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Yet quarantine compliance is essential for the combination of testing, contact tracing, and isolation of sick people to work. Simply telling people they’ve been exposed and letting them loose on the nation’s Outback Steakhouses is not sufficient

Public-health departments are reluctant to seem like bad cops—or cops at all.

Hawaii created its quarantine law as a travel quarantine, stopping everyone at the airport. These types of quarantines are logistically easier to implement—they don’t require contact tracers—than medical quarantines, in which the state orders a certain individual to stay in isolation

Some other countries have imposed much tougher travel restrictions and quarantine policies. At one point, Greeks were required to text authorities to explain why they needed to go out. Norway quarantined its own citizens under threat of a fine or imprisonment. Most foreigners still can’t fly to Vietnam.

Keen believes that Hawaii residents are on such high alert because of long-ago pandemics that came to the islands and killed large percentages of the population

“Generations of stories you hear, from great-grandparents, grandparents, parents, that the pandemics nearly killed off Native Hawaiians,” she told me. “So there is a great fear here of outsiders coming in and bringing it with them.”

On the mainland, states cite a combination of COVID-19 denial, logistical hurdles, and funding and personnel shortages to explain why they haven’t been willing or able to enforce quarantines.

scofflaws: Some people stay inside for three or four days, then decide, “I’m bored with staying home,”

Some states can’t quarantine people, because they have too many cases to trace

Even if a North Dakotan wants to do the right thing, she might not be able to without going hungry or losing her job. Grocery delivery isn’t available in parts of the large and rural state

In fact, many COVID-exposed Americans who want to stay home and quarantine have an intractable problem: Their bosses won’t let them

The Families First Coronavirus Response Act granted paid leave to recover from COVID-19 to many Americans. But the law doesn’t cover everyone: Large companies aren’t included, and small companies can claim an exemption. Because of these exemptions, only 47 percent of private-sector workers have guaranteed access to coronavirus-related sick leave,

The U.S. is the only country out of 193 nations to exclude workers from sick-leave benefits based on the size of the company they work for, according to a recent UCLA study.

“We don’t really pay people to stay at home to quarantine,” Polly Price, a global-health professor at Emory University, says. But that’s exactly the problem: In a study in Israel, people were more likely to quarantine after exposure to COVID-19 if they were paid during their isolation.

Months into the pandemic, half of Americans didn’t know they might have the right to stay home with pay if they contracted the coronavirus.

even if they did, employers might have pressured them to come to work if they were no longer showing symptoms,

“After testing positive, employees are being scheduled and expected to work as long as they don’t show symptoms and [are] not placed in quarantine,” a worker at a Georgia taco restaurant complained in July. OSHA has formally inspected just 11 of the employers in these incidents. “Under the Trump administration, OSHA decided to do almost no enforcement,”

America’s laissez-faire federal pandemic response has, in effect, treated each state like its own country

When it comes time to isolate sick people, though, it becomes painfully clear that states aren’t countries. Wisconsin can’t stop Iowans from driving into it. North Dakota doesn’t have enough health workers to trace all of its infected citizens. The governor can’t help you when your employer is—legally—dragging you back into the office.

the reason Hawaii has been so ruthlessly effective at quarantine is that it in some ways still acts as its own country with its own border controls.

The state consistently has some of the lowest case numbers in the nation. As with so many other pandemic rules, Americans might not like quarantine, but it works.

Federal health officials also offered two new ways to shorten quarantine periods. Those without symptoms may end quarantine after seven days if they are tested for the virus and receive a negative result, or after 10 days without a negative test.

“We are at the point now, even before Christmas, that there may not be room at your hospital, because we don’t have enough health care workers to take care of you,”

Some patients may not develop symptoms until two weeks after exposure, and even longer in a very small fraction of cases. Infected individuals may pass the virus to others before they develop symptoms; recent studies show they are most infectious two days before symptoms begin, and for about five days afterward.

Daily deaths have been exceeding 2,000 for the first time since early May, and close to 100,000 Americans are already hospitalized.

Until now, the C.D.C. has recommended a 14-day quarantine period following potential exposure, and Dr. Walke stressed that the full two weeks is still considered ideal and the surest way to curb transmissions.

Federal health officials also offered two new ways to shorten quarantine periods. Those without symptoms may end quarantine after seven days if they are tested for the virus and receive a negative result, or after 10 days without a negative test.

“We can safely reduce the length of quarantine, but accepting that there is a small residual risk that a person who is leaving quarantine early could transmit to someone else if they became infected,”

Some patients may not develop symptoms until two weeks after exposure, and even longer in a very small fraction of cases. Infected individuals may pass the virus to others before they develop symptoms; recent studies show they are most infectious two days before symptoms begin, and for about five days afterward.

He praised Republican Gov. Mike DeWine for taking bold steps early, including declaring a state of emergency when there were only three reported cases on March 9, four days before the federal government followed suit. Thirty states had declared a state of emergency by the time Trump declared a national emergency on March 13.

“They didn’t move fast enough,” said Crossley, of the federal government. “And what you’ve seen is more local and state officials sounding the alarm. “We needed a national response to this event.”

With seven reported infections in the United States by the end of the day, Health and Human Services Secretary Alex Azar declared a public health emergency on Jan. 31, and Trump announced strict travel restrictions, barring most foreign visitors coming from China. He also imposed the nation’s first mandatory quarantine in 50 years.

Officials spent three hours war-gaming how they would respond. The drill prompted the state to send 300 employees home early to test their remote work capability. That unmasked a serious problem: A quarter of the team could not perform their jobs at home because they needed access to secure computer systems.

Then he heard the news: The United States had identified its first case of person-to-person transmission involving someone who had not traveled overseas. Also, the World Health Organization classified the coronavirus as a public health emergency of international concern.

Chicago Jan. 31: 9,927 cases worldwide, seven cases in the United States

Tallahassee Jan. 30: 8,234 cases worldwide, five cases in the United States

“We are concerned about our public health system’s capacity to implement these measures, recognizing they may inadvertently distract us from our ongoing tried-and-true efforts to isolate confirmed cases and closely monitor their contacts,” according to a previously unreported Feb. 6 letter. “We also worry about the potential to again overwhelm laboratory capacity, recognizing that national capacity has not been adequate to quickly test our highest-risk individuals.”

“In the first few sets of conversations, we were not hearing answers to those questions,” Lightfoot, a Democrat, said of her talks with federal officials. “It was kind of like, either silence, or ‘Do the best you can,’ which was obviously not acceptable.”

she drafted a letter to Trump on behalf of the mayors from Detroit, Los Angeles, New York, San Francisco and Seattle. They insisted on clear, written directions from the federal government, according to the letter, and worried about diverting health-care resources during flu season, when hospitals were already stretched.

Americans who had visited China’s Hubei province would be forced to quarantine for 14 days, and those who visited other parts of China would be screened for symptoms and asked to isolate themselves for two weeks. Chicago Mayor Lori Lightfoot was caught off guard. The directive came with little guidance. Where were local governments supposed to quarantine the travelers? What would they do if someone refused to quarantine? Who was going to pay for the resources needed to quarantine people?

Mount Kisco, N.Y. Feb. 9: 40,150 cases worldwide, 11 cases in the United States

Weeks earlier, Amler had started fitting employees for personal protective equipment and training them on how to use the gear. In January, she watched what was happening in Wuhan with growing concern: “It seemed impossible that it wouldn’t eventually spill out of China into the rest of the world.”

San Francisco Feb. 24: 79,561 cases worldwide, 51 cases in the United States

Trump continued to reassure the public that there was little to worry about. On Feb. 24, he tweeted, “The Coronavirus is very much under control in the USA.”

But Colfax and his public health staff in San Francisco were seeing something else when they studied the “curves” of the pandemic — graphs showing how many cases were reported in other regions over time.

Wuhan’s curve was climbing exponentially, and other countries, such as Italy, were seeing soaring infection rates as well. Colfax noticed that in every infected region, officials were more and more aggressive about restricting their populations

“It became apparent that no jurisdiction that was where the virus was being introduced, was sort of, in retrospect, thinking, ‘Oh, we overreacted,’ ” Colfax said.

On Feb. 24, Colfax and other health officials assembled their research and met with Mayor London Breed. They made an urgent request: Declare a state of emergency

by the end of the meeting, Breed was convinced. They needed to declare a state of emergency so that they could tap into state and federal funds and supplies, and redeploy city employees. The next day, San Francisco became one of the first major cities in the United States to do so, after Santa Clara and San Diego counties did earlier in the month.

It would take another 17 days, as the virus infected people in nearly every state, before Trump declared a national emergency.

In New Orleans, officials moved ahead with Mardi Gras festivities in late February that packed people into the streets. It was a decision the mayor would later defend as coronavirus cases traced to the celebration piled up.

On Feb. 27, at a White House reception, Trump predicted that the coronavirus would disappear. “Like a miracle,” he said.

“No red flags were given,” by the federal government, New Orleans Mayor LaToya Cantrell, a Democrat, later said in a CNN interview. “If we were given clear direction, we would not have had Mardi Gras, and I would’ve been the leader to cancel it.

San Antonio Feb. 29: 86,011 cases worldwide, 68 cases in the United States

The last day of February marked a major turning point for the coronavirus in the United States: The first American who had been diagnosed with the illness died

In a Saturday news conference, Trump described the patient from the Seattle area as a “medically high-risk” person who had died overnight. A CDC official said that the man, who was in his 50s, had not traveled recently — another sign that the virus was snaking through local communities.

During the announcement, Trump asked the media to avoid inciting panic as there was “no reason to panic at all.”

“We’re doing really well,” he said. “Our country is prepared for any circumstance. We hope it’s not going to be a major circumstance, it’ll be a smaller circumstance. But whatever the circumstance is, we’re prepared.”

That same afternoon in San Antonio, the CDC mistakenly released a woman from quarantine who was infected. The woman was one of dozens of evacuees from Wuhan whom the federal government had brought to a nearby military base and then isolated at the Texas Center for Infectious Disease.

the woman had been dropped off at a Holiday Inn near the San Antonio airport and headed to a mall where she shopped at Dillard’s, Talbots and Swarovski and ate in the food court.

As local officials learned details about the infected woman’s movements and how she had been transported at 2 a.m. back to the Texas Center for Infectious Disease, they waited for the CDC to issue a statement. Hours passed, but they heard nothing. “They were like quiet little mouses,” Wolff said. “They were all scared to talk because I think they felt they were going to get in trouble with the president of the United States because he was saying there was not a problem.”

The next day, San Antonio officials declared a public health emergency and filed a lawsuit to prevent the CDC from releasing the 120 people in quarantine until they were confirmed negative for the virus or completed a 28-day quarantine. A judge denied the motion, but the CDC agreed that evacuees must have two consecutive negative tests that are 24 hours apart and that no one with a pending test can be released.

In Oklahoma City, the coronavirus became a reality for Mayor David Holt, a Republican, when the NBA abruptly canceled a Thunder basketball game after a Utah Jazz player tested positive on March 11. Until then, Holt said, the coronavirus felt “distant on many levels.”

Mount Kisco, N.Y. March 3: 92,840 cases worldwide, 118 cases in the United States

Within days, state authorities set up an emergency operations center in New Rochelle and created a one-mile containment zone. Inside the perimeter, schools and community centers shuttered and large gatherings were prohibited.

Through it all, local officials faced backlash from some community leaders who thought they were overreacting.

San Francisco March 5: 97,886 cases worldwide, 217 cases in the United States

Days after San Francisco’s emergency declaration, Breed stood in front of news cameras to announce the city’s first two cases of the coronavirus.

They were not related, had not traveled to any coronavirus-affected areas and had no contact with known coronavirus patients: It was spreading in the community.

By then, Miami Mayor Francis X. Suarez, a Republican, had announced the cancellation of the Ultra Music festival, a three-day celebration that draws about 50,000 people. Miami was the first city to call off a major music festival, and Suarez faced tremendous backlash

When he tried to order more masks, none were immediately available. By then the entire country was scrambling for protective gear.

Days later, Holt huddled on the phone with other leaders from the United States Conference of Mayors. For about 20 minutes, Seattle Mayor Jenny Durkan, a Democrat, detailed the crisis seizing her city

“She sounded like the main character in a Stephen King novel,” Holt recalled. “She had hundreds of cases, she had dozens of deaths.”

“Any struggles that we’re having, whether it be testing or other issues, or even just convincing our public of the seriousness of the matter, there are some roots back to the time period in January and February, when not all national leadership was expressing how serious this was,” Holt said.

While the mayors held their conference call on March 13, Trump declared a national emergency to combat the coronavirus.

By then, Suarez had tested positive for the coronavirus and was in quarantine. As of Sunday, he remained in isolation, leading the city by phone calls and video chats. He wanted to stop flights into Miami and the governor to order residents to shelter in place as California and other states had already done.

There are more than 52,000 cases in New York.

The state has about half of the total confirmed Covid-19 cases in the entire US.

Mr Cuomo also said he would sue nearby Rhode Island if the authorities there continued targeting New Yorkers and threatening to punish them for failing to quarantine. Skip Twitter post by @RyanWelchPhotog

New York Governor Andrew Cuomo responded by saying that quarantining the state of New York would be "preposterous" and "anti-American".

"If you said we were geographically restricted from leaving, that would be a lockdown."

He added later: "I don't know how that can be legally enforceable. And from a medical point of view, I don't know what you would be accomplishing.

The CDC then published a statement urging residents of those three states to "refrain" from all non-essential domestic travel for 14 days.

On Friday, Rhode Island Governor Gina Raimondo deployed National Guard troops to stop cars with a New York licence plate, to remind them of their state's advice that they quarantine

Soldiers are going door-to-door in coastal vacation communities to ask if any residents have recently visited New York City.

All individuals who have traveled to New York have already been ordered to self-quarantine for 14 days. These added measures will make sure law enforcement identifies individuals who should be following the self-quarantine order, said the governor, a Democrat.

New York is coronavirus epicenter in the US, with more than 52,300 cases and at least 728 deaths as of Saturday, according to CNN's state-by-state count.

Rhode Island has more than 239 cases with two deaths as of Saturday.

"I've got my hands full here with responding to this crisis and I'm not going to second guess or criticize what other governors are doing or not doing," Edwards said.

Earlier in the week, DeSantis said he would expand his executive order mandating a 14-day self-isolation period for travelers coming to Florida from airports in New York, New Jersey and Connecticut.

The governor said he would have to look at what it would take to shut the border.

In New Mexico, Gov. Lujan Grisham on Friday ordered that everyone traveling by air into New Mexico self-quarantine for 14 days immediately upon arrival. Under the state's emergency order, people will only be allowed to leave quarantine for medical care

In Kansas, the government said any travelers from Colorado and Louisiana must self-quarantine when they arrive in the state.

Kansas has already placed self-quarantine requirements on travelers from Florida, Washington, California, New York, New Jersey and Illinois.

A fifth Republican member -- Rep. Louie Gohmert of Texas -- was told by officials over the weekend that he had been in proximity to the individual, but he is not planning to self-quarantine, a Gohmert aide tells CNN, details the congressman himself confirmed on Twitter on Monday evening.

Find everyone they interact with by deploying contact tracing on a scale America has never attempted before.

focus restrictions more narrowly on the infected and their contacts so the rest of society doesn’t have to stay in permanent lockdown.

Instead, the president and his top advisers have fixated almost exclusively on plans to reopen the U.S. economy by the end of the month, though they haven’t detailed how they will do so without triggering another outbreak

Administration officials, speaking on the condition of anonymity to describe internal deliberations, say the White House has made a deliberate political calculation that it will better serve Trump’s interest to put the onus on governors — rather than the federal government — to figure out how to move ahead.

without substantial federal funding, states’ efforts will only go so far

The next failure is already on its way, Frieden said, because “we’re not doing the things we need to be doing in April.”

In recent days, dozens of leading voices have coalesced around the test-trace-quarantine framework, including former FDA commissioners for the Trump and George W. Bush administrations, Microsoft founder Bill Gates and top experts at Johns Hopkins, Columbia and Harvard universities.

On Wednesday, former president Barack Obama weighed in, tweeting, “Social distancing bends the curve and relieves some pressure … But in order to shift off current policies, the key will be a robust system of testing and monitoring — something we have yet to put in place nationwide.”

And Friday, Apple and Google unveiled a joint effort on new tools that would use smartphones to aid in contact tracing.

What remains unclear is whether this emerging plan can succeed without the backing of the federal government.

“It’s mind-boggling, actually, the degree of disorganization,” said Tom Frieden, former Centers for Disease Control and Prevention director. The federal government has already squandered February and March, he noted, committing “epic failures” on testing kits, ventilator supply, protective equipment for health workers and contradictory public health communication.

Experts and leaders in some states say remedying that weakness should be a priority and health departments should be rapidly shored up so that they are ready to act in coming weeks as infections nationwide begin to decrease

In America, testing — while still woefully behind — is ramping up. And households across the country have learned over the past month how to quarantine. But when it comes to the second pillar of the plan — the labor-intensive work of contact tracing — local health departments lack the necessary staff, money and training.

In South Korea, Taiwan, China and Singapore, variations on this basic strategy were implemented by their national governments, allowing them to keep the virus in check even as they reopened parts of their economy and society

In a report released Friday, the Johns Hopkins Center for Health Security and the Association of State and Territorial Health Officials — which represents state health departments — estimate 100,000 additional contact tracers are needed and call for $3.6 billion in emergency funding from Congress.

“We can’t afford to have multiple community outbreaks that can spiral up into sustained community transmission,” he said in the interview.

Unless states can aggressively trace and isolate the virus, experts say, there will be new outbreaks and another round of disruptive stay-at-home orders.

“All people are talking about right now is hospital beds, ventilators, testing, testing, testing. Yes, those are important, but they are all reactive. You are dealing with the symptoms and not the virus itself,”

The nonprofit Partners in Health quickly put together a plan to hire and train 1,000 contact tracers. Working from their homes making 20 to 30 calls a day, they could cover up to 20,000 contacts a day.

Testing on its own is useless, Nyenswah explained, because it only tells you who already has the virus. Similarly, tracing alone is useless if you don’t place those you find into quarantine. But when all three are implemented, the chain of transmission can be shattered.

Until a vaccine or treatment is developed, such nonpharmaceutical interventions are the only tools countries can rely on — besides locking down their cities.

to expand that in a country as large as the United States will require a massive dose of money, leadership and political will.

“You cannot have leaders contradicting each other every day. You cannot have states waiting on the federal government to act, and government telling the states to figure it out on their own,” he said. “You need a plan.”

When Vermont’s first coronavirus case was detected last month, it took two state health workers a day to track down 13 people who came into contact with that single patient. They put them under quarantine and started monitoring for symptoms. No one else became sick.

He did the math: If each of those 30 patients had contact with even three people, that meant 90 people his crew would have to locate and get into quarantine. In other words, impossible.

Since 2008, city and county health agencies have lost almost a quarter of their overall workforce. Decades of budget cuts have left the them unable to mount such a response. State health departments have recently had to lay off thousands more — an unintended consequence of federal officials delaying tax filings until July without warning states.

In Wuhan, a city of 11 million, the Chinese had 9,000 health workers doing contact tracing, said Frieden, the former CDC director. He estimates authorities would need roughly one contact tracer for every four cases in the United States.

“In the second wave, we have to have testing, a resource base, and a contact-tracing base that is so much more scaled up than right now,” he said. “It’s an enormous challenge.”

Gov. Charlie Baker (R) partnered with an international nonprofit group based in Boston

“You will never beat a virus like this one unless you get ahead of it. America must not just flatten the curve but get ahead of the curve.”

The group is paying new hires roughly the same salary as census takers, more than $20 an hour. As of Tuesday — just four days after the initial announcement — the group had received 7,000 applicants and hired 150.

“There’s a huge untapped resource of people in America if we would just ask.”

“There needs to be a crash course in contact tracing because a lot of the health departments where this is going to need to happen are already kind of flat-out just trying to respond to the crisis at hand,”

Experts have proposed transforming the Peace Corps — which suspended global operations last month and recalled 7,000 volunteers to America — into a national response corps that could perform many tasks, including contact tracing.

On Wednesday, the editor in chief of JAMA, a leading medical journal, proposed suspending the first year of training for America’s 20,000 incoming medical students and deploying them as a medical corps to support the “test, trace, track, and quarantine strategy.”

The national organization for local STD programs says $200 million could add roughly 1,850 specialists, more than doubling that current workforce.

Technology could also turn out to be pivotal. But the invasive nature of cellphone tracking and apps raises concerns about civil liberties.

Such technology could take over some of what contact tracers do in interviews: build a contact history for each confirmed patient and find those possibly exposed. Doing that digitally could speed up the process — critical in containing an outbreak — and less laborious.

In China, authorities combined the nation’s vast surveillance apparatus with apps and cellphone data to track people’s movements. If someone they came across is later confirmed as infected, an app alerts them to stay at home.

In the United States, about 20 technology companies are trying to create a contact tracing app using geolocation data or Bluetooth pings on cellphones

President Trump said Saturday that he might order a quarantine of New York, New Jersey and parts of Connecticut, a dramatic exercise of federal power that would impose restrictions on travel by millions of Americans in order to prevent them from carrying the coronavirus to other parts of the country.

Mr. Trump, who has lurched from one public message to another in the weeks since the coronavirus crisis began to consume the United States, said he could announce such a move later Saturday, signaling that he had not reached a final decision about a short-term order.

Mr. Trump — who first broached the idea of the quarantines as Gov. Andrew M. Cuomo of New York was giving a news conference — said he had talked with Mr. Cuomo just hours earlier.

“I spoke to the president about the ship coming up,” Mr. Cuomo said, referencing the U.S.N.S. Comfort,

the naval hospital ship now bound for New York. “I didn’t speak to him about any quarantine.”

Gov. Ned Lamont of Connecticut said that he had been in close communication with Mr. Cuomo and Gov. Phil Murphy of New Jersey.

Mr. Trump’s public airing of his deliberations came one day after he signed a $2 trillion economic stimulus package and as cases in the tristate area continued to climb

New York reported 52,318 confirmed cases, as of Saturday morning, with 728 deaths statewide. In New Jersey, there were 8,825 cases and the death toll had risen to 108. Connecticut had nearly 1,300 cases, with 27 deaths.

Cases have also been growing elsewhere across the country,

at least 17 states reporting tallies of at least 1,000 infections and the surgeon general, Jerome Adams, signaling that Chicago, Detroit and New Orleans were emerging as hot spots.

Gov. Gina Raimondo of Rhode Island said Friday that state troopers would begin stopping drivers with New York license plates so that National Guard officials could collect contact information and inform anyone coming from the state that they were subject to a mandatory, 14-day quarantine.

The National Guard had already been deployed to bus stations, train stations and the airport to enforce Ms. Raimondo’s order, which also applies to anyone who has been to New York in the past 14 days.

“Right now we have a pinpointed risk,’’ she added. “That risk is called New York City.”

New York City’s mayor, Bill de Blasio, has questioned the wisdom of such orders.

New York State’s primary is delayed, and New York City may fine those who break social-distancing rules.

And New York City officials are expected to decide this weekend whether to impose $500 fines on residents flouting social-distancing rules during the coronavirus outbreak by gathering in large groups at parks and ignoring police orders to disperse.

The vast majority of New Yorkers have been respecting the rules, Mayor Bill de Blasio said on Friday,

officials had observed some violations.

All of them then imagine a phase two, which relaxes — but does not end — social distancing while implementing testing and surveillance on a mass scale. This is where you must begin imagining the almost unimaginable.

The CAP and Harvard plans both foresee a digital pandemic surveillance state in which virtually every American downloads an app to their phone that geotracks their movements, so if they come into contact with anyone who later is found to have Covid-19, they can be alerted and a period of social quarantine can begin

o state the obvious: The technological and political obstacles are massive. While similar efforts have borne fruit in Singapore and South Korea, the US is a very different country, with a more mistrustful, individualistic culture. Already, polling shows that 70 percent of Republicans, and 46 percent of Democrats, strongly oppose using cellphone data to enforce quarantine orders.

The alternative to mass surveillance is mass testing. Romer’s proposal is to deploy testing on a scale no one else is contemplating — 22 million tests per day — so that the entire country is being tested every 14 days, and anyone who tests positive can be quickly quarantined

The AEI proposal is the closest thing to a middle path between these plans. It’s more testing, but nothing approaching Romer’s hopes. It’s more contact tracing, but it doesn’t envision an IT-driven panopticon. But precisely for that reason, what it’s really describing is a yo-yo between extreme lockdown and lighter forms of social distancing, continuing until a vaccine is reached.

This, too, requires some imagination. Will governors who’ve finally, at great effort, reopened parts of their economies really keep throwing them back into lockdown every time ICUs begin to fill? Will Trump have the stomach to push the country back into quarantine after he’s lifted social distancing guidelines?

even if the political hurdles could be cleared, it’s obvious, reading the AEI proposal, that there’ll be no “V-shaped recovery” of the economy. Scott Gottlieb, the former FDA commissioner who helped craft the plan, says he thinks something like 80 percent of the economy will return — that may sound like a lot, but it’s an economic collapse of Great Depression proportions.

As unlikely as these futures may be, I think the do-nothing argument is even less plausible: It imagines that we simply let a highly lethal virus kill perhaps millions of Americans, hospitalize tens of millions more, and crush the health system, while the rest of us go about our daily economic and social business.

That is, in my view, far less likely than the construction of a huge digital surveillance state. I care about my privacy, but not nearly so much as I care about my mother.

My point isn’t to criticize these plans when I have nothing better to offer. Indeed, my point isn’t to criticize them at all. It’s simply to note that these aren’t plans for returning to anything even approaching normal

They either envision life under a surveillance and testing state of dystopian (but perhaps necessary!) proportions, or they envision a long period of economic and public health pain, as we wrestle the disease down only to see it roar back, as seems to be happening in Singapore.

As of now, the White House has neither chosen nor begun executing on a plan of its own. That’s a terrible abdication of leadership, but reading through the various proposals, you can see why it’s happened. Imagine you’re the president of the United States in an election year. Which of these futures, with all its costs and risks and pain, would you want to try and sell to the American people?

In no other high-income country — and in only a few countries, period — have political leaders departed from expert advice as frequently and significantly as the Trump administration. President Trump has said the virus was not serious; predicted it would disappear; spent weeks questioning the need for masks; encouraged states to reopen even with large and growing caseloads; and promoted medical disinformation.

many agree that the poor results in the United States stem in substantial measure from the performance of the Trump administration.

“As an American, I think there is a lot of good to be said about our libertarian tradition,” Dr. Jared Baeten, an epidemiologist and vice dean at the University of Washington School of Public Health, said. “But this is the consequence — we don’t succeed as well as a collective.”

That tradition is one reason the United States suffers from an unequal health care system that has long produced worse medical outcomes — including higher infant mortality and diabetes rates and lower life expectancy — than in most other rich countries.

First, the United States faced longstanding challenges in confronting a major pandemic. It is a large country at the nexus of the global economy, with a tradition of prioritizing individualism over government restrictions.

The New York Times set out to reconstruct the unique failure of the United States, through numerous interviews with scientists and public health experts around the world. The reporting points to two central themes.

When it comes to the virus, the United States has come to resemble not the wealthy and powerful countries to which it is often compared but instead far poorer countries, like Brazil, Peru and South Africa, or those with large migrant populations, like Bahrain and Oman.

That’s more than five times as many as in all of Europe, Canada, Japan, South Korea and Australia, combined.

Over the past month, about 1.9 million Americans have tested positive for the virus.

one country stands alone, as the only affluent nation to have suffered a severe, sustained outbreak for more than four months: the United States.

Nearly every country has struggled to contain the coronavirus and made mistakes along the way.

it quickly became clear that the United States’ policy was full of holes. It did not apply to immediate family members of American citizens and permanent residents returning from China, for example. In the two months after the policy went into place, almost 40,000 people arrived in the United States on direct flights from China.

On Jan. 31, his administration announced that it was restricting entry to the United States from China: Many foreign nationals — be they citizens of China or other countries — would not be allowed into the United States if they had been to China in the previous two weeks.

A travel policy that fell short

In retrospect, one of Mr. Trump’s first policy responses to the virus appears to have been one of his most promising.

The administration’s policy also did little to create quarantines for people who entered the United States and may have had the virus.

ven more important, the policy failed to take into account that the virus had spread well beyond China by early February. Later data would show that many infected people arriving in the United States came from Europe

South Korea, Hong Kong and Taiwan largely restricted entry to residents returning home. Those residents then had to quarantine for two weeks upon arrival

South Korea and Hong Kong also tested for the virus at the airport and transferred anyone who was positive to a government facility.

“People need a bit more than a suggestion to look after their own health,” said Dr. Mackay, who has been working with Australian officials on their pandemic response. “They need guidelines, they need rules — and they need to be enforced.”

Travel restrictions and quarantines were central to the success in controlling the virus in South Korea, Hong Kong, Taiwan and Australia, as well as New Zealand, many epidemiologists believe. In Australia, the number of new cases per day fell more than 90 percent in April. It remained near zero through May and early June, even as the virus surged across much of the United States.

the tolls in Australia and the United States remain vastly different. Fewer than 300 Australians have died of complications from Covid-19, the illness caused by the virus. If the United States had the same per capita death rate, about 3,300 Americans would have died, rather than 158,000.

there is a good chance that a different version of Mr. Trump’s restrictions — one with fewer holes and stronger quarantines — would have meaningfully slowed the virus’s spread.

travel restrictions had been successful enough in fighting the coronavirus around the world that those views may need to be revisited.“Travel,” he said, “is the hallmark of the spread of this virus around the world.”

Traditionally, public health experts had not seen travel restrictions as central to fighting a pandemic, given their economic costs and the availability of other options, like testing, quarantining and contact tracing

But he added that

By early March, with the testing delays still unresolved, the New York region became a global center of the virus — without people realizing it until weeks later. More widespread testing could have made a major difference, experts said, leading to earlier lockdowns and social distancing and ultimately less sickness and death.

While the C.D.C. was struggling to solve its testing flaws, Germany was rapidly building up its ability to test. Chancellor Angela Merkel, a chemist by training, and other political leaders were watching the virus sweep across northern Italy, not far from southern Germany, and pushed for a big expansion of testing.

By the time the virus became a problem in Germany, labs around the country had thousands of test kits ready to use. From the beginning, the government covered the cost of the tests. American laboratories often charge patients about $100 for a test.

Without free tests, Dr. Hendrik Streeck, director of the Institute of Virology at the University Hospital Bonn, said at the time, “a young person with no health insurance and an itchy throat is unlikely to go to the doctor and therefore risks infecting more people.”

Germany was soon far ahead of other countries in testing. It was able to diagnose asymptomatic cases, trace the contacts of new patients and isolate people before they could spread the virus. The country has still suffered a significant outbreak. But it has had many fewer cases per capita than Italy, Spain, France, Britain or Canada — and about one-fifth the rate of the United States.

One measure of the continuing troubles with testing is the percentage of tests that come back positive. In a country that has the virus under control, fewer than 5 percent of tests come back positive, according to World Health Organization guidelines. Many countries have reached that benchmark. The United States, even with the large recent volume of tests, has not.

In Belgium recently, test results have typically come back in 48 to 72 hours. In Germany and Greece, it is two days. In France, the wait is often 24 hours.

The conflicting advice, echoed by the C.D.C. and others, led to relatively little mask wearing in many countries early in the pandemic. But several Asian countries were exceptions, partly because they had a tradition of mask wearing to avoid sickness or minimize the effects of pollution.

The double mask failure

By January, mask wearing in Japan was widespread, as it often had been during a typical flu season. Masks also quickly became the norm in much of South Korea, Thailand, Vietnam, Taiwan and China.

In the following months, scientists around the world began to report two strands of evidence that both pointed to the importance of masks: Research showed that the virus could be transmitted through droplets that hang in the air, and several studies found that the virus spread less frequently in places where people were wearing masks.

What that index didn't take into account — and what has compounded months of governmental failures — is that even before COVID-19 arrived on its shores, the U.S. was an unusually sick country for its level of wealth and development.

High blood pressure, obesity and metabolic disorders are all on the rise in the U.S.

Healthy life expectancy — the number of years people can expect to live without disability — is 65.5 years in the U.S., more than two decades fewer than in Japan.

65,700 Americans died of drug overdoses in 2019, more than double the number in 2010. Those deaths account for more than half of all drug overdose fatalities worldwide and held down life expectancy in the U.S.

Mortality for mothers and children under 5 is 6.5 per 1,000 live births in the U.S., compared to 4.9 for other wealthy countries.

All in all, more than 40% of American adults have a pre-existing health condition that puts them at higher risk of severe COVID-19.

A study published in August found cardiovascular disease can double a patient's risk of dying from COVID-19, while diabetics — who number more than 30 million in the U.S. — are 1.5 times more likely to die.

Context: Lancet Editor-in-Chief Richard Horton has called COVID-19 a "syndemic" — a synergistic epidemic of a new and deadly infectious disease and numerous underlying health problems. The U.S. is squarely in the heart of that syndemic.

Those conditions are particularly prevalent in minority communities with unequal health care access that have disproportionately suffered from COVID-19.

A report from McKinsey earlier this month estimated that poor health costs the U.S. economy about $3.2 trillion a year

For every $1 invested in targeting population health, the U.S. stands to gain almost $4 in economic benefit, and altogether health improvements could add up to a 10% boost to U.S. GDP by 2040.

The bottom line: There is no excuse for the way the U.S. has mishandled COVID-19, but the seeds of this catastrophe were planted well before the novel coronavirus arrived on American shores.

2. How movement spread COVID-19

What's happening: Researchers in Germany studied the effect of entry bans and mandatory quarantines on COVID-19 mortality, and found the earlier such measures were implemented, the greater the effect they had on limiting deaths.

Of note: The study found mandatory quarantines for incoming travelers were more effective than outright entry bans, largely because such bans often exempted citizens and permanent residents, while quarantines usually applied to everyone.

The U.S. lost track of at least 1,600 people flying in from China in just the first few days after the ban went into effect, according to reporting from the AP.

Border controls are of little use if governments don't track and quarantine travelers coming from infected areas.

The bottom line: A virus only moves with its host. One lesson we should learn for future pandemics is that restricting that movement is key to controlling a new pathogen, even though the costs of such controls will only grow in a globalized world.

more than 178,000 confirmed cases at colleges and universities since the pandemic began.

The “snitch form” yields a lot of power, and there’s potential for abuse, even false reports. But combined with the quarantine, there’s evidence it might be working.

“We need everyone to do their part,”

But we just call it the “snitch form.”You can report students for failing to wear a mask, failing to social distance, failing to wash their hands for at least 20 seconds, and failing to cough or sneeze into a tissue or elbow.

nearly 600 students tested positive the week of Sept. 6, Dr. Robbins announced a “last-ditch effort” to stem the outbreak: a two-week shelter-in-place recommendation.

At the University of Colorado, there’s sometimes an “us vs. them” mind-set pitting independent students against those in fraternities and sororities.

“I drove past the Hill last night,” Delaney Hartmann, a 19-year-old sophomore majoring in political science, told me recently, “and there were tons of people at restaurants, at the bars, not wearing masks.”

“I don’t want to blame every single individual who is living on the Hill who is in a sorority or fraternity,” she said. “But it is definitely a source of a lot of the outbreaks.”

Some fraternity and sorority members “have taken a while to truly understand” the seriousness of Covid-19

“The administration severely underestimated their ability to manage tens of thousands of college students going through the longest period of isolation and uncertainty in our lives.”

“I think if they’re already partying, they’re not really going to stop,”

“I was going into my very first college exam,” said Noah Cotton, 18, a freshman who lived in a dorm with a major outbreak. Instead of focusing on his answers, he wondered: “Do I have enough to eat? How am I going to be able to talk to people?”

“Most minority students don’t have the means to just leave the dorm, to travel, to get an apartment, to feel safe,” he said.

“Due to the actions the university took to contain a rise in cases early in the semester, including robust testing, isolation of positive students, and quarantines, Covid-19 cases have remained low on campus since the third week of September,”

As restrictions here are lifted, Chancellor Angela Merkel has singled out tracking infection chains as the key, above “all else.” Germany aims to have five contact tracers for every 25,000 people — or about 16,000 for its population of 83 million.

Privacy concerns — which run strong in Europe and particularly deep in Germany, with its not-so-distant memories of fascism and communism — have limited the potential of contact-tracing apps. So the tracing is largely a case of calling the recently diagnosed patient and asking his or her movements.

Germany’s trace-and-quarantine approach is by no means flawless. In about 65 percent of the cases here, health authorities have no idea how a person was infected. Asymptomatic carriers are no doubt falling through the cracks.

The whole conversation lasts just over 10 minutes. It’s a simple case, but that’s been normal since social distancing restrictions, health workers here say. Someone from the health department will call him daily to check in on his symptoms.

He contends that contact tracing and quarantines have been more important to containing the virus than the more widely lauded testing program.

“There are two things: the contact tracing and the quarantine,” Larscheid said. In Germany, the contacts of a positive coronavirus case are not generally tested unless they have symptoms.

“Testing is nice, but if you’re tested or not tested and are in quarantine, it makes no difference,” Larscheid said. Testing could also lull someone into a false sense of security, he said — a negative result might mean it’s just too early for an infection to register on a test.

Reinickendorf began to build its contact tracing team in March, as an outbreak in a kindergarten went beyond the capacity of the usual contingent of health officials. Workers were moved from parts of the local administration for which the outbreak had caused work to slow.

They say the numbers are distorted by isolated outbreaks in several nursing homes and a meatpacking plant. In Berlin, where there’s no requirement to wear a mask, there are only a few dozen new cases a day. Parks and markets have remained busy throughout the pandemic.

Critics promptly called the idea unworkable, saying it would cause chaos in a region that serves as the economic engine of the eastern United States, accounting for 10 percent of the population and 12 percent of GDP.

The United States has now recorded more than 122,000 cases of the respiratory virus, the most of any country in the world.

CDC warns residents of New York, New Jersey, Connecticut against non-essential travel

Since the virus first appeared in the United States in late January, Trump has vacillated between playing down the risks of infection and urging Americans to take steps to slow its spread.

Trump said on Saturday afternoon that he might impose a ban on travel in and out of New York and parts of New Jersey and Connecticut,

He offered few specifics.

Trump’s announcement came as the U.S. death count crossed 2,100, more than double the level from two days ago.

The CDC later warned the states’ residents against non-essential domestic travel for 14 days.

It was the latest reversal for Trump, who has been reluctant to order U.S. companies to produce much-needed medical supplies, despite the pleas of governors and hospital workers.

Tests to track the disease’s progress also remain in short supply, despite repeated White House promises that they would be widely available.

Though Trump has apparently opted not to impose checkpoints on highways and airports leading out of New York, some states have imposed limits of their own.

New Yorkers arriving in Florida and Rhode Island face orders to self-isolate if they intend to stay, and the governors of Pennsylvania and West Virginia have asked visiting New Yorkers to voluntarily self-quarantine.

New Hampshire Governor Chris Sununu on Saturday asked all visitors to his state who don’t come for work reasons to voluntarily self-quarantine.

New coronavirus cases in China leveled off after the government imposed a strict lockdown of Wuhan, the epicenter of the disease.

Any travel restrictions, voluntary or not, might be too late.

. “So-called low-risk areas are not to be believed. Bureaucrats everywhere have already begun covering up,” another said.

Such patients, usually found by tracing the contacts of confirmed cases, are quarantined for 14 days and released if they do not show any symptoms. But the number of reports of new cases has started to worry the public.

Documents seen by the South China Morning Post reportedly showed more than 40,000 asymptomatic patients that would not have been included in China’s total number of infections of more than 80,000.

the financial news magazine Caixin called on the government to publish data on asymptomatic carriers. “Within China, transmission caused by asymptomatic infections has occurred many times. The number needs to be made public as soon as possible. Investigation and and research is needed to raise the public’s alertness,” it said.

Last week, authorities formally arrested a man in Beijing who was diagnosed as an asymptomatic carrier in mid-February. He repeatedly visited grocery stores, pharmacies and other public places against regulations. His mother has been infected and 20 other close contacts have now been quarantined.

China’s top respiratory disease expert Zhong Nanshan told the state broadcaster CGTN that while asymptomatic patients who have been in close contact with confirmed patients can be “very infective”, he did not believe they posed a “big problem” in China.

Last week, the premier, Li Keqiang, called on health officials to investigate whether asymptomatic people were contagious, in order to help the country’s ongoing prevention plans, and ordered officials “not to cover up” cases.

But the infectious disease expert Zhang Wenhong, said at a symposium on Friday that asymptomatic carriers would continue to pose a major risk, even as China took measures, such as temporarily banning foreigners from entering the country.

“Now, we only allow Chinese people to come back. But when our country’s doors open again, there will be large numbers coming in. When they are asymptomatic, the risk is great.”

if the UK’s GDP falls by more than 6.4% per person as a result of the lockdown, more years of life will be lost than saved.”

(there’s a great takedown of the argument here).

Let’s just agree nonetheless that in principle, at some point, there will be a crossover moment when quarantine and lockdown cease to have the net-positive impact they are now having. The question is simply when that cross-over occurs, and how we can get there soonest.

If we declare victory before we achieve it, we could have the worst of both worlds — a burst in new infections leading to a second shutdown, a collapse of faith in the authorities, more deaths, and a deeper depression.

Letting up on an epidemic before it has run its course can create a second wave, as in 1918, and as feared in China right now, that would take the country down in the fall of an election year.

At the same time, if quarantine and social distancing are stretched out too long, we could be losing more lives in the aggregate than we would be saving. We could also be risking ever-more extremist politics or even civil disorder

What matters is the timing. Getting that right is the single biggest challenge as we go forward. But that requires a huge amount of data we don’t yet have: specifically, a much better sense of just how widespread COVID-19 is in the broader population.

we need equipment we don’t yet have: tests for the virus that are quick and easy and ubiquitous; and, perhaps more importantly, serological tests, to see who is now immune and can return to work and normal life.

If we’re luckier still, we could get a breakthrough in treatments as doctors and nurses understand this disease better and we buy some time.

If we’re lucky and we find out more people have already gotten COVID-19 without the worst symptoms than we now believe, then the return to semi-normal could come more quickly

At best, we could get the virus to peak at a level that does not overwhelm our medical system and manage economically until a vaccine is available. At best.

The goal is not to “beat” the virus, because it can’t be beaten. Now that it’s a pandemic, it’s here to stay

The goal is not to fight it, or wage war on it.  COVID-19 is not a rival military. The goal is to find the optimal path to living with it.

I want Anthony Fauci making that decision. Right now, as complete a shutdown as possible is the only sane option.

if we make that collective pro-life decision — and, mercifully, we are — we are also saying something quite profound about who we are as Americans. We are saying that the lives of the elderly, and the poor, and the vulnerable matter more, when all is said and done, than our GDP.

In this century, the Evangelical right has embraced the cult of prosperity, the efficacy of torture, and the denial of health care to the poor. They upped the ante in 2016, of course, by embracing a pagan worshipper of Mammon, with a sideline in philandery, cruelty, gluttony, pride, deceit, envy, insatiable greed, and the foulest abuse of women

In an apparent attempt to defend a president who clearly dismissed and for too long ignored the greatest threat to the U.S. since 9/11, they’ve decided to embrace what they once called the “culture of death.”

The correct response to COVID-19, many pastors have declared, is to let it rip.

The elderly, instead of protecting themselves, should sacrifice what’s left of their lives to save the jobs of the young and to help Trump keep the economy going. Wealth, it appears, is far preferable to life — or at least when a Republican is president.

But if by ignoring “social distancing,” we individually and collectively guarantee someone’s death down the line, why is that not a kind of indirect killing?

Yes, Christians should not cower in constant fear of death. But we don’t have to embrace it either. I’m trying to think of a version of the Gospels where Jesus meets a leper and tells him not to worry, he’s going to die some day anyway, and make the best of it; or when he tells Martha and Mary to suck it up, and accept that Lazarus is dead, and move on. He didn’t. In fact, he risked and lost his own life by raising Lazarus from the dead.

In Taiwan, officials boarded planes arriving from Wuhan and assessed passengers for symptoms before allowing anyone to disembark. Within days, Singapore, South Korea and other Asian states had implemented similar steps.

A year after SARS, Taiwan established a National Health Command Center that brought together all levels and branches of government, preparing for the possibility of another disease outbreak. Its interventions over the past two months have been decisive in keeping Taiwan ahead of the curve

They didn’t hesitate, they didn’t want to die,” Wang said. “The mortality rate was so high [during SARS] and they didn’t know how bad this one was going to be. Nobody thought it was like the flu.”

As early as Jan. 5, Taiwan was tracing people who had been in Wuhan in the previous 14 days. Those with symptoms of respiratory infections were quarantined.

In subsequent weeks, authorities used data and technology to identify and track cases, communicated effectively to reassure the public, offered relief to businesses and allocated medical resources where they were needed most — rationing face masks and dramatically increasing their production.

On Jan. 27, Taiwan combined the databases of its National Health Insurance Administration and National Immigration Agency, allowing it to track everyone who had been in Wuhan in the recent past and alert doctors to patients’ travel histories

Now, Taiwan is hoping to keep its infection numbers down and has asked residents not to travel abroad after its biggest single-day jump of cases — 23 — on Wednesday. It is also barring most noncitizens from entering.

South Korea, meanwhile, has become the poster child for testing. Its success is rooted in a previous failure: The limited availability of test kits was seen as having aggravated the 2015 MERS outbreak, when the country suffered the second-highest caseload after Saudi Arabia.

Whereas the United States and Japan keep testing tightly controlled by a central authority, South Korea opened the process to the private sector, introducing a path to grant “emergency usage approval” to tests for pathogens of pandemic potential.

More than 260,000 people in South Korea have been tested for the virus, the highest per capita anywhere, with testing and treatment fees covered by the government and drive-through centers capturing global attention

Singapore, too, benefited from its own capabilities to test, as did Hong Kong and Japan. All developed their own diagnostic tests when the covid-19 genome sequence was published.

Outside mainland China, the territory had been the biggest casualty of the Communist Party’s coverup of the SARS outbreak, with some 300 deaths and little clarity on what was unfolding until it was too late.

This time, though, and without needing to be told much, Hong Kong residents took matters into their own hands. The city’s financial district was reduced to a ghost town in early February as companies closed offices. Bakeries known for hour-long weekend lines were abandoned.

Parties, weddings and family gatherings were canceled — without any government order. Almost everyone rushed to ­procure masks; a recent study ­estimated that 74 percent to 98 percent of residents wore them when leaving their homes. Voluntary social distancing was hailed as a key reason for the lower rate of infections.

From electronic wristbands to smartphone trackers, Asian jurisdictions have pulled out all the stops to ensure that suspected patients comply with quarantine and isolation orders, monitoring that is backed by laws that were tightened post-SARS.

Singapore used its FBI equivalent, the Criminal Investigation Department, to effectively interrogate every confirmed case with stunning granularity — even using patients’ digital wallets to trace their footsteps. Those caught lying face fines and jail time.

In South Korea, information on the movements of infected people before they were tested is collected and relayed over smartphones, creating a real-time ma

Taiwan tracks infected people’s whereabouts via smartphones

In Hong Kong, everyone subject to a compulsory quarantine must activate real-time location-sharing on their phone or wear an electronic wristband.

These measures have been backed by local populations that lived through previous epidemics and have largely shed concerns about privacy and tracking.

Americans should not focus “only on the kind of high-profile displays of state power that have made headlines from China” but also look at countries such as South Korea that are “balancing Democratic openness with rapid, concerted public-health action.”

Experts agree, though, that Western governments must be prepared to limit their citizens’ movements, mandate isolation for positive cases and track contacts regardless of privacy concerns.

In a matter of weeks, China has gone from being the epicenter of the virus to almost the only refuge from it, prompting hundreds of thousands of Chinese citizens abroad to flock home. Some 20,000 people are arriving on flights into China every day

“Certainly, China is indeed very safe now,” said Li, while the United States is just becoming more dangerous.

“The U.S. can’t test everyone, like in China. Testing an entire planeload of passengers and providing results the next day is impossible in the U.S.,” he said, referring to the entry procedures he went through on arrival in his home country.

There has also been a rush of returned from Britain since a government adviser advocated a “herd immunity” strategy, suggesting that it could be helpful if 60 percent of the population was infected.

Beijing’s municipal government on Sunday introduced new rules requiring all people arriving in the capital go into “centralized quarantine” at hotels for 14 days upon arrival, at their own expense.

Areas around the country, from Inner Mongolia in the north to Sanya on the island of Hainan in the south, have instituted similar measures, requiring stays in quarantine centers rather than trusting people to isolate themselves at home. More local authorities are expected to follow suit.

Beijing police authorities have made an example of a 37-year-old Chinese woman who works at Massachusetts biotechnology company Biogen and attended the Boston conference that has been linked to other infections, according to local media reports

She failed to report she was feeling sick before boarding her flight, took painkillers to suppress her fever and then lied to flight attendants about her condition, local police said.

The suspicious attendants reported her to police authorities upon arrival, who quarantined her and had her tested for the virus. It came back positive. In addition to being sick, she is now under criminal investigation for obstructing infectious disease prevention.

"Just being present there sends a message that people are not forgotten. They are not alone. They can see that there's people from the outside there, and it brings a level of accountability for staff and for ICE as well," he says. "Now that's not happening. We don't have that contact with people, and we don't have that direct connection, and we might lose that direct information that we get from them."

The White House is asking Congress to give ICE $249 million more as part of its emergency coronavirus funding request. This is how the White House says the money would be spent, according to the funding request that was sent to lawmakers Tuesday night:

While there aren't any confirmed cases of the novel coronavirus in ICE detention, we've heard about quarantines and outbreaks of other viruses in these facilities many times before.

"They're really concerned. They see what's on TV. And they hear the President saying don't be together in groups of 10 or more, that events of 50 or more people are being canceled. And they look around and see they're in close quarters with people, with staff coming in and out of the detention center daily. And they feel like sitting ducks," says Andrea Meza, director of RAICES' family detention services program.

"ICE takes very seriously the health, safety and welfare of those in our care. ... Pursuant to our commitment to the welfare of those in the agency's custody, ICE spends more than $269M annually on the spectrum of healthcare services provided to those in our care," she said.