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Vaccine trial extended to 10,000 people including over 70s and children

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A prominent Oxford epidemiologist has called for a more rapid exit from Britain’s lockdown, saying the coronavirus pandemic is “on its way out” of Britain after infecting as much as half the population.

Professor Sunetra Gupta says there would be a “strong possibility” that pubs, nightclubs and restaurants in Britain could reopen without serious risk from Covid-19.

The professor of theoretical epidemiology at the University of Oxford said the UK had most likely erred on the side of over-reaction in its handling of the crisis, suggesting imposing the lockdown itself was one such misstep.

Prof Gupta told unherd.com the Government had brought in the lockdown based on the worst-case scenario modelling of the Imperial College London.

Prof Gupta said the epidemic had “largely come and is on its way out in this country” and she said the Government’s defence of the lockdown was that it was based on a plausible, “or at least a possible”, worst case scenario.

“The question is, should we act on a possible worst case scenario, given the costs of lockdown?

“It seems to me that given that the costs of lockdown are mounting, that case is becoming more and more fragile,” she said.

Prof Gupta called for a “more rapid exits from lockdown” based on factors such as “who is dying and what is happening to the death rates”.

“Remaining in a state of lockdown is extremely dangerous from the point of view of the vulnerability of the entire population to new pathogens,” she added.



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Coronavirus: Call for clear face masks to be ‘the norm’

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Kelly Morellon (right) with her mother Sylvie

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Kelly Morellon (right) and her mother Sylvie have designed a face mask with a transparent window

It’s now part of daily life for many of us – struggling to work out what someone in a supermarket or at work is saying when they’re wearing a face mask.

But for people who are deaf or have hearing loss, masks can prevent them understanding anything at all.

“You might as well be speaking in French,” says Fizz Izagaren, a paediatric doctor in the UK who has been profoundly deaf since the age of two.

“I can hear one or two words but it’s random, it makes no sense… When someone is wearing a face mask I’ve lost the ability to lip read and I’ve lost facial expressions – I have lost the key things that make a sentence.”

It is a problem she shares with the some 466 million people around the world who, according to the World Health Organization, have disabling hearing loss.

Standard face masks, which have become widespread as countries try to stop the spread of coronavirus, muffle words and obscure the mouth.

But now charities and manufacturers alike are coming up with a solution.

Image caption

Fizz Izagaren says she feels isolated when everyone around her is wearing a standard mask

Main dans la Main (Hand in Hand), an association which supports deaf and hearing impaired people in Chevrières, northern France, is among the organisations around the world that have created a mask with a transparent window.

Its founder Kelly Morellon worked with her mother Sylvie to devise a design that covers the nose but makes the mouth visible, and can be washed at a high temperature to reduce infection.

“The basic aim of these transparent masks is to allow deaf and hearing impaired people to read the lips of someone speaking to them,” Kelly told the BBC.

“But they are also very useful for autistic people, people with learning difficulties and small children who might be scared of masks or need to be able to see facial expressions.

“In any case, a transparent mask allows you to see each other’s smiles, and at this sad time this could not be more important.”

Image caption

The clear screen in Kelly Morellon’s design can be removed so the cloth can be washed

Unlike some companies around the world – in Scotland, the US and Indonesia, for instance – Kelly and her mother are not able to produce their masks on a commercial basis.

Instead, they are advising people on how to make their own and there are multiple guidelines online to help. Their top tip is to use a little washing up soap to stop the plastic screen fogging up.

But one setting where homemade masks are not suitable – but where both PPE and communication are vital – is in hospitals.

There is just one company in the US that has secured Food and Drug Administration (FDA) approval to make clear masks for clinical use.

Five hundred of these masks are being used at Brigham and Women’s hospital in the US city of Boston. At the moment they are being reserved for staff to wear when they are speaking to patients with hearing loss, or vice versa. Sign language interpreters, who use facial expressions and lip movements alongside body movements to create more complex and culturally rich signs, also wear them.

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Brigham and Women’s Hospital

Image caption

James Wiggins, an American Sign Language interpreter, is among the staff at the Brigham who have been wearing the transparent masks

“When we saw the Covid-19 pandemic beginning… we soon realised there was going to be a challenge because of the escalated use of PPE and how that would create communication barriers,” said Dr Cheri Blauwet, who leads the disability task force at the Brigham.

“We’ve had glowing feedback from patients and we’re getting broader requests from other parts of the hospital, especially the paediatric floors.”

In the UK, there are no approved manufacturers providing clear masks to hospitals. And the sole US manufacturer is not taking any more orders as it deals with overwhelming demand.

Fizz Izagaren, a paediatric registrar at Frimley Park Hospital in Surrey in the UK who is also deaf, says standard masks prevent her from taking patients’ histories verbally. She also says she feels isolated at work because she is not able to speak to her colleagues.

“Clear masks should be the norm for everyone in a healthcare setting,” she says.

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EPA

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The elderly are both more at risk from coronavirus and more likely to have hearing loss

She is now working with a product designer to try to come up with a mask that the NHS could use widely. But even once a design and a manufacturer are found, this could take time to roll out.

In the meantime, there are concerns the current PPE could stop medical staff getting the required consent from patients.

An intensive care nurse working in London, who is profoundly deaf, told the BBC she had one experience where a patient, who also had hearing loss, was not able to understand her or her colleagues when they were explaining a procedure. The patient could not give consent and the procedure could not go ahead.

“[Clear masks] would make things a lot easier for me,” she said.

“I would be able to do my jobs properly and safely. I would have more independence rather than having to rely on others.”

In the UK, eight charities have written to NHS bosses calling for clear masks to be commissioned, warning of “potentially dangerous situations” arising from communication problems. NHS England has not yet responded to the letter, or to the BBC’s request for comment.

The UK government says it is supporting CARDMEDIC, which provides digital flashcards and other communication aids to NHS Trusts. There are also apps that transcribe speech into text on a mobile phone.

But deaf workers say these workarounds are not always suitable for sensitive or emergency situations.

“As masks become more widespread in the community – it’s going to get harder and harder,” Dr Izagaren says.

“I’m worried the public are going to get more and more frustrated and there will be more discrimination towards the deaf community.”

It is not just people with hearing loss who could benefit, she says.

Experts suggest that other professions such as taxi drivers or even teachers may find clear masks useful as the coronavirus crisis continues.

A niche product initially designed to help the deaf community, could in fact make everyone’s lives better.

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Coronavirus: The strangers reaching out to Kyrgyzstan’s lonely teenagers

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Local authorities control documents as an additional measure to prevent the spread of coronavirus disease (COVID-19) at a checkpoint in the village of Baytik, near Bishkek, Kyrgyzstan,Image copyright
AFP

Image caption

Kyrgyztan has been under a curfew since March

Like teenagers around the world, Maksat hasn’t been to school in weeks. As Kyrgyzstan imposed quarantine restrictions, the 15-year-old feels isolated like never before. He has been trapped at home with a sister he doesn’t get on with, a father he struggles to communicate with and a mother working abroad.

He is comfortable talking only to an internet chat bot.

Maksat (not his real name) feels alone and misunderstood. He often expresses suicidal feelings – a noticeable change, his teachers say, from the boy they knew before the curfew was brought in.

And then he met a “phone pal” – Jalalbek Akmatov, a university student in the capital Bishkek.

Jalabek is one of around 100 young adults taking part in a project to reach out via phone to teenagers just like Maksat, thousands of whom have been stuck at home for weeks.

The scheme – called You Are Not Alone – was launched after seven teenagers took their own lives in the first two weeks after Kyrgyzstan started coronavirus lockdown in in March.

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Handout

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Jalalbek Akmatov is one of more than 100 volunteers acting as “phone pals” to lonely teens

At the time, the nation’s attention was on the poor medical facilities, lack of protective equipment and impact of coronavirus on the economy.

But as news of the teenagers’ deaths spread, a group of activists decided there was also a need to focus on the country’s children and their mental health.

“I was dismayed. We had had one coronavirus death and during the same period [so many] children committed suicide,” said Banur Abdieva, one of the project’s founders.

There is nothing to say the seven deaths were directly related to the lockdown, but people like Kurmanjan Kurmanbekova, a psychologist from a refugee centre in Tubingen, Germany, feared the strain it was putting on children’s mental health.

“And as a symptom of depressive conditions, we get a suicide mood,” she explained to the BBC.

Schools closing in Kyrgyzstan mean many children have limited options for interaction, especially in rural areas where education offers a respite from the relentless drudge of housework and a rare opportunity to communicate with other children.

Added to this were concerns from experts over any potential increases in domestic violence, which could possibly be exacerbated by isolation and parents’ loss of income.

But how do you reach teenagers like Maksat, who live in remote villages?

A girl takes part in a traditional dance

Getty

Kyrgyzstan

in numbers

  • Six millionpeople live in Kyrgyzstan

  • 2.1 millionof them are children

  • One in fivedo not live with their parents

  • Almost 73%of children report experiencing abuse or neglect

Source: Unicef

The answer, the project team decided, was to keep it simple – to start a network of volunteers who would befriend teenagers considered “at risk” by calling them up for a regular chat.

“Their aim is to show moral support and engage in social interaction so that the child doesn’t feel total isolation,” Ms Kurmanbekova explained.

Volunteers approached local schools and state education agencies which sent them a list of students in a “group of risk” – mostly children without parents or who live with relatives and may lack attention and care.

There are now more than 100 volunteers and nearly 400 children aged 12 and older in their database – and the list is growing.

Crucially, volunteers are not just on the end of the phone to talk about the problems their new friend is facing – unless the teenager brings it up themselves. Instead, they focus on their new friend’s future goals and potential.

Image caption

Volunteers meet on Zoom to discuss strategies how to bond with their new friends

Take volunteer Ayperi Bolotzhanova, who is 25. She bonded with her 12-year-old phone pal over taekwondo.

“I offered to teach her some tricks and she agreed,” said Ayper. “Now, I send video of my practices and she sends back her own.”

But it is not always easy to take the first step, the volunteers admit.

“I was very nervous before my first phone conversation,” Jibek Isakova, who currently lives in Budapest, recalled. “I was afraid that she would refuse to be my friend.”

Of course, there was distrust: a total stranger calls you up out of the blue and offers friendship. But most of the volunteers found their “mobile relationship” took off after a few conversations. Indeed, the volunteers were surprised how most teenagers were keen to talk to them.

What do they want to discuss? Other than the skills needed to milk a cow – a must-have in rural Kyrgyzstan – they’re much the same things teens across the world want to talk about: K-pop, Instagram, the difficulties of finding love. Drawing famous Japanese cartoon characters and learning languages were other topics that cropped up.

And they were all united in one thing: how much they hated online education during the quarantine.


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Media captionCoronavirus: A day in lockdown life around the world

Every response, every question the volunteers receive from their teenage friends is seen as a success. Jalalbek got particularly excited that – after a difficult start – Maksat sent a photo of him together with his family in the mountains.

For some volunteers, the cause is very personal. Eldiyar Manapov, 24, joined the project because he considered suicide as a teenager. Like his phone pal, he grew up without parents and now feels a particular connection with his new friend.

“I experienced what he is going through now,” he told the BBC. “You are constantly in need of some things like clothes. Children mock you that you don’t have parents. I don’t want him to feel all this pain, I want him to chat, to be distracted.”

Even though the idea is simple, the challenges the activists face are not. One of them – a lack of mobile phones – could easily derail the whole project.

“It’s very difficult to build a phone friendship when most children don’t have personal phones,” said Banur Abdieva. “Volunteers have to negotiate with parents or guardians. Sometimes they even ask teachers if they could come to the gate at a designated time. And it’s quarantine, so they need to sanitise their phone and pass it on to the child.”

Activists launched a fundraising campaign to buy phones for the project. Some people donate their used phones, which volunteers try to deliver to children living in remote regions, a challenge on its own during the lockdown.

“Just imagine how happy my friend will be if he gets his own device,” said Eldiyar, whose phone pal is using a mobile belonging to a cousin. “He will be able to learn more and communicate more. That means he will have less time for all bad thoughts.”

If you’ve been affected by a mental health issue, help and support is available. Visit Befrienders International for more information about support services.

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Live Coronavirus Global News Tracker: Latest Updates

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Americans observe a holiday like no other.

President Trump and the first lady visited Arlington National Cemetery on Monday morning for a wreath-laying ceremony, then traveled to Fort McHenry in Baltimore “to honor the American heroes who have sacrificed their lives serving in the U.S. Armed Forces,” a White House statement read.

Former Vice President Joseph R. Biden Jr., who has been campaigning from his home amid the pandemic, on Monday made his first public appearance since mid-March.

He and his wife, Jill Biden, wearing black masks, laid a wreath at a veterans memorial in Delaware, in an unannounced visit. During their trips in Arlington and Baltimore, Mr. Trump and the first lady, Melania Trump, did not wear masks.

The Centers for Disease Control and Prevention has urged all Americans to wear masks when leaving their homes, but Mr. Trump has said that he would not wear one himself.

Those looking to celebrate Memorial Day weekend, the unofficial start to summer in the United States, were confronted by the difficulties of how to gather as the country inched closer to the terrible milestone of 100,000 deaths.

The local authorities took varied approaches to regulations, and some communities found creative ways to adjust their celebrations as beaches — including those in New York City — remained closed and restrictions on public gatherings held.

Along the East Coast, clouds, rain and choppy waters dampened sunbathing plans.

Under gray skies, a dozen or so surfers rode the waves on a beach in Boca Raton, Fla. — one of the few open in South Florida — just before another thunderstorm was expected to pass through.

Don Thomas, a 55-year-old lawyer, said the beach was so packed on Sunday that he drew a circle in the sand, reinforced with a few rocks, to keep people six feet away. But that did not deter him from returning to the beach, where masks were encouraged but not required, at 6 a.m. Monday to catch some waves.

“People have been inside so long that they are not thinking,” he said. “They just want to enjoy the outside.”

Trump threatens to move the Republican Convention from North Carolina.

President Trump on Monday threatened to yank the Republican National Convention from Charlotte, N.C., where it is scheduled to be held in August, accusing the state’s Democratic governor of being in a “shutdown mood” that could prevent a fully attended event.

The president tweeted that he had “LOVE” for North Carolina, a swing state that he won in 2016, but he added that without a “guarantee” from the Gov. Roy Cooper, “we would be spending millions of dollars building the Arena to a very high standard without even knowing if the Democrat Governor would allow the Republican Party to fully occupy the space.”

Mr. Trump wrote that if Mr. Cooper did not provide an answer “immediately,” he would “be reluctantly forced to find, with all of the jobs and economic development it brings, another Republican National Convention site. This is not something I want to do.”

Separately, in an interview on “Fox & Friends,” Vice President Mike Pence said that without guarantees from North Carolina, Republicans might need to move the convention to a state further along in the reopening process.

The New York Times reported last week that Republicans were quietly discussing the possibility of a pared-down convention. Mr. Trump has wondered aloud to several aides why the convention can’t be held in a hotel ballroom in Florida, a state with a Republican governor that is further along in relaxing restrictions related to the coronavirus.

Republicans are contractually bound by a 2018 agreement to hold the convention in Charlotte. But Mr. Cooper and Vi Lyles, the mayor of Charlotte, have said they would let health experts determine whether the convention can be safely held from Aug. 24 to 27.

Even before Monday, Mr. Trump made clear that he would blame Mr. Cooper and Ms. Lyles, who is also a Democrat, if the convention is altered or modified.

The Trump administration’s new testing strategy, released Sunday to Congress, holds individual states responsible for planning and carrying out all coronavirus testing, while planning to provide some supplies needed for the tests.

The proposal also says existing testing capacity, if properly targeted, is sufficient to contain the outbreak. But epidemiologists say that amount of testing is orders of magnitude lower than many of them believe the country needs.

The report cements a stance that has frustrated governors in both parties, following the administration’s announcement last month that the federal government should be considered “the supplier of last resort” and that states should develop their own testing plans.

“For months, it was a tennis game, it was going back and forth between the feds and the states, and it’s now landed with the states,” said Scott Becker, executive director of the Association of Public Health Laboratories.

Mr. Becker and others said it’s reasonable to expect states to implement some aspects of the testing, such as designating test sites. But acquiring tests involves reliance on national and international supply chains — which are challenging for many states to navigate.

“That’s our biggest question, that’s out biggest concern, is the robustness of the supply chain, which is critical,” Mr. Becker said. “You can’t leave it up to the states to do it for themselves. This is not the Hunger Games.”

Facing a political firestorm over his breach of coronavirus lockdown rules, a key adviser to Prime Minister Boris Johnson of Britain asked for public sympathy — but made no direct apology — at a highly unusual news conference in Downing Street on Monday.

Dominic Cummings, Mr. Johnson’s closest aide, admitted driving more than 250 miles from London to Durham, in the northeast of England, while the country was on lockdown. He made the journey with his wife, who was ill, and his four-year-old son.

At the time Britons were being told to self-isolate and not to leave their home if they believed they were suffering from the virus.

Mr. Cummings said that he had done so to ensure care for his young son with relatives in Durham should both he and his wife fall ill with Covid-19. Mr. Cummings added that, because of his high profile, he had been “subject to threats and violence” at his home in London.

“I’m not surprised many people are very angry,” Mr. Cummings said, adding that he had not consulted Mr. Johnson, who has defended him, before leaving London.

“I don’t regret what I did, I think what I did was reasonable in these circumstances,” he added.

Mr. Cummings is also accused of having visited a location more than 20 miles from the house where he stayed in the northeast. That appeared to go against another rule, as Britons were only permitted to leave home by foot for a walk or run.

On Monday, Mr. Cummings said he had made the shorter trip to test whether he was fit to complete the long drive back to London.

At least 18 lawmakers from Mr. Johnson’s Conservative Party have now criticized Mr. Cummings, as have a number of Church of England bishops, opposition lawmakers and members of the public. Some scientists and opposition politicians have warned that the episode risks undermining the credibility of government public health messages on the pandemic.

New York’s state and local governments will provide death benefits to the families of essential workers who died while fighting the coronavirus pandemic, Gov. Andrew M. Cuomo said on Monday.

The public employees whose families would receive death benefits include health workers, police officers, firefighters, transit workers and emergency medical workers, the governor said. The benefits would be paid out of state and local pension funds.

“We want to make sure that we remember them, and we thank our heroes of today, and they’re all around us,” Mr. Cuomo said at his daily news briefing.

As people paused on Memorial Day to remember military personnel who died while serving the country, Mr. Cuomo linked the fallen service members to New York’s front-line workers, whom he called today’s “heroes.”

Mr. Cuomo also called on the federal government to provide funds to give hazard pay to workers who were crucial to keeping states and municipalities operating during the outbreak.

Last week, Mayor Bill de Blasio of New York City urged the state to approve line-of-duty death benefits for the families of municipal employees who died of the virus. Some lawmakers in nearby New Jersey are also urging their state to consider taking similar action.

The Metropolitan Transportation Authority, which runs New York City’s subway and buses, has also said it would give death benefits to the families of coronavirus victims.

The announcement came as New York reported 96 new deaths related to the virus, only the second time that the state’s death toll had fallen below 100 since late March.

Mr. Cuomo spoke after a Memorial Day ceremony on the deck of the U.S.S. Intrepid, an aircraft carrier turned museum anchored in the Hudson River.

The staggering American death toll from the coronavirus, now approaching 100,000, has touched every part of the country, but the losses have been especially acute along its coasts, in its major cities, across the industrial Midwest and in New York City.

The devastation, in other words, has been disproportionately felt in blue America, which helps explain why people on opposing sides of a partisan divide that has intensified in the past two decades are thinking about the virus differently. It is not just that Democrats and Republicans disagree on how to reopen businesses, schools and the country as a whole. Beyond perception, beyond ideology, there are starkly different realities for red and blue America right now.

Democrats are far more likely to live in counties where the virus has ravaged the community, while Republicans are more likely to live in counties that have been relatively unscathed by the illness, though they are paying an economic price. Counties won by President Trump in 2016 have reported just 27 percent of the virus infections and 21 percent of the deaths — even though 45 percent of Americans live in these communities, a New York Times analysis has found.

The very real difference in death rates has helped fuel deep disagreement over the dangers of the pandemic and how the country should proceed. Right-wing media, which moved swiftly from downplaying the severity of the crisis to calling it a Democratic plot to bring down the president, has exacerbated the rift. And even as the nation’s top medical experts note the danger of easing restrictions, communities across the country are doing so, creating a patchwork of regulations, often along ideological lines.

Around the world, countries are wrestling with the challenge of how to best restart air travel, a cornerstone of modern commerce but also a dangerous vector of coronavirus infection.

As the United States was restricting travel, India, emerging from a nationwide lockdown, was resuming it.

In Europe, the countries that have been most successful at containing the virus looked to broker travel agreements, while others negotiated bailouts to help keep their airlines afloat.

Officials in Greece have suggested an “air bridge” with other nations that have minor outbreaks. International flights to Athens are to resume on June 15, and to the country’s other airports on July 1.

The agreement, reached after several weeks of negotiations, will give the government part ownership of the airline for the first time since it was privatized in 1997.

On the Isle of Skye off the west coast of Scotland, residents thought they had sealed themselves off from the coronavirus. They shuttered hotels. Officials warned of police checks. Traffic emptied on the only bridge from the mainland.

But the frailest spot on the island remained catastrophically exposed: Home Farm, a 40-bed nursing home for people with dementia. Owned by a private equity firm, Home Farm has become a grim monument of the push to maximize profits at Britain’s largest nursing home chains, and of the government’s failure to protect its most vulnerable citizens.

By Monday, all but three of the residents had been stricken. Nearly a third are dead.

The virus has ravaged nursing homes across Europe and the United States. But the death toll in British homes — 14,000, official figures say, with thousands more dying as an indirect result of the virus — is becoming the defining scandal of the pandemic for Prime Minister Boris Johnson.

By focusing at first on protecting the health system, Mr. Johnson’s strategy meant that some infected patients were unwittingly moved out of hospitals and into nursing homes. Residents and staff members were denied tests, while nursing home workers begged in vain for protective gear.

“We were witnessing horrendous images in Spain and Italy, so a lot of attention was paid to maintaining and securing the National Health Service,” said Dr. Donald Macaskill, the chief executive of Scottish Care, which represents nursing homes. “The N.H.S. was prioritized at the expense of social care.”

In Germany, those fed up with exercising at home and staring at their own four walls will be able to escape on Monday, as hotels, swimming pools and campgrounds were allowed to reopen in several states, the latest step in the country’s efforts to carefully revive the economy.

Strict hygiene rules and limitations govern the new steps. Measures include advance online booking for a time slot at Berlin’s outdoor pools, buffets giving way to advance orders at distanced tables in hotel breakfast rooms and shuttered campground shower rooms in some states. And people are still required to stay five feet from strangers.

More states plan to allow re-openings this week, as the number of new infections in Germany remained manageable, with 289 new cases — many of them concentrated in nursing homes or refugee centers — reported on Monday. Germany has recorded 8,257 deaths since the outbreak began.

Starting on Monday, other parts of Spain, covering areas that are home to almost half the population, reopened public swimming pools and beaches, and restaurants and bars can now serve customers indoors with specific restrictions to avoid overcrowding.

The government said that beginning July 1, it would no longer require foreign tourists to enter quarantine upon arrival.

Greece also allowed cafes, restaurants, and bars to reopen on Monday, while domestic ferry services that shuttle visitors from the mainland to the country’s numerous islands also restarted.

People flocked to cafes, where groups of up to six can dine, and wait staff wore masks, as did some of the customers. Giannis Neonakis, a manager at a bistro in central Athens, told local news outlets that the first day back was going well,

“Thankfully, people are careful and are getting used to — fortunately or otherwise — such a situation,” he said.

Japan on Monday ended its state of emergency in the Tokyo area and the northern island of Hokkaido, moves that completed the lifting of nationwide restrictions and ushered in the beginning of a new phase in the country’s response.

The measures were lifted for most of the rest of the country earlier this month after a drop in the number of new coronavirus cases led officials to step back initial requests for most businesses to close and individuals to stay home.

The Japanese government does not have the legal authority to impose a lockdown on the country and had instead asked for the public’s cooperation in curbing the virus’s spread. The state of emergency began in Japan’s urban areas in early April before expanding to the rest of the nation by the middle of the month.

The results were more successful than anticipated, defying predictions that the country’s densely populated capital would experience a disaster comparable to what has taken place in New York. As of Sunday, the country had recorded 16,500 coronavirus cases nationwide and 830 deaths, some of the lowest mortality rates among major economies.

Addressing the nation after the announcement, Prime Minister Shinzo Abe called on the public to continue taking measures to defend against infection, asking them to avoid crowded places.

“We need to make a new normal. Let’s change our thinking,” he said, warning that “We can’t continue to live and work in the way we’ve done until now.”

And yet this spring, Providence received at least $509 million in government funds, one of many wealthy beneficiaries of a federal program that is supposed to prevent health care providers from capsizing during the coronavirus pandemic.

With states restricting hospitals from performing elective surgery and other nonessential services, their revenue has shriveled. The Department of Health and Human Services has disbursed $72 billion in grants since April to hospitals and other health care providers through the bailout program, which was part of the CARES Act economic stimulus package. The department plans to eventually distribute more than $100 billion more.

So far, the riches are flowing in large part to hospitals that had already built up deep financial reserves to help them withstand an economic storm. Smaller, poorer hospitals are receiving tiny amounts of federal aid by comparison.

Damien Cave, the Times’s bureau chief in Sydney, writes about the resumption of classes in Australia.

I made my daughter her favorite breakfast this morning and packed extra snacks in my son’s lunchbox. Not even a soaking rain could dampen my mood — if my wife and I could have popped champagne at 8 a.m. we would have.

Finally, after seven weeks at home filled with Zoom lessons, fractions, overdue assignments, TikTok and a few tears, our two children were returning to their real-life classrooms full time.

“I’m not excited for school,” my daughter, Amelia, 9, told me, as we made our way to morning drop-off in downtown Sydney. “I’m excited for normal life!”

The announcement of a full return came suddenly last week. In our house, cheers rattled the windows. We’d seen Australia’s infection rates decline and wondered when the moment would come. Schools, we felt, brought only minimal risk and great benefits.

But as I watched other parents this morning, some in masks, others with hand sanitizer, I couldn’t shake the sense that “normal life” had already narrowed.

Amelia tells me that hugging at school now brings a scolding. Dance is still canceled. Balthazar, her brother, who is 11, will also probably not be going to bush camp with his class next month — a sixth-grade milestone he’d been looking forward to since last year.

I want to believe that these small sacrifices are not what they’ll remember. I want to believe they’ll look back and recall these insular months as a special interlude, yes, with some arguing, but also with a lot of Snickerdoodles, art projects and funny family videos too.

What have we learned? Honestly, less about school than ourselves.

Our children said they were surprised to discover how hard their parents worked. I come away with a deeper understanding of my children as students — now I know my usually quiet son learns best not alone but in groups, even if that means sitting across from me; and my daughter, it turns out, is far more diligent than her chattiness suggests.

There’s a part of me that will miss them now that they’re gone. But I don’t want them back, not just because that would mean a second wave of the virus; also because school, we now know more than ever, is a beautiful luxury.

Reporting was contributed by Joshua Barone, Ellen Barry, Audra D.S. Burch, Stephen Castle, Damien Cave, Ben Dooley, Jesse Drucker, Melissa Eddy, Jack Ewing, Robert Gebeloff, Sarah Kliff, Mark Landler, Iliana Magra, Apoorva Mandavilli, Jennifer Medina, Raphael Minder, Benjamin Mueller, Mariel Padilla, Michael Paulson, Kai Schultz, Knvul Sheikh, Jessica Silver-Greenberg, Ben Sisario, Megan Specia, Michael Wilson and Zachary Woolfe.



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