Avaunt! and quit my sight! let the earth hide thee!
Thy bones are marrowless, thy blood is cold;
Thou hast no speculation in those eyes
Which thou dost glare with!

No, not Tadej Pogačar’s quotes from his post-stage press conference, or even the more eloquent Wout van Aert, as exciting as that would be, but Macbeth when confronted with Banquo’s ghost in the Shakespeare play.

That’s what Covid has been at this Tour de France, the ghost at the feast, the biggest threat to the biggest bike race of the year, one of the only things that looks like upsetting Tadej Pogačar’s perfect ride so far.

All 165 riders left in the race will be tested when they arrive in Châtel on Sunday evening, with the results expected some time on Monday. It is not known yet how they will be announced, whether there will be a slow trickle of teams announcing their potential losses, or whether it will come in one big drop from cycling’s governing body, the UCI.

One thing is certain, there is Covid in the peloton, or at least there has been. Guillaume Martin (Cofidis) became the latest casualty of the illness on Sunday morning, leaving the race, following Vegard Stake Laengen (UAE Team Emirates) and Geoffrey Bouchard (AG2R Citroën) on Saturday.

There have been Covid cases among the extended race bubble too, with staff members heading home from the Tour due to the illness. It has not gone away, even if it feels like it in wider society at times.

The latest Covid positives led to the UCI issuing a statement reminding people of their responsibilities.

“The UCI and its partners remind all participants in road races on the UCI International Calendar that the rules introduced over the last two years in the interests of everyone’s health and safety continue to apply,” it read.

“These include the obligation to wear a mask, to maintain sufficient physical distance and to disinfect hands frequently.”

Those positives are only the symptomatic riders, however, with there likely to be a number of asymptomatic athletes in the peloton, as many have gone untested this week; this is what the PCR tests over the rest day will look to pick up. It will be a nervy time for all involved.

“I think when you see yesterday and today people not starting, I think now people are getting a bit scared,” Connor Swift of Arkéa-Samsic said ahead of stage nine. “We’ll see from the tests later today, and clearly it’s still present. It’s a case of still being cautious when we can.”

Under the new UCI rules introduced before the Tour, a team no longer has to head home if two riders test positive, and the door has been opened to asymptomatic people to remain in the race if they are not transmitting it, as is the case of Bob Jungels (AG2R Citroën).

While some teams have been testing themselves, using lateral flow tests, every few days, others have been simply going with the flow and waiting for the PCR.

“We’re not,” Ineos Grenadiers’ Tom Pidcock said. “There’s no point testing if you don’t have symptoms, it’s a normal illness. If you’re ill, you’re ill. It’s simple. It’s not like if you’ve got Covid and you’ve got no symptoms you go home. We test when we need to test.”

As someone who had Covid relatively recently, at the Tour de Suisse, Pidcock is feeling reasonably protected from the virus.

“I’m feeling quite comfortable about it, I think I’m alright,” he said. “It wouldn’t be great if it did kick off. At the same time, I’m safe, but it’s not right really.”

He joked: “Me and Adam were saying it’s me and Adam in Paris, one, two. Me, and Adam and [Aleksandr] Vlasov.” 

Team DSM are using similar tactics. “We did the PCRs at the start, and if someone is showing symptoms or something like that, then we’re obviously testing,” Chris Hamilton explained. “Today, as soon as we finish the stage we’ll do the PCR and the staff get done tomorrow by the organisation as well.

“I think there was definitely concerns at the start of the Tour, because of how Suisse panned out and everything. It’s one of those things, there is stuff you can do about it I guess, but all we can do is be careful.”

The general classification contenders will be nervous about testing positive themselves, but also their key domestiques dropping from the race. This has already impacted race leader Tadej Pogačar, with Laengen going home on Saturday. Any more and the golden boy might be in trouble.

It increases the sense of jeopardy to wait for the organisation’s PCR test, but at the same time, what is the point of testing if there are no symptoms? Teams have no incentive to potentially find positives and be forced to send people home. In fact, it might be better that we are in a situation where only ill people are ejected.

“If you feel like you have symptoms, you do a lateral flow and see what happens,” Fred Wright (Bahrain Victorious) said. “I just do what told. I’m not too worried as I had Covid before. Let’s hope we limit as many people as possible that test positive. For piece of mind we might do another one on the rest day as well.”

“There’s nothing we can do, we’re just being cautious about using face masks and all this,” is what TotalEnergies’ Edvald Boasson Hagen had to say. “We hope for the best. We test what we have to do within the ASO rules.”

The tests on Sunday are compulsory, and could send shockwaves through the peloton. Or, everything might be pretty much fine. It is time to find out, and discover whether Banquo really is hanging around.

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Originally Appeared Here

As the Tour de France headed into the high Alps, three riders were unable to line-up for the start of stage 9 in Alige, with injury, fatigue and COVID-19 taking its toll. 

A total of 165 riders rolled out of the Swiss town for the first Alpine finish in Chatel but there were three non-starters. So far 11 riders have left the race, with a number of others likely to be hit by illness and injury before the Tour reaches Paris on July 24.

Kasper Asgreen (QuickStep-AlphaVinyl), Ruben Guerreiro (EF Education-EasyPost) and Guillaume Martin (Cofidis) all head home before the roll out in Aigle and before Tour de France enjoys the second rest day in Morzine. 

The Union Cycliste Internationale (UCI) announced that Martin would not start due to the application of the Covid-19 health protocol. 

He tested positive on Sunday morning and perhaps wanted to continue as per the new protocol. However a final decision is made collectively by the team doctor concerned, the Covid-19 doctor for the event and the UCI Medical Director, on the basis of the clinical elements available.  

The French rider was 14th overall in the general classification and had completed a series of eight consecutive Grand Tours. It is the first time that Martin has abandoned a stage race since he turned professional with Wanty in 2016.

Cofidis said that all the other riders and staff tested negative.

As per the UCI COVID-19 protocol, all riders, team staff and key race staff will undergo an antigen test on the rest day in Morzine on Monday.

Asgreen and Guerreiro also depart

Guerreiro also did not start stage 9, leaving the American team with seven riders. 

Initial reports indicated he was also a COVID-19 case but Guerreiro quickly clarified it was due to some kind of ‘non-COVID-related illness’.

The Portuguese rider was sharing a room at the Tour de France with Neilson Powless. He crashed hard in Denmark but seemed to have recovered before falling ill. 

QuickStep-AlphaVinyl announced that Asgreen would not start, saying:  “Despite his left knee healing following the Tour de Suisse injury, the recovery didn’t go as expected, so it has been decided by the team’s medical staff that he should stop in order to not endanger the second part of the season.” 

The Belgian team has been hit by a number of COVID-19 cases and lost Tim Declercq before the start. He was replaced by French national champion Florian Sénéchal but the loss of Asgreen means QuickStep-AlphaVinyl are down to 7 riders. 

After a number of COVID-19 cases amongst riders and inside the race bubble, the UCI called on everyone to respect the COVID-19 protocol.

“The UCI and its partners remind all participants in road races on the UCI International Calendar that the rules introduced over the last two years in the interests of everyone’s health and safety continue to apply.

“These include the obligation to wear a mask, to maintain sufficient physical distance and to disinfect hands frequently.”

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Originally Appeared Here

KEVIN COURTNEY

Let us consider the cringe-inducing public toilet.

Untold numbers of strangers have done their business there before you walked in. Microbes lurk on seats, knobs and handles. Flooring around toilets and urinals can be repulsively wet. Soap and towels may be nonexistent. Exit doors have to be pulled open.

Support local news coverage and the people who report it by subscribing to the Napa Valley Register. 

What got me thinking was a New York Times article, “How bad are the germs in public restrooms, really?”

Experts weighed in. Yes, every surface in a public restroom may be contaminated with microbes of one kind or another, including norovirus, salmonella, hepatitis A and MRSA, but most people pass through unscathed.

The story struck a nerve. More than 800 readers, most of them far more germ-obsessed than myself, wrote comments. Many focused on the finding that flushing a toilet can create an aerosolized plume of microbes that can reach five feet into the air and remain suspended for an hour or more before contaminating virtually every surface in the restroom.

People are also reading…

Every surface? Contaminated? How am I still alive?

Commenters said they enter public potties prepared to wipe down common surfaces with paper towels, toilet paper and disinfecting wipes. In a worst-case scenario, when it’s just you and your bare hands, a reader recommended using only the pinkie on your non-dominant hand for touching anything.

“I do not touch even my own body unless by accident,” another reader declared.

One commenter said they sprayed the soles of their shoes with disinfectant before getting back in their car. Restroom floors are the worst.

Scoffers also weighed in. If the health threat were substantial, “humanity would have been decimated since the introduction of the flushing toilet,” said one. “This is a foolish article pandering to people’s unreasonable fears about unseen microbes everywhere,” said another.

“Seriously, just wash your hands, then don’t touch anything and worry about other things,” one reader advised.

A guy in Maryland said he wished he hadn’t read the article. “Who needs to know that we are all walking through a plume of fecal matter when there is little we can do about it.”

I shared the story with Cheryl, but she was already up to speed on health threats lurking in restrooms.

She touches handles with a tissue, she always uses a seat cover when available, she hovers when appropriate.

She also voiced a personal gripe: she hates sharing restrooms with males who spray.

I’m mostly in the camp with those who said the story conveyed too much information. Having survived army toilets, all-male dorm toilets, untold gas station toilets, toilets in rural Greece, portable toilets at my annual Turkey Trots, and one spectacularly defaced portable at a national forest campground, my approach is to simply go numb when I’m away from home and nature calls.

I get in and get out fast. I don’t let my eyes wander where they need not wander. Extreme germophobes recommend wearing N95 masks to protect against public restroom aerosols. Not me. If I sense grossness, I double down on handwashing.

What’s the proper handwashing technique? Scrub with soap for at least 20 seconds, rinse, then dry. A paper towel is better than a blow dryer, which can spread germs.

Yes, air dryers save forests, but they can also blow germs up to 10 feet, according to the Times article.

All this attention on restrooms should not blind us to other commonly contaminated surfaces, readers noted.

Handrails, salt and pepper shakers, restaurant menus, reusable water bottles, cellphones, gas pump handles — the list of germy places is endless.

Rather than despair, a few readers suggested a reframe. Perhaps microbe exposure makes us healthier in the long run by stimulating our immune systems.

“Live filthy, stay healthy,” said one.

Hikers on the Appalachian Trail face difficult decisions as the coronavirus pandemic worsens: postpone a dream or ignore warnings and keep hiking.

Seniors dance in their homes, getting the exercise that is so important to maintaining their health and mobility amid the coronavirus pandemic.

Hopes are high for a new blood test for COVID-19, which shows results in a matter of minutes compared to the test kit which takes days for results.

Michigan State University is using a commercial oven to re-sterilize N95 masks.

Get opinion pieces, letters and editorials sent directly to your inbox weekly!

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Originally Appeared Here

Ti Gong

Elderly residents at “Ardor Gardens” senior living community enjoy building blocks.

Ti Gong

A worker disinfects the senior living community.

Normal life is gradually returning to senior care facilities in Shanghai, and a mindset change about senior care is emerging as a result of the COVID-19 resurgence, operators said.

A vigorous scene was on display at the “Ardor Gardens” senior living community located on the bank of the Dianshan Lake in Qingpu District as residents played table tennis and strolled to singing and fitness exercises.

Located in the Yangtze River Delta Ecology and Greenery Integration Demonstration Zone and opened last September, the complex accommodates more than 100 seniors.

The community has maintained a zero-infection record to date and has developed a stronger bond with its residents because of the COVID-19 resurgence.

Social life has partially returned to normal. The complex hosted an “island resort style” event recently with strict pandemic prevention measures, to create a relaxing, interactive and social event to enrich the lives of its residents.

It was also to express gratitude for the tireless efforts of nursing workers and to bring refreshment in the midst of summer.

Some residents arrived in a relaxed holiday feel, dressed in colourful summer outfits. After redeeming their event-special sun hats and bracelets, they posed for stylish looks.

They played fun games such as block stacking, dice tossing and sandbag throwing.

“Normal life and joy are back, and the relaxation brings the fun again just like being a child,” said a resident surnamed Zhang, 63.

Winners proudly held their trophies and showed off to each other with much laughter.

Ti Gong

Residents at “Ardor Gardens” senior living community play dice throwing.

A special exhibition of photos and oil paintings attracted attention.

The works on display were all created by residents, capturing not only moments of springtime scenery, but also many glorious worlds, touching and memorable – a timeless record of everyday life.

“I am deeply touched when seeing these works, which remind me of the lockdown period and all the care and support from nursing staff and peers at the community,” said another resident surnamed Zhu.

“There has been a change on the view toward senior care due to the COVID-19 resurgence,” said Ding Hui, a senior operator of the community.

“The lockdown had brought many challenges to the elderly group because it was difficult for many to grab food materials via apps and pick delivered goods.”

The community has received an increasing number of inquiries after the resurgence from elderly citizens, and some who were hesitating about accommodation at senior care facilities before the resurgence finally made up their mind to move there.

“In the past, many deemed distance is an important factor because there are more medical facilities in downtown areas,” Ding said.

“But now, they view an environment which is close to nature the same significant for senior care facilities, because it will ensure a pleasant mood, particularly during lockdown.

“Also, normal meal supply and nursing functions of senior care facilities are extra points.”

Ti Gong

A worker disinfects tables at the senior living complex.

From July, senior homes in Shanghai have lifted their ban on visits by family, which had been suspended for more than three months.

Visitors must have a green health code, and their travel history code should indicate that they have not visited or stayed in medium- or high-risk regions within the previous seven days, according to Shanghai Civil Affairs Bureau.

They should also have a negative nucleic acid test result within the past 24 hours. A reservation is mandatory.

They need to make real-name registration as well.

As early as 6:30am recently, Zhang Yi, a local resident, arrived at the Xinyi Senior Home in Yangpu District, where his mother Ye Genglan was waiting for him.

After he completed a number of procedures including scanning the “venue code,” showing a negative nucleic acid test result from within the past 24 hours, checking temperature, making registration and disinfecting belongings, he was allowed in.

At the senior home, off-line family reunions are staged everyday after the visit ban was lifted.

Tightly holding Ye’s hand, Zhang could not control his emotions. Before the COVID-19 resurgence, he visited Ye every morning. It all stopped in a sudden in March.

“I understand the pandemic prevention policy and am willing for cooperation giving consideration to seniors’ health,” Zhang said.

“But I really missed my mom during the lockdown period. After the relaxation of policy, I made reservation for a visit immediately.”

The senior home receives about 20 visitors daily.

Ti Gong

Elderly residents play games.

The number of visitors, visit frequency, and routes and visiting areas are set strictly based on capacity.

“We put notice and reservation information at the WeChat group of family members of elderly residents,” said Liu Junjun, director of the senior home.

“We give priority to elderly citizens who have been inoculated of COVID-19 vaccines or those with emergency situation.”

When it is sunny, the meeting will be arranged at an outdoor garden for prevention concerns.

For bed-ridden residents, their family members will be required to wear protective clothing for entry into living areas.

Shanghai is among the fastest aging cities in China. Residents over 60 comprised more than 36 percent of the permanent population as of the end of last year, hitting 5.34 million.

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Originally Appeared Here

Today’s early morning highlights from the major news organizations.

KHN:
Digital Mental Health Companies Draw Scrutiny And Growing Concerns

When Pat Paulson’s son told her he was feeling anxious and depressed at college, Paulson went through her Blue Cross Blue Shield provider directory and started calling mental health therapists. No providers in the Wisconsin city where her son’s university is located had openings. So she bought a monthly subscription to BetterHelp, a Mountain View, California, company that links people to therapists online. (Meyer, 7/8)

KHN:
The Push For Abortion Lawmaking After ‘Dobbs’ Is Unique, Legal And Political Experts Say 

The end of nationwide abortion protections has been met with a wave of calls from lawmakers and governors in at least a dozen states for special legislative sessions that would reshape the state-by-state patchwork of laws that now govern abortion in the U.S. “I haven’t seen so many states focusing their attention so quickly on one issue,” said Thad Kousser, a professor who studies state politics. (Zionts, 7/8)

KHN:
Vaccine And Testing Delays For Monkeypox Echo Failures In Early Covid Response

Andy Stone is one of the lucky ones. The New York City resident saw a tweet from a local AIDS activist saying that monkeypox vaccines would be available that day at a clinic in Manhattan. Stone, 35, and his husband booked appointments online right away and got their shots last month. “I want to do what I can to protect myself and others,” said Stone, a marketing consultant living in Brooklyn, who said his primary care doctor advised him to get the vaccine as soon as possible. (Andrews, 7/8)

KHN:
The Search For Scarce Formula Is Worse For Rural Families On WIC 

Two months after giving birth, Jennifer Magee noticed a change in her baby’s feeding routine that scared her: She was starting to drink more formula, almost every hour. Increased appetite is normal for growing infants, including Magee’s daughter, Aubrey. But amid the national formula shortage, Magee, 25, had only one container left, barely enough to last three days. (Saint Louis, 7/8)

KHN:
KHN’s ‘What The Health?’: A Chat With The Surgeon General On Health Worker Burnout

The pandemic has taken a toll on everyone, but those who work in health care have suffered disproportionately, according to a new report from the office of U.S. Surgeon General Vivek Murthy. And it’s not just the workers who are at risk. “If not addressed, the health worker burnout crisis will make it harder for patients to get care when they need it, cause health costs to rise, hinder our ability to prepare for the next public health emergency, and worsen health disparities,” according to the report. (7/7)

AP:
Dems Want To Tax High Earners To Protect Medicare Solvency

Senate Democrats want to boost taxes on some high earners and use the money to extend the solvency of Medicare, the latest step in the party’s election-year attempt to craft a scaled-back version of the economic package that collapsed last year, Democratic aides told The Associated Press. Democrats expect to submit legislative language on their Medicare plan to the Senate’s parliamentarian in the next few days, the aides said. (Fram, 7/7)

The New York Times:
Democrats Propose Raising Taxes On Some High Earners To Bolster Medicare

The proposal is projected to raise $203 billion over a decade by imposing an additional 3.8 percent tax on income earned from owning a piece of what is known as a pass-through business, such as a law firm or medical practice. The money that would be generated by the change is estimated to be enough to extend the solvency of the Medicare trust fund that pays for hospital care — currently set to begin running out of money in 2028 — until 2031. (Cochrane, Sanger-Katz and Tankersley, 7/7)

Politico:
Dems’ Climate And Tax Agenda To Consume Congress In July 

Negotiators are still ironing out key details, but Democrats are signaling that as soon as next week they will begin arguing their case to the Senate rules chief on why the package should pass with a simple majority in the chamber. No one is getting their hopes too high in a party still reeling from Manchin’s rejection of Build Back Better, Democrats’ previous version of the legislation. (Everett and Levine, 7/7)

The Hill:
Newsom Announces California Will Produce Its Own ‘Low Cost’ Insulin

California Gov. Gavin Newsom (D) announced on Thursday that his state will be producing its own “low cost” insulin, stating, “People should not go into debt to get lifesaving medication.” Newsom said that the state budget he recently signed includes $100 million for California to “contract and make [its] own insulin at a cheaper price, close to at cost, and to make it available to all.” (Breslin, 7/7)

The Hill:
GOP Senators Call For Hearings On Bipartisan Insulin Cost Bill 

Five GOP senators are calling on the Senate Finance Committee to hold hearings on bipartisan legislation to lower the cost of insulin. Led by Sens. Pat Toomey (Pa.), and John Barrasso (Wyo.), the Republicans said they were concerned the legislation from Sens. Susan Collins (R-Maine) and Jeanne Shaheen (D-N.H.) will be brought to the Senate floor for a vote without going through the committee first. (Weixel, 7/7)

AP:
Facing Pressure, Biden To Sign Order On Abortion Access 

President Joe Biden will take executive action Friday to protect access to abortion, according to three people familiar with the matter, as he faces mounting pressure from Democrats to be more forceful on the subject after the Supreme Court ended a constitutional right to the procedure two weeks ago. Biden will speak Friday morning “on protecting access to reproductive health care services,” the sources said. The actions he was expected to outline are intended to try to mitigate some potential penalties women seeking abortion may face after the ruling, but are limited in their ability to safeguard access to abortion nationwide. (Kim and Miller, 7/8)

The Hill:
Feinstein Says She’d Vote For Filibuster Carve-Out To Codify Abortion Rights 

Sen. Dianne Feinstein (D-Calif.) on Thursday said she supports the Senate removing the procedural filibuster rule in order to codify abortion rights into law. Feinstein said she “certainly would vote” to support a carve-out to the filibuster to pass the Women’s Health Protection Act and codify federal-level abortion protections. (Dress, 7/7)

AP:
Lone Mississippi Abortion Clinic Seeks Legal Path To Reopen 

Attorneys for Mississippi’s only abortion clinic filed papers Thursday asking the state Supreme Court to block a new law that bans most abortions and to let the clinic reopen next week. The clinic, Jackson Women’s Health Organization, is at the center of the recent U.S. Supreme Court ruling that overturned Roe v. Wade and took away women’s constitutional protection for abortion nationwide. (Pettus and Kolpack, 7/7)

Axios:
North Dakota’s Only Abortion Clinic Sues State Over Trigger Ban

Red River Women’s Clinic, the only remaining abortion provider in North Dakota, is suing state officials over the state’s trigger ban, which is set to take effect later this summer. (Gonzalez, 7/7)

AP:
Indiana’s Abortion Laws May Tighten Before Legislature Acts 

Indiana’s abortion laws will likely be tightened even before the Legislature is expected to start debating additional abortion restrictions later this month. Lawyers for the American Civil Liberties Union of Indiana conceded defeat Friday in their fight to block two anti-abortion laws following the U.S. Supreme Court’s decision last month to end constitutional protection for abortion. That led the state attorney general’s office on Wednesday to ask U.S. District Judge Sarah Evans Barker in Indianapolis to sign off on orders that would lift her injunctions that have prevented enforcement of those laws. (Davies, 7/7)

The New York Times:
After Roe, South Carolina Considers More Restrictions On Abortion

With anti-abortion Republicans in firm control of South Carolina’s legislature and executive branch, a new proposal offering something closer to an outright ban seems quite likely, although the details have yet to be hammered out. On Thursday, the exploration of a new abortion law began with a meeting of a 14-member, Republican-dominated House committee. But a bill introduced in the House has been left intentionally vague, with just a few lines of text — including a statement that state law would be changed “so as to prohibit abortions in the state of South Carolina.” (Fausset and Sasani, 7/7)

AP:
Senate GOP Advances Constitutional Amendment On Abortion

Republican state senators outvoted impassioned Democratic opposition late Thursday to advance a proposal to add language to the Pennsylvania Constitution stating explicitly that the document does not guarantee any rights relating to abortion or public funding of abortions. (Scolforo, 7/7)

USA Today:
‘DIY Abortion’ On TikTok: Experts Urge Americans To Avoid These Herbs

The changing landscape of abortion access across the country has prompted many Americans to turn to the internet for answers, including how to self-manage an unwanted pregnancy at home. Google searches for “DIY abortion” have skyrocketed since the Supreme Court’s decision in June overturning Roe v. Wade, the nearly 50-year landmark ruling that legalized abortion nationwide. (Rodriguez, 7/7)

NBC News:
U.S. To Ship 144,000 More Monkeypox Shots And Expand Testing As Cases Top 700

The Department of Health and Human Services announced Thursday that it will distribute 144,000 doses of the two-shot Jynneos vaccine, which is approved for monkeypox and smallpox, to cities and states starting Monday. That’s on top of 56,000 doses the department made available last week, of which 41,000 have been delivered. (Bendix, 7/8)

CIDRAP:
US Monkeypox Cases Top 600 In 34 States 

The monkeypox virus outbreak is growing in the United States and elsewhere, with the US Centers for Disease Control and Prevention (CDC) now reporting 605 cases in 34 states, the District of Columbia, and Puerto Rico. New York has the most cases, with 122, followed by California with 116 and Florida with 64. (Soucheray, 7/7)

AP:
Louisiana Identifies 1st Known Monkeypox Case In A Resident 

Louisiana’s first detected cases of monkeypox have been found in a state resident and a visitor from out of state, the Louisiana Department of Health reported Thursday. “There are likely more undiagnosed human cases of monkeypox existing in Louisiana than have been formally tested and identified to date,” a news release said. (7/7)

AP:
6 Monkeypox Cases Confirmed In Oregon 

Health officials in Oregon said Thursday they have confirmed six cases of monkeypox in the state. The cases — all affecting men — include one in Multnomah County; three in Lane County; and two in Washington County, the Oregon Health Authority said in a statement. There have been no deaths. (7/7)

The Boston Globe:
10 More Monkeypox Cases Diagnosed In Massachusetts As State Initiates Vaccination Program

Ten more men in Massachusetts have been diagnosed with monkeypox in the past week, bringing the number of cases in the state to 31 since the first infection was announced on May 18, health officials said Thursday, as the state rolled out a vaccination program for those at highest risk. (Fox, 7/7)

The Baltimore Sun:
A Baltimore Resident With A Case Of Monkeypox Makes The Case For An Urgent Public Health Response 

As his trip to Europe in mid-June was winding down, Justin, a 48-year-old Baltimore man, developed a fever and sore throat. His lymph nodes swelled. “When I started seeing dots on my body I thought, oh, boy, this isn’t anything I’ve experienced before,” he said. (Cohn, 7/7)

Newsweek:
Abe Shinzo Shot Despite Japan Having Incredibly Strict Gun Laws

In 1958, it was written into Japanese law that “no person shall possess a firearm or firearms or a sword or swords,”—the opposite of the U.S. Second Amendment’s affirmation of the “right of the people to keep and bear arms.” Handguns are forbidden, while small-caliber rifles have been illegal to buy, sell or transfer since 1971. The only guns that Japanese citizens can legally buy and use are shotguns and air rifles. To do so involves negotiating a head spinning amount of red tape, requiring attendance at an all-day class, passing a written test and getting at least 95 percent accuracy during a shooting-range test. (Cole, 7/8)

The Washington Post:
With Little Outcry, Chicago’s Bloody Weekend Eclipsed Highland Park Toll

No new counseling resources were announced this week on this city’s impoverished South Side, even after a man was shot to death in broad daylight, feet from a playground, days before July Fourth. There are no crowdsourced charity drives raising millions for victims’ families in Chicago, where the holiday weekend death toll reached at least 10 with 62 injured — numbers that exceed the toll from a July Fourth parade shooting in nearby Highland Park, Ill. In that affluent lakeside suburb, the violence was an anomaly. Here, it is a grimly regular occurrence. (Klemko, 7/7)

ABC News:
NYPD Says Murders And Shootings Are Down, Despite Recent High-Profile Incidents

The New York City Police Department said Thursday that murders and shootings are down in the city, despite three people being killed within an hour the night before. In June, murders were down 12% compared to the same period last year and shootings decreased by 13% last month compared to June 2021, the department said. (Grant and Katersky, 7/7)

ABC News:
About 300,000 Kids Under 5 Have Gotten At Least 1 Dose Of COVID Vaccine So Far

By the end of Thursday, roughly 300,000 children under the age of 5 years old will have received at least one dose of a COVID-19 vaccine, a senior Biden administration official told ABC News. The 300,000 shots in arms so far for kids under 5 is about 1.5% of the roughly 19.5 million U.S. children 4 years old and younger. (Pezenik, 7/7)

AP:
Slow Pace For Youngest Kids Getting COVID Vaccine Doses

U.S. officials had long predicted that the pace of vaccinating the youngest kids would be slower than for older groups. They expect most shots to take place at pediatricians’ offices. … More than 5 million pediatric doses have been shipped to more than 15,000 locations, the White House said, ready for parents and kids to come in. (Miller and Johnson, 7/7)

The New York Times:
What The BA.5 Subvariant Could Mean For The United States 

The most transmissible variant yet of the coronavirus is threatening a fresh wave of infections in the United States, even among those who have recovered from the virus fairly recently. … “I think there’s an underappreciation of what it’s going to do to the country, and it already is exerting its effect,” said Eric Topol, a professor of molecular medicine at Scripps Research, who has written about the subvariant. (Leatherby, 7/7)

San Francisco Chronicle:
What’s The Risk Of Getting COVID Outside? Here’s Why New Variants May Have Changed The Answer

Health experts agree that outdoor activities are still much safer than indoors, since viral aerosols don’t have a chance to accumulate in the air. But with the most transmissible variants yet, chances are you have less protection in certain situations. “Being at parks and outdoor sporting events is still what we should turn to,” said Dr. Anne Liu, an infectious disease doctor at Stanford. “But if you are in a dense crowd or in an outdoor space that has been modified to look like an indoor space, then the risk becomes higher.” (Vaziri, 7/7)

Houston Chronicle:
Harris County Surpasses 1 Million COVID Cases Under Worst Surge Yet

Harris County this week officially surpassed one million confirmed COVID-19 cases, according to state health department data, but medical experts say the true number is likely much higher. The continuing surge of infections has been attributed to BA.5, the newest sub-variant. BA.5 accounts for 53.6% of new cases, making it the dominant COVID strain in the U.S., according to the Centers for Disease Control. (Dozier, 7/7)

AP:
COVID-19 Cases Prompt Mask Mandate At Denali National Park 

Masks will be required for people using federal buildings or riding buses inside Denali National Park and Preserve because of high COVID-19 levels in the broader community, officials said Thursday. The mask mandate takes effect Friday, a statement from the park said. (7/7)

Los Angeles Times:
Physicians Caution Against Working Through COVID-19

Physicians caution, however, that rest is an important part of weathering a COVID-19 infection. Plugging away from home is better than putting others at risk of getting infected, but it can still strain the immune system, worsening the toll of a COVID infection, experts say. (Alpert Reyes, 7/7)

The New York Times:
The Pandemic Has Eroded Americans’ Trust In Experts And Elected Leaders Alike, A Survey Finds

As the coronavirus pandemic entered its third year, the American public had lost much of its trust both in public health experts and in government leaders, and was less worried than before about Covid-19, according to a survey conducted in early May and released Thursday by the Pew Research Center. (Chung and Olson, 7/8)

The Atlantic:
How Are We Possibly Still Disinfecting Things?

Although most people are no longer disinfecting their groceries, signs flaunting cleanliness are still all over the place. Public bathrooms tout regular spray-downs with disinfectant. Elevators advertise self-cleaning buttons. At my local Marshalls, the cashier sanitizes the credit-card reader after every use—even if I use Apple Pay! A recent issue of United Airlines’ in-flight magazine was “treated with an antimicrobial process,” according to its cover. Signs lining the queue for a Delta flight in June read, cryptically: certified by lysol pro solutions. (Tayag, 7/7)

The Wall Street Journal:
Theranos’s Ramesh ‘Sunny’ Balwani Found Guilty On All 12 Fraud Counts

A federal jury convicted Ramesh “Sunny” Balwani, the former top lieutenant to Theranos Inc. founder Elizabeth Holmes, on all 12 charges that he helped perpetuate a yearslong fraud scheme at the blood-testing startup. The verdict is the second conviction against Theranos leadership and comes six months after a jury found Ms. Holmes guilty of fraud; it secures another major victory for the U.S. government, which brought the case against the pair in 2018. (Somerville and Bobrowsky, 7/7)

Stat:
Drug Companies Will Have To Start Refunding Medicare For Certain Drugs

Starting next year, pharmaceutical companies will have to repay Medicare for any unused amount of drugs that come in single-dose vials. On Thursday Medicare implemented this new provision as part of its broader annual rule that updates physician payments for 2023. (Herman, 7/7)

AP:
Whistleblower Physician Reinstated At California VA Hospital 

A whistleblower physician who was forced into retirement after raising concerns about anesthesia staffing practices during surgeries at a Los Angeles Veterans Affairs hospital has gotten his old job back, federal officials said Thursday. (7/7)

AP:
Northern West Virginia Hospital Settles With Feds For $1.5M

A hospital in West Virginia’s Northern Panhandle has agreed to pay $1.5 million to the federal government to settle allegations that the medical center provided financial incentives to physicians for referring Medicare patients there, U.S. Justice Department officials said Thursday. (7/7)

Health News Florida:
A Florida Medical Malpractice Case Is Under The Microscope Of Hospital And Doctor Groups 

State and national groups representing hospitals and doctors are trying to help sway the Florida Supreme Court in a dispute about whether a medical malpractice lawsuit should have been allowed to move forward. (Saunders, 7/7)

AP:
NC Governor Signs Bills Addressing Sexual Assaults, Alcohol 

North Carolina Gov. Roy Cooper signed 11 bills on his desk into law Thursday, including legislation that addresses sexual assault, domestic violence and alcohol sales. … One signed measure makes clear that hospitals or medical offices can’t attempt to bill victims of sexual assault or their insurance companies for forensic medical examinations, leaving it to a special state fund that’s already been in place to cover the payment. (Robertson, 7/7)

AP:
Fentanyl-Driven Overdoses Jump, Officials Urge Naloxone 

An Oregon Health Authority analysis released Thursday has found that drug overdose deaths in Oregon more than doubled between 2019 and 2021, driven largely by misuse of the powerful synthetic opioid fentanyl. (7/8)

CIDRAP:
CDC Reports 12 More Unexplained Hepatitis Cases In Kids, 332 Total

In a weekly update, the US Centers for Disease Control and Prevention (CDC) yesterday reported 12 more unexplained pediatric hepatitis cases in children, raising the national total to 332. The number of affected states held steady, at 42. (7/7)

The Boston Globe:
Four Young Adults Sickened After Cohasset Swim Center Opens Prematurely, Town Says

Four young adults participating in a swim practice were sickened at the Cohasset Swim Center on Wednesday after the facility opened prematurely and a broken pipe caused a leak in its largest pool, town officials said. The center, which is not owned or operated by the town, opened to the public without its finalized building permit or pool health inspection permit, according to a statement Thursday from the office of Cohasset Town Manager Christopher G. Senior. (Fox, 7/7)

WUSF Public Media:
Contaminated Oysters Found As Far North As Tampa Bay Could Pose Health Risks

With a new state law addressing the clean-up of chemical compounds that have been widely used by industries, a Florida International University study says the substances have been found in oysters in Biscayne Bay, the Marco Island area and Tampa Bay. (7/7)

Albany Herald:
CIT Bracelets Help Ease Encounters Between Police, Mental Health Sufferers 

As a fashion statement they’re not much. But these rubber bracelets could make a big difference with police officers interacting with individuals suffering from mental illness and alter the results of an encounter from a trip to jail to referral to treatment. … The bracelets, which say CIT (Critical Intervention Training) on one side and Mental Health Alert on the other, can let police know how to better handle a situation when they encounter someone who is wearing one. (Mauldin, 7/6)

Axios:
Race May Factor Into Leukemia Survival, Study Suggests

Younger Black leukemia patients were likelier to die early or not go into complete remission than their white peers when receiving the same intensive treatment, according to a new study in Blood Advances. (Dreher, 7/7)

NPR:
Scientists Look To People With Down Syndrome To Test Alzheimer’s Drugs

People with Down syndrome are highly sought after for Alzheimer’s research studies because many develop the disease in their 40s and 50s, and most will get it if they live long enough. The elevated risk for Alzheimer’s comes from the extra copy of chromosome 21 carried by people with Down syndrome. (Hamilton, 7/7)

NPR:
HIV Patients Who Get Leishmaniasis Face A Tough Road. But Now There’s New Hope

“If you don’t get the treatment, you’re usually going to die from this,” says Dr. Fabiana Alves, director of the leishmaniasis cluster at the Drugs for Neglected Diseases Initiative. VL is even more devastating for a patient whose immune system has been compromised by HIV, simply because the existing VL treatments don’t work as well. And in parts of the world where VL is rampant, like eastern Africa and Southeast Asia, a significant percentage of patients are HIV positive. (Barnhart, 7/7)

USA Today:
Is ‘Hangry’ Real? New Study Says You Do Get Angry When Hungry

If you are someone who gets angry if you haven’t eaten, also known as “hangry,” a new study says you aren’t being irrational. The findings, published in the peer-reviewed journal Plos One on Wednesday, come from one of the first studies to examine the relationship of hunger and anger, Viren Swami, lead author and social psychology professor at Anglia Ruskin University in the U.K., told USA TODAY via email. (Mendoza, 7/7)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

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Originally Appeared Here

It’s a good point. Many chemicals used in cleaning products are toxic at high levels: even at the supposedly safe amounts recommended, they can catch in your throat. But would using fewer chemicals work? I set to cleaning the children’s old bedrooms. I lined up some eco products, some favourites of the Instagram cleaners (Pink Stuff and Elbow Grease), plus a batch of homemade cleaners, and pulled on my Marigolds.

First off – the loo. I sprinkled citric acid rather than squirting bleach, as Kate points out that “all bleach does is turn limescale white – use citric acid and it will actually dissolve”. The next day, it took a few flushes to get the last of the crystals away but it’s a long time since the loo has looked that pristine.

The 10-year-old stickers on my son’s furniture seemed welded on after an initial rub with the Elbow Grease – but given a spray, a five-minute wait, followed by some actual elbow grease and they came away easily enough. The Method spray did fine as well – and to my surprise, the vinegar spray worked like a dream.

Next up, brown smears of fossilised coffee spills on the skirting board. I used Pink Stuff Miracle Cream Cleaner which lightened them somewhat, and the Delphis Eco Cream certainly smelt nice, but the winner was a homemade paste of bicarbonate of soda, lifting the marks with elan – until I noticed it had left white crumbs all over the floor. A quick reformulation, this time to Kate’s preferred recipe which uses dish soap rather than water to hold it all together, and we had a winner.

The final challenge: the cooker. The burnt-on grease was too much for the Stardrops, Elbow Grease, below, and even bicarb paste. I turned to Bar Keeper’s Friend and the light abrasion scoured through the marks, like the posh Vim it is. Definitely a goal, and if at £2.99 for 300g (Lakeland) it’s one of the most expensive, if I’m only bringing it out when I need the big guns, it’ll last for months. 

With the homemade products doing impressively well, I totted up the cost. It turns out DIY cleaners are often, if not always, cheaper than the supermarket versions and the eco versions. Plus you’ll know what you are using. So if you want to be greener, then this is the way to put a bit of vim in your cleaning.

My plastic-free home green clean list

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Originally Appeared Here

With a heatwave on the way, Britons up and down the country will be using sunscreen to protect themselves during the hot weather. Sunscreen and sun block is paramount during hot, sunny weather as it helps protects the skin from absorbing UV radiation. However, sunscreen can be oily and leave stains on items of clothing and furniture.

Children wearing sunscreen may accidentally wipe it on sofas, carpets, chairs and other soft furnishings without even realising.

Now, Nic Shacklock from Online-Bedrooms.co.uk has shared his cornflour and bicarbonate of soda hack for removing sunscreen stains.

He said: “If sunscreen lands on furniture, the first thing you need to do is blot up as much as you can without spreading the stain further.

“Then head for the kitchen cupboards.

“Find some cornflour or baking soda and place on the stained area.

READ MORE: ‘The best way’ to clean patios for 29p – ‘removes stains and weeds’

Sainsbury’s Bicarbonate Of Soda costs £1.25.

ASDA Bicarbonate of Soda costs just 55p for 200g, while Wilko Original Bicarbonate of Soda is £1.75 for 500g.

Clean+Natural Bicarb Of Soda is £1 from Savers.

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On the five-hour drive to the docks of Buenos Aires, Claudia Osiani thought hard: do I board the cruise ship or cancel my birthday voyage? With her husband, Juan, she discussed the recent spate of deadly virus outbreaks on cruise ships in Japan and California. “This cruise is different; it will be packed with locals,” Juan reassured her, and it made them feel safer. He had sacrificed so much to provide Claudia with this fantasy of a 14-day voyage through the wilds of South America, and she loved him too much to let on that she was petrified at the thought of embarking.

It was early March 2020, and the first wave of the Covid-19 virus was spreading not only in Wuhan, China, but Italy and Spain. In the UK, cases totalled 273; in Argentina there were fewer than a dozen and it felt like a northern hemisphere issue. “We’re going so far south,” Claudia told Juan in the car. “It’s going to be a bunch of Argentinians on that ship, maybe some Chileans.”

At the docks they spotted their ship, the MS Zaandam. Christened in May 2000, the Dutch-flagged vessel had the feel of an ocean liner of a bygone age. She was steeped in the nearly 150-year history of the Holland America Line, for decades the industry leader in service and style, and known in its marketing materials as “the Spotless Fleet”.

Claudia and Juan had been together for 42 years. Claudia was a stickler for detail and liked to swim and cycle. She was an experienced psychologist, and gregarious, open to speaking her mind, making grand gestures. Juan, a soft-spoken accountant, was in many ways her opposite. His mother was an immigrant from Bath, England; his father was from the Netherlands. But they’d made it work, raising three children who’d given them nine grandchildren.

As the couple boarded, they found that almost none of the passengers came from Argentina or South America. Their hopes of cruising with people from countries spared by this new deadly virus vanished. Aboard the Zaandam were 305 Americans, 295 Canadians, 105 French, 131 Australians and 229 UK citizens.

As more than 1,200 guests and almost 600 crew settled in, the Zaandam became a buzzing community that included 10 decks, eight bars, two pools, a casino, a mini tennis court, an art gallery, a library and a performance hall with a capacity for 500. As last-minute preparations to leave were made, dancers limbered up, magicians rehearsed, members of an a cappella choir belted out tunes and a team of massage therapists were busy kneading away knots from the stress of life onshore. Few passengers were monitoring the news channels that would have alerted them that on 8 March 2020, just 48 minutes before the Zaandam’s departure, the US state department posted a warning that was as unambiguous as it was unprecedented: “American citizens, especially with underlying conditions, should not travel by cruise ship.”

Aboard the Zaandam, the musicians tuned their instruments.

The cruise was a once-in-a-lifetime chance to visit the strait of Magellan, navigate the Beagle Channel, follow Darwin’s route, and then cruise up the west coast of South America for an excursion to relive the excitement of Hiram Bingham’s 1911 “discovery” of Machu Picchu, high in the Peruvian Andes. They would end with a passage through the Panama Canal, island hop in the Caribbean and then disembark at Fort Lauderdale.

Down in the holds, the quartermasters went over the stores for the long trip. To feed all passengers and crew on a ship like the Zaandam for a long cruise typically required 60,000 kilos of vegetables, 40,000 eggs, 20,000 steaks, 16,000 cans of beer and soda, and hundreds of cases of wine. In addition to these carefully itemised supplies, another traveller was aboard the ship – a deadly stowaway probably hiding in the lungs of a passenger or a crew member.

In the run-up to the Zaandam’s departure from Buenos Aires, Holland America medical experts had dispatched advice on how to protect against coronavirus. Dr Grant Tarling delivered updates in cheery three- to five-minute videos posted on corporate websites. “Given recent events and general inquiries we have received about travellers’ health,” said Tarling, looking into the camera in one video released in late February, a map of the world behind him, “you may want to bring your own thermometer.” Tarling, the company’s lead medic, also demonstrated the correct position to sneeze, bringing his bent arm close to his nose. “If you cough or sneeze, do it into a tissue or your bent elbow.” His third piece of advice was: “Buy travel insurance.” The doctor suggested passengers read the insurance coverage closely to “make sure it is the kind ‘cancel for any reason’ and covers many unexpected travel situations, such as medical care and evacuation”.

Soon after boarding, Claudia noticed the coughs. Anybody can see these people are sick, she thought

Back at corporate headquarters, Holland America and its owner, Carnival Corporation – the world’s largest travel and leisure conglomerate with more than 100,000 employees and a stock valuation in the billions – had already dealt with the virus on several other ships. Two Carnival ships – the Grand Princess and the Ruby Princess – were suffering severe Covid outbreaks off the Pacific coasts of the US and Australia, respectively. The Diamond Princess had been hit hard in Japan a few weeks earlier, when hundreds were infected and at least nine people died.

Soon after boarding, Claudia noticed the first coughs. Once she tuned into the sound, it seemed to be everywhere. I can see these people are sick – anybody can, she thought.

Nine days into the cruise, as the world was locking down, Claudia marched down to the front desk, by the huge pipe organ. “How can the captain allow this? Allow people to gather in groups, so close to each other, if there is a pandemic all around?” she asked. Claudia urged the staff to take precautions, to protect the ship from Covid. She walked the ship, unnerved by all the older Europeans, Americans and Canadians gathering, seemingly oblivious to the threat. The gym, spa and hair salon were open, packed with people. This makes no sense, Claudia thought. Everywhere she glanced, she saw evidence of Carnival Corporation’s efforts to fulfil its brand slogan, Choose Fun.

In the tight crew quarters far closer to the waterline, workers began to succumb. Some told their supervisors; others soldiered on. Wiwit Widarto, the boat’s laundry supervisor, felt tired, his muscles aching. He assumed it must be his workload, or maybe a common cold. He and the rest of his crew were working nonstop, 10-12 hours a day, in the sweltering confines of the ship’s cramped laundry rooms, trying to keep up. More passengers and crew were spending more and more time in their cabins, which translated into piles of soiled sheets, towels and napkins.

Crew members made valiant attempts to limit the outbreak. They seemed to be everywhere, politely suggesting that passengers wash their hands or make use of the hand sanitiser stations. The self-serve buffets were shielded by Plexiglas, and servers were posted every few feet to ladle out the portions and minimise passengers’ contact with food. Even the US Centers for Disease Control and Prevention (CDC) and the World Health Organization were confused – was the virus able to live on surfaces? How long did it survive?

As the cruise entered the second week, fear was ruining the voyage for Claudia and Juan. Near the strait of Magellan, nervous locals had protested over the ship’s arrival, worried they might bring the virus to the remote Chilean city of Punta Arenas. Along with friends from Argentina, they drank tea in the dining room and avoided crowds. They were sitting near the sweeping main staircase – the one that always reminded Claudia of the one aboard the Titanic – when an announcement startled them.

“Good afternoon. This is your captain speaking from the bridge with an important announcement,” Captain Ane Smit began, addressing the entire ship. “I ask that everyone please listen closely.” The news was grim. An influenza-like respiratory virus had sickened many passengers. “Out of an abundance of caution, we must ask that you return to your staterooms as soon as you are done with lunch,” the captain continued, “where, regrettably, we are going to have to ask you to remain.”

Many cabins had less space than a one-car garage. Dozens of rooms were windowless. Claudia sat in the cabin with Juan, nervously staring out of a salt-streaked porthole, or watching television. Relying on her experience as a psychologist, she knew that anxiety, fear and depression were all rising. The uncertainty ate away at her.

Claudia Osiani at home in Argentina. Photograph: Alejandro Kirchuk/The Guardian

Instead of a comfortable crash pad for naps between happy hours and city tours, the cabin now felt like a cell for two. Meals, once a highlight, were now cloaked in anxiety. Lunch arrived via a disturbing, invisible operation. Claudia heard the sudden cry “Foooooooooood!”, then the clanking of a delivery cart as it was wheeled down the hall. Then at the next cabin, the cry “Foooooooood!”, and the next.

Opening the door, she found a tray on the floor. With bath soap, she washed every fork, knife and plate. When the soap ran out, she switched to shower gel for the glasses and edges of the tray, which she gingerly brought to the side of the bed. Claudia and Juan eyed the food with suspicion. They chewed cautiously, enjoying not a bite, nor a sip of the complimentary red wine. Juan and Claudia were supposed to be disembarking in three days – their original itinerary was nearly over – but now all schedules had been shredded.

Panicked by the outbreak, passengers rang and insisted on special services; Widarto made a point of going to their cabins to personally change their sheets or exchange towels. Some guests were clearly sick, but he helped them as best he could. Adding to the workload, one after another of Widarto’s staff members fell ill. He ordered them to bed, which meant he and the remaining members of staff had to work even harder. After three decades on cruise ships, Widarto was a perfectionist, and that drove him to work harder at times like these. When he called his wife, Anny, back in Indonesia, she noticed his voice was different. “You have to go to medical, to the pharmacy,” Anny said, growing more concerned. “You have to get some help.”

Widarto explained that he’d gone to the medical centre, but all they had to offer him was paracetamol. Anny was shocked. “You need to stay strong, focus on yourself, get better,” she said, attempting to raise his spirits. Widarto told her he’d do his best, but just before hanging up, he shocked his wife.

“Anny,” he said, “please pray for me.”

Widarto wore a mask and gloves when he could, but was that enough to protect against any virus left on sheets and pillowcases? Rumours flew about that Widarto had removed sheets from the bed of a guest so sickened that he was unable to walk and was transported to the medical centre in a wheelchair. Word was that the passenger had died, but no one could be sure.

Widarto faced more immediate challenges. He was losing staff at an alarming rate. Over the previous three days, they had kept getting sicker. Their cramped, sweltering workspace seemed to amplify the coughs. The two doctors aboard weren’t much help. A couple of housekeeping staff had reported to the sick bay, and returned with no more than a paracetamol and a bottle of cough syrup. Widarto was subdued as he confessed to a friend: “I can’t taste anything.”

As the Zaandam steamed north up the west coast of South America, country after country announced ever more strict precautions to protect their populations. None would take the chance of letting a cruise ship dock, despite intense efforts by the cruise line and diplomats to gain safe harbour. The crisis was growing by the day; an international pandemic – the first in a century – was declared, and airline travel was shutting down. Instead of their fantasy escape, the crew and passengers aboard the Zaandam were shunned. No one knew much about the new Covid virus, but cruise ships were assumed to be giant incubators.

Warren Hall, a South African gynaecologist who was the chief medic on the Zaandam, oversaw a sparse medical staff in the bow end of one of the lower decks. At the entrance, there was a reception and two examination rooms. The medical centre had surgical tools and medicine at the ready for emergency procedures. Down a hallway, there were four inpatient rooms, outfitted like those in a hospital.

Medical staff were experienced in treating life-threatening illnesses far from land: fatal heart attacks and falls were common among the older passengers. But when patients were in a grave condition, the ship would typically rush to port and unload the stricken individual. Now, the infirmary was awash with coughing passengers and ill crew members who lined up in the corridor, waiting their turn. Some looked as if they might topple over at any moment. Passengers and crew also crowded inside the tiny reception area. And in each of the examination rooms, a patient lay supine. The coughing was incessant. The two doctors and four nurses worked valiantly but were overwhelmed.

As the outbreak spread through the locked-down ship, family members of those trapped aboard launched social media campaigns to rescue their loved ones. They created a Facebook page and hundreds joined to share what they knew. Reporters began to interview passengers, and timelines were flooded with pleas for help. A newlywed Mexican couple on their honeymoon created a WhatsApp group. They named it Zaandam Prisoners.

They ploughed the seas, destination unknown, in some kind of surreal, vaguely luxurious floating prison

With no chance to escape, Claudia returned to a familiar role: caretaking. She rang her friends on board and cheerfully chatted about the sun, the sea and the wind. Her top priority was an elderly couple who were relying on sleeping pills to cope with the stress of lockdown. She knew that in situations of extreme, prolonged stress or trauma, people tended to self-medicate with whatever was at hand: booze or, in this case, sedatives. Claudia was able to help put their minds at ease by calling over the ship’s phone with soothing, detailed descriptions of scenes outside the cabin window in what she dubbed “weather therapy”.

A TV channel featured a live camera shot from the bow of the Zaandam, displaying the open ocean in a wide-angle panorama. Rather than bringing calm and tranquillity, the live feed further emphasised to Claudia that they were ploughing the seas, destination unknown. She felt as if she were incarcerated in some kind of surreal, vaguely luxurious floating prison.

In the medical centre, the patients got sicker and sicker. John Carter, a 75-year-old from north Devon, was among the most gravely ill. For hours, he was in a critical condition. Dr Hall diagnosed bacterial pneumonia brought on by an unknown viral infection. As Carter’s breathing worsened, Hall threaded a tube into his lungs and connected him to a ventilator.

Hall had just 11 tanks of oxygen on board, and the ventilator was going through the supply rapidly. Hall knew that a flood of elderly patients with respiratory issues would necessitate far more oxygen. Without it, they might die. There was no doubt that Carter had to have it. But it wasn’t enough, and Carter died. His grieving widow was then left alone, only able to speak by phone with family. They issued a plea on her behalf: “She is obviously distressed and extremely frightened … she is struggling … and feeling unwell.”

Wiwit Widarto, the boat’s laundry supervisor, who fell ill while working onboard. Photograph: courtesy of Anny Doko

Below decks, Widarto was trying to find the strength to call Anny at their home in Batam, Indonesia. He now felt too sick to work in the stifling heat. But, as always, guests called and called, requesting fresh sheets, or just needing to talk. Widarto felt obliged to go to their aid. He put on the best face he could for Anny as he called via WhatsApp. They exchanged hellos, and Widarto tried to calm Anny down, set her mind at ease. “Please don’t be sad,” he said. “You need to be a strong mom. For the kids.”

Anny pressed him, trying to find out what was wrong. Finally, Widarto confessed that his fever was rising, and the coughing was worse than ever. He thought the limited stocks of medicine were reserved for the ill passengers and was relying on home remedies, like hot tea with lemon. Then he interrupted the conversation: he had to go. A passenger had called, requesting a fresh blanket.

Anny was shocked. Why was Widarto insisting on working? He seemed distant, taking his time before answering.

“Please, please rest,” Anny pleaded. “Please. Don’t work while you’re feeling unwell.”

“I can’t. I can’t afford to do that,” Widarto finally responded. His voice trailed off. “Lots of my staff are falling ill. Someone’s got to work.”

“Please, stay strong,” Anny said; she was crying.

Entering the third week of its odyssey, the Zaandam sailed further north up the coast of South America; a flurry of diplomatic notes whizzed back and forth as US, Canadian, French and British diplomats pressed the government of Ecuador to let the passengers get off. Thanks to a policy of hiring former navy admirals and coastguard commanders, the Holland America leadership worked smoothly with the diplomats – on many issues they spoke the same language, fought for the same goals.

But even if the Zaandam obtained clearance to let passengers disembark, there was no assurance that Holland America could win permission to fly them home. “I’ll ask our team in Quito, but early signals are bad, as gov’t has shut down movement and borders,” wrote a US diplomat in an email. “The governor of Guayaquil has been very active in denying entry.”

Few options remained. Emergency medical flights were in short supply everywhere. Wealthy individuals around the world with the means to pay $25,000 or $200,000 for a private escape had booked jets, helicopters and yachts for a swift retreat from the virus. Holland America had the cash to secure these flights, but what would be the use if the plane couldn’t land?

Hundreds left the ship, but a cheerful receptionist told Claudia: ‘Sorry, you will not be disembarking’

Navigators aboard the Zaandam, helped by Holland America executives onshore, began charting multiple options – would they be allowed through the Panama Canal? Should they head to a US port in San Diego? But the reality was clear: they were on a voyage to nowhere. Passengers largely obeyed the lockdown orders. At times, small groups would be ushered out for 15 minutes of fresh air, but seeing crew members in masks just added to the sense of danger. No one knew how many were infected, but the number of little red stickers placed on the doors of those thought to have Covid marked the spread.

As the ship anchored off the coast of Panama, reinforcements finally arrived. Carnival Corporation had ordered the Zaandam’s sister ship the Rotterdam to rush down from Mexico. It carried essential crew and was empty of passengers. The plan was to dilute the problem by moving healthy passengers off the Zaandam and on to the Rotterdam. Additional medical supplies and personnel and support crew could also be brought aboard what was now dubbed by the media “The Pariah Ship”.

Claudia was praying that she and Juan would be allowed to transfer when she heard a knock. She opened the door and a crew member wearing a gown, gloves and a face mask delivered the good news: they were among the roughly 800 passengers cleared to leave. They gathered their suitcases and sat down in a small transfer boat known as a tender. Claudia was elated to be leaving; she knew she was lucky. Their early precautions had worked, as neither she nor Juan were infected. Now they were on a circuitous but hopeful path back to their home in Argentina.

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Back on the Zaandam, however, the raging outbreak had struck down scores of crew and passengers. Then on 27 March, Captain Smit took to the airwaves again – this time with the grim news that four passengers had died. One was John Carter. Another man had collapsed on his way to the bathroom and died on the floor. Another had suffocated, unable to breathe as his lungs were destroyed by Covid. Medical personnel were swamped by calls and overworked, forced to run from one cabin to another, yet still the patients waited hours, sometimes more, to be seen by a doctor.

As the Zaandam headed for Florida, mixed signals from the Trump administration stymied attempts by Holland America to find a way to get several dozen people in desperate need of medical care off the ships. It took endless rounds of negotiations between the cruise line, CDC officials, Florida state health authorities, the White House and diplomats from a dozen countries to finally develop an evacuation protocol that was acceptable to all.

Baggage handlers unload suitcases from the Zaandam in Florida. Photograph: Abaca Press/Alamy

On 2 April 2020, nearly a month after leaving Buenos Aires, a fleet of buses lined up on the docks of Port Everglades in Florida, and most passengers from both the Zaandam and Rotterdam were allowed to disembark. A row of ambulances were ready as well. One of the first people evacuated from the Zaandam was Widarto, who was now fighting for his life. Hall had done what he could, but Widarto’s condition had deteriorated, the virus destroying his lungs; he badly needed ICU care.

Within minutes, they moved Widarto down the gangway and into an ambulance. The ambulance sped off. A medical team at Broward Health Medical Center in Fort Lauderdale was waiting for him. But doctors were not optimistic: in a video call, they told Anny that her husband was losing the battle, that his lungs were filling with fluid, and that nothing they had done was stopping that deadly process. When that time came, the doctors could only revive him with the defibrillator, gambling that they could shock life back into his body. But that procedure could have devastating consequences, the doctor warned; he could end up paralysed. Anny had to make a choice: did she want him resuscitated? Or would it be kinder to let him die? She talked it over with her family and they agreed. “If he flatlines, let him die in peace,” she said. “That’s what God would want to happen. If God wanted him alive, he would be alive.” Anny was only able to see him on a video call before he died.

Two dozen passengers were medically evacuated, but hundreds more were deemed fit for travel. Bundled on to buses and dumped at airport terminals, they then crisscrossed the country and the world, and some carried the virus.

Although hundreds of passengers had walked off both the Zaandam and the Rotterdam, Claudia and Juan were told they could not disembark. Claudia waited for a few hours and then called reception. It took a moment to unravel what was happening. “Oh – we’re so, so sorry, but you will not be disembarking,” the receptionist announced cheerfully.

“What do you mean?” Claudia asked.

“There was a problem with your flight to Argentina. We need you to stay on the ship a little while longer, while we work out a solution.”

Claudia Osiani and her husband, Juan, at their home in Mar del Plata, Argentina. Photograph: Alejandro Kirchuk/The Guardian

The Argentinians were stuck in bureaucratic gridlock. So, too, were the hundreds of crew, as the CDC had decided it was too dangerous to let potentially infected crew members into society. The Rotterdam and the Zaandam left Florida and abandoned US territorial waters, docking instead near the Bahamas.

Day after day, the two ships sailed in what pilots call “doughnut patterns” as crew and approximately nine passengers remained locked down. With the help of the cruise line, Claudia was untangling the logistics of organising a flight back to Argentina when the captain’s voice sounded loudly over the ship’s public intercom. He appeared to be giving orders exclusively to the crew. To Claudia, it felt as if they didn’t exist; that they were ghosts on a ghost ship.

“Personnel will now move to deck two,” the captain declared. Or that’s what Claudia thought he had said. “Deck two, Juan? That’s us, right?”

Soon, a powerful chemical smell wafted into their cabin. A pungent disinfectant stench burned the back of her throat, making her wince. Claudia grabbed a face mask and burst out of the cabin, desperate to breathe fresh air. With Juan, she ran to an exit. Outside, the sun blinded them momentarily. Claudia fell to the deck, gasping for air.

Claudia spotted a surveillance camera and ran toward the tiny lens, screaming in Spanish for help. Soon, one of the ship’s officers arrived. Claudia scolded him for accidentally trying to poison them as they disinfected the ship. At first the officer didn’t understand her machine-gun Spanish, but eventually they were transferred to a new room with a private balcony. Despite the upgrade, they felt like orphans, forgotten on an empty cruise ship, with no sign of liberation.

As she entered her second month at sea, Claudia was still in lockdown, and as furious as ever. For another three weeks, they circled the Caribbean waiting for the plane to fly them home. Claudia knew that her years as a psychologist provided exactly the emotional toolkit she would need to endure this confinement. I can’t cry and throw a tantrum like a child, she thought. What surprised her, however, was how hard it was to apply her skills to a new patient: herself.

Help came in the form of her 80-year-old neighbour, a man named Tito from Uruguay, who, like clockwork every morning, strode out to his balcony, adjacent to Claudia and Juan’s room, and bellowed to the ocean: “Toooooooday … can be a goooooooood daaaaaaay! Let’s nail it!” Sometimes Claudia joined in the screaming.

Finally, the Argentinian government resolved the logistics, and arranged for charters and sanitation “bubbles” that could safely bring Claudia and Juan, and the other citizens, back to Uruguay and Argentina. It was now late April 2020, seven weeks after Claudia and Juan boarded what was supposed to be a two-week celebratory cruise.

In a statement, a representative of Holland America Line said: “As the world’s knowledge of Covid-19 evolved over time, Holland America Line aligned with guidelines from the CDC, the World Health Organization and other local health authorities.” They said of the stories in this article: “While some claims do not match the recollection of our team members who were there, that should not diminish the importance of the story of Zaandam, its guests and crew, and people in all walks of life who dealt with the devastating first weeks of a mysterious virus. We mourn all who were lost to Covid-19, and we are thankful for those who helped bring our full fleet back to sailing today with a continued strong commitment to health and safety.”

When Claudia arrived at the door to her seaside apartment in Mar del Plata, Argentina, the country was enduring the full brunt of the viral onslaught. Thousands were sick, a rigid lockdown in place. The official death toll stood at roughly 200.

Inside her home, instead of relief, Claudia felt vulnerable. Nothing was normal. Her favourite routines were prohibited under lockdown. No more swimming with her girlfriends. No more rehearsals with the theatre group. Even the smell of her house had changed. Or had she?

Before the Zaandam odyssey, before Covid, Claudia and Juan had carefully selected an apartment with an ocean view. Their living-room windows framed a wide slice of the Atlantic. Her panorama now felt like a mocking reminder, as if she was still trapped at sea. When Claudia looked out her window, she couldn’t escape the sensation that she was on the balcony of a cruise ship. After one brief glance into the expanse of the waves, Claudia drew the curtain and told herself: “That’s enough ocean view for the moment.”

Cabin Fever by Michael Smith and Jonathan Franklin is out on 14 July (Octopus Publishing Group). To support The Guardian and Observer, order your copy at guardianbookshop.com.

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Oakland, CA
www.thecloroxcompany.com

Sales: $4.1 billion for household and personal care products.

Key Personnel: Linda Rendle, CEO; Stacey Grier, EVP and chief growth and strategy officer; Kevin Jacobsen, EVP and CFO; Kirsten Mariner, EVP and chief people and corporate affairs officer; Eric Reynolds, EVP and COO; Michael Ott, SVP and chief R&D officer

Major Products: Household—Clorox, Formula 409, Liquid Plumr, Pine Sol and Green Works cleaning products. Personal Care—Burt’s Bees, Renew Life

Consumer demand for wipes hasn’t been quite the pull for Clorox.

New Products: Clorox Disinfecting Mist, Clorox Multi-Purpose Refillable Cleaner, Clorox Bathroom Refillable Cleaner

Comments: The pandemic gave a big lift to Clorox sales. After all, what’s better than bleach and wipes to kill coronavirus? But consumers grew weary of washing and disinfecting. Plus, lockdowns were lifted and folks dropped the mop and headed out. No surprise, then, that for the nine months ended March 31, 2022, Clorox reported a slight decline in sales to $5.3 billion. Sales within the household products business fell 1%.

In contrast, when covid was top of mind, corporate sales rose 9% in fiscal 2021. Household sales increased 10%. International sales rose 14%. The increase was attributed to volume increase was primarily driven by higher shipments from ongoing demand for disinfecting and other household products in every geographic region, as well as the impact of the Saudi joint venture acquisition.

Clorox executives are concerned about germs…and the environment. Earlier this year, the company launched Clorox Disinfecting Mist, which it calls an innovative, aerosol-free disinfecting mist that effectively kills 99.9% of bacteria and viruses on hard surfaces, sanitizes soft surfaces and even deodorizes and freshens the air. A quick-drying, bleach-free formula allows consumers to seamlessly disinfect a variety of surfaces, no wiping needed. The mist is housed in 100% recyclable bottle with a reusable sprayer, which can be reused with refill bottles for two to three years, according to Clorox.

Clorox also rolled out Clorox Multi-Purpose Refillable Cleaner and Clorox Bathroom Foamer Refillable Cleaner, two innovative cleaning solutions that deliver 10x the cleaning power while using 80% less plastic than the average single-use spray, according to the company. Each product comes in a sleek, reusable spray bottle that can be refilled up to 30 times, according to the brand.

At this year’s annual meeting of the American Cleaning Institute, Rachel Watson-Clark, director of research development, cleaning innovation and sustainability, urged the industry to develop a better sustainability plan for household cleaners. She pointed out that highly concentrated, ready-to-use trigger sprays with reusable bottles are a good recycling target. Watson-Clark noted that 130 million tons of single use plastics are produced every year. At the same time, 26% of home cleaning sales are now conducted via ecommerce.

“Cleaning plays a critical role in people’s lives, but there are areas that could be improved,” she observed.

According to results of a Clorox lifecycle analysis, moving to reusable bottles and concentrated formulas reduces the greenhouse gas emissions of a household cleaner by more than 58%. More impressive, Watson-Clark told ACI members that all cleaning products have the potential to be further concentrated. To get there, she suggested that standardization become a category norm to minimize consumer confusion and errors. A standard bottle size ensures safety, correct dilution and efficacy, she explained. At the same time, a standard neck finish defines the refill size and refill connection. For those who suggest standardization would detract from innovation, Watson-Clark insisted formulation chemistry, along with retail form and material, provides plenty of freedom to innovate and differentiate.

“Let’s concentrate the entire cleaning trigger spray category,” concluded Watson-Clark.

Consumer interest remains high for sustainable solutions. Even as raw material prices climb, consumers are willing to pay more for products they trust. Clorox has raised prices several times to offset inflation, including new rounds last fall and in April, with another coming this month, according to CEO Linda Rendle. 

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More than 70 boat landing events are planned across Michigan to mark this year’s Aquatic Invasive Species (AIS) Awareness Week, July 3-9. Public awareness about the impacts of harmful, nonnative aquatic plants and animals is critical to protecting Michigan’s ecosystems, tourism, and economy.

The boat landing events are part of the ninth annual Landing Blitz, in which representatives of state departments and local partners such as lake associations and cooperative invasive species management areas give boaters tips to prevent the spread of invasive species and comply with recently updated laws. The Landing Blitz website allows you to search for an event near you. Similar AIS Landing Blitz events will be held in each of the Great Lakes states and Canadian provinces.

Gov. Gretchen Whitmer has issued a proclamation to mark Aquatic Invasive Species Awareness Week, raising awareness about this important issue to stop the spread of invasive aquatic plants and organisms.

Help prevent the spread of aquatic invasive species by following these simple steps:

Required actions – it’s the law in Michigan

• Remove all aquatic organisms, including plants, from watercraft and trailers before launching or transporting.
• Remove all drain plugs and drain all water from bilges, ballast tanks, and live wells before transporting a watercraft.
• Dispose of unused bait in the trash, not in the water.

Recommended additional actions – protect our waters by following these steps

• Clean boats, trailers and equipment by removing plants, debris, and mud before leaving the access area. Dispose of the material in a trash receptacle or otherwise away from the water body, if possible.
• Wash boats and trailers before leaving the access area, if possible, or at a nearby car wash or at home.
• Dry boats and equipment for five days before launching into a different water body.
• Disinfect live wells and bilges with a bleach solution (1/2 cup bleach to five gallons water).

A short EGLE video from a past Landing Blitz shows how easy it is to clean, drain, and dry boats and trailers.

“Recreational boaters and anglers can play a key role in helping prevent the spread of invasive species,” said Kevin Walters, aquatic biologist with EGLE. “Instead of spreading invasive species, we’re asking people to help spread the word about simple steps that can be taken when out recreating on Michigan’s waters.”

Events at boat launches are contingent on weather and volunteer availability. Contact Kevin Walters for a list of events.

AIS Awareness Week is sponsored by EGLE’s Water Resources Division, in partnership with the Department of Natural Resources, Department of Agriculture and Rural Development, federal agencies, and private and nonprofit organizations. For more information about AIS Awareness Week or the AIS Landing Blitz, visit Michigan’s invasive species website, Michigan.gov/Invasives.

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