New Coronavirus News from 29 Aug 2020b

France doing everything possible to avoid repeat COVID-19 lockdown, says Macron [Reuters, 29 Aug 2020]

PARIS (Reuters) - French President Emmanuel Macron said on Friday his government was doing everything possible to avoid another nationwide coronavirus lockdown but added it would be dangerous to rule out any scenario.

“We’re doing everything to avoid another lockdown and in particular a nationwide lockdown,” Macron told journalists. “We’ve learned enough to know that nothing can be ruled out. But we’re doing everything to prevent it.”

The number of coronavirus infections has spiralled higher in France in recent weeks, particularly among young people, although the number of patients receiving life-saving treatment in hospitals is stable.

Asked how the government should spur households to spend the 100 billion euros in savings they are sitting on, Macron said consumers were holding back because of the continued spread of the virus, fear of unemployment and concerns about tax rises.

“What we must do is get people back to work,” the president said.

Socially-distanced spectators watch the Tour de France start from Nice [Euronews, 29 Aug 2020]

The Tour de France set off from the Mediterranean city of Nice on Saturday in a bubble of anti-COVID protocols to try to keep the 176 riders virus-free.

Socially-distanced spectators turned up to see "Le Grand Depart" in a much more muted atmosphere than normal.

Only after riders peeled off their face masks and raced from the starting line, serenaded by a uniformed band playing "La Marseillaise,'' did the Tour begin to look like its old, pre-COVID self.

A few hours later, powering past thin crowds on the finishing straight in Nice that would usually have been many rows deep, Norwegian rider Alexander Kristoff won the first stage with a fearsome final sprint.

For the next three weeks the riders will try to race along the country's roads during the pandemic, but no one yet knows whether the race will reach the finish line in Paris intact.

When is a positive not a positive? COVID-19 and the Tour de France [Cyclingnews.com, 29 Aug 2020]

By Laura Weislo

Chances of false results are high unless ASO do repeat testing on COVID-19 positives

Disclaimer: The coronavirus pandemic is a serious problem and COVID-19 has led to over 800,000 deaths worldwide. There is no doubt that people should be taking every precaution to keep from spreading SARS-CoV-2. This information is not meant to contradict public health policy or inform medical decisions. It only applies to situations where COVID-19 infections are expected to be very low such as the Tour de France bubble, so wear a mask, wash your hands, and stand clear of the riders, please.

The stakes are high for this shortened season of professional cycling. If COVID-19 spreads at the Tour de France, the consequences will be dire for the ASO, the UCI, the racing season and the population.

However, riders have already had issues with potential false COVID-19 positives and will undergo at least four PCR tests before and during the race. When, not if, a rider falsely turns up positive for the virus, the consequences will fall not on the ASO or UCI but on the teams, staff and riders.

The ASO and the UCI have meticulously prepared strict sanitary measures for the race, including pre-race monitoring and testing in hopes of keeping the virus away. But this level of sanitation counterintuitively makes interpreting a positive COVID-19 test more difficult.

Will the Tour de France have a positive? Possibly. Can we be sure one positive is accurate? Probably not.

Alpes-Maritimes, the region where the Tour de France will start is in a red zone, having crossed a threshold of confirmed infections with 5.5 per cent of tests confirming COVID-19 and 97 per 100,000 residents testing positive every day.

However, inside the 'team bubble' - all people who will be healthy with no symptoms of COVID-19, and who have been meticulously avoiding the public, wearing masks and washing their hands - the chances of that positive being wrong are alarmingly high.

ASO's written policy is to require any rider or staff member testing positive once to leave the Tour, even if a subsequent test is negative and they have no symptoms. An ASO spokesperson said this policy is "what the health authorities ask of us".

But they might want to take a cue from other professional sports.

The NBA, which had issues with possible false positives before creating their 'bubble' in Orlando, instituted follow-up tests for any players testing positives to rule false positives out.

After Detroit Lions quarterback Matthew Stafford turned up a false positive on July 31, the NFL announced it would do two follow-up tests on all positive asymptomatic individuals. Since then, they detected 77 false positives, all relating to the same laboratory in New Jersey.

The Tour de France's mobile environment makes follow-up testing trickier, but if the ASO did immediate follow-up tests (after publication of this article, they announced they would), the chances of getting back-to-back false positives would be far smaller.

Cyclingnews spoke to Ranga Sampath, PhD, the Chief Scientific Officer with the Foundation for Innovative New Diagnostics (FIND), a non-profit that conducted independent evaluations of almost 800 different COVID-19 diagnostic tests.

Sampath explains that no test is perfect and human error and problems with testing materials will always lead to some level of mistakes. "Any test has a low but not improbably chance of false positive," he says. "Even a test that is more than 99 per cent specific."

Most of the COVID-19 tests are highly specific in controlled laboratory tests but we don't know the actual rate of false positives in their real world use. Sampath says there is no such thing as a 100 per cent perfect test.

"If someone claimed 100 per cent specificity, I would not believe them. A test is not going to be 100 per cent all the time. You're battling the improbably odds of never being wrong."
COVID-Catch-22

From a public health perspective of stopping the spread of disease, diagnosing someone as COVID-19 positive when they don't really have it (false positive) is less of a concern than missing infections (false negative) and having them spread. But false positives can also wrongly put healthy people in isolation, cause undue stress and possible loss of income.

Dr Andrew N. Cohen of the Center for Research on Aquatic Bioinvasions has been vocal in his criticism of ignoring the importance of false positives and the global strategy of diagnosing COVID-19 based on a single positive test in the absence of any symptoms.

His own research led him to medical literature from previous pandemics - SARS-CoV-1, MERS, Ebola. For those diseases, the World Health Organisation (WHO) and Centers for Disease Control (CDC) recommended testing only people with symptoms or known contacts with confirmed cases. For SARS-CoV-1, they specified "a single test result is insufficient for the definitive diagnosis of SARS-CoV infection".

That all changed with COVID-19.

"The more data we get, the clearer that seems to be. Some of this is coming from the sports world, but a lot of it is coming from other places where people do a second test and check positive results, and they find a substantial portion of them are false positive," Cohen tells Cyclingnews.

"What we're saying is certainly out of the mainstream for what has been said for SARS-CoV-2, but it's completely in the mainstream for what the CDC and WHO and medical professionals have said up through 2019 about using PCR-based diagnostic tests, which is that they have a certain rate of false-positives, you need to watch out for them."

When you're testing people who are sick, there is invariably a greater proportion of them who will actually be infected with the virus, so in those cases, a positive result is more reliable. But when you begin testing large numbers of healthy people with no known exposure to infected people, the chances of any positive become so small that the chance of the result being falsely positive skyrockets.

The rate of false positives out of all of the tests done, Cohen says, is low - "down to 1 per cent or a fraction of a per cent, maybe 2 per cent in some places" but when the population you're testing is relatively free of COVID-19, "that's enough to have a substantial proportion of the positives be false positives. It's not intuitive - but that's how the statistics work out."

Sampath agreed with Cohen's logic, saying this is something that is considered in any diagnostic test and he also recommends follow-up testing.

"It's basic statistics: even with a highly specific test, if the prevalence of the virus is low, the chance of a false positive becomes high. Repeat testing is the only way to rule out a false positive," Sampath said.

Base rate fallacy a.k.a. False-positive paradox

The same math could explain the spate of positive results in recent weeks that have hit professional cycling.

Before the Vuelta a Burgos, Itamar Einhorn came back positive, and Israel Start-Up Nation pulled riders off the start line. Silvan Dillier (AG2R La Mondiale) was kept out of Strade Bianche, his teammate Larry Warbasse removed from the team's Tour du Limousin roster, Hugo Houle (Astana) sat out Il Lombardia, Inge van der Heijden was kept from the Dutch championships and Bora-Hansgrohe prohibited from racing the Bretagne Classic when Oscar Gatto tested positive.

What do they all have in common? Subsequent tests came back negative.

It's possible that these healthy athletes battled the virus so quickly that they never showed symptoms and their bodies eradicated it soon enough that their follow-up tests came back negative, but Houle also had a test for antibodies that might pick up evidence of a past infection - that too was negative.

Did they have COVID-19 or not? The answer to this puzzle might lie in the "base rate fallacy", also known as the "false positive paradox": The closer the baseline rate COVID-19 infection gets to the rate of falsely positive tests, (FPR) the less confidence we can have that any positive test is really picking up the COVID-19 virus.

Most people think that if the chance of getting a false-positive result is 1 in 1,000, then any positive result is 99.9 per cent true. That isn't the case, because you have to factor in the rate of infection in the population. If the infection rate is 1 in 1,000 and the chance of a false positive is the same, 1 in 1,000, then the chance a positive result is true is a coin flip - the positive could be real, or it could be false - 50-50.

Take 100,000 people, and assume 100 have COVID, and test them all. Up to 20 per cent of the tests can miss an active infection (either because people are tested too soon after exposure or they don't stick the swab up their nose far enough) and be a false negative.

Let's say that the lab being used is pretty good at their job and only 1 in 1,000 tests is a false positive.

Eighty COVID-19-infected people will be correctly identified, 20 will not because of false negatives. Of the other 99,900 healthy people, around 100 will test positive even though they aren't infected and 99,800 will be negative.

Just looking at the positives, there are a total of 180. 80 are correct and 100 are not! Only 44.4 per cent (80 of 180) of the positives were correct. That's the "Positive Predictive Value (PPV)".

The graph at the top of this section highlights the relationship between overall prevalence of the virus in a population and how much confidence we can have in a test given four different false positive rates.

The more careful the team bubble is to be virus-free, the less confidence we can have in any positive test.

Only 18 in 1,000 of the samples are positive in this example. The Tour de France team bubble will have at least that many tests.

If you do a second test to confirm the positive, the chances of getting a false-positive plummets because now you have two independent tests on the same person with the same outcome. One can be nearly 100 per cent confident of two identical results, but only there's a 13.8% chance the person is actually COVID-19 infected if they have one of each.

Even with one positive is followed by one negative, it's 97.6% likely the person doesn't have COVID-19 if the infection rate 100 in 100,000. Even if it's tenfold higher, one of each still casts doubt on a single positive.

This simple mathematical certainty is why the NBA and NFL added in a second PCR test for every positive to rule out false positives.

Cycling has chosen a safety-first policy, which is commendable. But if a rider or staffer who tests positive can have a rapid re-test then it would prevent quite a few people unnecessarily ejected from the race.

Both Cohen and Sampath recommend the Tour de France do double tests on anyone who comes up positive for COVID-19.

"If I were running the show, I'd think about setting up two swabbing stations, a few hundred yards apart, with separate staff, for riders' left and right nostrils (although I might check to see if there are any studies on the probability of having detectable virus in one nostril but not the other), sending the specimens by different couriers to two different labs that use two different assays and running both specimens (or if timing allows, running the second only if the first is positive). That's about as independent as one could get," Cohen says.

"It would be good data too. Over the multiple testings during the race, they'd likely detect at least a few false positives, thereby gathering important information on the false positive rate in actual practice. Protect the Tour and contribute to medical science—what could be better?"

Tour de France kicks off amid coronavirus concerns [The Connexion, 29 Aug 2020]

Green hills, yellow jerseys, grey skies and red zones... the Tour de France 2020 is underway.

The 107th edition of the Tour de France got underway today (August 29) in Nice, but it was far from business as usual.

The world’s biggest cycling race was due to run from June 27 to July 19 but was delayed by two months due to the global pandemic caused by coronavirus. This year’s event will also involve new safety measures which include limited crowds, mandatory masks and restrictions on contact with the riders.

Nice was recently placed in the ‘red zone’ by Prime Minister Jean Castex, which means that the virus is actively circulating in the area. This has led to concerns, reported by national and international media, that the tour may not make it to Paris this year, where it is supposed to conclude.

Mr Castex downplayed these concerns, telling journalists on Thursday that: “we have taken numerous precautions and health protocols and I would remind you that this is an open-air event.

“The places where the virus spreads and there is transmission have no organisation. The tour has an organiser,” he said.

This year’s race will see a total of 176 riders - riding for 22 different teams - compete for the coveted yellow jersey.

The yellow jersey (maillot jaune), is worn by the rider who sits at the top of the general classification. This means that they have the best time over all the stages. So, in theory, a rider does not need to win any stage of the tour to be crowned overall champion, they just need to have the lowest time over all stages.

The riders will navigate through six regions and 32 departments in France as they wind their way from the south coast up to Paris. They will also stop in 12 new cities.

They will cycle the five major mountain ranges of mainland France: the Alps, the Massif Central, the Pyrenees, the Jura and the Vosges.

Earlier this week weather forecasters were predicting the possibility of thunderstorms at the weekend, which could put a damper on the race’s opening days.

The first stage is a 156km route around the hills of Nice, starting and ending in the heart of the city. Two more stages will take place around Nice on Sunday and Monday before the tour moves on to Sisteron.

It is due to end on the Champs Élysées in Paris on September 20.

As COVID-19 Cases Rise, Tour de France Sets Off [Voice of America, 29 Aug 2020]

By Lisa Bryant

PARIS - The legendary Tour de France began Saturday, two months later than usual, and a day after France recorded its sharpest single-day coronavirus caseload since late March.

The crowds, usually packing the start of the Tour de France, are absent this year. Just 100 spectators were allowed for the early afternoon kickoff at the Promenade des Anglais in Nice —where masks are now required for all outdoor spaces.

That’s just a taste of how the virus this year is upending the 3,500-kilometer race, which crosses mountains, vineyards and villages of France. Team riders will be tested regularly for COVID-19 — and wear masks when not competing.

The big question is whether the Tour will end as planned three weeks from now at the Champs Elyees in Paris, or be forced to cut off early.

There are other reasons why the world's greatest bike race is very different this year.

Sixty-nine-year-old Francois Juillard, former head coach for the French track and field team, remembers following the Tour when he was young. The caravan came first, then the riders—who made difficult climbs seem easy. He says it was pretty spectacular.

That festive atmosphere — with candies showered at kids and tens of thousands of fans lining the roads — will be largely absent when the Tour passes Juillard's home in central France.
National coronavirus measures limit crowds to no more than 5,000.

And with the French back at work, Juillard says, the Tour will be a lot more virtual — experienced by many fans via TV instead of in real life.

Eric Bouvat, longtime doctor for Tour team AG2R La Mondiale, says it’s unclear how that will affect the race. Part of the exceptional performances of Tour riders comes from the stimulation from those cheering crowds, he says, and it’s unclear whether they’ll find other ways to compensate.

So, like many other things during this time of the corornavirus, the 107th Tour de France will break new ground — possibly marking the beginning, and not the end, of a new normal.

French authorities harden coronavirus rules at Tour de France [ESPN, 29 Aug 2020]

NICE, France -- French authorities have made it harder for Tour de France teams to reach the finish line in Paris by deciding they will be expelled from the race if two or more of their members, including staff, test positive for the coronavirus within a week.

Following guidelines issued by the health authorities, the move was announced Saturday by Tour organizers just a few hours before the start of the three-week race's opening stage in the Riviera city of Nice. It overruled a decision from cycling's governing body, the UCI, that had eased the Tour's exclusion rules.

Under the UCI protocol announced Friday, it would have been up to organizers to decide whether to throw a team out after two positive tests, with staff members not counted.

There are 22 squads of eight riders competing at the Tour, but a total of 30 members per team when staff are included.

"From two positive cases in a group of 30, there is a real risk of elimination of a team," Tour director Christian Prudhomme told France Info radio.

The UCI's revised protocol had excluded staff members from the calculations following complaints from teams who feared their riders would be unfairly excluded from the race.

This week, four staff members of the Belgian team Lotto-Soudal were sent home after "non-negative" coronavirus tests. The team said a mechanic and a member of the rider support staff returned "one positive and one suspicious result." Both left the race bubble along with their roommates.

In case of a positive result during the race, the UCI has urged organizers to "do everything possible" to perform a retest and a blood analysis before the next stage. The measure is aimed at avoiding false positive tests that could rule out healthy riders.

Tour organizers have set up a mobile coronavirus lab that can produce results in two hours and handle 50 tests a day on race days. However, Prudhomme said he can't guarantee a rider will be given the additional tests before he is removed from the race following an initial positive result.

"If it's in the evening, we will adapt so it can be done. But if we have a positive in the morning, he obviously won't be on the starting line if we don't have time for the follow-up test," Prudhomme said.

Late but alive, Tour de France races into COVID epidemic [Martinsville Bulletin, 29 Aug 2020]

By JOHN LEICESTER and SAMUEL PETREQUIN

NICE, France (AP) — Delayed but alive again and out on French roads, the strangest Tour de France ever set off Saturday in a bubble of anti-COVID protocols to try to keep the 176 riders virus-free for three weeks of racing through the country's worsening epidemic.

Only after riders peeled off their face masks and pedaled off from the start in the Mediterranean city of Nice, serenaded by a uniformed band playing “La Marseillaise,” did the Tour begin to look like its old, pre-COVID self, immediately delivering thrills and spills as storms made the roads as slippy as ice.

But with fans kept firmly at arm's length, told by the government that it was best to stay home and watch the racing on television, the Tour lost much of its festive atmosphere. There was very little of the usual up-close communing between athletes and their adoring public that made the venerable 117-year-old rolling roadshow unique among sports events in more carefree times.

Powering past thin crowds on the finishing straight in Nice that would usually have been crammed with spectators rows deep, Norwegian rider Alexander Kristoff won the first stage with a fearsome final sprint. He celebrated by giving a COVID-sensible fist-bump to a teammate.

Winning Stage 1 earned Kristoff the first yellow jersey of the 2020 Tour, which he will wear as the race leader on Sunday's Stage 2 that loops into the mountains behind Nice. Usually, a race official or a VIP would have helped him slip into the iconic jersey, one of the most coveted and recognizable in sports. But not this year, with social distancing the priority.

Kristoff stood alone on the winner's podium, flanked by a host and a hostess a safe distance away. He then disappeared backstage to wriggle into the jersey himself, before coming back out to pose for photos. Still, the thrill of wearing the jersey for first time in his eight Tours more than outweighed the weirdness.

“An amazing feeling,” he told reporters at the finish. “It means a lot for my career and a stage win shows I can still be up there even at 33 years old and with four kids.”

With infections rising steadily across France, the Tour has no guarantees of reaching the finish in Paris on Sept. 20. Riders will have daily health checks and coronavirus tests during the race, and can be tossed out if they fail them. Entire teams could be sent home if two or more riders or staff test positive for COVID-19 within a week. Fans have been told not to approach riders for selfies or autographs and to always wear masks.

Jean-Michel Blanquer, the French minister in charge of sports, was upbeat at the start Saturday, saying the Tour only has a “very slim” chance of being canceled before Paris but also cautioning that “everything is possible.”

“That type of thing could happen but of course I hope that it won’t and I think that it won’t because the Tour organizers have done an extraordinary job,” he said.

The crowd-control and social-distancing measures sucked much of the usual boisterous joy out of the Tour's first day. An eerie silence, and a thin crowd kept well away across an empty square, greeted riders as they paraded on stage at the start. Even a stone statue that overlooked the strange scene wore a mask, marked “protect ourselves."

Still, roadside fans were grateful for the spectacle, after gruesome months of mounting deaths in France — now at 30,600 — and lives turned upside down by the virus. The European soccer championships and the Olympic Games were postponed to 2021 and scores of other events have been canceled. But the Tour, delayed from July, survived and is becoming a gauge of the feasibility of continuing to hold sporting mega-events during the pandemic.

The sight of the peloton zooming past the corner that he chose by Nice's port caused 32-year-old tennis teacher Benjamin Sand to beam, thrilled by the riders' speed through the bend.
“We’re so lucky,” he said. “It’s such a breath of fresh air.”

Fans were also rewarded with high drama on the 156-kilometer (97-mile) first stage that did three loops around Nice and hilly backcountry to the city's north. Rain storms turned the tarmac so slick that riders eventually made a pact between themselves out on the road to dial back the pace after multiple crashes.

Among the most dramatic was Colombian rider Miguel Angel Lopez skidding headfirst into a road sign. He labored on to the finish. Another crash took out a heap of riders in the dash to the line on Nice's splendid seafront. The defending champion, Egan Bernal, suffered the blow of having two of his support riders on the Ineos team involved in painful pileups.

“People were crashing almost on every corner," said Kristoff. “It was really slippy out there.”

Delayed by COVID-19 pandemic, Tour de France sets off from Nice [Los Angeles Times, 29 Aug 2020]

Tour de France hosts await the Saturday start of the first stage of the Tour de France cycling race.

The strangest Tour de France ever finally set off Saturday from the Riviera city of Nice in an extraordinarily subdued atmosphere, amid fears the race could be stopped well before it reaches Paris.

The sight of the 176 riders on the starting line was already seen as a big win by organizers and French government officials relieved the mega-event drawing hundreds of thousands of roadside fans every summer could take place. After the European soccer championships and the Olympic Games were postponed to 2021, the Tour — delayed by two months — survived the COVID-19 pandemic.

But the normally buoyant atmosphere surrounding the event made way for brooding feelings. Instead of the usual pulsating crowds, riders were greeted by an eerie silence as their names were read out on a stage where they were presented to an empty square in downtown Nice, overlooked by a stone statue wearing a mask marked “protect ourselves.” A quiet crowd of a couple of hundred people, all masked, were kept more than 50 yards away behind metal barriers.

Since its inception in 1903, the race has been canceled only during the two world wars.

But the number of daily COVID-19 cases has been rising steadily across France, prompting concerns the Tour will have to be stopped if the situation deteriorates further.

“It’s a first miracle that we are able to start this race, but we want a second miracle to happen, which is the Tour de France to arrive in Paris,” UCI President David Lappartient said. “The goal is really to reach Paris.”

Jean-Michel Blanquer, the French minister in charge of sports, said the chances of the Tour being canceled before reaching Paris were “very slim,” but also added, “everything is possible.
That type of thing could happen, but of course I hope that it won’t, and I think that it won’t because the Tour organizers have done an extraordinary job.”

To ensure the 22 teams competing at the constantly traveling event remain coronavirus-free, organizers have put in place stringent rules keeping them away from fans.

Tour spectators and riders usually mingle at the start of stages, posing for pictures together and exchanging a few words. All this was impossible Saturday at the start of the 156-kilometer Stage 1, with fans not allowed to take selfies with their heroes or to get autographs. They could not approach the team buses of last year’s winner, Egan Bernal, and former world champion Peter Sagan, which were parked side by side.

Instead of the usual throngs, the park where the buses are gathered was largely empty, with, at best, just a few small clumps of people to cheer the riders as they rode past.

In addition to the social distancing imposed, French health authorities have also decided that an entire team will be expelled from the race if two or more of their members, including staff, test positive within a week, increasing the probability that only a fraction of the peloton will reach the Champs-Elysees in three weeks’ time.

On the starting line, riders kept their masks on until the last minute. After a uniformed band played “La Marseillaise,” the riders started rolling as planes trailing white smoke roared overhead. The crowd at the start, mostly just one row deep, cheered as they pedaled past, finally with their masks off.

Virus could cause surge in bankruptcies [News-Press Now, 29 Aug 2020]

By Greg Kozol

As a bankruptcy attorney for nearly 30 years, Noah Briles works with clients who struggle to keep up with medical bills or mortgage payments.

This year, another factor could fuel an increase in personal bankruptcies: the coronavirus.
Filings in the U.S. Bankruptcy Court's St. Joseph division increased 40% in the first seven months of 2020, from 110 last year to 155 in 2020. Most were Chapter 13 cases seeking reorganization of personal finances. Filings were down, however, in the western district that includes a much larger area.

Bankruptcy attorneys and financial counselors anticipate more bankruptcies, possibly in the second half of the year, due to rising unemployment and the end of relief measures designed to blunt the pandemic's economic damage.

"Some of these things take a little while to hit," Briles said. "People don't immediately think of filing for bankruptcy. I think it's eventually going to catch up for a lot of these people who have been out of work and are falling behind on mortgages and other payments."

Heading into 2020, a booming economy might have masked the precarious financial position of some households. On the eve of pandemic, the Federal Reserve Bank of New York reported total U.S. household debt of $14.3 trillion, more than the previous high mark prior to the 2008 economic collapse. A separate Harris Poll found that just more than half of American adults don't keep a household budget and 14% have more than $2,500 in credit card debt.

After the pandemic, economic uncertainty creates financial risk for those living paycheck to paycheck with high levels of debt.

"I think we are on the precipice of a major wave of insolvency," said Bruce McClary, vice president of communications for the National Foundation for Credit Counseling. The organization provides information and links to nonprofit credit counseling for individuals who are considering bankruptcy or going through the process.

"There is going to be a bankruptcy bubble," he said. "We need to be prepared for what will happen."

The size of that bubble may depend on whether coronavirus relief measures like increased unemployment insurance benefits are extended. More than 4 in 10 of Missouri's households include someone who lost employment income during the pandemic, according to Empower Missouri, an advocacy group for low-income Missourians.

"The common thought is there is going to be a rush of cases filed once the federal stimulus package stops," said Todd Griffee, another bankruptcy attorney in St. Joseph. "People, we think, have been living off credit card debt for necessities like food and clothing."

Briles said many of the consumer relief measures at the height of the pandemic granted moratoriums on making payments on utility bills, rent or mortgages. But they didn't extend the loan or modify the terms, even if the consumer is behind on payments. That means the bill, quite possibly a big one, is about to come due.

"It's kind of kicking the can down the road a little bit," Briles said. "Unfortunately, it can seem worse than ever when you finally get to the end of that road."

Briles has seen spikes in bankruptcies before, most recently immediately following the 2008 recession. Bankruptcy filings can track home foreclosures closely, with debtors seeking Chapter 13 restructuring in order to hold on to a house. The mortgage analytics company CoreLogic found that 7% of home mortgages were delinquent in May, the highest rate since 2014.

The rates of foreclosures and delinquencies can vary from market to market, but many homeowners are experiencing similar pressures.

"Whether it's three months from now or six months from now, I think it's going to catch up with people who are out of work and falling behind on mortgages and other payments," Briles said.
Griffee said bankruptcies are cyclical, meaning that a significant surge in filings might not happen until spring, which tends to be the busy season.

"Filings are up substantially in March, April and May," he said. "People are getting their tax refunds back and recovering from Christmas."

Afghanistan, Pakistan see surge in polio cases amid coronavirus pandemic [Fox News, 29 Aug 2020]

By Peter Aitken

They are the only countries to report new polio cases, health officials say

Afghanistan and Pakistan have seen a resurgence of polio while struggling to contain the coronavirus pandemic, according to reports.

The nations are the only countries in the world with new cases of polio, after the World Health Organization declared Africa free of the disease.

Production of the polio vaccine was halted in March to limit the risk of transmitting COVID-19 between children, parents and health workers, Radio Free Europe reported. Vaccination campaigns resumed in Afghanistan in July, but the country has seen a surge in polio cases during the time production of the vaccine had halted.

“These life-saving vaccinations are critical if children are to avoid yet another health emergency,” said Jean Gough, UNICEF Regional Director for South Asia. “As the world has come to see only too well, viruses know no borders and no child is safe from polio until every child is safe.”

Children under 5 are particularly vulnerable to the disease, which can lead to deformed limbs, paralysis and even death.

The Afghan Health Ministry has recorded 40 cases this year, with some new cases in areas previously free of the virus. Pakistan has recored 63 cases, The New Arab reported.

“Ongoing conflict and political instability make it difficult to access hard-to-reach areas, and migration along the porous and rugged border between Afghanistan and Pakistan further complicates vaccination efforts, making children on both sides vulnerable to contracting the debilitating disease,” according to UNICEF.

The coronavirus pandemic played havoc in the region, with Afghanistan recording around 48,000 positive cases and around 1,400 deaths, though testing remains difficult in the war-torn region and the true extent remains unknown.

Pakistan, meanwhile, has recorded over 300,000 positive cases of the virus, with over 6,200 deaths.

Peter Aitken is a New York born-and-raised reporter with a focus on national and global news.

Europe fears second coronavirus wave as cases surge [Axios, 29 Aug 2020]

by Jacob Knutson

Several European countries have reported a jump in new coronavirus cases in recent weeks after a drop in cases over June and July, according to Johns Hopkins University data.

Why it matters: The surge could indicate that Europe is on the verge of a second wave, though currently fewer people are dying from the virus and new cases have needed less medical treatment than those who got it in the spring, according to the Washington Post.

By the numbers: France experienced 7,462 new cases on Aug. 28, the largest jump since May 16.
• Germany reported around 1,737 cases and 3 deaths on Aug. 21, the highest increase in new cases since May 24.
• Italy had 1,460 cases on Aug. 28, its largest jump since April 1.
• Spain announced 9,779 cases on Aug. 28, which was a single day record for the country.

The big picture: The surge comes as almost every European country is planning to in-person schooling this school year with many starting next week. Public health officials worry that the classes could exacerbate the spike in cases, according to the Post.
• Paris implemented a mandatory public mask mandate on Friday as the number of "red zones" where the virus is actively spreading inside the country has risen from two to 21, according to the BBC.
• Police in Berlin disbanded a large protest over Germany's coronavirus restrictions after tens of thousands of participants refused to maintain social distancing on Saturday.
• In Spain, cases have increased in Madrid but have stabilized in Catalonia and Aragon after rising earlier in August, Reuters reports.

Horrible trade-offs in a pandemic | VOX, CEPR Policy Portal [voxeu.org, 29 Aug 2020]

BY Ricardo Hausmann & Ulrich Schetter

Fighting COVID-19 has forced countries around the world to make trade-offs between lives and livelihoods. But in countries where many people already live at or close to subsistence, the alternatives are more excruciating yet. This column analyses cases in which the trade-off is actually between lives and lives; in other words, countries that can save their populations from the pandemic or from deprivation, but not both. The authors consider ways to alleviate these trade-offs, as well as their implications for policy – both national and international.

Countries all over the world are fighting COVID-19 by reducing social and economic interactions, measures that have proven effective in parts of the world but are extremely costly. We are in the midst of the deepest recession since the great depression, and World GDP is expected to fall by 4.9% in 2020, with two-digit declines in many countries (IMF 2020).
A series of excellent papers suggest that the huge costs in terms of livelihoods are justified by the gains in terms of lives saved from the pandemic (e.g. Acemoglu et al. 2020, Alvarez et al 2020, Eichenbaum et al. 2020, Farboodi et al. 2020, Hall et al. 2020).

This focus on a trade-off between lives and livelihoods assumes that households are able to bear the economic losses arising from a lockdown and the global recession. But in parts of society that are at or close to subsistence – already struggling to make a living in normal times – deepening the recession via a lockdown may be extremely costly, forcing more households to suffer from deprivation. In other words, the central trade-off for optimal policy is not one between lives and livelihoods, but between lives and lives. This is not just a theoretical possibility: Global hunger is projected to double this year (WFP 2020), and in June 2020, even in the US 14 million children did not have enough to eat (Bauer 2020). At a more general level, a deeper recession may add to deprivation and to ‘deaths of despair’ (Case and Deaton 2020).

Fiscal policy can cushion the blow and help mitigate the excruciating trade-offs involved in fighting a pandemic. But this requires enormous fiscal space: The world is projected to run a fiscal deficit of 13.9% of GDP this year, and the US deficit may reach 23.8% (IMF 2020). Such policy measures are important in industrialised countries. They would be even more valuable in developing countries, where a larger fraction of the population lives in poverty. The problem is that these countries often had limited fiscal space to begin with, only to see it collapse beneath the global impact of COVID-19 on commodity prices, tourism, remittances, and capital flows (Hausmann 2020, Hevia and Neumeyer 2020).

What does this imply for policy? How does the optimal lockdown depend on accompanying policy measures to alleviate the economic shock? How do such measures impact welfare and compliance with lockdowns? What is the cost of limited fiscal space in a pandemic, and how does it affect policy? Are lockdowns a luxury good, desirable only for countries rich enough to be able to bear the consequences?

A theoretical analysis of horrible trade-offs and policy implications

To address these questions, we introduce a subsistence level of consumption into a tractable general equilibrium framework with heterogeneous agents (Hausmann and Schetter 2020). We then use this framework to analyse jointly optimal policies of a lockdown and transfer payments during a pandemic. In our model, the pandemic causes deaths from the disease and a temporary loss in total factor productivity (TFP)—the latter can also be attributed to global economic shocks. The government can decide to fight the pandemic via a lockdown and use lump-sum transfers financed via costly international borrowing to cushion the blow. The lockdown requires households to reduce their labour supply, thereby lowering disease transmission. A more stringent lockdown also deepens the recession. On the one hand, this gives rise to the much-debated trade-off between lives and livelihoods. On the other hand, it means that poorer parts of society will find it harder to subsist, will be less able to comply with the lockdown, and the poorest may even suffer from deprivation, giving rise to an excruciating trade-off between lives and lives (Levy Yeyati and Sartorio 2020).

We show that this trade-off fundamentally changes the main margin for optimal policy, and that a threat of deprivation to vulnerable parts of society imposes strong bounds on the optimal lockdown. If government borrowing is unconstrained, this is reflected in the fact that optimal policy saves most or all households from deprivation. Because the transfers needed to achieve this are costly, it further implies that the optimal lockdown is less strict in poorer countries where a larger fraction of the population is close to subsistence, i.e. countries more concerned by deprivation vis-à-vis the pandemic. In that sense, a lockdown may be seen as a ‘luxury good’. As a consequence, the aggregate death burden and the welfare loss from the pandemic are higher in poorer countries.

This is true with unlimited fiscal space. It can get much worse if government borrowing is constrained. We show that countries with limited fiscal space see themselves forced to fight less the pandemic itself than people dying from the disease — either directly, because the optimal lockdown is less strict, or indirectly, because compliance with the lockdown is lower.
Still, this may not be enough to save all parts of society from deprivation.1
Figure 1 illustrates these insights by means of a numerical example of our model. It presents comparative statics results with respect to aggregate TFP for the cases with (crossed-out lines) and without a binding government borrowing constraint. Further details are provided in the figure’s notes.

Distributional consequences within countries

The previous discussions highlight distributional consequences across countries. Yet, the pandemic and policy also have important distributional consequences within countries: On the one hand, the lockdown benefits the least—and may even hurt—the poorest households in a society. These households may not be able to afford full compliance with the lockdown and, hence, face a higher probability of dying from the disease (see e.g. Blundell et al. 2020). In extreme cases, they may not be able to live through the recession and may die from deprivation. On the other hand, and for the same reasons, poor households benefit most from transfers. We analyse the arising distributional conflict in two ways: We first show how a ‘median-voter’ framework can be applied to our set-up with a two-dimensional policy space.
This analysis suggests that, ceteris paribus, we should expect to observe stricter lockdowns and fewer transfer payments in countries that are governed by elites, and vice versa in countries with populist governments. Our work may thus help explain some of the differences in policy outcomes that we observe. Second, we ask whether supporting the poor may be in the self-interest of the rich. We show that the answer is affirmative if the externality of working is sufficiently large; that is, if compliance by the poor with the lockdown is sufficiently important for the pandemic and the risk to the rich of getting infected. Hence, providing transfers to vulnerable parts of society in times of a pandemic is not only the right thing to do, but may also be to the benefit of society at large.

Conclusion

COVID-19 is the biggest threat to global health and economic well-being in decades. In Hausmann and Schetter (2020), we contribute to the surging literature on COVID-19 by analysing horrible trade-offs in times of a pandemic.

We show how a subsistence level of consumption can shift the main margin for optimal policy from the much-debated trade-off between lives and livelihoods to a trade-off between lives and lives. Transfers are critical for mitigating this trade-off, and they also help fight the pandemic by increasing compliance with lockdowns.2 But many developing countries lack the fiscal space needed for such transfers, with devastating consequences: We show that these countries are forced to fight less the pandemic than people dying from the disease, and still part of society may suffer from deprivation. The dire forecasts of the World Food Programme and others show that such humanitarian tragedies are not just theoretical possibilities. The international community has the means to avoid them by providing additional financial support to developing countries (Bolton et al. 2020, Hausmann 2020b).

References
Acemoglu, D, V Chernozhukov, I Werning and M D Whinston (2020), “A multi-risk SIR model with optimally targeted lockdown”, Working Paper 27102, NBER.

Alvarez, F E, D Argente and F Lippi (2020), “A simple planning problem for COVID-19 lockdown”, Working Paper 26981, NBER.

Bauer, L (2020), “About 14 million children in the US are not getting enough to eat”, Brookings Up Front.

Blundell, R, M Costa Dias, R Joyce and X Xu (2020), “COVID-19 and inequalities”, Fiscal Studies, 41(2): 291–319.

Bolton, P, L Buchheit, P O Gourinchas, C T Hsieh, U Panizza and B W di Mauro (2020), “Born out of necessity: A debt standstill for COVID-19”, CEPR Policy Insight, 103.

Case, A and A Deaton (2020), Deaths of Despair and the Future of Capitalism, Princeton, NJ: Princeton University Press.

Eichenbaum, M, S Rebelo and M Trabandt (2020), “The macroeconomics of epidemics”, Working Paper 26882, NBER.

Farboodi, M, G Jarosch and R Shimer (2020), “Internal and external effects of social distancing in a pandemic”, Working Paper 27059, NBER.

Hall, R E, C I Jones and P J Klenow (2020), “Trading off consumption and COVID-19 deaths”, Working Paper 27340, NBER.

Hausmann, R (2020), “Flattening the COVID-19 curve in developing countries”, Project Syndicate.

Hausmann, R (2020b), “What should we be preparing for?”, Project Syndicate.

Hausmann, R and U Schetter (2020), “Horrible trade-offs in a pandemic: lockdowns, transfers, fiscal space, and compliance”, CID Faculty Working Paper No. 382.

Hevia, C and P A Neumeyer (2020), “A perfect storm: COVID-19 in emerging economies”, VoxEU.org, 21 April.

International Monetary Fund (2020), World Economic Outlook Update, June.

International Monetary Fund (2020b), “World Bank Group and IMF mobilize partners in the fight against COVID-19 in Africa”, Press Release 20/168.

Levy Yeyati, E and L Sartorio (2020), “Take me out: De facto limits on strict lockdowns in developing countries”, COVID Economics 39: 59—72.

World Food Programme (2020), COVID-19 External situation report, Technical Report 7.

Endnotes
1 There are many reasons why optimal lockdowns should depend on the stage of a country’s economic development, encompassing differences in the demographic structure, differences in urbanisation rates, and differences in the quality of the healthcare system. Incorporating such differences might affect the overall comparative statics across countries, but would not fundamentally change our main insights regarding the importance of a subsistence level of consumption and ample fiscal space for optimal policy and welfare.

2 These interactions also highlight the need to jointly analyze optimal containment and fiscal policies.

New York's not dead, but pandemic has laid bare deep-seated problems [The Guardian, 29 Aug 2020]

BY Ed Pilkington

Jerry Seinfeld got into a spat about the Big Apple with a fellow millionaire but for others racial and class inequalities give debate about the city’s health a very different look

Shabazz Stuart was one year old when the TV sitcom Seinfeld first went on air, and seven when the much-loved show about nothing broadcast its final episode. He’s only ever known it as one of those late-night repeats that are fun to watch when you’re at a loose end.

But this week there was no avoiding Seinfeld, or at least its creator and lead actor Jerry Seinfeld who roared back into the public eye with an opinion piece headlined “So You Think New York Is ‘Dead’”. The comedian was responding to a provocative post on LinkedIn by James Altucher, a hedge-fund manager who owns an Upper West Side standup comedy club where Seinfeld occasionally appears.

Seinfeld lambasted Altucher as a “putz” for having argued that New York City was “dead forever”. According to Altucher, the pandemic has turned Midtown into Ghost Town and sent his Wall Street buddies hightailing it for the exit, probably never to return.

Seinfeld had a pithy riposte to that: “Shut up. I will never abandon New York City. Ever.”

But Stuart, from his vantage point in a multi-occupied brownstone in Crown Heights, Brooklyn, found this highly public celebrity spat over the future of his city bemusing. Here were two hyper-wealthy Manhattanites going at each other in terms to which Stuart, like millions of other struggling New Yorkers in the outer boroughs, simply couldn’t relate.

“I don’t know if it’s very useful to have members of the ultra-rich elite talking about whether New York is dead,” he told the Guardian. “Their arguments aren’t very persuasive to my friends wondering whether to stay or leave, as none of us have that kind of money.”

Stuart thinks that to ask “Is New York dead?” is posing the wrong question. Look instead at the structural problems that were festering in the city long before Covid-19 came along.

“As a lifelong New Yorker I can understand Seinfeld wanting to be a cheerleader for the city, but that just masks the challenges we have. Covid just lit the match – the TNT has been here for some time.”

Does it make sense to pay all this rent when I could go to Philadelphia or Pittsburgh and have a higher quality of life?

Stuart, 31, is an African American New Yorker who runs a startup, Oonee, that aims to build secure bike parking facilities across the city. His company has been successful in other urban centers across the US, but has struggled to elicit a positive response from New York authorities.

It’s the reverse of the Big Apple’s vaunted image as a cutting-edge and thrusting city where new ideas are born and flourish. “New York lives on its reputation of being big and bold, of cultivating new ideas, but that’s not been our experience. The city is not adventurous, it’s complacent,” he said.

Under the pandemic all the things Stuart loved most about New York – the restaurants, the club scene, going to get a drink at 4am, the museums – have largely shut down or been curtailed. Then there’s the trash, another long-term feature of life in New York that bugs him.
“I’m on the street right now and there’s trash everywhere,” he said. “I love New York dearly, but I’ve never been in another city with such a waste management problem.”

But the main canker, one that also preceded the arrival of coronavirus by many years, is the cost of rents. Surveys have shown that more than four out of 10 New Yorkers who rent are “burdened”, meaning they spend a third of their income or more on housing, and of those more than half pay 50% or more.

Stuart is one of those “severely burdened” New Yorkers. He currently pays himself a pandemic-reduced salary of $2,000 a month – $1,400 of which disappears on a single bedroom in his shared brownstone.

Now he finds himself not alone. Every one of the occupants of the seven bedrooms in his house, he said, is asking the same thing: “Does it make sense to pay all this rent when I could go to Philadelphia or Pittsburgh and have a higher quality of life?”
***

New York has always been paranoid about its life expectancy as a vibrant metropolis. You could call it a survival complex.

“Since King Kong climbed up the Empire State Building, the city’s looked precarious,” said Kenneth Jackson, the pre-eminent historian of New York based at Columbia University. “And in many ways, it is. So it’s not crazy to wonder about these things.”

Nobody made money betting against New York

But rumors of the city’s demise have always been exaggerated so far. After the Twin Towers attacks on 9/11 the same doom-laden predictions you hear today were rife. Then it was confidently asserted that New Yorkers would never again agree to work at the top of Manhattan’s skyscrapers, and that the subway would be abandoned for fear of further terrorism.

None of that happened, and Jackson can see a similar narrative playing out today. “Like 9/11, the city will come back from this pandemic. It will be slow, it may not be next month or even next year, but it will come back. Nobody made money betting against New York,” he said.

The signs of recovery are to some extent already visible. Compared with the dark days of March and April, when ambulance sirens became the chorus of the city and a palpable fear of the microbe hung in the air, the city feels born again.

At its peak, New York City was recording more than 6,000 new confirmed cases of coronavirus a day, driving the total to almost 238,000 – almost exactly the same tally as the whole of Germany. The worst single day, 8 April, saw 810 recorded deaths.

Fast-forward to today, and the daily number of new cases is hovering around 250 and the average daily death rate is around five.

In a few short months, the city has transformed itself from being the coronavirus pariah of America, indeed the world, into the Covid comeback kid. The governor of New York state, Andrew Cuomo, who presided over the initial catastrophe and has much to answer for, even has the temerity to be writing a book on his handling of the crisis.

The Covid turnaround has been so dramatic that it is easy to imagine Seinfeld enjoying the view from his penthouse window in Manhattan and giving thanks for the city’s return. But Seinfeld’s New York, the New York in which most of the world gets to live vicariously through movies and glossy magazines, bears very little resemblance to real life just over the Harlem River in the Bronx.

Here you don’t have to scratch the surface very far to expose the raw, bloody wounds of racial inequality. Here the pandemic has laid bare uncomfortable truths about this city.

It began with emerging patterns of sickness and death. As coronavirus took hold, it became clear that the virus was cruelly focusing its destruction on pockets of the population. Those infected with the disease died in the Bronx – which is almost 90% black and Latino – at three times the rate of those in Manhattan whose largest demographic is white.

Once the virus was contained, the pain switched from death to economic misery. James Parrott, an economist at the Center for New York City Affairs at the New School, has produced a series of deep-dive reports through the pandemic that expose the severity of the crisis.

He found that while the official unemployment rate in the city was 20% in June, the actual figure measured by unemployment benefits was 33%. That rate rose in the Bronx to a heartbreaking 41%.

Those unemployed women and men in the Bronx, largely people of color, are the New Yorkers who are excluded from the bubble in which Seinfeld and Altucher bicker. In the Bronx, you don’t have time to sit around pontificating about whether New York is dead because you’re too busy trying to keep yourself and your family alive.

Up to 5% of New York’s population – more than 400,000 people – are thought to have fled the city at the start of the pandemic. Some drove down Long Island to the Hamptons, others went further afield, to Florida perhaps, where Altucher now says he has started over.

Though the data remains sketchy, the evidence suggests that most of those quitters were white and wealthy. Which is logical: in poorer areas of the Bronx, Queens and Brooklyn, escape is not an option.

“The workers who have lost their jobs and income, they are the ones who are staying in New York,” Parrott said. “They are rooted here, they don’t have the luxury of relocating.”

Parrott’s research underlines the bitter inequalities buried within the job losses. While lower-income and predominantly black and Latino workers in face-to-face industries have suffered devastating levels of unemployment – 61% in entertainment, 56% in food services, 49% in hotels – the decline in lucrative Wall Street jobs has been just 3%.

Hardship is beginning to bite. At the end of July, supplemental unemployment benefits of $600 a week expired, and already applications for food stamps have surged by 13% from the start of the pandemic. There are thought to be more than 2 million New Yorkers who are food insecure – a million more than before the pandemic.

Most worrying of all in Parrott’s analysis are the almost 250,000 dislocated undocumented immigrants in the city who came here to work and to forge lives but who have now fallen through the cracks and are receiving no financial assistance at all. Given their invisibility as non-citizens crouching in the shadows, the fate of this community is largely unknown.

“We’re going to see a lot more economic devastation,” Parrott said. “People are finding it increasingly hard to make the rent payments, there’s an unprecedented demand for food assistance. We are witnessing hunger.”

Uché Blackstock, a native New Yorker, has watched with mounting foreboding as the pandemic has ravaged her city. As an urgent care doctor in Brooklyn, she was there at the start when medical clinics were overflowing with sick and dying Americans, most of whom were black or brown.

Later, she observed how many of the white residents of her housing co-op in Clinton Hill left the city to hunker down in their second homes. When her two children returned to local public school recently it was disclosed that the student roll had tumbled from 1,000 children to 750.

“Black and brown communities have had a double whammy,” she said. “First the health consequences of the virus, now the economic hit of job losses.”

Despite all that, Blackstock says she has no intention of going anywhere. This city may be agonizing in its inequalities, cruel in its demands, and maddening in its complacency – but at least it is hers.

“Maybe I’m being idealistic, but I think native New Yorkers, we have a resilience that other folks lack. We understand the uniqueness of this city, what it means to live here now and long after the pandemic has gone.”