have hardly anything to fall back on. Nearly 70% of Americans have less than $1,000 in savings, according to GoBankingRates.

Also, poor people of color are more likely to suffer from underlying conditions that put them more at risk if they do get sick. Sadly, many have either no health care or substandard health care, especially in states where Republican governors and legislatures have refused to expand Medicaid as proposed under the Affordable Care Act. Undocumented immigrants are afraid to go to hospitals because they fear federal agents will seize them there, and deport them or their family members.

These people were already on the edge. With the coronavirus they are in free fall with no end in sight.  

People wait for a distribution of masks and food from the Rev. Al Sharpton on April 18, 2020, in the Harlem neighborhood of New York after a new state mandate was issued requiring residents to wear face coverings in public due to the coronavirus. (AP Photo/Bebeto Matthews)

Not only are they in danger at work, they are also at risk at home. Minorities and the poor are more likely to live in crowded quarters. They are more likely to have a family member who will bring the virus home from work. The idea of isolating or quarantining someone in an apartment with six or more people and one bathroom is a cruel joke.

We should not be surprised that African Americans are 2.4 times more likely to die from COVID-19 than whites, according to APM Research Lab.

The black community’s disadvantage can be traced back to slavery and the racism that blacks have historically endured. If African Americans had ever received just wages for their work, had been allowed to borrow money from banks, open businesses and own homes, then over generations their wealth may have equaled that in the white community.

Instead they were discriminated against, redlined, excluded from education and subjected to violence. Government programs in the postwar era that helped whites gain education and housing excluded blacks. Only within the last 50 years have things slightly improved, but to think that a people can overcome centuries of oppression in one generation is naive.

The next generation continues to suffer because schools have closed. People of color are less likely to have broadband available in their homes for distance learning. Nor do they have a quiet room where they can study. Nor do their parents have the time or ability to make up for what their children are losing by not going to school.

The virus has also undercut the greatest resource available to the poor and communities of color: grandparents. Children and parents are forced to keep distance from their most important supporters. Those who provided advice, emotional support and child care are unavailable. 

True, many of those who lost jobs have been helped by unemployment insurance. Some are receiving more in unemployment insurance than they did while on the job, but this simply highlights how terrible were their wages to begin with. And those who have continued working have rarely received hazard pay to reflect that they are putting their lives at risk every day they go to work.

The COVID-19 virus has put a spotlight on the inequality and racism that are endemic to our nation. The health of the nation must be measured by the health of those who are least advantaged. Unless all are healthy, unless all are protected, unless all have access to jobs with decent pay, then we are a sick nation in need of strong medicine.

The pandemic has revealed the need to raise the minimum wage to $15 an hour. It has shown that our education system is still separate and unequal and will continue to be that way until the amount of money spent on educating children of color equals that spent on white children. It has shown the need for universal health care that protects everyone, not just those with good jobs.

America is experiencing a health crisis, but the pandemic has also spotlighted the moral crisis that afflicts our country. Until we care for all God’s children, we will continue to be a nation that is sick in its soul.

Birthing Black babies during a pandemic

Tanafer Camara of TLC Consulting and Maternal Healing does her daughter’s hair. – Photo: Brittsense

by JR Valrey, Black New World Journalists Society

“Disparities in maternal health, mortality and morbidity was an issue before COVID-19 and is potentially exacerbated by the COVID-19 pandemic. We are already starting to see that African American, Indigenous and Latina women have died in childbirth as a result of either complications of COVID-19 or negligent and disparate care as a result of reduced in-person visits, even when the patient was at high risk,” said Tanafer Camara, a lactation consultant, post-partum healer, doula and maternal health strategist who works in a public practice at Highland Hospital in Oakland and also has her own private practice, T.L.C. Consulting and Maternal Healing.

“Before COVID-19, many women of color already felt they did not receive optimal or even standard care. Racism in care has long been an issue and affects every aspect of care. For this reason, I chose an all-Black team for my prenatal care.”

In a lot of ways, the COVID-19 pandemic has changed Black society’s thinking about what has been considered normal for the last 60 years in the ways of socializing, farming, eating, schooling, protecting ourselves and now birthing our babies.

We should reflect on how Black women were having babies when Jim Crow laws would not allow Black mothers in this country into white hospitals. Now that that threat is compounded by the economic virus of capitalism, the psychological virus of racism and the biological virus of COVID-19 to create a deadly combination, Black women and Black families have our backs against the wall.

“One of the most significant challenges has been changes to regular prenatal care and the limited number of support persons allowed in the hospital during childbirth. Before COVID, I had already planned a home birth and care with licensed midwives,” said Tanafer Camara, who is also an expecting mother due in August.

“I’ve had to have some of my visits done virtually. Also, I’ve had some ultrasound appointments cancelled and rescheduled, due to staffing shortages and reducing the number of patients in the waiting room. I’ve also had to wear a mask during those appointments. Pregnancy groups that I planned to be a part of like Black Infant Health, are now virtual as well, which really affects the group dynamics and the ability to bond with other pregnant women.”

In the post Obama era of the 21st century just like in the preceding eras, Black mothers have never stopped dying at staggering rates. “A Black woman is two times more likely than a white woman to die during her pregnancy, labor or within the first year after the birth due to preventable causes. Right now, the maternal mortality rate for Black women is 37.1 per 100,000 and for white women is 14.7 per 100.000 live births,” said Asatu Hall, a midwife and doula for over 20 years.

“Well, sadly, the overall COVID-19 mortality rate for Black Americans is 2.4 times as high as the rate for whites, Asians and Latinos. My friends who work as nurses and providers in the hospital have confirmed this.

“So our Black community continues to be the last priority in terms of outreach, education, testing and treatment of COVID-19. Most of us mothers have to work, so mamas who are nurses, front line staff in markets, in-home care providers, working in stores, banks, bus drivers, doctors, lactation experts and hairdressers are putting themselves at risk to feed their families.

“Now what if you’re pregnant?” said Asatu Hall, director of Sacred Grove Traditions, a grassroots organization empowering women and girls about holistic health.

Asatu Musunama Hall, MPH, Mama Tutu, with her son

“When you are pregnant, your amazing body naturally lowers your immunity so that your body doesn’t attack your baby as a foreign virus or bacteria. However, we have this new epidemic COVID-19, and mothers are going into the world with lowered immunity, coupled with the stress and the anxiety of being pregnant during this time, and all of this puts pregnant Black mothers more at risk for poor outcomes.”

The United States and the Americas were built on an unequal two tiered system almost half a millennium ago, with colonialism, chattel slavery, mass incarceration, lack of healthy food, lack of health care, and genocide being the favorite tools of the societal masters to keep the captive population in submission. No one in their right mind should think that COVID-19 pandemic is going to change that political dynamic.

“As a result, more families may seek out-of-hospital options for childbirth, and have to learn to assess and manage their own health needs. Disparities could potentially become greater with the shift to tele-health or virtual care as some communities and people may lack access to technology or knowledge of how to adapt to these new modalities,” said Tanafer Camara.

“Some high risk patients may slip through the widening gaps of an already broken system. However, there is hope in that there are many people and organizations working to change that. The work of maternal equity has been well under way, and we have been doing our best to adapt and adjust during this pandemic to continue to support and meet the needs of the community.”

The Bay Area’s Black birth workers are essential workers who deserve to be applauded for seeing us through this special time with vital information and learned techniques.

“From the birth workers I have spoken to (midwives, doulas, lactation specialists etc.), we are encouraging mothers to shelter in place, practice social distancing in addition to the recommended wearing of masks and gloves and washing hands frequently,” said Asatu Hall.

“We are advising mothers to stay home if possible and avoid people and crowds that are not in your immediate family and household. Treat yourself as if you are a newborn baby and limit your contact with folks who may be high risk which we don’t know because many people do not have symptoms.

“I personally advise folks to focus on their immune system, take vitamin C and Zinc, limit stress, take walks, dance and rest,” said Asatu Hall. “Prenatal visits are spaced out and many have incorporated zoom visits, telemedicine and phone check-ins. To protect our clients, we wear masks and gloves during in-person appointments and our standard gloves and hygienic techniques during births.”

Mid-March, when the quarantine started, seems like a lifetime ago, considering how quickly expectations and societal behavior has changed. At one time, in the not so distant past, having a home birth was considered radically “Afro-centric” or “Bohemian” or “Hotep-ish.” Today, you can be risking your life needlessly if you try to have a baby the way that your mother had you, in a hospital.

“If the mother is healthy and expecting a normal birth, her family should absolutely consider a homebirth. Homebirth is completely safe with an experienced midwife who has been trained and specializes in homebirth,” said Asatu Hall, a practicing midwife and doula who has delivered hundreds of Black babies.

“The hospital is not the environment, at this time, for healthy mothers and natural normal birth. It is a place for high-risk births where mothers have access to specialized staff, medicine and emergency equipment if needed. Also, one needs to consider the high number of COVID-19 cases that enter the hospital and the providers who are exposed to COVID-19.

“I would say protect yourself, pay attention to your immune system and what you can do to keep yourself and household safe. It’s common sense but it can be overwhelming for all us so keep it simple. Stay home and go out when you need to, wash your hands and keep your nose and face covered. Limit who comes into your space and keep your environment sanitized. Eat well, rest, drink water, and keep yourself mentally and spiritually balanced.

“If you have symptoms, don’t wait if your home remedies are not working so that you don’t infect the little ones or elders in your household or families,” said Asatu Hall.

In these current times of the mainstream media being controlled by six corporate oligarchs who are tangled up on Wall Street with big Pharma, the Black community wisely is cautious about trusting the above named entities when it comes to looking out for the health of the Black community in general, and Black expecting mothers specifically.

“You have the power to deliver a healthy baby at home. Your great great great grandmother did it probably, and the same strength is within you. Eat well, rest, drink water, and keep yourself mentally and spiritually balanced.

“Entertain the idea of talking to a midwife and doula and having a homebirth. Homebirth is an empowering, revolutionary action. If you are high risk or not ready for a homebirth, get a doula who can help guarantee a natural birth and avoid a C-section,” said Asatu Hall.

You could get in touch with Tanafer Camara at urbanmatriarch365@gmail.com and with Asatu Hall at 510-672-7926 or at https://sacredgrovetraditions.org/services.

The People’s Minister of Information JR Valrey, journalist, author and filmmaker, can be reached at blockreportradio@gmail.com or on Facebook. Visit www.youtube.com/blockreporttv. All stories written about COVID-19 were partially made possible by the Akonadi Fund #SoLoveCanWin.

As Washington D.C. Weighs Reopening, African Americans in the Nation’s Capital Brace for the Worst

It’s just past 7 a.m. as Tavis Clinton’s sanitation truck pulls to a stop in an alley in the Washington, D.C., neighborhood of Petworth, its streets lined by aging rowhouses and the occasional glass-and-metal gentrified upstart apartment complex. The 41-year-old sanitation crew chief, who like the other members of his three-man team is African American, navigates the massive orange city truck through the narrow lanes, his mouth covered in a star-spangled bandana. His colleagues jump off, grab a couple of wheeled bins and swing them in a practiced arc onto a mechanized arm that tips the refuse into the truck. The team then skates the bins back behind the still-quiet homes and sprints to the next set, panting through their face masks in the former swampland’s late spring heat.

Sanitation workers like Clinton show up before dawn to start their 6am shifts, wrapping themselves in masks, gloves, neon jackets and vests, and a take-no-prisoners esprit de corps to get through exhausting shifts removing the locked-down city’s refuse. The streets have been emptier but the trash is heavier with so many staying at home during the coronavirus pandemic. The three-man crews pack into the truck’s cab, where no social distancing is possible. When Clinton gets home to his wife and five children, he sprays his clothes his disinfectant and then scrubs hard in the shower before going anywhere near them.

“It’s tough,” Clinton says. “I just have to trust in my crew that once they leave work, they are home and they’re not out socializing, because it’s all our health at once.”

Clinton and his crew are part of the essential workforce that has kept America’s capital running during the pandemic, most of which are African American, according to the city. It’s one of the reasons officials say the African American community here has been so hard hit by COVID-19: While African Americans make up nearly 47% of the District of Columbia’s population, and account for 46% of the city’s COVID-19 cases, they also account for more than 76% of the city’s deaths.

Tavis Clinton disinfects his truck before beginning his route on May 22.

Tavis Clinton disinfects his truck before beginning his route on May 22.

Nate Palmer for TIME

Now, as the District’s officials weigh reopening non-essential businesses as early as Friday, they worry its black and brown residents, who are being disproportionately impacted by the virus, will bear the brunt of a second wave of infections once people leave their houses. Washington D.C. Mayor Muriel Bowser knows she has to both bring back business and minimize the health risk to the largely black and Latinx workers doing the work on the pandemic’s front lines. Latinx are the second highest risk group for COVID-19 in the U.S.; in the District, they make up 11% of the city’s population and 25% of infections. “You don’t get to open up and be successful if people are scared for their lives,” Bowser tells TIME.

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The virus’ disproportionate impact on the District of Columbia’s black community in particular reflects a broader pattern across the United States. Nationwide, African Americans comprise just 12.3% of the country but nearly 26.3% of the COVID-19 cases and 22.7% of deaths, according to CDC data. (At least 30% of states’ test results compiled by the CDC failed to record race.) A high rate of underlying conditions like diabetes and heart disease, coupled with historically lower-paid jobs, have put many African American communities at greater risk from COVID-19, experts say. The skewed toll “spotlights the underlying inequalities and extra burdens that black communities have historically had to deal with in this country,” former President Barack Obama said in his May 16th commencement speech for Historically Black Colleges and Universities.

Until this week, Washington, D.C.’s startlingly high proportion of African American deaths has helped make the city has a national outlier in its stay-at-home orders. On May 13, Bowser extended D.C.’s the order to June 8th, while nearly all other states moved toward some kind of reopening. Her caution proved prescient: the metropolitan D.C. area had the highest rate of positive COVID-19 tests in the nation on May 22, just ahead of the Memorial Day weekend, according to White House coronavirus response coordinator Deborah Birx. But after the holiday, Bowser told reporters on Tuesday that cases were again dropping, and some non-essential businesses could begin to open by Friday if the trend continued downward.

D.C. Mayor Muriel Bowser, right, speaks during a news conference about the coronavirus inside the Walter E. Washington Convention Center on May 11.

D.C. Mayor Muriel Bowser, right, speaks during a news conference about the coronavirus inside the Walter E. Washington Convention Center on May 11.

Patrick Semansky—AP

A woman wears a mask as she walks past a bus stop on 14th Street in downtown Washington, D.C., on April 15, 2020.

A woman wears a mask as she walks past a bus stop on 14th Street in downtown Washington, D.C., on April 15, 2020.

Drew Angerer—Getty Images

Bowser’s caution has put her at odds with the President living in her city limits who has been actively urging the country to get back to business. She is trying to walk a diplomatic line with the Trump Administration, since D.C. needs federal funding to bridge a nearly $725 million-dollar budget shortfall spurred by rising social-welfare costs and falling tax income due to the pandemic. But she doesn’t sugarcoat the fact that she thinks President Donald Trump’s push to reopen overlooks the needs of some of the most vulnerable Americans. “There is this kind of a callous calculation happening that surprises me,” she says. “It’s kind of like, ‘Well, this COVID is killing old people and, Oh, well. It’s killing black people, and poor people and essential workers. Oh, well.’”

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‘This death that’s going around’

For many of the early rising members of D.C.’s sanitation crews, COVID-19 has brought both a sense of renewed pride in their crucial work and a creeping sense of dread. “The public comes out when they are coming through the alleys, kids waiving at them,” says Earl Simpson, 43, the associate administrator of D.C.’s collection division. “I think the citizens really appreciate us being out there collecting the trash and recycling.”

Retired sanitation worker Maurice Pony Man Queen, 72, stands in the hallway at the Department of Public Works Solid Waste Collections Division on May 22.

Retired sanitation worker Maurice “Pony Man” Queen, 72, stands in the hallway at the Department of Public Works Solid Waste Collections Division on May 22.

Nate Palmer for TIME

But some have already left the job out of concern for their safety. Fear of the virus drove one of the city’s longest serving sanitation workers, Maurice “Pony Man” Queen, 72, to finally retire on April 3, after his “50 years, 7 months and 22 days of service.” He started the job just after Martin Luther King was assassinated in Memphis, where the reverend had traveled to support a protest by black sanitation workers. He says he never missed a week’s work until coronavirus struck. Now he’s worried about the young men he mentored who are still on the job. “We’re gonna have some more people die before all of this is resolved,” Queen says. “And I’m just hoping and praying that none of my family members or anybody that I know will be a part of this death that’s going around.”

COVID-19 is disproportionately impacting African American communities across the U.S. for a variety of reasons. Many inhabit the low-income, densely packed neighborhoods with a large number of multi-generational homes, which helps spread the virus, says Danyelle Solomon, vice president of race and ethnicity at the Center for American Progress (CAP). Other factors include type of employment, lack of a financial safety net and pre-existing health conditions, she says.

African Americans make up about a third of some of the service industry’s public-facing jobs like taxi drivers and barbers, according to CAP research. That’s in part why less than one in five black Americans, and less than one in six Latinx Americans are able to work from home, Solomon says. And for every $10 a typical white family has in the bank, a typical black family only holds $1, according to CAP research. “Wealth allows people to respond to that unexpected emergency like COVID-19,” she says, “resources you can draw upon when you’re not pulling a paycheck.”

When it comes to health, CAP’s analysis shows that 28% of people of color between the ages of 18 and 64 in the U.S. — or more than 21 million people — have a pre-existing condition, like asthma, hypertension, heart disease and diabetes, that could put them at higher risk of severe illness from COVID-19.

Sanitation worker Vincent Walker sits below a portrait of Mayor Muriel Bowser inside the Department of Public Works Solid Waste Collections Division.

Sanitation worker Vincent Walker sits below a portrait of Mayor Muriel Bowser inside the Department of Public Works Solid Waste Collections Division.

Nate Palmer for TIME

In Washington D.C., Mayor Bowser, who is 47, says the virus has been “efficient against underlying conditions that you see in the African American community, like diabetes and high blood pressure and heart disease.” She says it has also hit those who don’t have the luxury of staying home, and those who live in multiple-generation households that are getting more crowded as families double up when they can’t make rent because of lost wages. “Less than optimal health decisions, coupled with the inability to isolate, has put black and brown communities right in the crosshairs of COVID-19,” Bowser says.

Others say criticizing African Americans for lifestyle choices that lead to pre-existing conditions smacks of blaming the victim. Washington’s most populous black neighborhoods, concentrated in Wards 7 and 8, are food deserts, says Doni Crawford of the DC Fiscal Policy Institute, with only three large supermarkets serving 160,000 people. Decades of inequitable city planning also come into play, with homes in black and brown communities often located in more densely packed neighborhoods, or near warehouse or industrial districts, due to zoning practices, the 30-year-old affordable housing analyst says. “When you’re living close to a trash site, that negatively impacts your health.”

All these factors are further complicated by a historic distrust of doctors felt by many members of the African American community, says Dr. Michael Fauntroy, 54, associate professor of political science at Howard University, who studies African American political behavior. For many, that is rooted in the notorious Tuskegee experiment, he says, which started in 1932 when unethical U.S. Public Health Service researchers told African American men they were being “treated for ‘bad blood,’ a local term used to describe several ailments, including syphilis, anemia, and fatigue,” according to the CDC. Instead, they were being studied as syphilis consumed them, and infected their loved ones, long after a cure was found.

Lingering suspicion — and the prejudice African Americans continue to encounter in the modern health care system — has made some people reluctant to seek out care. It also means it can be hard to dislodge bad information, Fauntroy says, like the rumor in the early days of the pandemic that blacks couldn’t catch COVID-19. The Howard University professor recalls hearing that rumor repeated by one of his best students. “I almost lost my mind,” Fauntroy recalls, “because it’s just the single most illogical thing you can think of.”

‘Disregard for black life and black bodies’

Mayor Bowser is mindful of that history. As it became clear that D.C.’s black community was being hit hard by COVID-19, she reached out to fellow African Americans through a trusted voice, enlisting D.C. resident and former First Lady Michelle Obama to record a message that went out to denizens of the District via robocall and through social media in mid-April. It urged non-essential workers to stay home and explained where people could get free coronavirus testing. (An Obama spokesperson says she’s recorded similar messages for other major African American cities and broadcasters during the pandemic as well.) The robocall helped drive up numbers of people getting tested, Bowser says, putting the District in the top 10 states or territories in terms of people tested per capita, according to the District’s Director of the Department of Forensic Sciences Dr. Jenifer Smith.

Emery Heights Park on a cloudy day in Washington, D.C., on May 22.

Emery Heights Park on a cloudy day in Washington, D.C., on May 22.

Nate Palmer for TIME

But cases have still been spiking in some of the city’s low-income neighborhoods, so Bowser’s team has been setting up pop-up sites that offer free testing for essential workers, people in high risk categories, or people who think they may have been exposed. At the first one, on a sunny Saturday on May 16, a line of masked residents waited next to a mobile lab near a charter school in Brightwood, a neighborhood in northwest D.C. that was once home to a pre-Civil War community of free African Americans. Today it’s a cross-section of black, Latinx and Amharic families, and is situated within the District’s Ward Four, which has the highest number of COVID-19 cases in the city.

Juan, a plumber, stands in line to get tested because his boss is in the hospital with COVID-19. “I have four children in the house,” he says. “I have to make sure that everything is okay.”

The economic impact of COVID-19 people in low-income neighborhoods like Brightwood is putting people at higher risk of infection in D.C., health care workers say. Homes that were already tight are now even more crowded as families move in together to save money. “A lot of people have lost their jobs, and the people that didn’t lose their jobs have lost hours,” says Maria Gomez, RN, president and CEO of Mary’s Center, which is providing the pop-up center’s testing services. To save rent, families are doubling up. “So one family that already was crowded in an apartment is moving in with another one that was already crowded.”

A few blocks away, on the neighborhood’s main drag, most businesses are closed, other than a funeral home and the occasional pharmacy or liquor store. One of the few open shops is Elsa Ethiopian Kitchen, where Elsa Yirge, the 45-year-old owner, works behind the counter. Her husband Beniam Belay greets drivers from Uber, Seamless and Grubhub in a bright African-print face mask, to the sound of an Ethiopian soap opera playing on a wall-mounted TV.

He says business has been down 80% since the pandemic hit. Just before COVID-19, the business leased more space upstairs to hold tables for up to 40 guests. Now, they don’t know how they’ll pay rent at the end of the month. The restaurant applied for a loan through the Paycheck Protection Program (PPP), the emergency federal program designed to help small business owners struggling under the shutdown. “We never heard back on our loan application,” Elsa says. When asked what they’ll do, she just shrugs, a grim look on her face.

Stimulus measures meant to bail out small businesses struggling under stay-at-home orders haven’t had the impact on minority-owned businesses that advocates would like to see, according to Crawford and co-author Qubilah Huddleston’s research for the DC Fiscal Policy Institute. Only a quarter of PPP loans could be used for expenses like rent, while three-quarters of the aid was structured to cover staff paychecks. “More than 90% of black businesses nationwide are sole proprietorships with no employees,” Crawford says. The Latinx community is also struggling, according to a recent Latino Decisions poll, which found that 35% of respondents had lost a job, 29% owned a small business that was on the brink or had already gone under, and 43% had trouble making rent.

Brightwood resident Carol Lightfoot, 73, stands on her front porch on May 22.

Brightwood resident Carol Lightfoot, 73, stands on her front porch on May 22.

Nate Palmer for TIME

But for people in the capital who have watched friends and neighbors get sick, rushing back to normal life isn’t necessarily the answer. Next door to the testing site, Carol Lightfoot, 73, and her brother George, 69, watch neighbors line up for nearly half a mile from the front porch of their peeling 1800s-era Victorian home, which in its day hosted salons for members of the black intelligentsia like W.E.B. Du Bois. When the Lightfoots realized they could get tested for free, they lined up too, as the siblings share a host of serious health conditions, including diabetes, hypertension, and asthma.

Lightfoot has empathy for people who have lost income during the pandemic, but calls the primarily white protestors she’s seen on TV dismissing the virus “ridiculous,” adding that they’d likely feel differently “if it was a member of their family or friends who came down with it.”

As Trump continues to push for reopening, homemade posters have appeared on a handful of D.C. lamp posts across the District. “Coming soon to your City: Trump Caskets,” the signs say, with an image of the President grinning over an open coffin. It’s a snapshot of how some District residents view Trump’s handling of the pandemic, says longtime Washington, D.C.-based public radio host Kojo Nnamdi. Many African Americans here see the disproportionate impact of COVID-19 on their community as part of a wider pattern of neglect by the Trump Administration, he says. “These are people who are convinced that President Trump does not have the interests of poor and people of color at heart. They think that President Trump prefers to err on the side of the major corporation, the big banks, and the business community.”

Nnamdi, now 75, predicts the pandemic will renew the movements for black equality that first inspired him to travel to the U.S. from Guyana as a college student and briefly join the revolutionary-minded Black Panther Party. Policy analyst Huddleston, 29, agrees. “It just reflects the disregard for black life and black bodies to say that we know that there are specific communities being decimated and devastated, economically, health wise, etc. But we’re still going to open anyway because the show must go on,” she says.

Mayor Bowser sees this crisis as an opportunity for Trump to reach out to the nation’s black community. “If there is ever a place where we could really look at the disproportionate impact on African Americans, it’s D.C., she says. “I think Trump gets that this is an issue that he can lean into for African Americans. I don’t know if he knows what the answer is.”

In Brightwood, nobody is talking politics. Juan and the other residents standing in line to get tested are just focused on getting through this crisis, like Clinton on his early morning sanitation shift. He may have to get out and help the public every day for a living, but in his private life, Clinton says he is planning to stay from public places for a while. “You gotta choose. What’s best? The economy? We need to get it back together so people can work, but you also gotta be safe,” he says. “It’s out there.”

With reporting by Chris Wilson

Please send tips, leads, and stories from the frontlines to virus@time.com.

Contact us at editors@time.com.

Slog AM: Dr. Doom Predicts Decade of Depression, Racist Dog Walker on Leave, UW Medicine Furloughs 4,000

Brb, gotta get 18 holes in before we hit 100,000 deaths.

Brb, gotta get 18 holes in before we hit 100,000 deaths. CHIP SOMODEVILLA / STAFF

Trump golfs as nation mourns: Trump called for churches to resume in-person services immediately on Friday. But instead of popping a couple of hydroxies and sitting in a pew on Sunday, he hit the links at Trump National Golf Club in Sterling, VA, reports the Washington Post. Meanwhile, the national coronavirus death toll rose to almost 100,000 over the weekend, a milestone the President said we wouldn’t cross.

If you didn’t read the New York Times feature on the ~100,000 dead: Read it over lunch.

The current COVID-19 numbers in Washington: On Monday evening, the number of deaths rose to 1,070 and the number of cases rose to 20,065. Infection counts have been hovering around 200 per day since mid-April.

Dr. Doom predicts a decade-long depression: In an interview with New York Magazine that makes me want to take up smoking again, Nouriel Roubini, the New York University economics professor who correctly predicted the 2008 housing crisis, said he foresees a U-shaped recovery in the near-term and a “Greater Depression” thereafter. He persuasively argues that the 16% to 25% of unemployed Americans will only be able to find part-time work as businesses begin to reopen and cut labor costs to save money while doing so. Lower wages will lead to less consumer spending, slowing recovery.

On top of that: Roubini continues, an economic “decoupling” from China will bring manufacturing but not jobs back to the U.S., since the new companies will staff their factories with robots. Super-charged natural disasters fueled by climate change, COVID-19 outbreaks across the world, and potentially other pandemics will not help. The only thing that could help ease the pain? “Give [workers] education, a social safety net — so if they lose their jobs to an economic or technological shock, they get job training, unemployment benefits, social welfare, health care for free.”

Former Obama economist predicts quick recovery will boost Trump’s reelection bid: In a doomsday scenario from a different angle, Harvard economist Jason Furman has reportedly been hopping on Zoom calls with “anyone who will listen” and laying out his case for a “partial” V-shaped recovery. Furman thinks the post-pandemic economy will look more like economies hit by natural disasters: huge job losses upfront, followed by a surge in positive economic activity once businesses open up again and take workers off furlough. In the months leading up to November, Furman argues, America will see the best jobs and growth numbers it has ever seen. The overall economy will be bad, but Trump will point to the rising numbers and say “Great Depression” predictions were false, and that he’s the only who can save us, etc. An “informal” Joe Biden advisor told Politico that the campaign is “very much aware of this,” and preparing accordingly.

Stocks soar as New York Stock Exchange reopens its floor: “Most traders will continue to work remotely, NYSE President Stacey Cunningham said in a Wall Street Journal column, while the fraction of those who do return will undergo temperature checks, wear masks and work with Plexiglas barriers to ensure social distancing,” reports the Washington Post.

Woman in Central Park attempts to weaponize state against black birder: The woman in this video appears to know that police will respond quickly and with force to a white woman screaming about an “AFRICAN AMERICAN man threatening [her] life,” which is why she called the cops on a black guy who apparently told her to put her dog on a leash and then screamed that very phrase over and over. On top of being a racist scold, she also can’t handle her animal for shit.

Company where woman works taking this episode “very seriously:”

Incidentally: Journalist and podcaster Phoebe Judge recorded an episode of This Is Love featuring ornithologist and Clemson University professor of wildlife ecology Drew Lanham, who wrote about his avian obsessions in the memoir The Home Place: Memoirs of a Colored Man’s Love Affair with Nature.

A string of anti-Asian “bias incidents” in Ballard: Seattle Police suspect one guy spent the weekend harassing “people of Asian descent,” according to the Seattle Times. He chased and yelled at a woman and a couple in Golden Gardens, and he yelled a bunch of racist shit at a restaurant on Northwest Market Street. If you see him, call the cops. Also, fuck that guy, and fuck this guy, forever.

5,500 workers now furloughed at UW Medicine: That’s 15% of their workforce out for anywhere between one and eight weeks, according to the Seattle Times. The 4,000 union jobs put on hold include members from “SEIU1199NW, SEIU 925, the Washington Federation of State Employees and the Washington State Nurses Association” working at “Harborview Medical Center, UW Neighborhood Clinics and both University of Washington Medical Center campuses, among other divisions at the health care system.”

Meanwhile, the biggest hospitals are receiving massive bailouts: As with every other industry, so with hospitals: the wealthiest organizations are taking in piles of stimulus money, according to the New York Times. Despite its $12 billion in reserves and its two in-house venture capital firms, Providence Hospital Systems, which runs Swedish Hospital and 51 others across the country, took over $500 million in CARES Act money. (I did not know that Providence ran its own venture capital firms, did you know?) While other hospitals struggle to survive, Providence is paying its CEO enough money “to finance about a month of operations at the St. Claire hospitals in Kentucky.” So why did Providence make health care workers fight so hard for so long for a measly pay raise and more control over staffing when they were swimming in a room full of gold coins? That’s capitalism, baby!

Upscale Bremerton apartment complex set to increase rent 20% the day after the eviction ban expires: Spyglass Hill Apartments, which is owned by Sound West Group, hit a tenant in a studio apartment with a major rent hike slated for June 5, according to the Kitsap Sun. This instance portends a flood of economic evictions—and every other kind of eviction—that will sweep the state the week after next. If any landlord is trying to pull the same kind of shit on you, file a complaint with the attorney general’s office and send me an email with a photo of the rent hike letter.

NHL green-lights training to resume in “early June:” According to King 5, the league plans to allow hockey players to start practicing in “small groups” on a “strictly voluntary” basis starting early next month.

Port Orchard restaurant owner “protested” for one day by opening his restaurant to sit-down customers: “We’re doing this for freedom,” owner Craig Kenady told KIRO 7. But whose freedom? Certainly not the freedom of the 1,070 Washingtons now dead from COVID, or the 20,000+ who got sick with it, all of whom deserved to live in a state free from this guy’s idea of freedom.

Can we rent 5 people from Staten Island to just roam around the state yelling at these idiots: A NYC Department of Parks and Recreation official tweeted: “In Staten Island they call this ‘asking her politely to leave.'”

Maybe these people will stfu now that fishing is back: “Many of Washington state’s coastal waters are set to reopen for fishing on Tuesday,” reports the Associated Press.

North-end stabbing: A 59-year-old male died Saturday evening on Aurora after somebody stabbed him. Suspect still on the loose, reports KOMO.

Love Slog AM/PM?

South-end shooting: Two people were shot to death in a Safeway Parking lot in Rainier Beach on Saturday, reports KIRO. The suspect or suspect(s) are still at large.

Keep your head on a swivel if you’re driving on I-5: There’s black bears afoot, reports KOMO, and they’re not wearing masks.

What’s the deal with this pile of poles? Seattle City Light is replacing some light poles “at multiple locations scattered around the vicinity” near the Hiawatha Community Center, reports the West Seattle Blog. That’s the deal.

N.Y. Stock Exchange to Reopen: Live Updates

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Gov. Andrew M. Cuomo of New York provides the state’s latest coronavirus stats.CreditCredit…Spencer Platt/Getty Images

Here’s what you need to know:

Cases and deaths in New York State

10,000 cases

7-day average

Total cases

Includes confirmed and probable cases where available

See maps of the coronavirus outbreak in New York »

The Mid-Hudson region just north of New York City is reopening.

ImageRye Playland Beach in Westchester County reopened last week.
Credit…James Estrin/The New York Times

On Tuesday morning, a seven-county region just north of New York City began the slow process of restarting its economy.

“The door has crept open,” said Marc Molinaro, the executive of Dutchess County, which has so far lost at least 137 residents to Covid-19, including Mr. Molinaro’s father. “When you’re little and you’re in a darkened room and you just kind of open the door to see the light, that’s kind of what we’re experiencing today.”

In the counties of the Mid-Hudson region — Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester — people can now pick up retail purchases in stores or at curbside, and commence work in manufacturing and construction.

The region, home to more than 2.3 million people, includes New Rochelle, the city where the outbreak began in New York State.

The reopening leaves only Long Island and New York City under lockdown, and Long Island is set to begin reopening on Wednesday.

Mayor Bill de Blasio has said he is hopeful the city’s five boroughs can begin reopening in the first half June. Gov. Andrew M. Cuomo is basing his reopening authorizations on several metrics, including declines in hospitalizations, deaths and new hospitalizations, and testing and contact tracing capacity.

Mr. Cuomo said on Tuesday that the state would direct more resources to some low-income New York City neighborhoods that have been hit hardest by the virus. They include the ZIP codes covering Norwood in the Bronx and Far Rockaway and Corona in Queens, each of which has had more than 80 people newly hospitalized for the virus in the past week.

Other news from Mr. Cuomo’s morning briefing:

  • Another 73 people died of the virus in New York, the third day in the last four with under 100 deaths. “In this absurd new reality, that is good news,” he said.

  • Mr. Cuomo will meet with President Trump on Wednesday to discuss infrastructure, among other things.

    Mr. Cuomo said he planned to urge the president to advance several projects requiring federal approval, including an AirTrain to La Guardia Airport and a new rail tunnel under the Hudson River to replace the deteriorating ones in use. “There is no better time to build than right now,” Mr. Cuomo said.

N.J. schools can hold outdoor graduation ceremonies in July.

Schools in New Jersey will be allowed to hold outdoor graduation ceremonies in July, Gov. Philip D. Murphy announced on Tuesday.

The announcement came after Mr. Murphy loosened a number of restrictions ahead of the Memorial Day weekend, including allowing outdoor gatherings of up to 25 people.

New Jersey, which has reported more than 155,000 cases of the virus, was hit hard by the pandemic and has at times surpassed New York in the number of deaths, hospitalizations and cases per 100,000 people.

Mr. Murphy said that graduation ceremonies can begin on July 6, but they must comply with social distancing “ensuring the health and safety of all in attendance.”

New Jersey reported 54 new deaths on Tuesday, bringing the state’s total to 11,191.

New rule as stock exchange reopens: no public transit riders.

Credit…Hiroko Masuike/The New York Times

Anyone entering the building must wear a mask, follow social-distancing rules, undergo temperature checks and abstain from using public transit.

The latter requirement prompted criticism when the stock exchange’s president, Stacey Cunningham, announced it May 14.

Some critics argued it was classist. Others suggested it would clog city streets. The transportation news site Streetsblog called the rule “a preview of the coming carpocalypse.”

But no one will be required to come in, and traders and other employees can keep working remotely, Ms. Cunningham said.

The stock exchange has been closed since March 23, even as markets remained open.

With so much trading conducted electronically, some regard the in-person trading floors as a photogenic relic. But in an op-ed in The Wall Street Journal, Ms. Cunningham wrote that “stocks trade better when the floor is open, with reduced volatility and fairer prices,” saving investors millions of dollars a day.

Gov. Andrew M. Cuomo rang the opening bell to mark the start of trading.

Uber and Lyft drivers sue N.Y. over unemployment benefits.

Doh Ouattara drove for Uber and Lyft from 2016 until mid-March of this year. With three children under 6 to provide for and the pandemic exploding, he decided to apply for unemployment.

But despite hundreds of calls to the New York State Department of Labor and two state rulings that deemed gig workers like him to be employees eligible for benefits, he has yet to receive any payment.

On Monday, Mr. Ouattara and three other Uber and Lyft drivers, along with the New York Taxi Workers Alliance, filed a complaint in federal court against Governor Cuomo and the Labor Department, saying the state illegally failed to pay benefits to drivers in a timely way.

The lawsuit says drivers are waiting months to receive benefits, if they receive them at all, compared with the two to three weeks that the state has said is typical for other workers.

According to the lawsuit, a key problem is that the state has not forced companies like Uber and Lyft to provide the data on workers’ earnings that employers must typically supply.

Lacking such data, the suit says, the state has required drivers to complete a lengthy application process that involves more steps and paperwork than other workers face.

Mr. Ouattara, who was trained as an accountant in the Ivory Coast before moving to the United States, could afford to pay only half his rent in April and none this month. “My savings are almost gone — I’ve used them for food, basic necessities,” he said. “It is getting very, very stressful.”

The virus upended Islam’s holiest month.

Credit…Todd Heisler/The New York Times

For Muslims in the New York area, the coronavirus transformed the monthlong holiday of Ramadan from a joyful occasion marked by family dinners, communal prayers and busy social calendars into a somber month celebrated under the shadow of sickness, death and joblessness.

The family of Ali Mamun, a Bangladeshi immigrant who worked as a psychiatrist in Brooklyn and died of the virus, visited him in a New Jersey cemetery during the holy month, which ended on Saturday.

They were shocked to find a vast field of freshly dug graves, the dead all in their 50s and 60s, many bearing distinctly Bengali names.

“I never imagined Ramadan to be like this,” said Sayyid Chaudury, 31, Dr. Mamun’s son-in-law. “Ramadan is very much about family — breaking the fast with your family and then going to the mosque every night to read one of the prayers, but this Ramadan feels mostly empty and void and lonely.”

Amid the pandemic, the summer share house takes a hit.

Credit…Johnny Milano for The New York Times

It was all Cher Landman was looking forward to this summer: her share of a beach house in Southhampton, a chance to participate in a seasonal ritual for many New Yorkers.

Instead, she will most likely be spending the summer holed up in her one-bedroom apartment in Brooklyn, out several thousand dollars for a country house she cannot set foot in.

A Type 1 diabetic, Ms. Landman, 36, is at higher risk for serious illness were she to contract the coronavirus. Suddenly a summer of clambakes and poolside hangs with a revolving cast of roommates seemed unwise.

The ritual of the summer share, in which collectives of beach-seeking New Yorkers pool their resources to rent oceanside escapes on Long Island and in New Jersey, has long been a mainstay.

But with the coronavirus outbreak lingering, the notion of the summer share house seems all but finished this year.

On the list of negative impacts of this crisis, the end of the summer share is perhaps among the most trivial and least upsetting in a world where people have lost jobs, fallen ill and nearly 100,000 Americans have died.

Those whose summer plans were dashed acknowledge that having a canceled vacation to be disappointed about — with so many more mortal traumas unfolding everywhere you look — is in itself a kind of privilege.

But for those in the rarefied segment of affording such experiences, summer by the sea was a balm to which they said they looked forward to, particularly now.

“It’s really depressing. I was recently single, and thought, ‘Maybe I’ll meet someone through this, that could be a good idea,’ and to broaden my social circles. None of that can happen now,” said Ms. Landman, a comedian. “When you are in a share house you can’t control all the people, and God knows what they’ve been doing.”

Are you a health care worker in the New York area? Tell us what you’re seeing.

As The New York Times follows the spread of the coronavirus across New York, New Jersey and Connecticut, we need your help. We want to talk to doctors, nurses, lab technicians, respiratory therapists, emergency services workers, nursing home managers — anyone who can share what’s happening in the region’s hospitals and other health care centers.

A reporter or editor may contact you. Your information will not be published without your consent.

Reporting was contributed by Maria Cramer, Michael Gold, Nikole Hannah-Jones, Andy Newman, Sarah Maslin Nir, Dana Rubinstein and Noam Scheiber.

N.Y.C.’s Northern Suburbs Reopen: Live Updates

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Gov. Andrew M. Cuomo of New York provides the state’s latest coronavirus stats.CreditCredit…Spencer Platt/Getty Images

Here’s what you need to know:

Cases and deaths in New York State

10,000 cases

7-day average

Total cases

Includes confirmed and probable cases where available

See maps of the coronavirus outbreak in New York »

The Mid-Hudson region just north of New York City is reopening.

ImageRye Playland Beach in Westchester County reopened last week.
Credit…James Estrin/The New York Times

On Tuesday morning, a seven-county region just north of New York City began the slow process of restarting its economy.

“The door has crept open,” said Marc Molinaro, the executive of Dutchess County, which has so far lost at least 137 residents to Covid-19, including Mr. Molinaro’s father. “When you’re little and you’re in a darkened room and you just kind of open the door to see the light, that’s kind of what we’re experiencing today.”

In the counties of the Mid-Hudson region — Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester — people can now pick up retail purchases in stores or at curbside, and commence work in manufacturing and construction.

The region, home to more than 2.3 million people, includes New Rochelle, the city where the outbreak began in New York State.

The reopening leaves only Long Island and New York City under lockdown, and Long Island is set to begin reopening on Wednesday.

Mayor Bill de Blasio has said he is hopeful the city’s five boroughs can begin reopening in the first half June. Gov. Andrew M. Cuomo is basing his reopening authorizations on several metrics, including declines in hospitalizations, deaths and new hospitalizations, and testing and contact tracing capacity.

Mr. Cuomo said on Tuesday that the state would direct more resources to some low-income New York City neighborhoods that have been hit hardest by the virus. They include the ZIP codes covering Norwood in the Bronx and Far Rockaway and Corona in Queens, each of which has had more than 80 people newly hospitalized for the virus in the past week.

Other news from Mr. Cuomo’s morning briefing:

  • Another 73 people died of the virus in New York, the third day in the last four with under 100 deaths. “In this absurd new reality, that is good news,” he said.

  • Mr. Cuomo will meet with President Trump on Wednesday to discuss infrastructure, among other things.

    Mr. Cuomo said he planned to urge the president to advance several projects requiring federal approval, including an AirTrain to La Guardia Airport and a new rail tunnel under the Hudson River to replace the deteriorating ones in use. “There is no better time to build than right now,” Mr. Cuomo said.

N.J. schools can hold outdoor graduation ceremonies in July.

Schools in New Jersey will be allowed to hold outdoor graduation ceremonies in July, Gov. Philip D. Murphy announced on Tuesday.

The announcement came after Mr. Murphy loosened a number of restrictions ahead of the Memorial Day weekend, including allowing outdoor gatherings of up to 25 people.

New Jersey, which has reported more than 155,000 cases of the virus, was hit hard by the pandemic and has at times surpassed New York in the number of deaths, hospitalizations and cases per 100,000 people.

Mr. Murphy said that graduation ceremonies can begin on July 6, but they must comply with social distancing “ensuring the health and safety of all in attendance.”

New Jersey reported 54 new deaths on Tuesday, bringing the state’s total to 11,191.

New rule as stock exchange reopens: no public transit riders.

Credit…Hiroko Masuike/The New York Times

Anyone entering the building must wear a mask, follow social-distancing rules, undergo temperature checks and abstain from using public transit.

The latter requirement prompted criticism when the stock exchange’s president, Stacey Cunningham, announced it May 14.

Some critics argued it was classist. Others suggested it would clog city streets. The transportation news site Streetsblog called the rule “a preview of the coming carpocalypse.”

But no one will be required to come in, and traders and other employees can keep working remotely, Ms. Cunningham said.

The stock exchange has been closed since March 23, even as markets remained open.

With so much trading conducted electronically, some regard the in-person trading floors as a photogenic relic. But in an op-ed in The Wall Street Journal, Ms. Cunningham wrote that “stocks trade better when the floor is open, with reduced volatility and fairer prices,” saving investors millions of dollars a day.

Gov. Andrew M. Cuomo rang the opening bell to mark the start of trading.

Uber and Lyft drivers sue N.Y. over unemployment benefits.

Doh Ouattara drove for Uber and Lyft from 2016 until mid-March of this year. With three children under 6 to provide for and the pandemic exploding, he decided to apply for unemployment.

But despite hundreds of calls to the New York State Department of Labor and two state rulings that deemed gig workers like him to be employees eligible for benefits, he has yet to receive any payment.

On Monday, Mr. Ouattara and three other Uber and Lyft drivers, along with the New York Taxi Workers Alliance, filed a complaint in federal court against Governor Cuomo and the Labor Department, saying the state illegally failed to pay benefits to drivers in a timely way.

The lawsuit says drivers are waiting months to receive benefits, if they receive them at all, compared with the two to three weeks that the state has said is typical for other workers.

According to the lawsuit, a key problem is that the state has not forced companies like Uber and Lyft to provide the data on workers’ earnings that employers must typically supply.

Lacking such data, the suit says, the state has required drivers to complete a lengthy application process that involves more steps and paperwork than other workers face.

Mr. Ouattara, who was trained as an accountant in the Ivory Coast before moving to the United States, could afford to pay only half his rent in April and none this month. “My savings are almost gone — I’ve used them for food, basic necessities,” he said. “It is getting very, very stressful.”

The virus upended Islam’s holiest month.

Credit…Todd Heisler/The New York Times

For Muslims in the New York area, the coronavirus transformed the monthlong holiday of Ramadan from a joyful occasion marked by family dinners, communal prayers and busy social calendars into a somber month celebrated under the shadow of sickness, death and joblessness.

The family of Ali Mamun, a Bangladeshi immigrant who worked as a psychiatrist in Brooklyn and died of the virus, visited him in a New Jersey cemetery during the holy month, which ended on Saturday.

They were shocked to find a vast field of freshly dug graves, the dead all in their 50s and 60s, many bearing distinctly Bengali names.

“I never imagined Ramadan to be like this,” said Sayyid Chaudury, 31, Dr. Mamun’s son-in-law. “Ramadan is very much about family — breaking the fast with your family and then going to the mosque every night to read one of the prayers, but this Ramadan feels mostly empty and void and lonely.”

Amid the pandemic, the summer share house takes a hit.

Credit…Johnny Milano for The New York Times

It was all Cher Landman was looking forward to this summer: her share of a beach house in Southhampton, a chance to participate in a seasonal ritual for many New Yorkers.

Instead, she will most likely be spending the summer holed up in her one-bedroom apartment in Brooklyn, out several thousand dollars for a country house she cannot set foot in.

A Type 1 diabetic, Ms. Landman, 36, is at higher risk for serious illness were she to contract the coronavirus. Suddenly a summer of clambakes and poolside hangs with a revolving cast of roommates seemed unwise.

The ritual of the summer share, in which collectives of beach-seeking New Yorkers pool their resources to rent oceanside escapes on Long Island and in New Jersey, has long been a mainstay.

But with the coronavirus outbreak lingering, the notion of the summer share house seems all but finished this year.

On the list of negative impacts of this crisis, the end of the summer share is perhaps among the most trivial and least upsetting in a world where people have lost jobs, fallen ill and nearly 100,000 Americans have died.

Those whose summer plans were dashed acknowledge that having a canceled vacation to be disappointed about — with so many more mortal traumas unfolding everywhere you look — is in itself a kind of privilege.

But for those in the rarefied segment of affording such experiences, summer by the sea was a balm to which they said they looked forward to, particularly now.

“It’s really depressing. I was recently single, and thought, ‘Maybe I’ll meet someone through this, that could be a good idea,’ and to broaden my social circles. None of that can happen now,” said Ms. Landman, a comedian. “When you are in a share house you can’t control all the people, and God knows what they’ve been doing.”

Are you a health care worker in the New York area? Tell us what you’re seeing.

As The New York Times follows the spread of the coronavirus across New York, New Jersey and Connecticut, we need your help. We want to talk to doctors, nurses, lab technicians, respiratory therapists, emergency services workers, nursing home managers — anyone who can share what’s happening in the region’s hospitals and other health care centers.

A reporter or editor may contact you. Your information will not be published without your consent.

Reporting was contributed by Maria Cramer, Michael Gold, Nikole Hannah-Jones, Andy Newman, Sarah Maslin Nir, Dana Rubinstein and Noam Scheiber.

May 23 marks state’s new largest rise in COVID-19 cases

On May 23, North Carolina saw a new record single-day increase of COVID-19 cases: 1,107, up from a previous high of 853 cases on May 16. The bump came just one day after restaurants, breweries, personal care services and pools were permitted to reopen at 50% capacity as the state moved into Phase 2 of its three-part reopening plan. “This is a notable and concerning increase,” said Dr. Mandy Cohen, the state’s secretary of health and human services, in a May 23 press release.

But cases are just one aspect of the coronavirus data for North Carolina. Here’s a look at where the latest numbers stand in Buncombe County and across the state. 

Case count 

From the start of the pandemic through May 25, North Carolina has reported 23,964 lab-confirmed cases of COVID-19 and 754 deaths. Buncombe County accounts for 276 of those cases, as well as 15 deaths. 

Across the state’s 18 westernmost counties, there have been 1,299 cases of COVID-19, according to NCDHHS data. Burke, Henderson and Rutherford counties top WNC for the most cases per 10,000 residents at 33, 27 and 25, respectively. Case count is the only metric that the state reports at the county level.

An estimated 51.1% of adults in North Carolina are at higher risk for developing severe COVID-19 based on being 65 years or older, having at least one underlying health condition, or both, according to data from the NC State Center for Health Statistics Behavioral Risk Factors Surveillance System. People with at least one high-risk underlying health condition make up striking percentages of those who had died of the disease as of May 19: 100% of individuals ages 18-24, 54% of those 25-49, 74% of those 50-64 and 70% of those 65 or older. 

NCDHHS estimates that 14,954 of the state’s COVID-19 patients, or more than 62%, have recovered. To find this metric, state health officials assumed a median recovery period of 14 days for non-hospitalized patients and 28 days for hospitalized patients. 

Percent positive 

More testing means more cases of COVID-19 will be diagnosed, Cohen noted during a May 16 press conference. However, she added, the rise in positive cases may also be linked to the statewide easing of restrictions. 

To correct for the increase in testing, health officials use the “positivity rate,” or percentage of positive tests out of all tests administered. The World Health Organization recommends that before reopening, states should maintain a rate of positivity at 5% or lower for at least 14 days. 

TRENDING UP: The percentage of positive COVID-19 results as a portion of all tests for the disease has increased since mid-May. Graphic courtesy of NCDHHS

NCDHHS reports that 8% of all tests came back positive on May 24, the latest day for which data is available. The seven-day rolling average aggregated by the state shows the positivity rate trending upward since May 16. 

According to national data compiled by the COVID Tracking Project and the Johns Hopkins Coronavirus Resource Center, North Carolina joins 28 other states in exceeding the WHO’s recommended percentage of positive tests

Hospitalizations and personal protective equipment

As of May 25, 627 COVID-19 patients are hospitalized in North Carolina, with 81% of the state’s hospitals reporting. 75% of the state’s ventilator supply is currently available, and just over 700 intensive care unit beds remain open. 

Per statistics updated on May 25, the state has adequate supplies of face shields, gloves and procedure masks to protect frontline health care workers for at least 30 days. Gowns remain hard to source, explained Mike Sprayberry, the state’s director of emergency management, during a May 21 press conference. 

CAPACITY REMAINS STRONG: As of May 25, 75 percent of North Carolina’s ventilators are available in the event of a spike in COVID-19 cases. Graphic courtesy of NCDHHS

Tracing

As of May 20, 152 new contact tracers had been hired through the Carolina Community Tracing Collaborative. Cohen emphasized the need for contact tracers to reflect state demographics during a May 20 press conference, noting that the hiring team focused on bringing on contact tracers from communities especially vulnerable to COVID-19. 

NCDHHS and the Carolina Community Tracing Collaborative reported the following demographics for the new contact tracing hires: 29% African American, 13% Hispanic or Latino, 3% American Indian or Alaska Native, 3% Asian, 39% White, 10% two or more races and 10% who didn’t respond. 45% of these contact tracers are bilingual. 

In other news: 

  • Buncombe County and Western North Carolina Community Health Services continue to offer free community-based COVID-19 testing. This week, testing will be able at 52 Coxe Avenue on Tuesday, May 26, from 1-4 p.m.; Sandy Mush Community Center on Wednesday, May 27, from 1-4 p.m.; and Deaverview Community Apartments on Thursday, May 28, from 1-4 p.m. Language translation services will be available at all three locations. 
  • Asheville will delay reopening three city pools at Recreation Park, Malvern Hill Park and Walton Street Park, as well as Splasheville in Pack Square Park, until at least Wednesday, July 1. City officials are working closely with state and local health officials and will reassess the reopening date later in the summer. 
  • The Western North Carolina VA Health Care System is coordinating with the Mayo Clinic’s national program for COVID-19 treatment. The program allows plasma from recovered COVID-19 patients to be donated, screened and used for treatment in those who are sick with the coronavirus.
  • The Asheville Area Chamber of Commerce has released a Smart Restart Toolkit with guidance for business reopening. Guidance is broken down by industry and includes links to resources such as regional suppliers and Asheville’s ‘We Care’ Stay Safe Pledge.

PRESS ROOM: The 18th U.S. Surgeon General and American Heart Association Board Member, Dr. Regina Benjamin joins National Newspaper Publishers Coronavirus Pandemic Task Force

By BlackPressUSA

PULL QUOTE: NNPA NEWSWIRE — “I am honored to collaborate with the NNPA on behalf of the American Heart Association to share facts and insights to support the health news and resources shared directly with African American communities,” said Dr. Benjamin, who is also Founder and CEO of BayouClinic/Gulf States Health Policy Center in LaBatre, Alabama.

DALLAS, TX: May 12, 2020 — Regina Benjamin, M.D., MBA, 18th U.S. surgeon general and member of the American Heart Association’s National Board of Directors joins the National Newspaper Publishers Association (NNPA) Coronavirus Task Force and Resource Center providing expertise on the COVID-19 and its disproportionate effect on African American communities.

Regina Benjamin, M.D., MBA, 18th U.S. surgeon general and member of the American Heart Association’s National Board of Directors.

The NNPA, the trade association of African American-owned newspapers and media companies, established the Coronavirus Pandemic Task Force to provide timely and up-to-date Coronavirus information and resources for the African American community.

“I am honored to collaborate with the NNPA on behalf of the American Heart Association to share facts and insights to support the health news and resources shared directly with African American communities,” said Dr. Benjamin, who is also Founder and CEO of BayouClinic/Gulf States Health Policy Center in LaBatre, Alabama.

This pandemic is uncovering what health experts have known for years. Access to health care, healthy food, education, and family income are the basis of poor underserved communities. In addition to social factors, health factors such as high blood pressure, diabetes, heart disease and stroke tend to plague underserved communities at high rates and it seems that these populations are at increased risk for contracting the coronavirus.

“We are grateful that Dr. Benjamin has joined the NNPA’s Coronavirus Task Force, which is made up of top infectious disease doctors, medical and health experts from various organizations, and public officials. As a trusted source in African American communities and other communities of color, it is important that we are at the helm with updates and information from reliable top officials and organizations about how the coronavirus is impacting communities of color across the nation,” said Dr. Benjamin F. Chavis, Jr, president and CEO, NNPA.

The task force sends out periodic national COVID-19 alerts to all in the NNPA database, and establishes ongoing coordination between the NNPA and the National Medical Association (NMA), National Black Nurses Association (NBNA), and medical schools at HBCUs to collaborate on best practices and other vital information to assist Black America throughout the pandemic.

Daily briefings of the pandemic and original and pertinent content about COVID-19 would be published at www.BlackPressUSA.com. For more information about COVID-19 from the American Heart Association, visit Heart.org.

About the National Newspaper Publishers Association

The NNPA is the national trade association for 225 African American owned newspapers and media organizations in 40 states, including the District of Columbia. The NNPA in 2020 is celebrating its 80th anniversary, and 193 years of the Black Press and its first publication of the Freedom’s Journal in 1827. Today, concluded by a Nielsen study, Black-owned newspapers are the most trusted source of news and information for 50 million African Americans. The NNPA newswire, BlackPressUSA.com, daily curates African American news, entertainment, sports, education and public policy matters in all the U.S. major media markets.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.