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Symone Sanders, a senior adviser to Biden's campaign, stressed to CNN's Jake Tapper on "State of the Union" Sunday morning that the former vice president's campaign has adhered to guidelines from the US Centers for Disease Control and Prevention since the onset of the pandemic earlier this year.

"We are adhering to CDC guidance, we are listening to the public health experts and we are taking every single precaution. Our staff are wearing masks and are social distancing everywhere -- on planes, in cars, inside events, outside events," Sanders said. "We're wearing the masks that are keeping us safe."

"I think that tells you a lot of what you need to know about how the Trump campaign has treated this from the outset," Bedingfield said.

"If I'm going to be spending time with the President or other team members, first of all we're tested beforehand. There's about a full hour space from the time that we're tested until we make sure that we're in the clear," Miller said. "We keep distance from the President at all times. The closest I ever get to the President is about eight feet, maybe six feet -- usually pretty solid distance back. A lot of times it's more like ten feet."

And we make sure that anyone has their temperature checked. People are washing hands, they're using hand sanitizer."

"What I can't speak to since I'm not part of White House operations, I'm not part of the White House medical unit, is the exact -- how much time he was spending with Hope and the proximity for these things. I can't speak to that.

The letter cited a 2019 memo from the police chief of the time that exhorted officers to “avoid wearing noncompliant garments that could prejudice the decorum of the institution.”

“It’s not a prejudice against the color,” he added, but rather a question of decorum.

Italians took to social media to joke about Pink Panthers, gift horses and fragile masculinity.

The office of the commissioner for the coronavirus emergency, which supplies and distributes medical and personal protection devices, declined to comment.

“I hope that after we raised our concerns there will be an attempt to distribute more sober colors,” Mr. Paoloni said.

Teresa Bellanova, the deputy infrastructure minister, said on Twitter that she saw nothing wrong with having officers wearing colored masks. “The respect for uniforms is not given by colors,” she said, “but by how the men and women who wear those uniforms behave and work.”

"It's unacceptable that we're sending medical professionals like lambs to the slaughterhouse without giving anything to protect themselves," said Dr. Marianne Hamra, who works in New Jersey. "Bandanas and scarves? C'mon CDC -- that's completely ridiculous."

Meanwhile, New York has now topped Washington state as the new epicenter of coronavirus cases with at least 20,875 infected, according to CNN's tally of cases.

In New Jersey, 35 physicians and nurses are no longer working at Holy Name Medical Center because they are either have or are suspected of having Covid-19.

"I'm very concerned that if things don't slow down, if the supply chains do not open up, if we don't figure out a way to get the nurses in here from the federal government (and) from the military," he said. "I feel in a week or so from now I may not be able to feel the same way."

A nurse in western Ohio said that, save for one specific unit where Covid-19 patients are supposed to be sent, nurses at the medical center are forbidden from wearing masks -- not just N95 masks, but surgical masks or any masks.

"I don't want to bring anything home to my kids," she said. "I'm a single mom. I signed up to be a frontline worker, but I don't have the equipment to do it."

Milla Kviatkovsky, a hospitalist physician in San Diego, helped launch a petition on Change.org called "US Physicians/Healthcare Workers For Personal Protective Equipment in Covid-19 Pandemic."

Many physicians, she said, worry about the ethical implications of institutions saying it's ok to perform procedures without protective gear when it's never been ok before.

"Are we doing more harm than good by going in there with no equipment and potentially spreading this to so many other people?" she said in an interview with CNN. "Are we taking out the front lines to our defense when we're so early on in the equivalent of a health care war right now?"

China’s vast manufacturing machine has moved into overdrive to supply the country and the world with masks, testing kits, respirators and other gear to fight the global coronavirus pandemic.

Companies big and small that once manufactured other items are now in the business of making anti-coronavirus gear — and regulators in China are struggling to enforce standards while encouraging the flow.

Spanish health officials said they bought the tests from an unnamed third-party distributor but argued that they did not need to wait for a certified list from China

Still, the news was unwelcome for Spaniards who have waited for several days for their government’s promised rollout of hundreds of thousands of tests to help track the spread of the virus

In a statement on social media, Bioeasy said that Spanish officials did not understand how to conduct the test and that it made videos and issued instructions to help them

As it has in other industries, from cars to electronics, China has become essential to the medical supply business and has challenged outdated notions that it primarily makes cheap, shoddy goods. Even before the coronavirus struck it made roughly half the world’s protective masks and has become a major force in the manufacturing of day-to-day medical gear.

But even as it encourages production, the Chinese government has also had to step up enforcement efforts to stop defective and uncertified products

The problem isn’t confined to China.

In the United States, an initial coronavirus test kit rolled out by government officials contained a faulty indicator

Regulators have shut down tens of thousands of shops making fake masks,

Earlier this month, Chinese regulators vowed to step up cooperation with local law enforcement to stamp out counterfeits and shoddy goods

At the same time, local officials have worked to streamline the certification process to bring new capacity and new devices online.

the coronavirus more often infects clusters of family members, friends and work colleagues,

“You can contain clusters,” Dr. Heymann said. “You need to identify and stop discrete outbreaks, and then do rigorous contact tracing.”

The microphone should not even be at the White House, scientists said, so that briefings of historic importance do not dissolve into angry, politically charged exchanges with the press corps, as happened again on Friday.

Americans must be persuaded to stay home, they said, and a system put in place to isolate the infected and care for them outside the home

Travel restrictions should be extended, they said; productions of masks and ventilators must be accelerated, and testing problems must be resolved.

It was not at all clear that a nation so fundamentally committed to individual liberty and distrustful of government could learn to adapt to many of these measures, especially those that smack of state compulsion.

What follows are the recommendations offered by the experts interviewed by The Times.

they were united in the opinion that politicians must step aside and let scientists both lead the effort to contain the virus and explain to Americans what must be done.

medical experts should be at the microphone now to explain complex ideas like epidemic curves, social distancing and off-label use of drugs.

doing so takes intelligent, rapidly adaptive work by health officials, and near-total cooperation from the populace. Containment becomes realistic only when Americans realize that working together is the only way to protect themselves and their loved ones.

Above all, the experts said, briefings should focus on saving lives and making sure that average wage earners survive the coming hard times — not on the stock market, the tourism industry or the president’s health.

“At this point in the emergency, there’s little merit in spending time on what we should have done or who’s at fault,”

The next priority, experts said, is extreme social distancing.If it were possible to wave a magic wand and make all Americans freeze in place for 14 days while sitting six feet apart, epidemiologists say, the whole epidemic would sputter to a halt.

The virus would die out on every contaminated surface and, because almost everyone shows symptoms within two weeks, it would be evident who was infected. If we had enough tests for every American, even the completely asymptomatic cases could be found and isolated.

The crisis would be over.

Obviously, there is no magic wand, and no 300 million tests. But the goal of lockdowns and social distancing is to approximate such a total freeze.

In contrast to the halting steps taken here, China shut down Wuhan — the epicenter of the nation’s outbreak — and restricted movement in much of the country on Jan. 23, when the country had a mere 500 cases and 17 deaths.Its rapid action had an important effect: With the virus mostly isolated in one province, the rest of China was able to save Wuhan.

Even as many cities fought their own smaller outbreaks, they sent 40,000 medical workers into Wuhan, roughly doubling its medical force.

Stop transmission within cities

the weaker the freeze, the more people die in overburdened hospitals — and the longer it ultimately takes for the economy to restart.

People in lockdown adapt. In Wuhan, apartment complexes submit group orders for food, medicine, diapers and other essentials. Shipments are assembled at grocery warehouses or government pantries and dropped off. In Italy, trapped neighbors serenade one another.

Each day’s delay in stopping human contact, experts said, creates more hot spots, none of which can be identified until about a week later, when the people infected there start falling ill.

South Korea avoided locking down any city, but only by moving early and with extraordinary speed. In January, the country had four companies making tests, and as of March 9 had tested 210,000 citizens — the equivalent of testing 2.3 million Americans.

As of the same date, fewer than 9,000 Americans had been tested.

Fix the testing mess

Testing must be done in a coordinated and safe way, experts said. The seriously ill must go first, and the testers must be protected.In China, those seeking a test must describe their symptoms on a telemedicine website. If a nurse decides a test is warranted, they are directed to one of dozens of “fever clinics” set up far from all other patients.

Isolate the infected

As soon as possible, experts said, the United States must develop an alternative to the practice of isolating infected people at home, as it endangers families. In China, 75 to 80 percent of all transmission occurred in family clusters.

Cellphone videos from China show police officers knocking on doors and taking temperatures. In some, people who resist are dragged away by force. The city of Ningbo offered bounties of $1,400 to anyone who turned in a coronavirus sufferer.

In China, said Dr. Bruce Aylward, leader of the World Health Organization’s observer team there, people originally resisted leaving home or seeing their children go into isolation centers with no visiting rights — just as Americans no doubt would.

In China, they came to accept it.“They realized they were keeping their families safe,” he said. “Also, isolation is really lonely. It’s psychologically difficult. Here, they were all together with other people in the same boat. They supported each other.”

Find the fevers

Make masks ubiquitous

In China, having a fever means a mandatory trip to a fever clinic to check for coronavirus. In the Wuhan area, different cities took different approaches.

In most cities in affected Asian countries, it is commonplace before entering any bus, train or subway station, office building, theater or even a restaurant to get a temperature check. Washing your hands in chlorinated water is often also required.

The city of Qianjiang, by contrast, offered the same amount of money to any resident who came in voluntarily and tested positive

Voluntary approaches, like explaining to patients that they will be keeping family and friends safe, are more likely to work in the West, she added.

Trace the contacts

Finding and testing all the contacts of every positive case is essential, experts said. At the peak of its epidemic, Wuhan had 18,000 people tracking down individuals who had come in contact with the infected.

Dr. Borio suggested that young Americans could use their social networks to “do their own contact tracing.” Social media also is used in Asia, but in different ways

When he lectured at a Singapore university, Dr. Heymann said, dozens of students were in the room. But just before he began class, they were photographed to record where everyone sat.

Instead of a policy that advises the infected to remain at home, as the Centers for Disease and Prevention now does, experts said cities should establish facilities where the mildly and moderately ill can recuperate under the care and observation of nurses.

There is very little data showing that flat surgical masks protect healthy individuals from disease. Nonetheless, Asian countries generally make it mandatory that people wear them.

The Asian approach is less about data than it is about crowd psychology, experts explained.All experts agree that the sick must wear masks to keep in their coughs. But if a mask indicates that the wearer is sick, many people will be reluctant to wear one. If everyone is required to wear masks, the sick automatically have one on and there is no stigma attached.

Also, experts emphasized, Americans should be taught to take seriously admonitions to stop shaking hands and hugging

Preserve vital services

Only the federal government can enforce interstate commerce laws to ensure that food, water, electricity, gas, phone lines and other basic needs keep flowing across state lines to cities and suburbs

“I sense that most people — and certainly those in business — get it. They would prefer to take the bitter medicine at once and contain outbreaks as they start rather than gamble with uncertainty.”

Produce ventilators and oxygen

The manufacturers, including a dozen in the United States, say there is no easy way to ramp up production quickly. But it is possible other manufacturers, including aerospace and automobile companies, could be enlisted to do so.

Canadian nurses are disseminating a 2006 paper describing how one ventilator can be modified to treat four patients simultaneously. Inventors have proposed combining C-PAP machines, which many apnea sufferers own, and oxygen tanks to improvise a ventilator.

One of the lessons of China, he noted, was that many Covid-19 patients who would normally have been intubated and on ventilators managed to survive with oxygen alone.

Retrofit hospitals

In Wuhan, the Chinese government famously built two new hospitals in two weeks. All other hospitals were divided: 48 were designated to handle 10,000 serious or critical coronavirus patients, while others were restricted to handling emergencies like heart attacks and births.

Wherever that was impractical, hospitals were divided into “clean” and “dirty” zones, and the medical teams did not cross over. Walls to isolate whole wards were built

Decide when to close schools

Recruit volunteers

China’s effort succeeded, experts said, in part because of hundreds of thousands of volunteers. The government declared a “people’s war” and rolled out a “Fight On, Wuhan! Fight On, China!” campaign.

Many people idled by the lockdowns stepped up to act as fever checkers, contact tracers, hospital construction workers, food deliverers, even babysitters for the children of first responders, or as crematory workers.

“In my experience, success is dependent on how much the public is informed and participates,” Admiral Ziemer said. “This truly is an ‘all hands on deck’ situation.”

Prioritize the treatments

Clinicians in China, Italy and France have thrown virtually everything they had in hospital pharmacies into the fight, and at least two possibilities have emerged that might save patients: the anti-malaria drugs chloroquine and hydroxychloroquine, and the antiviral remdesivir, which has no licensed use.

An alternative is to harvest protective antibodies from the blood of people who have survived the illness,

The purified blood serum — called immunoglobulin — could possibly be used in small amounts to protect emergency medical workers, too.

“Unfortunately, the first wave won’t benefit from this,” Dr. Hotez said. “We need to wait until we have enough survivors.”Find a vaccine

testing those candidate vaccines for safety and effectiveness takes time.

The roadblock, vaccine experts explained, is not bureaucratic. It is that the human immune system takes weeks to produce antibodies, and some dangerous side effects can take weeks to appear.

After extensive animal testing, vaccines are normally given to about 50 healthy human volunteers to see if they cause any unexpected side effects and to measure what dose produces enough antibodies to be considered protective.

If that goes well, the trial enrolls hundreds or thousands of volunteers in an area where the virus is circulating. Half get the vaccine, the rest do not — and the investigators wait. If the vaccinated half do not get the disease, the green light for production is finally given.

In the past, some experimental vaccines have produced serious side effects, like Guillain-Barre syndrome, which can paralyze and kill. A greater danger, experts said, is that some experimental vaccines, paradoxically, cause “immune enhancement,” meaning they make it more likely, not less, that recipients will get a disease. That would be a disaster.

One candidate coronavirus vaccine Dr. Hotez invented 10 years ago in the wake of SARS, he said, had to be abandoned when it appeared to make mice more likely to die from pneumonia when they were experimentally infected with the virus.

Reach out to other nations

“Particularly to his supporters, the behavioral choices he makes carry far more weight than virtually anything else,” Jeremy Konyndyk, a senior fellow at the Center for Global Development, told me. Konyndyk added that even if Trump and those around him benefit from special testing, “what’s seen” by Americans is, “don’t wear a mask.”

“The big question now is should the Biden campaign be given access to these same tests, which would allow him to also begin to travel, meet with staff and stay competitive with the GOP ticket?” Democratic strategist Simon Rosenberg told me.

There are quite a few problems with Cruz’s comments. For starters, CDC guidelines recommend that people who’ve been vaccinated should still wear masks and practice social distancing when in public.

“For now, fully vaccinated people should continue to [...] take precautions in public like wearing a well-fitted mask and physical distancing,” reads a March 8 post on the CDC website.

The new CDC guidance says fully vaccinated people can:Read MoreVisit other vaccinated people indoors without masks or physical distancingVisit indoors with unvaccinated people from a single household without masks or physical distancing, if the unvaccinated people are at low risk for severe disease.

Skip quarantine and testing if exposed to someone who has Covid-19 but are asymptomatic, but should monitor for symptoms for 14 daysThis means that vaccinated grandparents may finally feel comfortable visiting their unvaccinated grandchildren and giving them a big hug, especially if they're local -- the CDC still says people should avoid travel -- and as long as none of the unvaccinated people in that household are at risk for severe Covid-19.

However, people who are fully vaccinated still need to take precautions in many scenarios. The guidelines say fully vaccinated people must:Wear a mask and keep good physical distance around the unvaccinated who are at increased risk for severe Covid-19, or if the unvaccinated person has a household member who is at higher riskWear masks and physically distance when visiting unvaccinated people who are from multiple households.

If fully vaccinated people live in a non-health care congregate setting, such as a group home or detention facility, they should quarantine for 14 days and get tested if exposed to someone with a suspected or confirmed Covid-19 case.The guidelines say that the risk of infection in social activities like going to the gym or restaurant is lower for the fully vaccinated. However, people should still take precautions, as transmission risk in these settings is higher and increases the more unvaccinated people are involved. So wear that mask on the treadmill, and if dining out, keep it on while waiting for your meal

Walensky said CDC travel guidelines will remain the same for the vaccinated until there is more data about how much or how little vaccinated people can transmit the virus to others. She added that a "larger swath" of the population will also need to be vaccinated before it's really safe. About 90% of the country is still not vaccinated, Walensky said. Travel brings too much exposure to crowds and the spread of variants is also a real concern.

"We are here in no small measure because of the safety protection that many, many Americans have taken with regard to their family, friends and neighbors," Zients said. "We ask people to continue to do that so we can get there, as quickly and as permanently as possible."There are now 30 million people in the United States who are fully vaccinated, but the United States still averaged more than 60,000 cases per day over the last seven days, according to Johns Hopkins University.

"We continue to have high levels of virus around the country, and more readily transmissible variants have now been confirmed in nearly every state, while we work to quickly vaccinate people more and more each day, we have to see this through," Walensky said Monday. "Let's stick together. Please keep wearing a well fitting mask and taking the other public health actions we know work to help stop the spread of this virus."

It’s not uncommon for a vaccine to forestall severe disease but not infection. Inoculations against the flu, rotavirus, polio and pertussis are all imperfect in this way.

The research available so far on how well the vaccines prevent transmission is preliminary but promising. “We feel confident that there’s a reduction,” said Natalie Dean, a biostatistician at the University of Florida. “We don’t know the exact magnitude, but it’s not 100 percent.”

a study in Scotland conducted tests every two weeks, regardless of symptoms, on health care workers who had received the Pfizer-BioNTech vaccine. Investigators found that the vaccine’s effectiveness in preventing infection was 70 percent after one dose, and 85 percent after the second.

“If the case numbers are zero, it doesn’t matter whether it’s 70 percent or 100 percent,” said Zoe McLaren, a health policy expert at the University of Maryland, Baltimore County, referring to vaccine effectiveness.

Mask-wearing policies also will depend on how many unvaccinated people remain in the population

“Are you wearing a mask to protect yourself from severe Covid, or are you wearing a mask for public health?” Dr. Klein said. “It’s right to do your part in the community beyond yourself.”

"I think it's a great milestone, a great day," Biden said. "It's been made possible by the extraordinary success we've had in vaccinating so many Americans so quickly."

Unvaccinated people "remain at risk" of illness and death,

The CDC says masks may still be required by state, local, tribal or territorial laws as well as businesses and workplaces. But some local jurisdictions swiftly announced they would update their own regulations to conform with the CDC guidance, and more are expected to follow.

Walensky noted that the Pfizer, Moderna and Johnson & Johnson vaccines are all 100% effective in preventing hospitalizations and deaths from COVID-19, even if they don't prevent 100% of coronavirus infections. They are also effective agains

"We have been doing this for 15 months at this point and not everybody's going to want to shed their masks immediately," she said. "It's going to take us a little bit of time to readjust."

For example, Atlas misrepresented the effectiveness of masks, suggested that lockdowns kill people and discouraged testing of asymptomatic people.

He also dismissed forecasts from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine that forecasts 399,000 coronavirus deaths in the US by February 1 under current conditions.

In October, Twitter removed a tweet from Atlas that sought to undermine the importance of wearing a face mask, because Atlas' tweet was in violation of the its Covid-19 Misleading Information Policy, a spokesman for the company told CNN. The tweet said, "Masks work? NO" followed by a series of falsehoods about the science behind the effectiveness of masks in combating the pandemic.

“Ultimately, masculinity still matters, we’ve learned. It’s how candidates still try to prove they are the best candidate,” said Ms. Cooper. “And so, even in 2020, Democrats decided the safest bet to beat a white man in his 70s is another white man in his 70s.”

He has said he believes men who change diapers are “acting like the wife.” “Macho Man” is the song that plays at his rallies, even after the Village People objected. “He seeks to distinguish himself as the manliest — and thus, in his mind, the most-qualified — person to be president,” said Kelly Dittmar, a scholar at the Center for American Women and Politics at Rutgers University.

On the other end of the spectrum, or perhaps somewhere in the middle, is Mr. Biden, a “Dad-like” figure, as the philosopher Kate Manne put it, who has vowed to be America’s protector through a dark period, with some combination of strength, empathy and compassion.

“He’s offering a more paternalistic type of masculinity, in that you can be a strong leader, but still be compassionate and empathetic,” said Marianne Cooper, a sociologist at Stanford University who studies gender and work.

On the one extreme is President Trump, who leaves little subtlety in his approach: Bragging about his sexual prowess, along with the size of his nuclear button, proclaiming “domination” over coronavirus and mocking his opponent for the size of his mask (“the biggest mask I’ve ever seen”), as if mask-wearing is somehow weak.

From Richard Nixon to Ronald Reagan and right on through Mr. Trump, largely white, Christian, heterosexual presidential candidates have “performed” manhood in all sorts of ways: Donning hard hats and posing inside military tanks; battling over who would be the better guy to have a beer with; and implying their opponents were soft, weak, or “sleepy.”

“Michael Dukakis had a 17-point lead over Bush in the summer of 1988,” said Mr. Katz, whose book on presidential masculinity has been adapted into a documentary called “The Man Card.” “So what did they do? They relentlessly attacked his manhood. They suggested he was a failed protector, that he was ‘soft,’ that he wasn’t a ‘real man.’”

“I think the performance of masculinity means a lot,” he noted, “because it has the potential to eclipse all else.”

Girls receive a message that they “become” women — typically through a biological event like menstruation — while men are told throughout their lives to “be” men or to “man up,” as if masculinity is something that can be easily lost.“You don’t really say ‘be a woman’ the way you say ‘be a man’ or ‘man up,’” she said.Image

“Trump is the personification of this masculinity contest culture,” Ms. Cooper said. “It’s bad for organizations, it’s terrible for a country.”

Maybe women were always the intended audience for the contests. Whether that’s true, they seem to be ready to render a clear judgment. Mr. Biden is leading among women by as much as 20 points.

the fact that airplanes help spread disease across geographies does not mean that you are necessarily at risk during flight.

Airplanes also use the same air filter — a HEPA filter — recommended by the CDC for isolation rooms with recirculated air. Such filters capture 99.97 percent of airborne particles.

Consider one study that examined a passenger with tuberculosis on an airplane. It found that the median risk of infection to the other 169 passengers on the airplane was between 1 in 10,000 to 1 in a million.

Wearing a mask, as some airlines now require, reduced the incidence of infection another 10-fold.

The required aircraft systems do a really good job of controlling airborne bacteria and viruses.

To get technical, airplanes deliver 10 to 12 air changes per hour. In a hospital isolation room, the minimum target is six air changes per hour for existing facilities and 12 air changes per hour for new.

If planes made you sick, we would expect to see millions of people sick every year attributable to flights. We haven’t seen it because it’s just not happening.

What’s more, airplanes are essentially designed to isolate airflow. Even if someone coughs on your flight without a mask, it is likely those virus particles will travel one or two rows,

To guard against transmission via large droplets and contaminated surfaces, we do need to take some additional steps. Wearing a mask on planes should be mandated, and wiping down tables and arm rests with a disinfectant provides an additional layer of defense.

you are more at risk of getting sick when traveling, but it’s not the airplane that’s making you sick.

Every time you fly, you may also take a cab, bus or subway; stand in long lines in the airport; eat unhealthy foods; sit for extended durations; spend time in spaces with hundreds or thousands of other travelers; stay at a hotel or friend’s home; arrive in a different climate and change time zones, disrupting your sleep. All of these factors are known to affect your immune system.

In 2013, I was one of the lead authors of a report for the Transportation Research Board of the National Academies on infectious disease mitigation in airports and airplanes. Let me distill some of the recommendations from that report

For starters, airports should mandate mask wearing; increase ventilation rates; make bathrooms touchless; consider deploying upper-room germicidal UV fixtures in areas with high-occupant density; institute temperature screening; deploy hand-sanitizer stations; and, once passengers arrive at their gates, require that they stay in their designated area except for bathroom usage.

Airlines should ensure gate-based ventilation is operating during boarding and disembarkation; carefully choreograph the loading of airplanes; mandate mask use; and provide meals and bottled water during boarding and discontinue in-flight meal and drink service.

Individuals have an important role to play, too. First, stay home and do not travel if sick. Comply with rules for mask wearing; wash hands before and after each step at the airport; keep the personal overhead ventilation on and pointed down; and maintain physical distancing to the extent possible.

“It doesn’t have to do with UV light, it has to do with dilution,” she told TPM, a subtle poke at President Trump. “What it appears with this virus is that though it’s highly contagious, to get a good infectious process going, you need to start with a substantive amount. Dilution disperses viral particles present in the physical area.”

That level of dispersion just doesn’t happen inside, she said, especially during the summer when air conditioners are recirculating the same air. 

Wen added that mask-wearing can reduce the risk of transmission “five-fold.”

“This should help to inform people even more about big decisions they can make in their own lives, to be doing as much as they can outdoors vs. indoors,”

The nationwide lack of spikes also speaks to the uniformity with which protesters donned masks at the demonstrations, per Hassig.

“It takes engagement with mask-wearing somewhere above 70 percent, at least 60, to really dampen down transmission,”

If the data holds, though, she pointed out how this knowledge could play into how people live their lives while the pandemic still lingers.

The problem with masks, Hassig said, is the psychological element. She called it a “normative behavior” much like littering. It’s hard to be the first person to drop a wrapper on the ground; it’s much less hard to do so if the pavement is already dotted with trash. That dynamic, she said, can go both ways — people are apt to feel uncomfortable if they’re the odd one out in a group either mostly wearing masks or mostly not. 

"We're in the middle of this fourth industrial revolution," he noted. With all the changes in technology, he said, Americans are wondering, "Will there be a middle class? What will people be doing? ... There's genuine, genuine anxiety."

Biden's interview -- his first since the election that also included Harris -- underscored a complete course correction from Trump's attitude towards the virus.

There is a question, however, whether Biden's calls for national unity will resonate among people who didn't vote for him after Trump's relentless attacks on the legitimacy of his victory in the presidential election.

Biden's call to action may carry greater urgency now that the virus is taking hold in rural areas of the heartland with comparatively rudimentary health care systems, which escaped the first wave of infection that concentrated in many cities that tend to vote for Democrats.

Biden will take office amid the most extreme domestic circumstances of any president since Roosevelt, with sickness and death rampant and millions of Americans unemployed, hungry or at risk of losing their homes.

"I asked him to stay on the exact same role he's had for the past several presidents, and I asked him to be a chief medical adviser for me as well, and be part of the Covid team," Biden told Tapper

Trump has frequently mocked the wearing of masks. He is holding holiday parties inside the White House in defiance of his own government's health recommendations.

it is conceivable that one of Biden's first acts after delivering his inaugural address in 47 days will be to put his mask back on.

Biden said in the interview he had asked Dr. Anthony Fauci, who Trump has marginalized and insulted, to continue his current role as the nation's top infectious diseases specialist in Biden's administration and announced an effective promotion for the globally respected expert. Fauci told NBC on Friday that he immediately accepted.

More than 276,000 people have now died from coronavirus in the United States and the nation set a new record for hospitalizations on Thursday with more than 100,667 people being treated for Covid-19.

Biden emphasized that he and Fauci spoke about the fact that "you don't have to close down the economy" if Americans are following through with other safety protocols to prevent the spread of the virus.

"When Dr. Fauci says we have a vaccine that is safe, that's the moment in which I will stand before the public and say that," Biden said. People have lost faith in the ability of the vaccine to work

The President-elect said it is already clear to him from his conversations with governors across the country, as well as 50 Democratic and Republican mayors, that they will need a significant amount of money to get the vaccine where it needs to go.

"It's going to cost literally billions of dollars to get this done. We can keep schools open. We can keep businesses open. But you have to be able to get the vaccine distributed."

The President-elect noted that the Trump administration has been "cooperating with us of late" and looping them in on the plans for how they are going to deliver on the vaccine, but he said, "There's not any help getting out there."

Come Christmas time, there's going to be millions of people see their unemployment run out. So, there's a whole range of things that have to be done."

What's immediately needed is relief for people in their unemployment checks; relief for people who are going to get thrown out of their apartments after Christmas because they can't afford to pay the rent anymore; relief on mortgage payments; relief on all the things that are in the original bill the House passed," Biden said. "People are really hurting. They're scared to death."

"President-elect Biden, and his leadership and listening to scientists, believe that if we all wore our masks for 100 days, we would have a significant reduction in the transmission of the virus," said Rick Bright, a former Trump administration vaccine expert who resigned after warning the administration ignored warnings about the early spread of Covid-19.

Since the first day Biden asked her to join him on the ticket, she said he has been "very clear with me that he wants me to be the first and the last in the room" on major decisions

Biden told Tapper that his Justice Department will operate independently, and that he would not direct them on how or who to investigate: "I'm not going to be saying go prosecute A, B or C -- I'm not going to be telling them," Biden said. "That's not the role, it's not my Justice Department it's the people's Justice Department."

He said he planned to enlist Harris on whatever the most urgent need was at a given moment, much as he did for President Barack Obama as vice president.

"Whatever the most urgent need is that I'm not able to attend to, I have confidence in turning to her," Biden said, noting that was dissimilar from former Vice President Al Gore's approach, which was to handle an entire issue portfolio like the environment. "Look, there's not a single decision I've made yet about personnel or about how to proceed that I haven't discussed it with Kamala first."

I don’t know, somehow sitting in the Oval Office behind that beautiful Resolute Desk, the great Resolute Desk. I think wearing a face mask as I greet presidents,

if everybody wears a mask, everything disappears.”

I don’t agree with the statement that

Tonight, as an example, everybody’s had a test, and you’ve had social distancing and all of the things that you have to.

He could be speaking 200 feet away from them, and he shows up with the biggest mask I’ve ever seen.

we have it under control. It’s going to be just fine.”

nd those people are all recuperating successfully.”

The Coronavirus is very much under control in the USA. We are in contact with everyone and all relevant countries.

Many individuals who get coronavirus will experience nothing worse than seasonal flu symptoms, but the overall profile of the disease, including its mortality rate, looks more serious. At the start of an outbreak the apparent mortality rate can be an overestimate if a lot of mild cases are being missed. But Bruce Aylward, a WHO expert, who led an international mission to China to learn about the virus and the country’s response, said this has not been the case with Covid-19. The evidence did not suggest that we were only seeing the tip of the iceberg. If borne out by further testing, this could mean that current estimates of a roughly 1% fatality rate are accurate. This would make Covid-19 about 10 times more deadly than seasonal flu, which is estimated to kill between 290,000 and 650,000 people a year globally.

For flu, some hospital guidelines define exposure as being within six feet of an infected person who sneezes or coughs for 10 minutes or longer. However, it is possible to be infected with shorter interactions or even by picking the virus up from contaminated surfaces, although this is thought to be a less common route of transmission.

Scientists were quick out of the gates in beginning development of a vaccine for the new coronavirus, helped by the early release of the genetic sequence by Chinese researchers. The development of a viable vaccine continues apace, with several teams now testing candidates in animal experiments. However, the incremental trials required before a commercial vaccine could be rolled out are still a lengthy undertaking – and an essential one to ensure that even rare side-effects are spotted. A commercially available vaccine within a year would be quick.’

Patients were streaming in nonstop, she said, coughing and sweating, with fevers and "fear in their eyes." The nurse wrote that she cried in the bathroom during her break, peeling off the PPE that left indentations in her face.

The nurse, who said she works in a Covid-19 triage area, said the previous night was "so far the worst I have seen."

'I cried the entire ride home'

"What's very devastating for me is some people we know will not survive," he said, "and since they're not allowed to have visitors, I may be the last face they see and voice they hear ever as I put them to sleep (general anesthesia) prior to being on a ventilator.

Deburghgraeve shared a video with CNN of him donning his PPE, putting on gloves, a protective gown, a face mask and then another mask that looks like a space helmet.

Dr. Cory Deburghgraeve, an anesthesiologist at the University of Illinois in Chicago, said he's working 94 hours this week. He's the designated "airway anesthesiologist" giving coronavirus patients breathing tubes in a procedure called intubation.

A physician assistant working in an emergency room in Queens, New York, told CNN there was an "every man for themselves" mentality when it came to the PPE at the hospital.

"You have people out on the streets that have masks and meanwhile the hospitals are all running out of masks," said the physician assistant, who CNN is not naming because they feared repercussions for speaking to the media.

The physician assistant said they were told they would have to make their N95 mask last for five days. The PPE is being prioritized, the physician assistant said, for staff working with intubated patients, who are most at risk of infection.

"There's patients everywhere," the physician assistant said

An emergency room physician at a hospital in the New York borough of Queens said doctors and nurses must deal with cramped spaces.

"Stretchers are packed in metal-to-metal, stacked three deep head to toe, with no space ... to walk to patients," the physician said. "When patients deteriorate, you hope you see them from across the room and hope you can move enough stretchers out of the way to get that person to a critical care area."

"I don't have the support that I need, and even just the materials that I need physically to take care of my patients," Smith said. "And it's America and we're supposed to be a first-world country."

Security concerns, moreover, keep most information about stockpile purchases under wraps. Details about the contracts and inventory are rarely made public, and even the storage locations are secret.

Former Emergent employees, government contractors, members of Congress, biodefense experts and current and former officials from agencies that oversee the stockpile described a deeply dysfunctional system that contributed to the shocking shortages last year.

Purchases are supposed to be based on careful assessments by government officials of how best to save lives, but many have also been influenced by Emergent’s bottom line

The stockpile has long been the company’s biggest and most reliable customer for its anthrax vaccines, which expire and need to be replaced every few years.

In the two decades since the repository was created, Emergent’s aggressive tactics, broad political connections and penchant for undercutting competitors have given it remarkable sway over the government’s purchasing decisions related to the vaccines

While national security officials still consider anthrax a threat, it has not received specific mention since 2012 in the intelligence community’s annual public assessment of dangers facing the country, a report that has repeatedly warned of pandemics.

Emergent bought the license for the country’s only approved anthrax vaccine in 1998 from the State of Michigan. Over time, the price per dose the government agreed to pay Emergent increased nearly sixfold, accounting for inflation, contributing to record revenues last year that topped $1.5 billion

The company, whose board is stocked with former federal officials, has deployed a lobbying budget more typical of some big pharmaceutical companies

Competing efforts to develop a better and cheaper anthrax vaccine, for example, collapsed after Emergent outmaneuvered its rivals, the documents and interviews show.

preparations for an outbreak like Covid-19 almost always took a back seat to Emergent’s anthrax vaccines

the government approved a plan in 2015 to buy tens of millions of N95 respirators — lifesaving equipment for medical workers that has been in short supply because of Covid-19 — but the masks repeatedly lost out in the competition for funding over the years leading up to the pandemic

After Dr. Frieden and others in the Obama administration tried but failed to lessen Emergent’s dominance over stockpile purchases, the company’s fortunes rose under Mr. Trump, who appointed a former Emergent consultant with a background in bioterrorism to run the office that now oversees the stockpile

“If I could spend less on anthrax replenishment, I could buy more N95s,” Dr. Kadlec said in an interview shortly after leaving office. “I could buy more ventilators. I could buy more of other things that quite frankly I didn’t have the money to buy.”

And now, as some members of Congress push for larger reserves of ventilators, masks and other equipment needed in a pandemic, a trade group led in part by a top Emergent lobbyist has warned that the purchases could endanger companies focused on threats like anthrax and smallpox by drawing down limited funds.

Last year, as the pandemic raced across the country, the government paid Emergent $626 million for products that included vaccines to fight an entirely different threat: a terrorist attack using anthrax.

“I think it’s pretty clear that the benefit of the vaccine is marginal,” he said in an interview

“They’re very vicious in their behavior toward anybody they perceive as having a different point of view,” said Dr. Tara O’Toole, a former Homeland Security official who says she ran afoul of Emergent in 2010 after telling Congress that the nation needed a newer and better anthrax vaccine.

That year, the company that would become Emergent — then known as BioPort — paid Michigan $25 million to buy the license for a government-developed anthrax vaccine and an aging manufacturing plant.

The company opened its doors with one product, called BioThrax, and one customer, the Defense Department, which required the vaccine for service members.

Emergent’s anthrax vaccine was not the government’s first choice. It was more than 30 years old and plagued by manufacturing challenges and complaints about side effects. Officials instead backed a company named VaxGen, which was developing a vaccine using newer technology licensed from the military.

Emergent’s successful campaign against VaxGen — deploying a battalion of lobbyists, publicly attacking its rival and warning that it might cease production of its own vaccine if the government didn’t buy it — established its formidable reputation. By 2006, VaxGen had lost its contract and the government had turned to Emergent to supply BioThrax.

“They were totally feared by everybody,” Dr. Philip Russell, a top health official in the administration of President George W. Bush, said in an interview. He said that he clashed with Emergent when he backed VaxGen, and that his reputation came under attack, which was documented by The Times in 2006. (Dr. Russell died this January.)

the group of federal officials who make decisions about the stockpile and other emergency preparations — known as the Phemce, for the Public Health Emergency Medical Countermeasures Enterprise — ordered up a study. It found in 2010 that the government could not afford to devote so much of its budget to a single threat.

Instead, the review concluded, the government should invest more in products with multiple applications, like diagnostic tests, ventilators, reusable respirator masks and “plug and play” platforms that can rapidly develop vaccines for a range of outbreaks.

from 2010 through 2018, the anthrax vaccine consumed more than 40 percent of the stockpile’s budget, which averaged $560 million during those years.

Emergent and the government have withheld details of the stockpile contracts, including how much the company has charged for each dose of BioThrax, but executives have shared some of the missing information with investors.

The company in 1998 agreed to charge the government an average of about $3.35 per dose, documents show. By 2010, the price had risen to about $28, according to financial disclosures and statements by Emergent executives, and now it is about $30

Over the past 15 years, the company recorded a gross profit margin of about 75 percent for the vaccine, in an arrangement that one Emergent vice president called a “monopoly.”

Emergent’s rise is the stuff of lore in biodefense circles — a tale of savvy dealings, fortuitous timing and tough, competitive tactics.

One afternoon in October 2010, Wall Street investors gathered at the Millennium Broadway Hotel in Manhattan for a presentation by Mr. Burrows. He shared with them a secret number: 75 million.That was how many BioThrax doses the government had committed to stockpiling, and it was the backbone of Emergent’s thriving business. In pursuit of that goal, the government had already spent more than $900 million, and it continued to buy virtually every dose Emergent could produce. It had even awarded the company more than $100 million to expand its Michigan factory.

“The best approach toward anthrax is antimicrobial therapy,” Dr. Anthony S. Fauci, the government’s top infectious-disease expert, told Congress as early as 2007.

In an analysis published in 2007, the firm determined that giving antibiotics immediately after a large outdoor anthrax attack was likely to reduce serious illnesses by more than 80 percent. Administering the vaccine would then cut serious illnesses only by an additional 4 percent.

Dr. Ali S. Khan, who ran the C.D.C. office managing the stockpile until 2014, said bluntly: “We overpaid.”

“A bunch of people, including myself, were sitting in a room and asking what kind of attack might happen,” said Dr. Kenneth Bernard, a top biodefense adviser to Mr. Bush, recalling a meeting in the months after the 2001 attacks.

“And somebody said, ‘Well, I can’t imagine anyone attacking more than three cities at once,’” he said. “So we took the population of a major U.S. city and multiplied by three.”

A team of Homeland Security and health officials began doing just that in 2013. The group determined, in a previously undisclosed analysis, that the government could stockpile less BioThrax and still be prepared for a range of plausible attacks, according to two people involved in the assessment. Separately, government researchers concluded that two doses of BioThrax provided virtually the same protection as three.

the National Intelligence Council, which helped draft the assessments during Mr. Obama’s second term, said in an interview that the idea of a three-city attack affecting 25 million people was “straining credulity.”

“If you talk to the head of the House Intelligence Committee,” Don Elsey, Emergent’s chief financial officer, told investors in 2011, “and you say, ‘What are you most worried about?’ he’ll say, ‘Let me see: Number one, anthrax; number two, anthrax; number three, anthrax.’”

Emergent’s sales strategy was to address that fear by promising the federal government peace of mind with its vaccine.

“There’s a political element involved,” Mr. Burrows, the company’s vice president of investor relations, said at an industry conference in 2016. “I don’t have a marketing expense. I have lobbying expense.”

Since 2010, the company has spent an average of $3 million a year on lobbying — far outspending similarly sized biotech firms, and roughly matching the outlays of two pharmaceutical companies with annual revenues at least 17 times greater, AstraZeneca and Bristol Myers Squibb

In 2015, as stockpile managers questioned the large purchases of BioThrax, the spending topped $4 million

“They were pouring it on — how poor they were and how this was going to ruin the company, and they’d have to close down factories, and America was going to be left without anthrax vaccine,”

“Their revolving door is moving at 60 miles per hour,” said former Senator Claire McCaskill, a Democrat from Missouri who had questioned spending on the vaccine while in the Senate. “There is really a lot of incestuousness because it’s such a specialized field.”

Ms. DeLorenzo, the Emergent spokeswoman, said the lobbying was necessary because government investment “in biodefense and other public health threats has not been as strongly prioritized as it should be.”

Over the past 10 years, Emergent’s political action committee has spread almost $1.4 million in campaign contributions among members of both partie

The move followed a yearslong pattern of retaining a bipartisan lobbying corps of former agency officials, staff members and congressmen, including Pete Hoekstra of Michigan, Tom Latham of Iowa and Jim Saxton of New Jersey.

“You have people coming and saying, ‘There’s no market for this — nobody’s going to produce this unless you buy enough of it to keep the production line open,’” he said. “It’s an absolutely appropriate argument to make.”

Emergent’s campaign proved effective. Despite the 2015 recommendation by the stockpile managers, Senate overseers made clear they opposed the reduction, and the government went ahead and bought $300 million worth of BioThrax.

Emergent executives, meanwhile, warned that there could be job losses at the factory in Lansing, Mich. — the capital of a swing state at the center of a contentious presidential campaign between Mr. Trump and Hillary Clinton.

Because Emergent was the sole manufacturer of a product deemed critical to national security, the company has played what one former executive described to The Times as “the we’re-going-to-go-bankrupt card.”

Dr. Hatchett said the idea gave him pause. But, he explained in an interview, “if there’s only one partner that can provide a product and only one customer for that product, the customer needs the partner to survive.”

Just a year later, Emergent spent about $200 million in cash, and made other financial commitments, to acquire Sanofi’s smallpox vaccine and GlaxoSmithKline’s anthrax treatment, two products with established pipelines to the stockpile. The purchases expanded Emergent’s hold over the reserve.

Ms. DeLorenzo said the acquisitions did not suggest the company was better off than it had claimed, but Dr. Bright said he and others involved in the bailout felt used.

a plan five years earlier to create an emergency supply of N95 respirators was simply not funded. A team of experts had proposed buying tens of millions of the masks to fill the gap during an outbreak until domestic manufacturing could ramp up, according to five officials involved in the assessment, which has not been previously disclosed.

By the time the novel coronavirus emerged, the stockpile had only 12 million of the respirators. The stockpile has since set a goal of amassing 300 million.

Dr. Kadlec, the Trump administration official overseeing the stockpile, said he used the previous administration’s mask recommendation to raise alarms as early as 2018.

Dr. Annie De Groot, chief executive of the small vaccine company EpiVax, spoke about the need to break Emergent’s lock on research dollars at a biodefense forum in 2015.

“Politicians want to look like they’ve addressed the problem,” she said. “But we need to actually listen to the scientists.”

Over the last five years, Emergent has received nearly a half-billion dollars in federal research and development funding, the company said in its financial disclosures.

“We know ahead of time when funding opportunities are going to come out,” Barbara Solow, a senior vice president, told investors in 2017. “When we talk to the government, we know how to speak the government’s language around contracting.”

The company used federal money to make improvements to BioThrax, and also found a way to earn government money from a competing anthrax vaccine it had excoriated. After the demise of VaxGen in 2006, Emergent bought the company’s unfinished vaccine and in 2010 persuaded the federal government to continue paying for research on it

By the time the research contract was canceled in 2016, Emergent had collected about $85 million, records show. The company then shelved the vaccine. “If the U.S. government withdraws funding, we re-evaluate whether there is any business case for continuing,” Ms. DeLorenzo said.

For more than 30 years, the government had been encouraging the development of a BioThrax replacement. In 2002, the Institute of Medicine had concluded that an alternative based on more modern technology was “urgently needed.” By 2019, there were three leading candidates, including one made by Emergent, known as AV7909.

Emergent’s candidate was hardly the breakthrough the government was seeking, former health officials said. AV7909 was essentially an enhanced version of BioThrax. The competitors were using more modern technology that could produce doses more rapidly and consistently, and were promising significant cost savings for the stockpile.

To qualify for emergency authorization, a vaccine must be at an advanced stage of development with no approved alternatives. Emergent acknowledged in its financial disclosures that there was “considerable uncertainty” whether the new vaccine met those requirements.

The election of Mr. Trump as president was good news for Emergent.

Dr. Lurie, the senior health official in the Obama administration who had tried to scale back BioThrax purchases, was out. Mr. Trump’s pick to replace her was Dr. Kadlec, a career Air Force physician and top biodefense official in the Bush administration who was fixated on bioterrorism threats, especially anthrax, current and former officials said

Soon after entering the Trump administration in 2017, Dr. Kadlec took a series of actions that he characterized as streamlining a cumbersome bureaucracy but that had the effect of benefiting Emergent.

He assumed greater control of purchasing decisions, diminishing the authority of the Phemce, the oversight group that had proposed buying less BioThrax. And in 2018, he backed a decision to move control of the stockpile to his office in the Department of Health and Human Services and away from the C.D.C., which is based in Atlanta and prides itself on being insulated from the influence of lobbyists.

Dr. Frieden, the former C.D.C. director, was strongly opposed. The move, he said, “had almost as an explicit goal to give the lobbyists more say in what got purchased.”

That July, the government made the announcement Emergent had been banking on, committing to buying millions of doses. Separately, it said it would stop funding Emergent’s competitors.

The decision to side with Emergent did not surprise Dr. Khan, the former C.D.C. official overseeing the stockpile.“Again and again, we seem unable to move past an old technology that’s bankrupting the stockpile,” he said.

Last month, as the death toll from Covid-19 neared a half-million, Mr. Kramer, the company’s chief executive, told analysts there had been no “evidence of a slowdown or a delay or a deprioritization,” and echoed a statement he had made in April when asked whether the pandemic might interrupt Emergent’s sales to the stockpile.“It’s pretty much business as usual,” he said then.