GAINESVILLE, Fla. (AP) — The decision to shelve detailed advice from the nation’s top disease control experts for reopening communities during the coronavirus pandemic came from the highest levels of the White House, according to internal government emails obtained by The Associated Press.

Blimey. They didn’t hold back on this. —Read, if for no other reason than the incredibly detailed timeline of #coronavirus.

If this lede doesn't get you, I don't know what will. @davidmcswane's latest:

If the authorities can’t satisfy the public’s desire to know more, others will fill the void with misinformation. Carl Bergstrom, professor of biology at the UW, is mentioned.

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via Health News - The New York Times https://nyti.ms/2WLL65m

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(United States Second Circuit) - Vacate and order the unsealing of summary judgment record and remand. Intervenors, Dershowitz and the Miami Herald, appeal from an order denying motion to unseal filings in a defamation suit stemming from a suit brought as a result of the conviction of Jeffrey Epstein. Appeals court held the district court failed to conduct appropriate review when it ordered records sealed. Appeals court ordered the unsealing of summary judgment materials as there was no privacy interest sufficient to justify continued sealing. The remaining documents require additional review by the district court applying appropriate standards.

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(California Court of Appeal) - Affirmed. The court found that Senate Bill No. 1107 directly conflicts with Political Reform Act of 1974 and does not further the purposes of the Act.

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By Rob Stein, Carmel Wroth, Alyson Hurt

To safely phase out social distancing measures, the U.S. needs more diagnostic testing for the coronavirus, experts say. But how much more?

The Trump administration said on April 27 that the U.S. will soon have enough capacity to conduct double the current amount of testing for active infections. The country has done nearly 248,000 tests daily on average in the past seven days, according to the nonprofit COVID Tracking Project. Doubling that would mean doing about 496,000 a day.

Will that be enough? What benchmark should states try to hit?

One prominent research group, Harvard's Global Health Institute, proposes that the U.S. should be doing more than 900,000 tests per day as a country. This projection, released Thursday, is a big jump from its earlier projection of testing need, which had been between 500,000 and 600,000 daily.

Harvard's testing estimate increased, says Ashish Jha, director of the Global Health Institute, because the latest modeling shows that the outbreak in the United States is worse than projected earlier.

"Just in the last few weeks, all of the models have converged on many more people getting infected and many more people [dying]," he says.

But each state's specific need for testing varies depending on the size of its outbreak, explains Jha. The bigger the outbreak, the more testing is needed.

On Thursday, Jha's group at Harvard published a simulation that estimates the amount of testing needed in each state by May 15. In the graphic below, we compare these estimates with the average numbers of daily tests states are currently doing.

Two ways to assess whether testing is adequate

To make their state-by-state estimates, the Harvard Global Health Institute group started from a model of future case counts. It calculated how much testing would be needed for a state to test all infected people and any close contacts they may have exposed to the virus. (The simulation estimates testing 10 contacts on average.)

"Testing is outbreak control 101, because what testing lets you do is figure out who's infected and who's not," Jha says. "And that lets you separate out the infected people from the noninfected people and bring the disease under control."

This approach is how communities can prevent outbreaks from flaring up. First, test all symptomatic people, then reach out to their close contacts and test them, and finally ask those who are infected or exposed to isolate themselves.

Our chart also shows another testing benchmark for each state: the ratio of tests conducted that come back positive. Communities that see about 10% or fewer positives among their test results are probably testing enough, the World Health Organization advises. If the rate is higher, they're likely missing a lot of active infections.

What is apparent from the data we present below is that many states are far from both the Harvard estimates and the 10% positive benchmark.

Just nine states are near or have exceeded the testing minimums estimated by Harvard; they are mostly larger, less populous states: Alaska, Hawaii, Montana, North Dakota, Oregon, Tennessee, Utah, West Virginia and Wyoming.

Several states with large outbreaks — New York, Massachusetts and Connecticut, among others — are very far from the minimum testing target. Some states that are already relaxing their social distancing restrictions, such as Georgia, Texas and Colorado, are far from the target too.

Jha offers several caveats about his group's estimates.

Estimates are directional, not literal

Researchers at the Global Health Initiative at Harvard considered three different models of the U.S. coronavirus outbreak as a starting point for their testing estimates. They found that while there was significant variation in the projections of outbreak sizes, all of the models tend to point in the same direction, i.e., if one model showed that a state needed significantly more testing, the others generally did too.

The model they used to create these estimates is the Youyang Gu COVID-19 Forecasts, which they say has tracked closely with what's actually happened on the ground. Still, the researchers caution, these numbers are not meant to be taken literally but as a guide.

Can't see this visual? Click here.

If social distancing is relaxed, testing needs may grow

The Harvard testing estimates are built on a model that assumes that states continue social distancing through May 15. And about half of states have already started lifting some of those.

Jha says that without the right measures in place to contain spread, easing up could quickly lead to new cases.

"The moment you relax, the number of cases will start climbing. And therefore, the number of tests you need to keep your society, your state from having large outbreaks will also start climbing," warns Jha.

Testing alone is not enough

A community can't base the decision that it's safe to open up on testing data alone. States should also see a consistent decline in the number of cases, of two weeks at least, according to White House guidance. If their cases are instead increasing, they should assume the number of tests they need will increase too.

And, Jha warns, testing is step one, but it won't contain an outbreak by itself. It needs to be part of "a much broader set of strategies and plans the states need to have in place" when they begin to reopen.

In fact, his group's model is built on the assumption that states are doing contact tracing and have plans to support isolation for infected or exposed people.

"I don't want anybody to just look at the number and say, we meet it and we're good to go," he says. "What this really is, is testing capacity in the context of having a really effective workforce of contact tracers."

The targets are floors, not goals

States that have reached the estimated target should think of that as a starting point.

"We've always built these as the floor, the bare minimum," Jha says. More testing would be even better, allowing states to more rapidly tamp down case surges.

In fact, other experts have proposed that the U.S. do even more testing. Paul Romer, a professor of economics at New York University, proposed in a recent white paper that if the U.S. tested every resident, every two weeks, isolating those who test positive, it could stop the pandemic in its tracks.

Jha warns that without sufficient testing, and the infrastructure in place to trace and isolate contacts, there's a real risk that states — even those with few cases now — will see new large outbreaks. "I think what people have to remember is that the virus isn't gone. The disease isn't gone. And it's going to be with us for a while," he says.

Can't see this visual? Click here.

Daniel Wood contributed to this report.

By Julie Appleby, Kaiser Health News

As many states begin to reopen — most without meeting the thresholds recommended by the White House — a new level of COVID-19 risk analysis begins for Americans.

Should I go to the beach? What about the hair salon? A sit-down restaurant meal? Visit Mom on Mother’s Day?

States are responding to the tremendous economic cost of the pandemic and people’s pent-up desire to be “normal” again. But public health experts remain cautious. In many areas, they note, COVID cases — and deaths — are still on the rise, and some fear new surges will follow the easing of restrictions.

“Reopening is not back to normal. It is trying to find ways to allow people to get back out to do things they want to do, and business to do business,” said Dr. Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials. “We can’t pretend the virus has gone away. The vast majority of the population is still susceptible.”

So far, state rules vary. But they involve a basic theme.

“They are making assumptions that people will use common sense and good public health practice when they go out,” said Dr. Georges Benjamin, executive director with the American Public Health Association.

As states start to reopen, people will have to weigh the risk versus benefit of getting out more, along with their own tolerance for uncertainty. The bottom line, health experts say, is people should continue to be vigilant: Maintain distance, wear masks, wash your hands — and take responsibility for your own health and that of those around you.

“It’s clearly too early, in my mind, in many places to pull the stay-at-home rules,” said Benjamin. “But, to the extent that is going to happen, we have to give people advice to do it safely. No one should interpret my comments as being overly supportive of doing it, but if you’re going to do it, you have to be careful.”

An added caveat: All advice applies to people at normal risk of weathering the disease. Those 60 or older and people with underlying health conditions or compromised immune systems should continue staying home.

“Folks who are at higher risk of having a more severe reaction have to continue to be very careful and limit contact with other people,” Plescia said.

So, should I go to the beach?

There’s nothing inherently risky about the beach, said Benjamin. But, again, “if you can, avoid crowds,” he said. “Have as few people around you as possible.”

Maintain that 6-foot distance, even in the water.

“If you are standing close and interacting, there is a chance they could be sick and they may not know it and you could catch it,” Plescia said. “The whole 6-foot distance is a good thing to remember going forward.”

Still, “one thing about the beach or anywhere outside is that there is a lot of good air movement, which is very different than standing in a crowded subway car,” he said.

Even so, recent images of packed beaches and parks raise questions about whether people are able or willing to continue heeding distancing directives.

But if we’re all wearing masks, do we really need to stay 6 feet apart?

Yes, for two reasons. First, while masks can reduce the amount of droplets expelled from the mouth and nose, they aren’t perfect.

Droplets from sneezing, coughing or possibly even talking are considered the main way the coronavirus is transmitted, from landing either on another person or surface. Those who touch that surface may be at risk of infection if they then touch their face, especially the eyes or mouth. “By wearing a mask, I reduce the amount of particles I express out of my mouth,” said Benjamin. “I try to protect you from me, but it also protects me from you.”

And, second, masks don’t protect your eyes. Since the virus can enter the body through the eyes, standing further apart also reduces that risk.

Should I visit Mom on Mother’s Day?

This is a complex choice for many families. Obviously, if Mom is in a nursing home or assisted living, the answer is clearly no, as most care facilities are closed to visitors because the virus has been devastating that population.

There’s still risk beyond such venues. Data from the Centers for Disease Control and Prevention shows 8 out of 10 reported deaths from the coronavirus are among those 65 or older. Underlying conditions, such as heart or lung disease and diabetes, appear to play a role, and older adults are more likely to have such conditions.

So, what if Mom is healthy? There’s no easy answer, public health experts say, because how the virus affects any individual is unpredictable. And visitors may be infected and not know it. An estimated 25% of people show no or few symptoms.

“A virtual gathering is a much safer alternative this year,” said Benjamin.

But if your family insists on an in-person Mother’s Day after weighing Mom’s health (and Dad’s, too, if he’s there), “everyone in the family should do a health check before gathering,” he said. “No one with any COVID symptoms or a fever should participate.”

How prevalent COVID is in your region is also a consideration, experts say, as is how much contact you and your other family members have had with other people.

If you do visit Mom, wear masks and refrain from hugging, kissing or other close contact, Benjamin said.

My hair is a mess. What about going to the salon?

Again, no clear answer. As salons and barbershops reopen in some states, they are taking precautions.

States and professional associations are recommending requiring reservations, limiting the number of customers inside the shop at a given time, installing Plexiglas barriers between stations, cleaning the chairs, sinks and other surfaces often, and having stylists and customers wear masks. Ask what steps your salon is taking.

“Employees should stay home if they are sick or in contact with someone who is sick,” said Dr. Amanda Castel, professor of epidemiology at Milken Institute School of Public Health at the George Washington University. “Also, employers should make sure they don’t have everyone congregating in the kitchen or break room.”

Some salons or barbers are cutting hair outside, she noted, which may reduce the risk because of better ventilation. Salons should also keep track of the customers they see, just in case they need to contact them later, should there be a reason to suspect a client or stylist had become infected, Castel said.

Consider limiting chitchat during the cut, said Plescia, as talking in close proximity may increase your risk, although “it feels a little rude,” he admitted.

What if your stylist is coughing and sneezing?

“I would leave immediately,” he said.

What about dining at a restaurant?

Many states and the CDC have recommendations for restaurants that limit capacity — some states say 25% — in addition to setting tables well apart, using disposable menus and single-serve condiments, and requiring wait staff to wear masks.

“That’s the kind of thing that does help reduce the chance of spread of infection,” Plescia said.

If your favorite eatery is opening, call to ask what precautions are in place. Make a reservation and “be thoughtful about who you are having dinner with,” said Plescia. Household members are one thing, but “getting into closer physical contact with friends is something people should be cautious about.”

Overall, decide how comfortable you are with the concept.

“If you’re going to go to a restaurant just to sit around and worry, then you might as well do takeout,” he said.

And travel?

Consider your options and whether you really need to go, say experts.

Driving and staying in a hotel may be an option for some people.

If hotels are adequately cleaned between guests, “you could make that work,” said Plescia. Bring cleaning wipes and even your own pillows. Again, though, “if you’re going to see an elderly parent, you don’t want to contract something on the way and give it to them.”

Regarding air travel — airlines are taking steps, such as doing deep cleaning between flights. Fresh and recirculated air goes through special HEPA filters. While there is little specific research yet on the coronavirus and air travel, studies on other respiratory and infectious diseases have generally concluded the overall risk is low, except for people within two rows of the infected person. But a case involving an earlier type of coronavirus seemed to indicate wider possible spread across several rows.

Maintaining distance on the plane and in the boarding process is key.

“Wear a mask on the plane,” said Benjamin.

And plan ahead. How prevalent is the coronavirus in the areas you are traveling to and from? Are there any requirements that you self-isolate upon arrival? How will you get to and from the airport while minimizing your proximity to others?

But if it’s not essential, you might want to think twice right now.

“People who absolutely don’t have to travel should avoid doing it,” said Plescia.

Worship services are important to me. What precautions should be considered?

The distance rule applies as houses of worship consider reopening.

“As much as you can within religious rules, try to avoid contact,” said Benjamin.

He is not giving any advice on Holy Communion, saying that is up to religious leaders. But, he noted, “drinking from the same cup raises the risk if a person is sick or items are touched by anyone who is sick.”

Finally, keep in mind that much is being learned about the virus every day, from treatments to side effects to how it spreads.

“My own personal approach is, try to play it on the cautious side a bit longer,” said Plescia.

Castel agreed.

“We need a little more time to fully understand how COVID-19 works and more time to ramp up our testing, find treatments and hopefully a vaccine,” she said. “We all have social distancing fatigue. But we can continue to save lives by doing this.”

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The world needs people who love their enemies like Christ.

If you read the news or watch TV, you cannot escape the rise of extremism in the world. There are Islamic extremists, Hindu extremists, and even atheist extremists. Violence and hatred often mark the presence of extremism, but what if it was faced by something even stronger —love?

Maybe we need to see the rise of Christian extremists who use love to change the dark places. The world needs to be overrun with Christians who are driven, shaped, and compelled by Jesus’ words in Matthew 5:43–45: “You have heard that it was said, ‘Love your neighbor and hate your enemy.’ But I tell you, love your enemies and pray for those who persecute you, that you may be children of your Father in heaven” (NIV).

Christian extremists are those whose hearts are so filled with the love of Jesus that they supernaturally love their enemies. The apostle Paul describes this extreme love in Ephesians 3:16–21, saying:

“I pray that out of his glorious riches he may strengthen you with power through his Spirit in your inner being, so that Christ may dwell in your hearts through faith. And I pray that you, being rooted and established in love, may have power, together with all the Lord’s holy people, to grasp how wide and long and high and deep is the love of Christ, and to know this love that surpasses knowledge—that you may be filled to the measure of all the fullness of God.

Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us, to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen” (NIV).

America and the world need Christian extremists who love so beautifully ...

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Six keys to being more productive in life and ministry.

Pastors have a lot going on. We have to be present mentally, emotionally, and physically in many circumstances throughout each week. We often have families that are, or should be, a priority. We have responsibilities that pull us in many directions daily.

As the lead pastor for a church as well as a speaker, author, and doctoral student, I’m often asked, “Pastor, what is the key to your productivity?” Here are some principles I like to remember in order to be productive and try to maximize my God-given potential.

1. Know your calling

We are all first called to receive, embrace, and live from the life of God the Father, God the Son, and God the Holy Spirit. In response to the love of God, through the Holy Spirit’s power, we grow in our love for God.

For me, after that, I am called to love my wife and then my children.

I am called to serve and shepherd Transformation Church.

I am called to influence and encourage other pastors.

I am called to be an author.

I am called to complete a doctorate in the New Testament in context.

The specifics of your calling will differ, but by knowing and stewarding our callings, we can be free of the “tyranny of the urgent.” Once we clearly define our priorities, then if it’s not on that list, we really need to consider if it’s the best use of our time and other resources.

2. Simplify and declutter your life

A lack of productivity in people’s lives is often the result of not knowing our calling and having a cluttered life, filled with activities but not production.

In our 21st-century world, choices are everywhere, and we often clutter our lives with too many options because we are afraid we are going to miss out on something. ...

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Some call out people for not social distancing, others say there's plenty of room.

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Facets Of Folk Hit #1 On The Folk Alliance International Folk DJ Charts And Is Now On The List For Consideration For The Grammy® For Best Folk Album

With the start of the Major League Baseball season postponed due to the coronavirus pandemic, we here at The Denver Post took a look at how the Rockies would fare in MLB The Show 20 on PlayStation 4. We will have a story for every game that had been scheduled until real-life baseball returns. Here’s a look at the virtual Rockies’ preseason preview. Entering Friday's game, the Rockies were 24-12.

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It's going to be a little bit until the big shows.

The post Live Nation CEO Outlines Reopening Strategy: Experimenting with Shows In The Fall, Be On Sale in Q3/Q4, Full Scale By 2021 appeared first on Metal Injection.