Nurith Aizenman

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The open market of the coronavirus vaccines has left countries like South Africa in a bind as they try to figure out a way to protect their citizens. NPR's Nurith Aizenman explains.

Ever since the coronavirus reached the U.S., officials and citizens alike have gauged the severity of the spread by tracking one measure in particular: How many new cases are confirmed through testing each day. However, it has been clear all along that this number is an understatement because of testing shortfalls.

Now a research team at Columbia University has built a mathematical model that gives a much more complete — and scary — picture of how much virus is circulating in our communities.

How to make sure the world is never so devastated by another pandemic?

Health officials from around the globe have been vigorously discussing that question over the past week at the annual meeting of the World Health Organization's Executive Board. The members, whose nine-day-long, mostly virtual gathering concludes on Tuesday, have heard recommendations from four separate panels.

The coronavirus pandemic has now killed at least 1 million people worldwide. That's according to a tally maintained by Johns Hopkins University. This sobering milestone was reached just nine months after the first reported fatality in China last January. And public health experts believe the actual toll – the recorded deaths plus the unrecorded deaths – is much higher.

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New estimates released this week suggest the global impact of the coronavirus pandemic will reach even greater levels of awfulness before 2020 is over: A prominent forecasting team projects that between now and Jan. 1, the virus will kill an additional 1.9 million people worldwide, pushing the total death toll by year's end to above 2.8 million.

By Dec. 1, the U.S. death toll from COVID-19 could reach nearly 300,000. That's the grim new projection from researchers at the University of Washington's Institute for Health Metrics and Evaluation — one of the more prominent teams modeling the pandemic. The new forecast, released Thursday, projects that between now and December, 137,000 people will die on top of the roughly 160,000 who have died so far.

For weeks the U.S. coronavirus pandemic has largely been driven by spiraling outbreaks in the South and West. But some forecasters say Mid-Atlantic and Northeast states could soon be in deep trouble again, too.

The warning comes from researchers at the PolicyLab at Children's Hospital of Philadelphia, which has built a model to provide four-week forecasts for every U.S. county. NPR spoke to David Rubin, PolicyLab's director, an epidemiologist and professor at the University of Pennsylvania. Here are five takeaways:

The American conversation around masks and COVID-19 has taken a dizzying turn. For months, wearing masks has been politicized as a sign of liberal leanings. But in recent days, ever more governors — many of them Republican — have moved to mandate masks. This week President Trump — arguably the nation's most visible mask un-enthusiast — started referring to wearing them as "patriotic."

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Across the United States the coronavirus is once again on the march. On Wednesday alone there were nearly 50,000 new cases — a record. The case counts for each state suggest the disease is mainly spreading in a band stretching from Florida across much of the southernmost states and westward to California, with Idaho and Iowa also in trouble.

But when you use tools to drill down to more local data, the picture gets more complicated — and even more concerning. Here are five takeaways:

It may be time for a statewide lockdown in Arizona and Florida

Just weeks after parts of the U.S. began reopening, coronavirus infections are on the upswing in several states, including Arizona, Utah, Texas and Florida. Dramatic increases in daily case counts have given rise to some unsettling questions: Is the U.S. at the start of a second wave? Have states reopened too soon? And have the recent widespread demonstrations against racial injustice inadvertently added fuel to the fire?

In an open letter to a top Trump Administration official, 77 Nobel prize-winning American scientists say they are "gravely concerned" about the recent abrupt cancellation of a federal grant to a U.S. non-profit that was researching coronaviruses in China.

More than 82,000 people in the United States have died of COVID-19 as of Tuesday. How many more lives will be lost? Scientists have built dozens of computational models to answer that question. But the profusion of forecasts poses a challenge: The models use such a wide range of methodologies, formats and time frames that it's hard to get even a ballpark sense of what the future has in store.

Updated on May 5 at 3:02 p.m. ET to include additional White House reactions.

On Monday the New York Times published what appeared to be an explosive finding: an internal document from the Trump Administration that forecast many more coming deaths from the coronavirus than the president has predicted publicly.

Updated on May 1 at 10:50 a.m. ET

The U.S. government has suddenly terminated funding for a years-long research project in China that many experts say is vital to preventing the next major coronavirus outbreak.

Updated April 28, 5:00 p.m. ET

Across the U.S., state leaders are grappling with the challenging decision of when to relax the social distancing restrictions that have helped keep COVID-19 in check.

President Trump and his top scientific advisers on the coronavirus task force gave a much-anticipated presentation Tuesday night, laying out the data behind the president's recent shift in tone regarding the outbreak, including his decision to extend national social distancing guidelines through April 30.

As coronavirus infections rise across the United States, public health experts widely agree it's time for a drastic step: Every state in the nation should now issue the kind of stay-at-home orders first adopted by the hardest-hit places. And while most states will probably not need to keep the rules in place for months upon months, many health specialists say the lockdowns will need to be kept up for several weeks.

Yet among these same experts, there is debate when it comes to the natural next question: What strategy can be deployed after the lockdowns are lifted?

When it comes to the spiraling global coronavirus outbreak, scientists are still trying to pin down the answer to a basic question: How deadly is this virus?

Estimates have varied widely. For instance, at a Feb. 24 news conference in Beijing, a top Chinese health official, Liang Wannian, said the fatality rate for COVID-19 was quite high.

"Between 3 to 4% of patients have died," said Liang.

Three years ago, NPR accompanied disease ecologist Kevin Olival on a field trip to Malaysian Borneo.

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The number of people who are infected with the new coronavirus that is spreading from China is dwarfed by those affected by a far more common respiratory illness: seasonal flu.

Every year there are as many as 5 million severe flu cases worldwide and hundreds of thousands of deaths. By contrast, so far there have been about 20,000 (and rising) cases of coronavirus, most of them mild.

Just a few months ago, Tom Inglesby helped gather top officials from governments, businesses and health organizations around the world to play a kind of war game.

"It was a scenario looking at global consequences of a major new epidemic," says Inglesby, who directs the Center for Health Security at Johns Hopkins University.

Over the past decade there has been a surge of interest in a novel approach to helping the world's poor: Instead of giving them goods like food or services like job training, just hand out cash — with no strings attached. Now a major new study suggests that people who get the aid aren't the only ones who benefit.

The work is dirty, dangerous ... and thankless.

Sanitation workers in lower income countries often endure grueling conditions to perform a service that's vital to keeping their communities healthy. Yet their suffering has largely gone ignored — even by advocates for the poor.

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The aid group Doctors without Borders is suspending its work in the epicenter of the Ebola outbreak in the Democratic Republic of Congo. The move comes after two separate attacks on its treatment centers there. The organization says, at best, it will be weeks before it returns.

"When I send my teams I need to be sure that they are going to come back alive," says Emmanuel Massart, the on-the-ground emergency coordinator for Doctors Without Borders in the region. "The attacks were really, really violent."

The first took place last Sunday night.

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