Authorities in Beijing restricted more residents to their homes on Tuesday in a now 3-week-long effort to control a small but persistent COVID-19 outbreak in the Chinese capital.
Seven adjoining areas in the city’s Fengtai district were designated lockdown zones for at least one week, with people ordered to stay at home in an area covering about 4 by 5 kilometers (2.5 by 3 miles). The area is near a wholesale food market that was closed indefinitely on Saturday following the discovery of a cluster there.
The added restrictions come as Shanghai, China’s largest city, slowly starts to ease a citywide lockdown that has trapped most of its population for more than six weeks. The twin outbreaks in Beijing and Shanghai, the country’s most prominent cities, have focused attention on whether China can sustain its strict “zero-COVID” approach, as many other countries adapt to the fast-spreading omicron variant and ease restrictions.
China recorded 1,100 new cases on Monday, the National Health Commission said Tuesday. Of those, about 800 were in Shanghai and 52 were in Beijing. The daily number of new cases in Shanghai has declined steadily for more than two weeks, but authorities have been moved slowly to relax restrictions, frustrating residents.
In Beijing, the number of cases has held steady but new clusters have popped up in different parts of the city. City spokesperson Xu Hejian said that Beijing’s top priority is to screen people related to the cluster at the wholesale food market and isolate those who test positive. A second wholesale food market in Fengtai district was shut down Tuesday.
Most of Beijing is not locked down, but the streets are much quieter than usual with many shops closed and people working from home.
A whole town celebrated in 2020 when, early in the coronavirus pandemic, Thomasville Regional Medical Center opened, offering state-of-the-art medicine that was previously unavailable in a poor, isolated part of Alabama. The timing for the ribbon-cutting seemed perfect: New treatment options would be available in an underserved area just as a global health crisis was unfolding.
In the end, that same timing may be the reason for the hospital’s undoing.
Now deep in the red two years into the pandemic, the 29-bed, $40 million hospital with a soaring, sun-drenched lobby and 110 employees is among three medical centers in the United States that say they are missing out on millions in federal pandemic relief money because the facilities are so new they lack full financial statements from before the crisis to prove how much it cost them.
In Thomasville, located in timber country about 95 miles (153 kilometers) north of the Gulf Coast port of Mobile, hospital officials have worked more than a year to convince federal officials they should have gotten $8.2 million through the CARES Act, not just the $1 million they received. With a total debt of $35 million, the quest gets more urgent each day, said Curtis James, the chief executive officer.
“No hospital can sustain itself without getting the CARES Act money that everybody else got,” James said.
Employees are trying to save money by cutting back on supplies but residents including Judy Hutto are worried about the hospital’s future. Hutto drove there recently for tests from her home 15 miles (24 kilometers) out in the country.
“The areas needs it,” she said. “It’s a nice hospital.”
CEO Barry Beus also is trying to plug a gap at Rock Regional Hospital, located south of Wichita in Derby, Kansas. The hospital is due as much as $15.8 million, officials said, but because it only opened in April 2019 and lacks complete pre-pandemic financial statements, it has received just a little more than $985,000.
The only thing that’s saved the facility from financial ruin so far is the cooperation of doctors, contractors and vendors who haven’t pushed for payments, he said. “If we lose them, we lose the hospital,” said Beus.
Three Crosses Regional Hospital opened in 2020 in Las Cruces, New Mexico, and piled up a staggering $16.8 million in losses in just three quarters while receiving only $28,000 in aid, said Landon Fulmer, a Washington lobbyist working with all three hospitals to obtain additional funding. Each facility is being penalized for being new even though they provided the same costly COVID-19 care as other medical centers and lost revenue from other procedures including elective surgeries, he said.
“It really is quite a strange situation in a way, one that shouldn’t have happened,” Fulmer said.
With about 420,000 health care providers nationwide already receiving assistance from a $178 billion pot, the government isn’t covering 100% of losses for anyone, said Chris Lundquist, a spokesman for the U.S. Health Resources and Services Administration, which is overseeing the program.
“HRSA has strived to provide as much support as possible to as many hospitals as possible within the limits of the law and funding,” he said. The agency said it used proxy financial information for hospitals that opened in 2019 or 2020 to create an equitable payment system.
“They have all received funding,” said Lundquist.
While virtually all the aid money is spoken for, Lundquist said hospitals seeking additional aid can go through an appeals process. Hospitals also can seek a supplemental appropriation or funding in the upcoming fiscal years, he said. All three of the hospitals say they deserve more.
Officials in Thomasville are trying to leverage congressional influence. Mayor Sheldon Day has made several trips to Washington, D.C., to speak with members of the state’s congressional delegation and health officials, and the president of the Alabama Hospital Association, Dr. Don Williamson, has contacted the White House seeking help.
“They’ve been assured they’re going to be taken care of. But the fact is, when you’re dealing with government entities, you don’t have the money until you have the money,” said Williamson.
Located in southwest Alabama, Thomasville lies within an impoverished area called the Black Belt. About 70% of Black Belt residents qualify for Medicare or Medicaid, and health care has been limited for generations.
The last hospital shut down in Thomasville more than a decade ago, leaving only hospitals that offer fewer services in the surrounding region. Officials worked for years to secure a new hospital so residents wouldn’t have to drive 90 minutes for high-tech services such as digital imaging, full surgical options, echocardiograms, 3D mammography and more.
Using a partnership between the city and a municipal health care authority, Thomasville Regional secured federal funding from the Department of Agriculture and opened on March 3, 2020, before cases of COVID-19 caught fire in the rural South.
“We thought we were off to a good start,” said James, the chief executive. “And then everything shut down.”
Patients stopped showing up for scans, elective surgeries, mammographies and other moneymaking services because of pandemic shutdowns, and financial reports that looked promising turned perilous within weeks.
Recognizing that new hospitals couldn’t calculate COVID-19 losses because they couldn’t compare 2020 numbers with past years, Health and Human Services allowed hospitals to use budget numbers for calculations rather than prior financial statements. That’s how the hospital determined that it was missing out on more than $7 million in aid, James said.
While the hospital is still waiting on that aid, he said, the government did agree to provide $1 million in assistance that went to all other hospitals.
“That was OK, but other hospitals that are in our region got $8 million, $9 million,” he said.
The Birmingham-based Medical Properties Trust recently gave the hospital $2 million and James said leaders are confident Thomasville Regional will eventually get the extra federal aid. “But it will take time,” he said.
Like Thomasville Regional, Rock Regional in Kansas saw revenues dry up soon after opening, said Beus, the CEO. It’s still experiencing staff shortages because of the pandemic and having to pay a premium to travel nurses to work shifts on the wards, he said, all while working with consultants and members of Congress just trying to stay afloat.
“It’s been a little frustrating,” he said.
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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
North Korea on Tuesday reported another large jump in illnesses believed to be COVID-19 as a mass outbreak spreads through its unvaccinated population and military medical officers were deployed to distribute medicine.
State media said the North’s anti-virus headquarters reported another 269,510 people were found with fevers and six people died. That raises North Korea’s deaths to 56 after more than 1.48 million people became ill with fever since late April. North Korea lacks testing supplies to confirm coronavirus infections in large numbers, and the report didn’t say how many of the fever cases were COVID-19.
The outbreak is almost certainly greater than the fever tally, considering the lack of tests and resources to monitor and treat the people who are sick. North Korea’s virus response is mostly isolating people with symptoms at shelters, and as of Tuesday, at least 663,910 people were in quarantine.
In addition to lacking vaccines for its 26 million people, North Korea also grapples with malnourishment and other conditions of poverty and lacks public health tools, including antiviral drugs or intensive care units, which suppressed hospitalizations and deaths in other countries.
Some experts suspect North Korea is underreporting deaths to soften the blow for authoritarian leader Kim Jong Un, who already was navigating the toughest moment of his decade in power, with the pandemic further damaging an economy already broken by mismanagement and U.S.-led sanctions over his nuclear ambitions.
The North’s fatalities may surge in coming weeks as those who develop symptoms later succumb to the illness.
It’s also possible that fever cases are underreported by officials who worry about punishment or people don’t report their symptoms because they fear the strict quarantine measures, analysts say.
North Korea acknowledged domestic COVID-19 infections for the first time last Thursday, ending a widely doubted claim it was virus-free throughout the pandemic.
Describing the outbreak as a “great upheaval,” Kim imposed preventive measures including restrictions on movement and quarantines. But while he raised alarm over the virus, Kim also stressed that his economic goals should be met, indicating large groups of people will continue to gather for agricultural, industrial and construction work.
The official Korean Central News Agency said Tuesday that the military had deployed officers from its medical units to help with the transport of medicine to pharmacies in Pyongyang, which began to stay open 24 hours a day to deal with the virus crisis.
KCNA said the army units “expressed their will to convey the precious medicines, elixir of life, associated with the great love of Kim Jong Un for the people to the Pyongyangites.”
It’s unclear whether the North’s admission of an outbreak communicates a willingness to receive outside help. The country shunned millions of vaccines from the U.N.-backed COVAX distribution program, likely because of international monitoring requirements attached to those shots.
South Korea has publicly offered to send vaccines, medicine and health personnel, but North Korea has so far ignored the proposal amid icy relations between the rivals over a stalemate in larger nuclear negotiations between Washington and Pyongyang. Some experts say Kim’s praise of China’s pandemic response during a virus meeting last week indicates that the North would be more willing to receive help from its main ally.
Experts say the only realistic outside help would be offering limited supplies of vaccines to reduce deaths among high-risk groups, including the elderly and people with preexisting conditions, as it’s too late to stop a broad spread of the virus across the North’s population.
“With the country yet to initiate COVID-19 vaccination, there is risk that the virus may spread rapidly among the masses unless curtailed with immediate and appropriate measures,” Dr. Poonam Khetrapal Singh, the World Health Organization’s regional director for Southeast Asia, said in a statement. He said WHO is ready to provide North Korea with technical support to increase testing and with essential medicines and medical supplies.
Total Doses Distributed = 737,076,255. Total Doses Administered = 581,841,231. Number of People Receiving 1 or More Doses = 257,870,633. Number of People Fully Vaccinated = 220,618,615.
When the U.S. hit 1 million COVID-19 deaths on Monday, the news was driven by a government tally derived from death certificates.
But that’s not the only tally. And you may be wondering, where do these numbers come from? A look behind the data:
DEATH CERTIFICATES
Deaths certificates have long been considered the most comprehensive record of deaths and their causes. The Centers for Disease Control and Prevention systematically collects information from all 50 states to track fatalities from all causes, including cancer, drug overdoses and now COVID-19.
But early in the pandemic, officials recognized the COVID-19 data was sluggish and incomplete.
Testing was often unavailable. In some places — especially rural ones — coroners or medical examiners did not have the staff to ask about coronavirus symptoms when people died at home. Even when information was available, overworked doctors could be slow to do the death certificate paperwork.
DEATHS FROM CASE REPORTS
With information on death certificates slow to arrive, experts and news organizations began looking to other real-time sources of deaths.
They turned to state health department tallies derived from preliminary reports that were mainly of people diagnosed with COVID-19 who went to a hospital and died. Such data was more timely than death certificates, which can take weeks to fill out and process.
Johns Hopkins University became a leader in searching state health department websites and rapidly analyzing and posting those numbers.
OTHER COUNTS
Other organizations have their own counts, including NBC News, which two weeks ago reported that the U.S. had surpassed 1 million COVID-19 deaths, but did not explain in its story how it arrived at that figure.
Last week, federal officials issued statements about the nation hitting 1 million deaths, even though the U.S. government’s own data had yet to show it. Based on lags in the reporting of death certificate information, officials concluded it was likely the milestone had passed and that it was appropriate to remark on it.
HOW THE TALLIES HAVE CHANGED
As the pandemic dragged on, many states cut back on posting case and death numbers — some to just once a week.
“We’ve lost a lot of immediacy in our reporting.” Emily Pond, a Johns Hopkins research data analyst, said in an email.
At the same time, the numbers based on death certificates rose faster. One reason: Investigators have been going back and adding several thousand deaths in which COVID-19 was not named initially but was identified later after autopsies or other medical investigations, said Robert Anderson, who oversees death data for the CDC’s National Center for Health Statistics.
Most of those deaths happened early in the pandemic, when COVID-19 was still new and underdiagnosed. Anderson said many were relabeled last year, largely in response to a Federal Emergency Management Agency program that began providing funeral assistance for families who could produce a death certificate attributing a death to COVID-19.
As of Monday morning, the Johns Hopkins data portal counted 999,607 deaths. The CDC count based on death certificates was 1,000,292.
At least 900,000 of the death certificates included in the CDC tally list COVID-19 as the primary cause of death, the agency said. The others list it as a contributing cause.
Some experts believe even the current death certificate-based data is an undercount. But it’s the best available, said Andrew Stokes, a Boston University researcher.
“It’s kind of the final say,” he said.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
The U.S. death toll from COVID-19 hit 1 million on Monday, a once-unimaginable figure that only hints at the multitudes of loved ones and friends staggered by grief and frustration.
The confirmed number of dead is equivalent to a 9/11 attack every day for 336 days. It is roughly equal to how many Americans died in the Civil War and World War II combined. It’s as if Boston and Pittsburgh were wiped out.
“It is hard to imagine a million people plucked from this earth,” said Jennifer Nuzzo, who leads a new pandemic center at the Brown University School of Public Health in Providence, Rhode Island. “It’s still happening and we are letting it happen.”
Some of those left behind say they cannot return to normal. They replay their loved ones’ voicemail messages. Or watch old videos to see them dance. When other people say they are done with the virus, they bristle with anger or ache in silence.
“’Normal.’ I hate that word,” said Julie Wallace, 55, of Elyria, Ohio, who lost her husband to COVID-19 in 2020. “All of us never get to go back to normal.”
Three out of every four deaths were people 65 and older. More men died than women. White people made up most of the deaths overall. But Black, Hispanic and Native American people have been roughly twice as likely to die from COVID-19 as their white counterparts.
Most deaths happened in urban areas, but rural places — where opposition to masks and vaccinations tends to run high — paid a heavy price at times.
The death toll less than 2 1/2 years into the outbreak is based on death certificate data compiled by the Centers for Disease Control and Prevention’s National Center for Health Statistics. But the real number of lives lost to COVID-19, either directly or indirectly, as a result the disruption of the health care system in the world’s richest country, is believed to be far higher.
The milestone comes more than three months after the U.S. reached 900,000 dead. The pace has slowed since a harrowing winter surge fueled by the omicron variant. The U.S. is averaging about 300 COVID-19 deaths per day, compared with a peak of about 3,400 a day in January 2021.
The largest bell at Washington National Cathedral in the nation’s capital tolled 1,000 times a week ago, once for every 1,000 deaths. President Joe Biden on Thursday ordered flags lowered to half-staff and called each life “an irreplaceable loss.”
“As a nation, we must not grow numb to such sorrow,” he said in a statement. “To heal, we must remember.”
More than half the deaths occurred since vaccines became available in December of 2020. Two-thirds of Americans are fully vaccinated, and nearly half of them have had at least one booster dose. But demand for the vaccine has plummeted, and the campaign to put shots in arms has been plagued by misinformation, distrust and political polarization.
Unvaccinated people have a 10 times greater risk of dying of COVID-19 than the fully vaccinated, according to the CDC.
“To me, that is what is just so particularly heartbreaking,” Nuzzo said. Vaccines are safe and greatly reduce the likelihood of severe illness, she said. They “largely take the possibility of death off the table.”
Angelina Proia, 36, of New York, lost her father to COVID-19 in April 2020. She runs a support group for grieving families on Facebook and has seen it divided over vaccinations. She has booted people from the group for spreading misinformation.
“I don’t want to hear conspiracy theories. I don’t want to hear anti-science,” said Proia, who wishes her father could have been vaccinated.
Sara Atkins, 42, of Wynnewood, Pennsylvania, channels her grief into fighting for global vaccination and better access to health care to honor her father, Andy Rotman-Zaid, who died of COVID-19 in December 2020.
“My father gave me marching orders to end it and make sure it doesn’t happen again,” Atkins said of the pandemic. “He told me, ‘Politicize the hell out of my death if I die of this.’”
Julie Wallace and her husband, Lewis Dunlap, had cellphone numbers one digit apart. She continues paying to keep his number. She calls it just to hear his voice.
“It’s just so important to hear that sometimes,” she said. “It gives you a little bit of reassurance while also tearing your heart out.”
Brian Sonia-Wallace, poet laureate of West Hollywood, California, has traveled the country writing poems for hire. He imagines a memorial of a million poems, written by people who don’t normally write poetry. They would talk to those who are grieving and listen for points of connection.
“What we need as a nation is empathy,” said Tanya Alves, 35, of Weston, Florida, who lost her 24-year-old sister to COVID-19 in October. “Over two years into the pandemic, with all the cases and lives lost, we should be more compassionate and respectful when talking about COVID. Thousands of families changed forever. This virus is not just a cold.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
