The Pandemic

Initial document prepared May 14th. Some minor updates added June 23rd 2020.

It seems obvious that the virus cannot be eliminated in the world population until effective vaccines are developed - its propagation must be managed to allow a controlled spread of the virus whilst allowing economies to function. To put the virus into context, the death rate in Europe will be about 20% more than the last severe flu season (2017/18).

Initial responses to the spread of the virus have used periods of social distancing and stay at home orders to reduce case and death rates especially amongst the at risk older population and to avoid overwhelming the hospital and healthcare systems. In Washington, the Governor’s action and the response of Washingtonians have diminished cases and most importantly the hospitalization and death rates. These rates have reduced greatly in May and June and have not followed the dire estimates from some models and emergency hospitals were not needed. Indeed, the use of masks, hand washing and social distancing may be allowing more asymptomatic/low illness severity spread of the virus. It has also been encouraging to see no spikes in cases following recent street protests. Indeed, it is becoming clear that we have to focus on hospitalization and death rates, not just case rates.

In Washington State, the normal average daily death rate is about 150 persons per day. The current COVID-19 death rate of 5 to 10 persons per day is a small perturbation on that number (see chart in Reference 1). At the peak of the outbreak in Washington the COVID-19 death rate was ~40 per day and we may still see short-term fluctuations or statistical corrections that might approach that level on top of a falling rate. The death rate is now at the level where other effects of the stay at home policy, such as fear of seeking medical attention, may add or subtract from the death rate. For instance, the reduction of traffic may reduce traffic related deaths, fear of may increase the suicide rate and deaths from drug overdose may increase, and untreated heart attacks and reduced rates of cancer diagnosis and childhood vaccination may cause longer term rises in illness and morbidity.

As the economy reopens, continued use of age appropriate social distancing, face masks, frequent hand washing, temperature measurement combined with testing, contact tracing and self-isolation of those testing positive will be needed to control outbreaks as we are likely far from herd immunity. These measures may also help reduce the viral load that occurs in an inadvertent infection. The viral load experienced in an infection seems to be important in determining the severity of the disease (see the German epidemiological study by Prof Hendrick Streeck in Reference 2). The infection with low doses of virus may also be allowing symptom-free spread of the virus. Hence, the important parameters to monitor in testing and contact tracing may not be just the number of infections in an outbreak but also take into consideration the number of hospitalizations associated with an outbreak.

Even as the economy opens up, it will remain important throughout to isolate the elderly and those adults with underlying health conditions known to increase hospitalizations and mortality.

To open the economy requires switching to a more local control of outbreaks via testing and contact tracing. This seems to have been successfully used by other countries to confine outbreaks, whilst allowing significant economic activity. Additionally, the development and use of antiviral drugs (e.g. Gilead Science’s drugs Remdesivir) and some steroids would help reduce the time patients with COVID19 stay in the hospital and death rates and hence reduce pressure on health care systems. The psychological effects of the pandemic can also not be underestimated, with some forecasts predicting an extra 70 thousand addition suicides in 2020 due to fears of the pandemic, the economic fall out and the stress of being confined at home.

– see https://www.ecowatch.com/coronavirus-mental-health-drugs-suicide- 2645952573.html?rebelltitem=5#rebelltitem5

https://www.statnews.com/2020/04/30/suicides-two-health-care-workers-hint-at-covid-19-mental- health-crisis-to-come/ (in case hyperlinks fail to open, please copy and paste links into your web browser)

https://www.sciencemag.org/news/2020/06/cheap-steroid-first-drug-shown-reduce-death-covid- 19-patients

Despite the fact that in the US we are still close to the peak of infections with rates still upwards of 20,000 per day and recently risen to 30,000 per day as a few states reopened before going through a peak, the overall hospitalization and death rates from the virus are still falling – see Reference 3 for a copy of page 13 of the weekly updated CDC report that shows the mortality rate for pneumonia, COVID-19 and influenza for May 2nd reported on May 14th – see also the Covibes or Worldometer data for June 23rd. This graph may indicate a seasonality to the spread of the virus, or some mutation in the virus to a less severe illness, or a reduction of the number of possible cases due to natural or acquired immunity from infections by other types of corona viruses of a portion of the population and to symptom-free spread of the disease or a combination of these, perhaps, with other unknown factors. The numbers of people who are naturally immune and the numbers of symptom- free infections remains unknown though the data from the Diamond Princess indicates that only about 25% or so of the population are vulnerable. To obtain these vital numbers will require reliable tests for antibodies from randomly chosen samples of a population. Knowing these important numbers will allow close

estimation of how many people will need to be infected to achieve some level of herd immunity/reduced illness response to the virus if they are re-infected. In predicting the number of cases in an outbreak, there are many models being used that have had varying success (some greatly overestimating cases and deaths) in predicting the course of the outbreak. Models must estimate many parameters imprecisely and are difficult to get right. However, there seems to be an almost universal epidemiological curve that can be fitted to any outbreak, even when different forms of social distancing are in place, as long as the methodology of measuring an outbreak remains consistent during the outbreak. See Reference 4 for a link and reproduction of some of the curves for the US from the CoVibes web site created by Dr Patrick Tam. We think this will be useful to decision makers. For instance, the curves for the US predict a total of about 125 to 150 thousand deaths as the epidemic recedes - more details in Reference 4 below.

Children and COIVD-19 We are fortunate indeed that children are the least at risk from this highly contagious disease. The Swiss research strongly suggests that children under 10 are not easily infected and may have low numbers of receptors for the virus (Reference 5) and are allowing brief contact between grandparents and children. Additional, very detailed research in Iceland (Reference 6) that can detect the direction of infection, shows that adults can infect children but it is extremely rare for children to infect adults. Other countries are opening up their schools or, like Sweden, never closed their schools for under 16’s. As cases are falling in Sweden it seems like the mingling of children at school is not resulting in a huge spread of the disease amongst staff and parents. In our own state, childcare has been open since the stay at home order – due to the fear at the time of overwhelming the health cares system, the Governor needed to keep essential workers attending their jobs in the healthcare system and other essential systems such as communications and the internet, software. Thus childcare was kept open even though the risk to children was low but it was unknown whether they would be silent super- spreaders. The risk taken has paid off. With all the reasonable and suitable precautions in place, childcare centers do not seem to be associated with outbreaks in childcare workers and families. Indeed, with younger children it is hardly possible to maintain social distancing suggesting that class sizes may be more flexibly sized in the future than initially thought. All this suggests that schools, especially those for ages 12 and under, are at low risk for COIVD-19 illness amongst staff and pupils, and are not significant sources of spread of the corona virus, whether the virus activity is low or high in the rest of the population. The key to safety at schools would seem to lie with keeping adults observing appropriate distancing. Thus, keeping staff in small groups with masks and social distancing and preventing parents from mingling with staff and each other would be most important. A recent article in the Lancet, concludes that school closings do little to reduce COVID-19 deaths compared with other social distancing measures - see Reference 7. Here is a quote from one of the authors of the scientific article:-

“Data on the effects of school closures on COVID-19 are limited as the pandemic is still under way, but researchers at University College London said evidence from flu epidemics and outbreaks caused by other coronaviruses suggests their impact on the spread of the disease will be small. “We know from previous studies that school closures are likely to have the greatest effect if the virus has low transmissibility and attack rates are higher in children. This is the opposite of COVID-19,” said Russell Viner, an expert at UCL’s Great Ormond Street Institute of Child Health who co-led the research. “Policymakers need to be aware of the equivocal evidence when considering school closures for COVID-19 given the profound and long lasting effect they will have on children - particularly the most disadvantaged,” he said.”

It is not known how seasonal COIVD-19 will be at this time. However, assuming it is, we would like to suggest that schools in Washington State open in September rather than any later in the year. This would allow schools to take advantage of the summer break from flu (and possibly COIVID-19) and to practice all the required PPE and measures. As suggested above, we have already done the experiment for children by keeping childcare open since the stay home stay safe order and we are not seeing outbreaks associated with operation of childcare centers. Additionally, delaying the opening of schools to the beginning of flu season may cause some conflation of flu and COIVD- 19 symptoms and cause unnecessary stress as parents confuse the two. Another measure that will be important will be encouraging staff and parents (and all eligible Washingtonians) to have flu shots.

With the soon to be implemented testing and contact tracing system, it may well be possible to avoid wholesale closures of schools in the fall and implement local measures to contain any outbreak in school staff especially if staff operate in small pods.

We also have the example of , a country with a similar population to Washington State and not dissimilar numbers of infections and deaths have that has been opening up in 2 week phases since April and have not experienced major new outbreaks. 100,000 senior year students returned to school on May 4th, and other businesses such as hair saloons, barber shops opened prior to May 4th. Here is a link to their opening timetable (as of May19th)

Note dates are reversed 15.05.2020 = 15 May, 2020 https://metropole.at/coronavirus-in-austria/

At the end of the References, the timetable from the article is reproduced.

Opening earlier or at the normal time will open a window to allow some catch-up in the education of pupils and reduction of stress for children, parents and staff. Indeed, it is hard to overstate the stress on families and extending the resumption of education may be extremely counterproductive and will likely result in increased domestic difficulties such as abuse and continued reduction in productivity for those working at home. In addition, many providers of private education may not be able to continue in business if school closures remain in place until October. In addition to the job losses, failure of private schools would put enormous additional pressure on the public education system and lead to a shortage of childcare for working families. The psychological benefit of being able to keep schools open may be invaluable in the midst of any further outbreaks and the pain of the recovering economy.

References - please read, digest and watch the interviews. Note that summaries of the Levitt and Streeck interviews are given at the end of the Reference section.

Reference 1 Death rate in Washington

Reference 2 Interview with Prof Hendrick Streeck , virologist from the University of Bonn, on a detailed experimental study of a corona virus outbreak in . Some 10% of those tested after two super- spreader events at nightclubs in the area had anti-bodies and no previous symptoms. Death rate was (likely over) estimated at 0.37%. The likely hood of spread of the virus from one family member to another was 15%.

https://www.youtube.com/watch?v=vrL9QKGQrWk&feature=youtu.be https://youtu.be/vrL9QKGQrWk?t=8 Reference 3 CDC’s CovidView https://www.cdc.gov/coronavirus/2019-ncov/covid-data/pdf/covidview-05-15-2020.pdf ) Page 13 of their document showing the same of deaths across the United States for pneumonia, flu and COVID-19 showing data up to May 2nd as reported on May 14th.

Reference 4 CoVibes tracking site Dr Patrick Tam has put together a COVID-19 tracking (CoVibes.org) site using a universal epidemiological curve. Dr Tam collaborates in this effort with Professor Michael Levitt at Stanford University Medicine. Professor Levitt is a structural biologist and was awarded the Nobel Prize in Chemistry in 2013. An interview with Professor Levitt gives a particularly clear view of the epidemic. https://youtu.be/bl-sZdfLcEk https://youtu.be/bl-sZdfLcEk?t=3

Also interesting is this interview – “the fear is worse than the virus” that discusses the way the virus may be weakening and that existing and yet-to-be diagnosed cancer patients are staying away healthcare systems out of fear. This could lead to about 50,000 extra deaths in the UK if the lockdown continues for 6 months. https://youtu.be/uk2YZfnsOPg

USA predictions from CoVibes (unfortunately, the web site, at the time of writing, does not have an entry for US-WA, but this may be added soon):

USA cumulative totals showing the prediction to date closely following the epidemiological curve - about 124 thousand total deaths are predicted. In ‘normal’ times in the US the death rate is about 230,000 people per month. This half-month of excess deaths in the US is much less than the estimates from early models that estimated a number close to a year of extra deaths (2.8 million).

Professor Levitt (Private communication, available on request) has done a study of the expected deaths in Europe from COVID-19. He estimates that the eventual death rate will be 15% higher than the deaths in the 2017/18 flu season. Some 8% of deaths are in the below 65 age range, 50% are in the 85 and older range. This is very similar to the flu. Here are the curve for Austria it is deeper into reopening its economy

Reference 5 Swiss claim that children do not drive the spread of the virus

https://www.swissinfo.ch/eng/fact-check_true-or-false--children-are-not-the-drivers-of-the- coronavirus-pandemic/45710550

Reference 6 Iceland and testing data https://www.sciencemuseumgroup.org.uk/blog/hunting-down-covid-19/

https://www.usnews.com/news/best-countries/articles/2020-05-04/what-iceland-can-teach-the- world-about-minimizing-the-coronavirus

Reference 7 Article from the Lancet https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30095-X/fulltext

Article Abstract In response to the coronavirus disease 2019 (COVID-19) pandemic, 107 countries had implemented national school closures by March 18, 2020. It is unknown whether school measures are effective in coronavirus outbreaks (eg, due to severe acute respiratory syndrome [SARS], Middle East respiratory syndrome, or COVID-19). We undertook a systematic review by searching three electronic databases to identify what is known about the effectiveness of school closures and other school social distancing practices during coronavirus outbreaks. We included 16 of 616 identified articles. School closures were deployed rapidly across mainland China and Hong Kong for COVID-19. However, there are no data

on the relative contribution of school closures to transmission control. Data from the SARS outbreak in mainland China, Hong Kong, and Singapore suggest that school closures did not contribute to the control of the epidemic. Modelling studies of SARS produced conflicting results. Recent modelling studies of COVID-19 predict that school closures alone would prevent only 2–4% of deaths, much less than other social distancing interventions. Policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19, and that combinations of social distancing measures should be considered. Other less disruptive social distancing interventions in schools require further consideration if restrictive social distancing policies are implemented for long periods.

Journalist summary of Lancet article https://www.reuters.com/article/us-health-coronavirus-schools/school-closures-will-have-little- impact-on-covid-19-control-review-finds-idUSKBN21O32E

Summary of Streeck YouTube interview by Unherd TV (note that he discusses children and how little they are infected in the online interview, but is not included in the in their summary)

The deadliness of Covid-19, measured by the “Infected Fatality Rate” or what percentage of infected people end up dying, has become an issue of global significance.

At UnHerd, we’ve spoken to experts at both ends of the range of estimates, from Neil Ferguson (who believes the IFR to be just under 1%, perhaps 0.8-0.9%) to Johan Giesecke who maintains that it is nearer 0.1%, or one in a thousand.

This may sound like splitting hairs — they are both under one percent after all — but in reality the difference between these estimates changes everything. At the lower end, a much more laissez-faire policy becomes possible, and at 30,000 deaths it starts to look like the UK has already been through the worst of it; at the higher end, a policy of continued ultra-caution is necessary because a more relaxed approach could mean hundreds of thousands of additional deaths.

That’s why the study conducted by Professor Hendrik Streeck of the University of Bonn is so significant: a representative sample population within Germany was tested and examined in great detail to determine what percentage had already been infected with Covid-19.

The headline result is that 15% of that population was infected, which implies an Infection Fatality Rate of 0.36%. This would put him somewhat in the middle of the previous experts we have spoken to. Professor Streeck was keen to point out, however, that he still believes this is a conservative estimate, and thinks it may be closer to 0.24-0.26% and may come down further still as we know more. He published the higher number to err on the side of caution: “it is more important to have the most conservative estimate and see the virus as more dangerous than it is,” he said.

To show just how significant every percentage point difference makes, if the 0.36% is correct for the UK, and we have had 30,000 Covid-19 deaths, that would mean around 8.3 million people have been infected, or 12.5% of the population — not enough to start feeling confident of much immunity in the community. If the lower estimate is correct, 0.24%, and there has actually been closer to 50,000 Covid-19 deaths (as per the FT’s speculations) then that figure suddenly rises to over 20 million, which at around a third of the population would fundamentally change the calculus of how bold we can be coming out of lockdown.

LOCKDOWN CAME ‘TOO FAST’ Contrary to the main critique of the UK government, that it was too slow in implementing lockdown, Professor Streeck feels that lockdown measures were introduced too fast, meaning that we didn’t have enough time to assess whether the individual components (such as better hygiene and some social distancing) were sufficient to slow the spread.

He also places great emphasis on the viral load that you are initially exposed to as a determinant of how serious your infection becomes, and has noticed the importance of ‘super-spreading events’ in spreading the disease. These tend to be indoor events with bad circulation, and people dancing or being close together, singing, shouting or (in the case of one of the German carnivals he studied) kissing.

This means that, in Professor Streeck’s view, a more feasible approach than attempting to suppress the virus completely until a vaccine (which he is not confident will arrive), allowing the gradual spread of the disease with lower doses, through continued hygiene measures, could lead to a widespread of partial immunity. This would eventually have the effect of downgrading Covid-19 to just another virus that circulates within the human population but, like influenza and other coronaviruses, is a manageable ongoing threat.

I am convinced that we are not going to get rid of SARS-COV-2, so it is going to become an endemic virus — which means it is going to live in our population, and we have to start living with it and find measures so that people are not dying of it but at the same time we can achieve normality.

Summary of Levitt interview on YouTube by Unherd tv As he is careful to point out, Professor Michael Levitt is not an epidemiologist. He’s Professor of Structural Biology at the Stanford School of Medicine, and winner of the 2013 Nobel Prize for Chemistry for “the development of multiscale models for complex chemical systems.” He’s a numbers guy — as he told us in our interview, his wife says he loves numbers more than her — but then, much

of modern science is really about statistics (as his detractors never tire of pointing out, Professor Neil Ferguson is a theoretical physicist by training).

With a purely statistical perspective, he has been playing close attention to the Covid-19 pandemic since January, when most of us were not even aware of it. He first spoke out in early February, when through analysing the numbers of cases and deaths in Hubei province he predicted with remarkable accuracy that the epidemic in that province would top out at around 3,250 deaths.

His observation is a simple one: that in outbreak after outbreak of this disease, a similar mathematical pattern is observable regardless of government interventions. After around a two week exponential growth of cases (and, subsequently, deaths) some kind of break kicks in, and growth starts slowing down. The curve quickly becomes “sub-exponential”.

This may seem like a technical distinction, but its implications are profound. The ‘unmitigated’ scenarios modelled by (among others) Imperial College, and which tilted governments across the world into drastic action, relied on a presumption of continued exponential growth — that with a consistent R number of significantly above 1 and a consistent death rate, very quickly the majority of the population would be infected and huge numbers of deaths would be recorded. But Professor Levitt’s point is that that hasn’t actually happened anywhere, even in countries that have been relatively lax in their responses.

He takes specific issue with the Neil Ferguson paper. “In a footnote to a table it said, assuming exponential growth of 15% for six days. Now I had looked at China and had never seen exponential growth that wasn’t decaying rapidly.”

The explanation for this flattening that we are used to is that social distancing and lockdowns have slowed the curve, but he is unconvinced. As he put it to me, in the subsequent examples to China of South Korea, Iran and Italy, “the beginning of the epidemics showed a slowing down and it was very hard for me to believe that those three countries could practise social distancing as well as China.” He believes that both some degree of prior immunity and large numbers of asymptomatic cases are important factors.

He also observes that the total number of deaths we are seeing, in places as diverse as New York City, parts of England, parts of France and Northern Italy, all seem to level out at a very similar fraction of the total population. “Are they all practising equally good social distancing? I don’t think so.” He disagrees with Sir David Spiegelhalter’s calculations that the totem is around one additional year of excess deaths, while (by adjusting to match the effects seen on the quarantined Diamond Princess cruise ship) he calculates that it is more like one month of excess death that is need before the virus peters out.

More generally, he complains that epidemiologists only seem to be called wrong if they underestimate deaths, and so there is an intrinsic bias towards caution. “They see their role as scaring people into doing something, and I understand that… but in my work, if I say a number is too small and I’m wrong, or too big and I’m wrong, both of those errors are the same.”

He believes the much-discussed R0 is a faulty number, as it is meaningless without the time infectious alongside.

He describes indiscriminate lockdown measures as “a huge mistake,” and advocates a “smart lockdown” policy, focused on more effective measures, focused on protecting elderly people.

I think the policy of herd immunity is the right policy. I think Britain was on exactly the right track before they were fed wrong numbers. And they made a huge mistake. I see the standout winners as Germany and Sweden. They didn’t practise too much lockdown and they got enough people sick to get some herd immunity. I see the standout losers as countries like Austria, Australia and Israel that had very strict lockdown but didn’t have many cases. They have damaged their economies, caused massive social damage, damaged the educational year of their children, but not obtained any herd immunity.

“There is no doubt in my mind, that when we come to look back on this, the damage done by lockdown will exceed any saving of lives by a huge factor.

- PROFESSOR MICHAEL LEVITT

He is philosophical about the future and sees this as a generational mistake:

I think this is another foul-up on the part of the baby boomers. I am a real baby boomer — I was born in 1947, I am almost 73 years old — but I think we’ve really screwed up. We’ve caused pollution, we’ve allowed the world’s population to increase threefold in my lifetime, we’ve caused the problems of global warming and now we’ve left your generation with a real mess in order to save a relatively small number of very old people. - PROFESSOR MICHAEL LEVITT

It’s a view that doesn’t fit the narrative, but which we felt deserved to be heard.

Please forgive quality issues on the video: Prof Levitt was joining us down the line from Tel Aviv and we had intermittent bandwidth issues which have done our best to edit out.

Timetable for Austria to reopen from the Metropole article The Coronavirus in Austria & Vienna | Back to Kindergarten By Benjamin Wolf May 20, 2020 After the Austrian government took increasingly drastic measures in March to contain the coronavirus, the country successfully flattened the curve in April – for the moment. Now, Austria enters phase two of its lockdown, with a plan to gradually lift restrictions step by step. Here’s the current timetable in Austria, as they were announced.

May 20, 2020: • The compulsory year of kindergarten – suspended during the coronavirus lockdown – is now again in force. • The right of entry of Slovak care-givers was relaxed; 24-hour care-givers coming from Slovakia now don’t have to produce a medical certificate with a negative COVID-19 test result anymore. • Starting today, companies can apply for grants from the Finance Ministry covering fixed costs or replacing lost revenue in the period from March 16 to September 15. The opposition criticized that the criteria for the grants are too strict and that many small and one-person firms would not have access to the funds. The government also increased the budget for short-time work (Kurzarbeit) to €12 billion.

May 19, 2020: • The unemployment numbers in Austria have begun to decrease again, they fell by 55,000 in April of this year, to a total of 532,693 unemployed (according to national statistics). Another 1.3 million employees are registered for short-time work (Kurzarbeit), but the extent of the usage of this tool varies (employees can be registered and work from 0 to 100% of their actual hours).

May 18, 2020: • Today, 700,000 students in Austria return to school, after a nine-week hiatus due to the corona measures. Many schools have introduced a phased approach to school start, so that a smaller number of children enters the building at any one time. Big classes are split to reduce overall class sizes and a protection for mouth and nose (ideally masks) is required on hallways and on public transport.

May 17, 2020: • The City of Vienna published plans for the open-air baths in the summer. The public pools will reopen on May 29, but the total number of visitors will be capped, with an effective limit of at least 10 square meters of space per guest. Visitors will be encouraged to book their tickets online beforehand, a new pricing scheme (€1 for children, €2 for teenager, €3 for adults for a day pass) should speed up the entrance process.

May 16, 2020: • Slovenia, Croatia and Italy have all announced that they want to open their borders to one another and other EU citizens in the coming weeks.

May 15, 2020: • The government announced its plan to reopen cultural venues and allow events again in stages throughout the summer. This is the current schedule:

• Restaurants and bars will reopen today, with new hygiene guidelines. The sector has suffered massively under the lockdown and the closure of borders, with up to 63% of the lost revenue coming in normal times from – now absent – tourists. Tax breaks are planned for July.

• Vienna’s municipal authorities (Ämter) reopen today. Citizens are asked to reserve a time

slot beforehand and wear masks while frequenting the venue. • Slovenia is reopening its borders for EU citizens today and will stop require them to self- quarantine for seven days. There will still be spot controls on the borders to Austria, Italy and Hungary. • The State Secretary of Culture, Ulrike Lunacek (Greens), announced her resignation today. Lunacek and the government had recently faced increasingly harsh criticism from Austria’s cultural sector, who bemoaned a lack of attention and support for creatives.

May 14, 2020: • On May 13, Chancellor Sebastian Kurz (ÖVP) visited the village Mittelberg in the in Tyrol. Now, media and the opposition harshly criticize the circumstances of the visit. Their criticism: Nobody was wearing face mask and the government’s distance rules were not at all or only partly respected. The NEOS want to press charges. May 13, 2020: • The Austrian-German border will reopen completely on June 15. Already starting this Friday, May 15, there will only be spot checks on the border. The decision taken jointly by the Austrian and German governments is crucial for Austria’s tourism sector, for which Germans are the largest group of guests after Austrians holidaying at home. • The city of Vienna will send vouchers for use in local bars and restaurants to every household. One-person households will get a voucher for €25, two people will get €50 in total. The city will start sending out the vouchers to the 950,000 Viennese households in mid-June. • In April 2020, up to 20% more people were traveling with bicycles in Vienna. The federal government has meanwhile confirmed a tenfold increase of the budget for cycle lanes this year. • Following heavy criticism regarding the government’s lack of attention to the cultural sector, Health Minister Rudolf Anschober (Greens) now announced “two big steps” for theaters and similar events by May 29. The minister did not further specify what these steps would entail. • The government announced a fund of €700 million for NGOs and other caritative funds to cover running costs in these extraordinary times over the next two quarters.

May 12, 2020: • The Austrian football Bundesliga has a new kick off date: Training sessions can restart this Friday, the first football matches – in front of TV cameras, but without an audience in

stadiums – are likely to kick off two weeks later. • As of this May, 550,000 people in Austria are unemployed and another 1.3 million people on short-time work (Kurzarbeit), both historical highs. However, since mid-April the number of unemployed has again begun to fall, driven mainly by the construction industry which uses the good weather to full effect. • As most of the Austrian economy and public life is opening up again step by step, the cultural and event sector is still in deep sleep, as mandated by government rules. Artists, creators and organizers now criticized harshly the lack of a coherent plan and insufficient support for the creative industries, while Culture State Secretary Ulrike Lunacek (Greens) insists that a plan is forthcoming. • The number of patients in intensive care in Austria due to COVID-19 has fallen to 59, another 205 people are hospitalized due to the coronavirus.

May 11, 2020: • The trains of the ÖBB and subway cars, buses and trams of the Wiener Linien are as of today again running on a regular schedule. Mobility is on the rise again, but public transport is still significantly emptier than before corona (on some routes, tehre are up to 80% fewer travelers). • The government announced a €500 million support package for restaurants and bars in Austria, acknowledging that the sector was hit particularly hard by the crisis. Chancellor Sebastian Kurz called the Gasthäuserkultur (the tradition of meeting up and eating out at restaurants and bars) “a part of the Austrian soul.” • Today at 7:56, the first express train from Romania arrived, bringing 24-hour care workers directly to Austria. The care workers will have to do 24-hour fast PCR COVID-19 test. • Vienna’s statistical office, the MA23, reported that up until April 26, “no excess mortality” could be recorded in the city of Vienna. “The data shows that Vienna has come through the crisis very well so far,” says Klemens Himpele, chief statistician of the city. • The federal government is weighing an up to tenfold budget increase for the building of cycling paths following the corona crisis.

May 8, 2020: • The Ministry of Health published guidelines for guests of restaurants and bars, which will open on May 15. • The Ministry of Education published a decree specifying regulations for schools while will re-open over the coming weeks. For example, no more than 18 pupils are permitted per classroom, music lessons will take place without singing and afternoon teaching will be

possible for high school students older than 14 years.

May 7, 2020: • For the first time since the beginning of the coronavirus pandemic, less than 100 people are in intensive care in Austrian hospitals (as of today, 97 need an ICU unit). The number of people in Austria actively infected with COVID-19 fell to 1,430, about the same number as in mid-March. • Austria’s flagship carrier Austrian Airlines plans to cut 1,100 out of 7,000 jobs by 2023, provided a deal to bail out the airline is still found with the the Austrian government (a support package of €878 million is in the works). AUA mother Lufthansa is currently negotiation with the German government for a similar package.

May 6, 2020: • Austria will prolong border controls due to the coronavirus pandemic until May 31 (the previous date of expiry was May 7). During this period, only selected border crossings are open and travelers entering Austria either have to bring a medical certificate proving their negative COVID-19 status or subject themselves to a 14-days quarantine.

May 5, 2020: • A case study with random participants conducted by Statistik Austria was published yesterday. Based on the tests of 1,432 randomly selected individuals in Austria, the number of active COVID-19 infections in the week of April 21-24 is estimated to have been no

more than 10,823 (0.15% of the population), within a confidence interval of 95%. This is the upper range, meaning that a significantly lower infection rate is highly likely. • In Tyrol, a commission of inquiry has been formed to investigate the so-called “Causa Ischgl.” The police also presented a separate 1,000 pages inquiry into the events, based on which the local office of the attorney will decide whether to press charges.

May 4, 2020: • Vienna Airport started to offer COVID-19 fast tests onsite. The results should be available within three hours. It is necessary to make an appointment in advance via e-mail to [email protected]. One test costs €190.

Demand for local travel will rise in short term. Then ripple out to regional/state/national/international demand as consumer confidence regains slowly. $200 COVID tests @ airport upon arrival/departure probably the new norm for int'l travel in interim Vienna Airport to Offer Coronavirus Tests to Avoid Quarantine Vienna Airport will offer onsite coronavirus testing from Monday to enable passengers entering Austria to avoid having to be quarantined for 14 days. • According to a report in The Times of Israel, Austria launched an initiative to adopt joint coronavirus protocols and open up to tourism and trade with each other. Before opening their borders, the 7 countries – all with strong tourism sectors – would establish common guidelines including masks, safe distances and testing. Vienna Airport, for example, has already started to offer 3-hour fast tests to travelers (for €190). • Travelers entering Austria from abroad have to enter a 14-day period of self-quarantine, unless they can show a medical certificate not older than 4 days proving their negative status of COVID-19. The test can also be done in Austria during the quarantine, which can be ended earlier if the result is negative. • The number of new infections with coronavirus is falling all across Austria, only in Vienna the numbers are still rising, albeit from a low level. • Today, students in senior year (approx. 100,000 pupils) return to schools. • As of April 2020, more than 570,000 people in Austria were unemployed. That’s an unemployment rate of 12.5% or 5.5 percentage points higher than in February, according to national statistics (internationally comparable numbers coming from Eurostat and the ILO usually show Austria’s unemployment rate up to four percentage points lower).

May 3, 2020:

• Employees in Austria like teleworking, says a new survey. Seven out of ten employees who have been working at home during the last weeks stated that they would like continue teleworking after the crisis, 60% even said that their productivity at home was higher than at the office. Two thirds think that the pandemic will change society markedly and also two thirds think that these changes will be for the better. • Vienna’s kindergartens expect more children in the coming weeks. The share of children attending kindergartens may rise from single digits to 25-40% of the total.

May 2, 2020:

• Today, May 2, shopping centers, stores larger than 400 m², hair, beauty and massage salons can re-open. Wearing masks is mandatory inside shops and in public buildings, heightened attention to distance rules and hygiene while shopping or in public is strongly advised. Events can again take place with a maximum of 10 people, private gatherings are allowed – social distancing rules apply throughout. • The number of active coronavirus cases in Austria is still declining. The four-day average of new infections fell to 0.36%. As of May 1, there are 1,759 active cases in Austria. 13,110 people recovered from the virus and 589 people passed away.

Coronavirus in Austria, May 1, 2020 (c) © 2020 Infogram

• Salzburg’s chief infectiologist Richard Greil cautioned that distance rules during the easing of restrictions are somewhat of an “experiment.” The government has variably advised to keep 1-meter distance or “the size of a baby elephant.” Others advise 2 meters. Greil underlined that the current infection rates (R) in Austria is very low (around 0.3), which led to the political decision of carefully attempting to ease measures.

• In a home for asylum applicants in Vienna housing 400 people, 15 have tested positive for coronavirus. The home has now been evacuated, the inhabitants are in quarantine.

May 1, 2020:

• As of today, May 1, the restrictions on movements in Austria do not apply anymore. But several measures still apply: People are called on to meet in small groups only, reduce physical contact and often wash hands. Social distancing (e.g. keeping 1 meter distance from other people in public spaces) is advised, wearing masks in supermarkets, shops and public places is mandatory. • The budget for short-time work (Kurzarbeit) was raised to €10 billion by the government. Currently, 1.1 million employees in Austria are registered in the scheme. However, many companies may have also applied as a precaution – the actual working time (and wage subsidy) of those registered can range from 0 to 100%. • Zoos like Vienna’s Tiergarten Schönbrunn will re-open on May 15. Visitors are asked to buy tickets and reserve certain time-slots beforehand, wearing masks throughout the visit is mandatory. For length, clarity and loading times, we have decided to split off the timeline of what happened in March into two separate articles: “The Coronavirus in Austria & Vienna | What Happened in March” & “The Coronavirus in Austria & Vienna | What Happened in April.”

Numbers As of today, May 19, 2020, the situation in Austria according to the Ministry of Health is as follows: People tested: 372,3435 – of which in Vienna: 86,247 Daily tests: 6,042 Confirmed cases: 16,231 (+56 cases (+0.3%) since yesterday) – of which in Vienna: 2,942 Active cases: 921 (-15 cases (-1.6%) since yesterday) – of which in Vienna: 546 Increase on previous day: +0.17% – four-day average: +0.31% Total hospitalized: 182 (-14 cases (-7.1%) since yesterday) – of which in Vienna: 81 In intensive care: 39 (-6 cases (-13.3%) since yesterday) – of which in Vienna: 14 Recovered: 14,678 (+64 cases (+0.4%) since yesterday) – of which in Vienna: 2,252 Deceased: 632 (+3 case (+0.5%) since yesterday) – of which in Vienna: 144 The Ministry of Health has also developed a COVID-19 dashboard (see partial screenshot above) with details on the coronavirus outbreak in Austria, listing for example affected regions, age groups, gender and status of the cases. Austrian tech & startup media house Trending Topics has also set up a comprehensive tracking board for the coronavirus in Austria (in German).

Resources The City of Vienna has compiled comprehensive information on questions and answers regarding coronavirus and the COVID-19 disease in English. The Austrian Ministry of Health has put together FAQs on the coronavirus and also provides material to download on how to protect yourself and others from the disease, also in English. Furthermore, the ministry will constantly update its German language website with information on the number of people tested and cases of COVID-19 in Austria.