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Sister stories Pt.5 -  Exploring College Hill

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Sister stories Pt.5 -  Exploring College Hill

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My sister and her partner got bored and decided to go explore Thayer, but then they got lost and they ended up on what I believe is the shops near Fox point and found a bunch of good restaurants and a liquor store (they were under the impression that, like in South Texas, the sale of liquor had been banned in Providence due to Covid). They came back with a lot of bread and cookies from a Portuguese bakery.

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My sister and her girlfriend were hoping that because people were taking the virus more seriously on the East coast, things would dwindle down a lot sooner and a lot of the tourist attractions would open up again so they could explore. Since this is not the case they've asked me to take them to quieter, more scenic locations. I took them to Gano Street Park during sunset so they could see the path and the river.

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Both my sister and I smoke cigarettes but it's not something we're able to do back home because our mom does not approve of it (she is heavily against anything that is not air going into the lungs)and she also carefully smells for signs of smoking. Almost every other night we go outside and we smoke and talk about what her plans are and how my projects are going.

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Since my sister came up north in a rush and not much luggage, she had to leave behind a lot of her belongings in her old apartment. She entrusted my family and her partner's (Vanessa's) family to move stuff out. There were a lot of anxious phone calls that were made and a whole mess with the U-Haul company but they were able to get everything and my sister managed to breathe a lot easier after.

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My sister has had a cat for the last couple of years that her old boss had given her. His name was Basil, and even though Basil was really annoying and scratched everyone and everything up, my sister really loved him. After she came up north, she had entrusted someone to take care of him and he got lost and my sister was really frustrated that she wasn't there to look for Basil herself.

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Hasta el cielo está encarcelado

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Mate de Rio Grande so Sul, Brasil.

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brunch with the family— eggs over toast and fruit on the side. cooking with my mother helped mend parts of our relationship

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this day we made oatmeal bowls for the family. this was my oatmeal bowl :)

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arroz con habichuelas and egg “cakes”

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rice, potato salad, baked chicken, and avocado salad

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white rice w. steamed vegetables & teriyaki shrimp

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I've been sewing every day to keep me centered and grounded. I use both machine and hand sewing, so the entire process from cutting to finishing is very methodical, repetitive, and cathartic. It helps me to feel closer to my family in Peru because of our family's connection to crafting and construction.

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Fieldwork individual contributions. Buscando títulos...

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Collective Storytelling Project.
Searching for titles (and blog images?)

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Jugando al escondite con su propia sombra, mientras la cara está escondida detrás del barbijo... #pandemicgames

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My roommate recounts a lot of memories from Cow House on John St. Her friend group lived there. I ask, “Why is it called that?” and she responds, “I don’t know!” It’s big, and yellow. It doesn’t look like a barn and it doesn’t look like a cow. While running down Benefit Friday morning, I came across a house in the process of getting painted, but the ladders were empty and the brushes sat in their buckets. This was a house that actually looked like a cow. So I walked into the street and took pictures from various angles to get the right lighting. As I looked at the photos walking back towards the sidewalk, someone yelled from their car, “It’s not art, it’s primer!” I looked up startled to a couple of painters laughing at me from their car—must’ve been a sandwich break.

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Today I made a video giving advice to the current seniors of my highschool on making a college decision and on the college experience overall. Having to make a video that is going to be posted online encouraged me to actually get dressed and fix my hair nicely. In fact, I decided to put on some college gear, which instantly felt comforting and brought back memories.

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I have not stopped looking at this picture of flowers I quickly saw on my walk last week. I think they are so beautiful and the vibrant red color just makes me happy. I wanted to show it again. I wish I could hang out, eat, and take pictures near a flower garden.

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Sunday morning’s weather has been rainy and gloomy. Just like the trees using the puddles as a mirror, I see my mood reflected in the weather.

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I made this sign for my mother to take a selfie with and post on her school’s website to show her appreciation for the students along with her co-workers. I hope it makes the kids feel missed. My mother works in an elementary school, and I truly have no idea what these kids are thinking right now. When I was younger, I cried if I had to miss a day of school. RIP to all the school faculty/staff/workers that have passed and best wishes to their families!

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Fridays are tough. I have been on my laptop for hours because of class, my job, and events I am involved in organizing. It is crazy how my keyboard is my new spokesperson. No matter how tired I get of looking at my laptop screen, my fingers still move across the keyboard, frantically…. I must communicate.

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What happens when you see this dandelion and you immediately feel that it actually looks like the transparent picture of a corona virus? It means that we are completely subjugated by the pandemic and that it will be very hard to continue to see reality as it is

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Inside it’s even worse, and it’s not about staying inside. It’s just inside us

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Darkness is not even a color, its the depth of our souls and the definition of our being and body. Buscando ligereza. Adónde se habrá escondido que nadie puede encontrarla ?

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I appreciate my mother’s efforts to make our home still feel peaceful. Like our sanctuary. Serene. Relaxing. Sometimes we feel so trapped by our gated NYC apartment windows, but we are coping! Thank you mommy...I should appreciate your candles more.

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This is the third birthday I celebrate over Zoom. I can no longer be surprised if on August 15th, at 11:59, my friends are preparing to start that Zoom call, forcing my first birthday wishes to be virtually. My favorite part of birthdays is always found in human interaction.

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“I feel blessed. I know I am not able to be outside but I am grateful that I have my family and that they are healthy. I often think about how annoying they are, but I am glad they have the energy to be annoying. I know there are people who only wish their parents would annoy them instead of being sick on a bed, not being able to hug or kiss them due to this awful illness. The constant noise that my little brother makes sounds like music compared to the sound of a respirator that many other people are experiencing, and for that I am glad my family and I are able to count our blessings *pray hands emoji*”

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I decided to initiate storytelling today: While FaceTiming my friend that I call almost everyday, I realized that we never really check in with each other. Sometimes we find comfort in our assumptions that people we know are probably doing ok, and perhaps this has allowed us to talk for hours each day without any attempt to tap into each other’s inner thoughts and emotions. Sometimes we are also so busy that we just update each other on what we have to do, but not on how we feel about what we have done. Sometimes I am guilty of only talking/sharing about myself and not even bothering to or forgetting to ask about the other person. I want to break this habit and initiate storytelling more often.

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Taking this course has really made me realize how rare it is for people to ask one another for their stories or even to hear a story in general. It is unfortunate that during times of crisis is when we are more inclined to share, and, even more so, willing to listen. Are these inclinations out of obligation? I hope this is a practice that we maintain -- I’ve learned so much about other people and I enjoy doing so!

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Final Reflection

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I finally went outside today with my sister for a groceries and post-office run. The five block radius was liberating. These flowers were beautiful and an indication of life continuing to thrive and be vibrant!

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I feel for so many people worldwide. Seeing ignorant posts on social media shaming people for not taking advantage of all this “free time” and instead being “unexcusable unproductive” truly frustrates me. To those in unsafe or unpleasant home conditions, to those who are grieving a lost or sick loved one, to high school and college seniors, to scared essential workers, to all those going through it, I am sorry.

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30 minutes ahead, yet I still can’t bring myself to fix it.

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A pesar del silencio, desde el silencio de este mediodía, me surge esta canción. Encontrando poesía en la casa

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Obras de arte desde #elencierro.
En busca de otras que nos hagan encontrar alguna miga de belleza en este horror

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I have become very food focused throughout this quarantine, I track my food everyday now— it’s become compulsive.

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Árbol de Guayacán, Ciudad de Panamá.

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Lockdown conditions in Spain keep everyone at home. This is the view from my window

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My focus has been terrible throughout this all, so I tend to start my work past 1am, when I am somewhat attentive. Here is a glimpse of the view i’m stuck with everyday at 3am. I have yet to understand what exactly any of this is telling me.

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View outside.

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This morning I sat on the roots of a tree next to the Seekonk River. For the past couple of weeks, my walks and runs have ended here. In fact, I've started to plan my routes so as to eventually come to this bank. I imagined my family having breakfast on the opposite side of the country, though they were probably still asleep. I felt the distance, but thought how lucky I was to be quarantined in a place like Providence. I wanted to share the view of that broken bridge with my mother, father, sisters and brother. I wanted them to hear the water lapping against the rocks nearby.

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I've been trying to bake something about once a week as part of intentionally doing things that bring me joy. It can be really easy to become overwhelmed with school work or job searching or other responsibilities. This gives me a chance to do something fun and recenter.

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Photo taken on Monday at the same time and same place as the Sunday photo. However, this photo is taken outside on the porch. It was colder than usual today.

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I thought that in prison everything was dirty and unhealthy and insane. But what happens when beauty gets into prison? I never thought that it had the magic power of transforming prison into beauty. Contagiously.

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Lo primero qué hare en cuanto termine el confinamiento/The first thing I will do once the lockdown is over: our new collective video is online. Share it and spread your wishes. ...Hopes and dreams are also contagious:-)

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thursday: 7:01pm

friday: his first cake (w/ browned butter frosting)

saturday: cocktail party for 2

sunday: in bloom--blushing

monday: pumpkin pancakes

For the most part, this weekend was spent indoors studying for an upcoming exam. These details are what distinguished one day from the next, and I cherish them. A tree, a new recipe, dressing up without anywhere to go.

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Today I'm thinking about this article. I read it this morning, and it has me considering my interpretation of normal. I have friends talking about taking a semester off if they can't go back to Brown in the fall because they don't want to miss out on their "college experience." I don't know how to tell them that it's not just the rest of 2020, but that the next two to three years are going to look very different.

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A tent in an outdoor I.C.U. hospital in Central Park. Credit... Misha Friedman for The New York Times

There will be no quick return to our previous lives, according to nearly two dozen experts. But there is hope for managing the scourge now and in the long term.

A tent in an outdoor I.C.U. hospital in Central Park. Credit... Misha Friedman for The New York Times

The coronavirus is spreading from America's biggest cities to its suburbs, and has begun encroaching on the nation's rural regions. The virus is believed to have infected millions of citizens and has killed more than 34,000.

Yet President Trump this week proposed guidelines for reopening the economy and suggested that a swath of the United States would soon resume something resembling normalcy. For weeks now, the administration's view of the crisis and our future has been rosier than that of its own medical advisers, and of scientists generally.

In truth, it is not clear to anyone where this crisis is leading us. More than 20 experts in public health, medicine, epidemiology and history shared their thoughts on the future during in-depth interviews. When can we emerge from our homes? How long, realistically, before we have a treatment or vaccine? How will we keep the virus at bay?

Some felt that American ingenuity, once fully engaged, might well produce advances to ease the burdens. The path forward depends on factors that are certainly difficult but doable, they said: a carefully staggered approach to reopening, widespread testing and surveillance, a treatment that works, adequate resources for health care providers - and eventually an effective vaccine.

Still, it was impossible to avoid gloomy forecasts for the next year. The scenario that Mr. Trump has been unrolling at his daily press briefings - that the lockdowns will end soon, that a protective pill is almost at hand, that football stadiums and restaurants will soon be full - is a fantasy, most experts said.

"We face a doleful future," said Dr. Harvey V. Fineberg, a former president of the National Academy of Medicine.

He and others foresaw an unhappy population trapped indoors for months, with the most vulnerable possibly quarantined for far longer. They worried that a vaccine would initially elude scientists, that weary citizens would abandon restrictions despite the risks, that the virus would be with us from now on.

"My optimistic side says the virus will ease off in the summer and a vaccine will arrive like the cavalry," said Dr. William Schaffner, a preventive medicine specialist at Vanderbilt University medical school. "But I'm learning to guard against my essentially optimistic nature."

Most experts believed that once the crisis was over, the nation and its economy would revive quickly. But there would be no escaping a period of intense pain.

Exactly how the pandemic will end depends in part on medical advances still to come. It will also depend on how individual Americans behave in the interim. If we scrupulously protect ourselves and our loved ones, more of us will live. If we underestimate the virus, it will find us.

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Refrigerated trucks were used as mobile morgues on Randall's Island in New York. Credit... Misha Friedman for The New York Times

Covid-19, the illness caused by the coronavirus, is arguably the leading cause of death in the United States right now. The virus has killed more than 1,800 Americans almost every day since April 7, and the official toll may be an undercount.

By comparison, heart disease typically kills 1,774 Americans a day, and cancer kills 1,641.

Yes, the coronavirus curves are plateauing. There are fewer hospital admissions in New York, the center of the epidemic, and fewer Covid-19 patients in I.C.U.s. The daily death toll is still grim, but no longer rising.

The epidemiological model often cited by the White House, which was produced by the University of Washington's Institute for Health Metrics and Evaluation, originally predicted 100,000 to 240,000 deaths by midsummer. Now that figure is 60,000.

While this is encouraging news, it masks some significant concerns. The institute's projection runs through Aug. 4, describing only the first wave of this epidemic. Without a vaccine, the virus is expected to circulate for years, and the death tally will rise over time.

The gains to date were achieved only by shutting down the country, a situation that cannot continue indefinitely. The White House's "phased" plan for reopening will surely raise the death toll no matter how carefully it is executed. The best hope is that fatalities can be held to a minimum.

Reputable longer-term projections for how many Americans will die vary, but they are all grim. Various experts consulted by the Centers for Disease Control and Prevention in March predicted that the virus eventually could reach 48 percent to 65 percent of all Americans, with a fatality rate just under 1 percent, and would kill up to 1.7 million of them if nothing were done to stop the spread.

A model by researchers at Imperial College London cited by the president on March 30 predicted 2.2 million deaths in the United States by September under the same circumstances.

By comparison, about 420,000 Americans died in World War II.

The limited data from China are even more discouraging. Its epidemic has been halted - for the moment - and virtually everyone infected in its first wave has died or recovered.

China has officially reported about 83,000 cases and 4,632 deaths, which is a fatality rate of over 5 percent. The Trump administration has questioned the figures but has not produced more accurate ones.

Fatality rates depend heavily on how overwhelmed hospitals get and what percentage of cases are tested. China's estimated death rate was 17 percent in the first week of January, when Wuhan was in chaos, according to a Center for Evidence-Based Medicine report, but only 0.7 percent by late February.

In this country, hospitals in several cities, including New York, came to the brink of chaos. Officials in both Wuhan and New York had to revise their death counts upward this week when they realized that many people had died at home of Covid-19, strokes, heart attacks or other causes, or because ambulances never came for them.

In fast-moving epidemics, far more victims pour into hospitals or die at home than doctors can test; at the same time, the mildly ill or asymptomatic never get tested. Those two factors distort the true fatality rate in opposite ways. If you don't know how many people are infected, you don't know how deadly a virus is.

Only when tens of thousands of antibody tests are done will we know how many silent carriers there may be in the United States. The C.D.C. has suggested it might be 25 percent of those who test positive. Researchers in Iceland said it might be double that.

China is also revising its own estimates. In February, a major study concluded that only 1 percent of cases in Wuhan were asymptomatic. New research says perhaps 60 percent were. Our knowledge gaps are still wide enough to make epidemiologists weep.

"All models are just models," Dr. Anthony S. Fauci, science adviser to the White House coronavirus task force, has said. "When you get new data, you change them."

There may be good news buried in this inconsistency: The virus may also be mutating to cause fewer symptoms. In the movies, viruses become more deadly. In reality, they usually become less so, because asymptomatic strains reach more hosts. Even the 1918 Spanish flu virus eventually faded into the seasonal H1N1 flu.

At the moment, however, we do not know exactly how transmissible or lethal the virus is. But refrigerated trucks parked outside hospitals tell us all we need to know: It is far worse than a bad flu season.

No one knows exactly what percentage of Americans have been infected so far - estimates have ranged from 3 percent to 10 percent - but it is likely a safe bet that at least 300 million of us are still vulnerable.

Until a vaccine or another protective measure emerges, there is no scenario, epidemiologists agreed, in which it is safe for that many people to suddenly come out of hiding. If Americans pour back out in force, all will appear quiet for perhaps three weeks.

Then the emergency rooms will get busy again.

"There's this magical thinking saying, 'We're all going to hunker down for a while and then the vaccine we need will be available,'" said Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

In his wildly popular March 19 article in Medium, " Coronavirus: The Hammer and the Dance," Tomas Pueyo correctly predicted the national lockdown, which he called the hammer, and said it would lead to a new phase, which he called the dance, in which essential parts of the economy could reopen, including some schools and some factories with skeleton crews.

Every epidemiological model envisions something like the dance. Each assumes the virus will blossom every time too many hosts emerge and force another lockdown. Then the cycle repeats. On the models, the curves of rising and falling deaths resemble a row of shark teeth.

Surges are inevitable, the models predict, even when stadiums, churches, theaters, bars and restaurants remain closed, all travelers from abroad are quarantined for 14 days, and domestic travel is tightly restricted to prevent high-intensity areas from reinfecting low-intensity ones.

The tighter the restrictions, experts say, the fewer the deaths and the longer the periods between lockdowns. Most models assume states will eventually do widespread temperature checks, rapid testing and contact tracing, as is routine in Asia.

Even the "Opening Up America Again" guidelines Mr. Trump issued on Thursday have three levels of social distancing, and recommend that vulnerable Americans stay hidden. The plan endorses testing, isolation and contact tracing - but does not specify how these measures will be paid for, or how long it will take to put them in place.

On Friday, none of that stopped the president from contradicting his own message by sending out tweets encouraging protesters in Michigan, Minnesota and Virginia to fight their states' shutdowns.

China did not allow Wuhan, Nanjing or other cities to reopen until intensive surveillance found zero new cases for 14 straight days, the virus's incubation period. Compared with China or Italy, the United States is still a playground.

Americans can take domestic flights, drive where they want, and roam streets and parks. Despite restrictions, everyone seems to know someone discreetly arranging play dates for children, holding backyard barbecues or meeting people on dating apps.

Partly as a result, the country has seen up to 30,000 new case infections each day. "People need to realize that it's not safe to play poker wearing bandannas," Dr. Schaffner said.

Even with rigorous measures, Asian countries have had trouble keeping the virus under control.

China, which has reported about 100 new infections per day, recently closed all the country's movie theaters again. Singapore has closed all schools and nonessential workplaces. Japan recently declared a state of emergency. (South Korea has struggled at times, too, but on Sunday reported only eight new cases, the first single-digit increase in two months.)

Resolve to Save Lives, a public health advocacy group run by Dr. Thomas R. Frieden, the former director of the C.D.C., has published detailed and strict criteria for when the economy can reopen and when it must be closed.

Reopening requires declining cases for 14 days, the tracing of 90 percent of contacts, an end to health care worker infections, recuperation places for mild cases and many other hard-to-reach goals.

"We need to reopen the faucet gradually, not allow the floodgates to reopen," Dr. Frieden said. "This is a time to work to make that day come sooner."

Imagine an America divided into two classes: those who have recovered from infection with the coronavirus and presumably have some immunity to it; and those who are still vulnerable.

"It will be a frightening schism," Dr. David Nabarro, a World Health Organization special envoy on Covid-19, predicted. "Those with antibodies will be able to travel and work, and the rest will be discriminated against."

Already, people with presumed immunity are very much in demand, asked to donate their blood for antibodies and doing risky medical jobs fearlessly.

Soon the government will have to invent a way to certify who is truly immune. A test for IgG antibodies, which are produced once immunity is established, would make sense, said Dr. Daniel R. Lucey, an expert on pandemics at Georgetown Law School. Many companies are working on them.

Dr. Fauci has said the White House was discussing certificates like those proposed in Germany. China uses cellphone QR codes linked to the owner's personal details so others cannot borrow them.

The California adult-film industry pioneered a similar idea a decade ago. Actors use a cellphone app to prove they have tested H.I.V. negative in the last 14 days, and producers can verify the information on a password-protected website.

As Americans stuck in lockdown see their immune neighbors resuming their lives and perhaps even taking the jobs they lost, it is not hard to imagine the enormous temptation to join them through self-infection, experts predicted. Younger citizens in particular will calculate that risking a serious illness may still be better than impoverishment and isolation.

"My daughter, who is a Harvard economist, keeps telling me her age group needs to have Covid-19 parties to develop immunity and keep the economy going," said Dr. Michele Barry, who directs the Center for Innovation in Global Health at Stanford University.

It has happened before. In the 1980s, Cuba successfully contained its small AIDS epidemic by brutally forcing everyone who tested positive into isolation camps. Inside, however, the residents had their own bungalows, food, medical care, salaries, theater troupes and art classes.

Dozens of Cuba's homeless youths infected themselves through sex or blood injections to get in, said Dr. Jorge Pérez Ávila, an AIDS specialist who is Cuba's version of Dr. Fauci. Many died before antiretroviral therapy was introduced.

It would be a gamble for American youth, too. The obese and immunocompromised are clearly at risk, but even slim, healthy young Americans have died of Covid-19.

The next two years will proceed in fits and starts, experts said. As more immune people get back to work, more of the economy will recover.

But if too many people get infected at once, new lockdowns will become inevitable. To avoid that, widespread testing will be imperative.

Dr. Fauci has said "the virus will tell us" when it's safe. He means that once a national baseline of hundreds of thousands of daily tests is established across the nation, any viral spread can be spotted when the percentage of positive results rises.

Detecting rising fevers as they are mapped by Kinsa's smart thermometers may give an earlier signal, Dr. Schaffner said.

But diagnostic testing has been troubled from the beginning. Despite assurances from the White House, doctors and patients continue to complain of delays and shortages.

To keep the virus in check, several experts insisted, the country also must start isolating all the ill - including mild cases.

In this country, patients who test positive are asked to stay in their homes but keep away from their families.

Television news has been filled with recuperating personalities like CNN's Chris Cuomo, sweating alone in his basement while his wife left food atop the stairs, his children waved and the dogs hung back.

But even Mr. Cuomo ended up illustrating why the W.H.O. strongly opposes home isolation. On Wednesday, he revealed that his wife had the virus.

"If I was forced to select only one intervention, it would be the rapid isolation of all cases," said Dr. Bruce Aylward, who led the W.H.O. observer team to China.

In China, anyone testing positive, no matter how mild their symptoms, was required to immediately enter an infirmary-style hospital - often set up in a gymnasium or community center outfitted with oxygen tanks and CT scanners.

There, they recuperated under the eyes of nurses. That reduced the risk to families, and being with other victims relieved some patients' fears. Nurses even led dance and exercise classes to raise spirits, and help victims clear their lungs and keep their muscle tone.

Still, experts were divided on the idea of such wards. Dr. Fineberg co-wrote a New York Times Op-Ed article calling for mandatory but "humane quarantine processes."

By contrast, Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health, opposed the idea, saying: "I don't trust our government to remove people from their families by force."

Ultimately, suppressing a virus requires testing all the contacts of every known case. But the United States is far short of that goal.

Someone working in a restaurant or factory may have dozens or even hundreds of contacts. In China's Sichuan Province, for example, each known case had an average of 45 contacts.

The C.D.C. has about 600 contact tracers and, until recently, state and local health departments employed about 1,600, mostly for tracing syphilis and tuberculosis cases.

China hired and trained 9,000 in Wuhan alone. Dr. Frieden recently estimated that the United States will need at least 300,000.

Even though limited human trials of three candidates - two here and one in China - have already begun, Dr. Fauci has repeatedly said that any effort to make a vaccine will take at least a year to 18 months.

All the experts familiar with vaccine production agreed that even that timeline was optimistic. Dr. Paul Offit, a vaccinologist at the Children's Hospital of Philadelphia, noted that the record is four years, for the mumps vaccine.

Researchers differed sharply over what should be done to speed the process. Modern biotechnology techniques using RNA or DNA platforms make it possible to develop candidate vaccines faster than ever before.

But clinical trials take time, in part because there is no way to rush the production of antibodies in the human body.

Also, for unclear reasons, some previous vaccine candidates against coronaviruses like SARS have triggered "antibody-dependent enhancement," which makes recipients more susceptible to infection, rather than less. In the past, vaccines against H.I.V. and dengue have unexpectedly done the same.

A new vaccine is usually first tested in fewer than 100 young, healthy volunteers. If it appears safe and produces antibodies, thousands more volunteers - in this case, probably front-line workers at the highest risk - will get either it or a placebo in what is called a Phase 3 trial.

It is possible to speed up that process with "challenge trials." Scientists vaccinate small numbers of volunteers, wait until they develop antibodies, and then "challenge" them with a deliberate infection to see if the vaccine protects them.

Challenge trials are used only when a disease is completely curable, such as malaria or typhoid fever. Normally, it is ethically unthinkable to challenge subjects with a disease with no cure, such as Covid-19.

But in these abnormal times, several experts argued that putting a few Americans at high risk for fast results could be more ethical than leaving millions at risk for years.

"Fewer get harmed if you do a challenge trial in a few people than if you do a Phase 3 trial in thousands," said Dr. Lipsitch, who recently published a paper advocating challenge trials in the Journal of Infectious Diseases. Almost immediately, he said, he heard from volunteers.

Others were deeply uncomfortable with that idea. "I think it's very unethical - but I can see how we might do it," said Dr. Lucey.

The hidden danger of challenge trials, vaccinologists explained, is that they recruit too few volunteers to show whether a vaccine creates enhancement, since it may be a rare but dangerous problem.

"Challenge trials won't give you an answer on safety," said Michael T. Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy. "It may be a big problem."

Dr. W. Ian Lipkin, a virologist at Columbia University's Mailman School of Public Health, suggested an alternative strategy. Pick at least two vaccine candidates, briefly test them in humans and do challenge trials in monkeys. Start making the winner immediately, even while widening the human testing to look for hidden problems.

As arduous as testing a vaccine is, producing hundreds of millions of doses is even tougher, experts said.

Most American vaccine plants produce only about 5 million to 10 million doses a year, needed largely by the 4 million babies born and 4 million people who reach age 65 annually, said Dr. R. Gordon Douglas Jr., a former president of Merck's vaccine division.

But if a vaccine is invented, the United States could need 300 million doses - or 600 million if two shots are required. And just as many syringes.

"People have to start thinking big," Dr. Douglas said. "With that volume, you've got to start cranking it out pretty soon."

Flu vaccine plants are large, but those that grow the vaccines in chicken eggs are not suitable for modern vaccines, which grow in cell broths, he said.

European countries have plants but will need them for their own citizens. China has a large vaccine industry, and may be able to expand it over the coming months. It might be able to make vaccines for the United States, experts said. But captive customers must pay whatever price the seller asks, and the safety and efficacy standards of some Chinese companies are imperfect.

India and Brazil also have large vaccine industries. If the virus moves rapidly through their crowded populations, they may lose millions of citizens but achieve widespread herd immunity well before the United States does. In that case, they might have spare vaccine plant capacity.

Alternatively, suggested Arthur M. Silverstein, a retired medical historian at the Johns Hopkins School of Medicine, the government might take over and sterilize existing liquor or beer plants, which have large fermentation vats.

"Any distillery could be converted," he said.

In the short term, experts were more optimistic about treatments than vaccines. Several felt that so-called convalescent serum could work.

The basic technique has been used for over a century: Blood is drawn from people who have recovered from a disease, then filtered to remove everything but the antibodies. The antibody-rich immunoglobulin is injected into patients.

The obstacle is that there are now relatively few survivors to harvest blood from.

In the pre-vaccine era, antibodies were "farmed" in horses and sheep. But that process was hard to keep sterile, and animal proteins sometimes triggered allergic reactions.

The modern alternative is monoclonal antibodies. These treatment regimens, which recently came very close to conquering the Ebola epidemic in eastern Congo, are the most likely short-term game changer, experts said.

The most effective antibodies are chosen, and the genes that produce them are spliced into a benign virus that will grow in a cellular broth.

But, as with vaccines, growing and purifying monoclonal antibodies takes time. In theory, with enough production, they could be used not just to save lives but to protect front-line workers.

Antibodies can last for weeks before breaking down - how long depends on many factors, Dr. Silverstein noted - and they cannot kill virus that is already hidden inside cells.

Having a daily preventive pill would be an even better solution, because pills can be synthesized in factories far faster than vaccines or antibodies can be grown and purified.

But even if one were invented, production would have to ramp up until it was as ubiquitous as aspirin, so 300 million Americans could take it daily.

Mr. Trump has mentioned hydroxychloroquine and azithromycin so often that his news conferences sound like infomercials. But all the experts agreed with Dr. Fauci that no decision should be made until clinical trials are completed.

Some recalled that in the 1950s inadequate testing of thalidomide caused thousands of children to be born with malformed limbs. More than one hydroxychloroquine study has been halted after patients who got high doses developed abnormal heart rhythms.

"I doubt anyone will tolerate high doses, and there are vision issues if it accumulates," Dr. Barry said. "But it would be interesting to see if it could work as a PrEP-like drug," she added, referring to pills used to prevent H.I.V.

Others were harsher, especially about Mr. Trump's idea of combining a chloroquine with azithromycin.

"It's total nonsense," said Dr. Luciana Borio, a former director of medical and biodefense preparedness at the National Security Council. "I told my family, if I get Covid, do not give me this combo."

Chloroquine might protect patients hospitalized with pneumonia against lethal cytokine storms because it damps down immune reactions, several doctors said.

That does not, however, make it useful for preventing infections, as Mr. Trump has implied it would be, because it has no known antiviral properties.

Several antivirals, including remdesivir, favipiravir and baloxavir, are being tested against the coronavirus; the latter two are flu drugs.

Trials of various combinations in China are set to issue results by next month, but they will be small and possibly inconclusive because doctors there ran out of patients to test. End dates for most trials in the United States are not yet set.

Previously unthinkable societal changes have taken place already. Schools and business have closed in every state, and tens of millions have applied for unemployment. Taxes and mortgage payments are delayed, and foreclosures forbidden.

Stimulus checks, intended to offset the crisis, began landing in checking accounts this week, making much of America, temporarily, a welfare state. Food banks are opening across the country, and huge lines have formed.

A public health crisis of this magnitude requires international cooperation on a scale not seen in decades. Yet Mr. Trump is moving to defund the W.H.O., the only organization capable of coordinating such a response.

And he spent most of this year antagonizing China, which now has the world's most powerful functioning economy and may become the dominant supplier of drugs and vaccines. China has used the pandemic to extend its global influence, and says it has sent medical gear and equipment to nearly 120 countries.

A major recipient is the United States, through Project Airbridge, an air-cargo operation overseen by Mr. Trump's son-in-law, Jared Kushner.

This is not a world in which "America First" is a viable strategy, several experts noted.

"If President Trump cares about stepping up the public health efforts here, he should look for avenues to collaborate with China and stop the insults," said Nicholas Mulder, an economic historian at Cornell University. He has called Mr. Kushner's project "Lend-Lease in reverse," a reference to American military aid to other countries during World War II.

Dr. Osterholm was even blunter. "If we alienate the Chinese with our rhetoric, I think it will come back to bite us," he said.

"What if they come up with the first vaccine? They have a choice about who they sell it to. Are we top of the list? Why would we be?"

Once the pandemic has passed, the national recovery may be swift. The economy rebounded after both world wars, Dr. Mulder noted.

The psychological fallout will be harder to gauge. The isolation and poverty caused by a long shutdown may drive up rates of domestic abuse, depression and suicide.

Even political perspectives may shift. Initially, the virus heavily hit Democratic cities like Seattle, New York and Detroit. But as it spreads through the country, it will spare no one.

Even voters in Republican-leaning states who do not blame Mr. Trump for America's lack of preparedness or for limiting access to health insurance may change their minds if they see friends and relatives die.

In one of the most provocative analyses in his follow-up article, " Coronavirus: Out of Many, One," Mr. Pueyo analyzed Medicare and census data on age and obesity in states that recently resisted shutdowns and counties that voted Republican in 2016.

He calculated that those voters could be 30 percent more likely to die of the virus.

In the periods after both wars, Dr. Mulder noted, society and incomes became more equal. Funds created for veterans' and widows' pensions led to social safety nets, measures like the G.I. Bill and V.A. home loans were adopted, unions grew stronger, and tax benefits for the wealthy withered.

If a vaccine saves lives, many Americans may become less suspicious of conventional medicine and more accepting of science in general - including climate change, experts said.

The blue skies that have shone above American cities during this lockdown era could even become permanent.

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The Coronavirus in America: The Year Ahead

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There will be no quick return to our previous lives, according to nearly two dozen experts. But there is hope for managing the scourge now and in the long term. A tent in an outdoor I.C.U. hospital in Central Park. Credit...

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Photo taken on Sunday from my nighttime work place. My family is always asleep when I am down here. The view is from my porch with a reflection into my house

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View from my kitchen window with a reflection on the inside. My batch of cookies is waiting inside, but I still want to be outside.

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My boyfriend and I have been making weekly playlists for one another for musical therapy. This is a playlist that I spent time on making for him. I listen to it everyday because it reminds me of our memories together.

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View at the same time (11 pm EST) but on Friday in San Francisco.

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View at night from my workroom video on Thursday

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are also a special way of spending time while learning how to patient and precise in each single folding and line

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I’ve never been the person to spend much time in my room, especially at college. I’d leave early in the morning and come back late at night. Since everything happened, I, like most, stay in my apartment, work primarily from my room. This window points out to Hope St. Three people stand on the corner, talking, and an occasional car passes by. It also faces West: turns out to be the perfect place to watch the sunset.

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For the past several years, I have rarely been home in Panamá when the sun is out (the school bus picked me up at 6:40 am and I came back at around sunset), so I grew used to keeping the blinds down while I was in my room. Perhaps also because the main window points to the house's main entrance...

Anyway, I've spent a lot of time during the quarantine looking through my room windows, especially the one behind my bed. *Story continues in the other picture.*

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I have come to associate this view with the last song I've been working on, since I lied down facing the back of my bed looking out while I wrote it.

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I’ve been a bit obsessed with these lately.. I put them on and take them off at least twice a day. The isolation has made me come to terms with my appearance and I am more aware of what I look like than ever before in my life. One thing that’s been grasping onto my sanity is getting ready as if I weren’t isolated.. as if life were like it was... as if I were going out to meet my friend up to have brunch. These are the earrings I’d wear for that gathering.

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parecemos tan grandes y también tan
chicos...

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My dad says that the bird sounds are too annoying for other class members to listen to, but I want to sit outside. It's different to go on a walk, wearing a mask, crossing the street every time someone approaches. I want this to be my sort of Main Green, where I used to spend hours on the grass doing work or with friends. A sort of Main Green without the "main" or the "green," really, instead an unpainted wood floor surrounded by mesh. I am above the green, not on it. I am not "main" to anything, but maybe I can make this place my own center.

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This tree was barren when I arrived. Since then, unaware of the human world that has been placed on pause, it has flourished. Each day, I watch this tree grow.

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Nunca había tenido el tiempo de limpiar estos ex-votos del pasado, ni tampoco había tenido el tiempo de colgarlos en la pared. Ahora hice ambos y ahora ellos me miran y yo los miro:)

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Leyendo "La Transmigración de los cuerpos" de Yuri Herrera (2013)

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Leyendo "La Transmigración de los cuerpos" de Yuri Herrera (2013)

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"Entonces fue que salió el gobierno a declarar Creemos que la epidemia --y fue la primera vez que usaron la palabra-- puede ser un poco más agresiva de lo que habíamos pensado (....) mejor quédese en casita y mejor no bese a nadie y no toque a nadie y cúbrase la nariz y la boca y reporte cualquier síntoma, pero sobre todo no se preocupe" (cap. 1)

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Every - time - I - go, ... I think about how much is going with me...

I am so aware of the quantity I take. That perforated line controls me,
As I sit and count in worry...

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There's an old map above my desk; it's not quite current. I've been thinking about it a lot lately because I've been thinking of how I can't go to any of these places right now. The ability to travel was something I took for granted until the virus caused it to go away. It's given me a new sense of gratefulness for the places I've been and excitement for the places I have left to explore.

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Parece que nos hayan vuelto estatuas:( A ver quién se da vuelta primero y vuelve a la vida:)

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Latin American Storytelling: a great example of photographic thread

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Latin American Storytelling: a great example of photographic thread

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Check the collaborative project of this group of 18 Latin American photographers covering the outbreak of the pandemic across different countries from the region. The project is called CovidLatam. Very inspiring for our own storytelling project and class padlet.
Read also this paper for Storybench:)

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There's this lamp that I've knocked over 2 times in the last 3 days and now it's all dented at the top and the lightbulb keeps teasing like it's going to stop working but it just keeps flickering on so I have a lot of respect for its resilience

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Post here thoughts and pictures that you would like to share while conducting the fieldwork for our joint Storytelling project on the current crisis

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Campus-sweet-Campus. ....What I miss the most of Brown

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Campus-sweet-Campus. ....What I miss the most of Brown

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The main green, the dorms, classes, the Rock, the SciLi, walking around the Watson, or on Thayer and smelling at the same time Korean food from Den Den, Bagel Gourmet bagels, having quite time in the Hay or hanging out in the quite green... What do you miss the most?

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A como Airlines
B como Ban
C como ???? (the forbidden word)
D como Doctor
E como Emergency
....

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We have started to write a Covid-19 alphabet book. Hemos conectado las letras del alfabeto con palabras que expresan lo que estamos viviendo. Coincidimos en dos palabras cruciales: I como Isolation and L as in loneliness.

Este abecedario sigue in progress.
Podemos compartirlos con amigos y familiares a ver si ellos encuentran otras palabras y de ahí otras historias y otras más.

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from a Providence, RI window #1, night view

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from a Providence, RI window #1, night view

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Hoy estoy pensando en.../Today I'm thinking about...

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Hoy estoy pensando en.../Today I'm thinking about...

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Go ahead, and write down a thought that you are having today in our storytelling wall... Let's fill the wall daily. Saquen sus voces para afuera y sus pensamientos también:)

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Ahora que pasamos más tiempo en casa, tenemos también tiempo de mirar por las ventanas y de darnos cuentas de cosas que siempre estuvieron ahí afuera pero que nunca realmente notamos. Estaríamos distraídos, cansados.... pero es como si estas cosas de repente ahora existen y de alguna manera nos hablan.
Comparte las cosas que estas viendo y que te están de alguna manera hablando a través del vidrio de tu ventana.