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    The European Union unveiling a massive coronavirus recovery plan worth hundreds of billions of euros to help countries rebuild their ailing economies, but the bloc remains deeply divided over what conditions should be attached to the funds. The move Wednesday comes as the 27-nation trading bloc is set to enter its deepest-ever recession as the impact from the coronavirus pandemic ravages economies. Virtually every country has broken the EU’s deficit limit as they’ve spent to keep health care systems, businesses and jobs alive. Earlier this month, the leaders of Germany and France — historically, the two main drivers of EU integration — agreed on a one-time 500 billion-euro ($543 billion) fund, a proposal that would add further cash to an arsenal of financial measures the bloc is deploying to cope with the economic fallout. That plan would involve the EU borrowing money in financial markets to help sectors and countries that are particularly affected by the pandemic. The European Commission’s blueprint is likely to resemble the Franco-German plan in many ways while attaching the fund to the EU’s next long-term budget. The big question will be how much money will take the form of grants and how much would be loans. Austria, Denmark, the Netherlands and Sweden — a group of countries dubbed the “Frugal Four” for their budgetary rectitude — are reluctant to see money given away without any strings attached, and their opposition to grants could hold up the project. “Will it be grants or loans? And if it will be grants, who are going to pay the grants? Loans, I think is a more interesting way forward to discuss, but we also have to discuss under what conditions shall we give these loans,” Swedish Finance Minister Magdalena Andersson said Tuesday. Whatever its content, the commission’s plan is likely to spark heated debate and the EU does not have time for the wrangling to drag on. The new budget period begins on Jan 1, and countries across the bloc are desperate for funds now. All 27 member countries must agree for the recovery fund to take effect. ___ Follow AP pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak.
  • “Do as I say, but not as I do” was the message many British saw in the behavior of Prime Minister Boris Johnson's key aide, who traveled hundreds of miles with coronavirus symptoms during the country's lockdown. While Dominic Cummings has faced calls for his firing but support from his boss over his journey from London to the northern city of Durham in March, few countries seem immune to the perception that politicians and top officials are bending the rules that their own governments wrote during the pandemic. From U.S. President Donald Trump to Israeli Prime Minister Benjamin Netanyahu, global decision-makers have frequently set bad examples, whether it's refusing to wear masks or breaking confinement rules aimed at protecting their citizens from COVID-19. Some are punished when they’re caught, others publicly repent, while a few just shrug off the violations during a pandemic that has claimed more than 350,000 lives worldwide. Here are some notable examples: NEW ZEALAND HEALTH MINISTER CALLS HIMSELF AN “IDIOT” In April, New Zealand’s health minister was stripped of some of his responsibilities after defying the country’s strict lockdown measures. David Clark drove 19 kilometers (12 miles) to the beach to take a walk with his family as the government was asking people to make historic sacrifices by staying at home. “I’ve been an idiot, and I understand why people will be angry with me,” Clark said. He also earlier acknowledged driving to a park near his home to go mountain biking. Prime Minister Jacinda Ardern said normally she would fire Clark but that the country couldn’t afford massive disruption in its health sector while it was fighting the virus. Instead, she stripped Clark of his role as associate finance minister and demoting him to the bottom of the Cabinet rankings. MEXICO’S LEADER SHAKES HANDS Mexican President Andrés Manuel López Obrador said it pained him not to embrace supporters during tours because of health risks, but he made a remarkable exception in March, shaking hands with the elderly mother of imprisoned drug kingpin Joaquin “El Chapo” Guzmán. Asked about shaking her hand when the government was urging citizens to practice social distancing, López Obrador said it would have been disrespectful not to. “It’s very difficult humanly,” he said. “I’m not a robot.” AMERICA’S PANDEMIC POLITICS The decision to wear a mask in public is becoming a political statement in the U.S. It's been stoked by Trump — who didn’t wear a mask during an appearance at a facility making them — and some other Republicans, who have questioned the value of masks. This month, pandemic politics shadowed Trump’s trip to Michigan as he toured a factory making lifesaving medical devices. He did not publicly wear a face covering despite a warning from the state’s top law enforcement officer that refusing to do so might lead to a ban on his return. Presumptive Democratic nominee Joe Biden, meanwhile, wore a mask along with his wife, Jill, as they laid a wreath Monday at a Delaware veterans’ memorial — his first public appearance since mid-March. Trump later retweeted Fox News analyst Brit Hume’s criticism of Biden for wearing a mask in public. Vice President Mike Pence was criticized for not wearing a mask while on a visit to the Mayo Clinic. NETANYAHU’S PASSOVER HOLIDAY While the rest of Israel was instructed not to gather with their extended families for traditional Passover Seder in April, Netanyahu and President Reuven Rivlin hosted their adult children for the festive holiday meal, drawing fierce criticism on social media. Israeli television showed a photo of Avner Netanyahu, the premier’s younger son, attending the Seder at his father's official residence. Benjamin Netanyahu later apologized in a televised address, saying he should have adhered more closely to the regulations. THE FRENCH EXCEPTION French President Emmanuel Macron also has been inconsistent with masks, leaving the French public confused. Although Macron has sometimes appeared in a mask for visits at hospitals and schools, it's a different story in the Elysee presidential palace and for speeches. During a visit to a Paris hospital on May 15, Macron initially wore a mask to chat with doctors but then removed it to talk with union workers. Interior Minister Christophe Castaner also faced criticism this month for huddling with dozens of mask-makers in a factory for a photo where everyone removed their masks. PUTIN’S DIFFERENT APPROACH The only time Russian President Vladimir Putin wore protective gear in public was on March 24, when he visited a top coronavirus hospital in Moscow. Before donning a hazmat suit, Putin shook hands with Dr. Denis Protsenko, the head of the hospital. Neither wore masks or gloves, and a week later, Protsenko tested positive for the virus. That raised questions about Putin’s health, but the Kremlin said he was fine. Putin has since held at least seven face-to-face meetings, according to the Kremlin website. He and others didn’t wear masks during those meetings, and Putin also didn’t cover his face for events marking Nazi Germany’s defeat in World War II. When asked why Putin doesn’t wear a mask during public appearances, spokesman Dmitry Peskov said the Kremlin has a different approach to protecting the president’s health. “When it comes to public events, we ask medical workers to test all the participants in advance,” Peskov told reporters. PUERTO RICO OFFICIAL’S INCONSISTENT MESSAGE Puerto Rico Gov. Wanda Vázquez was criticized for not always wearing a mask despite holding new conferences ordering people to cover their face outside their homes and inside businesses. A member of the opposition Popular Democratic Party also filed a police complaint last week against members of Vázquez’s New Progressive Party, alleging they violated a curfew by gathering to inaugurate the party’s new headquarters. Police are investigating the incident, which angered many Puerto Ricans. SCOTTISH MEDICAL OFFICIAL TAKES THE LOW ROAD Scotland’s chief medical officer, Dr. Catherine Calderwood, broke her own rules and traveled to her second home during lockdown in April. She faced blowback after photos emerged of her and her family visiting Earlsferry in Fife, which is more than an hour’s drive from her main home in Edinburgh. She apologized and resigned. “I did not follow the advice I’m giving to others,” Calderwood said. “I am truly sorry for that. I’ve seen a lot of the comments from … people calling me a hypocrite.” JAPAN’S GAMBLING SCANDAL A top Japanese prosecutor was reprimanded and later resigned this month after defying a stay-at-home recommendation in a gambling scandal. Hiromu Kurokawa, the country’s No. 2 prosecutor who headed the Tokyo High Prosecutors’ Office, acknowledged that he wasn't social distancing when he played mahjong for money at a newspaper reporter's home twice in May. Japan didn’t enforce a stay-at-home recommendation, but his case outraged the public because many were following social distancing measures. ITALIAN PRESS CONFERENCE CRITICISM At a March news conference to open a COVID-19 field hospital in Milan’s old convention center, photographers and video journalists were pushed into corners that did not allow proper spacing. Only text reporters were given seating in line with regulations. The Codacons consumer protection group announced it would file a complaint with prosecutors in Milan. “What should have been a moment of great happiness and pride for Lombardy and Italy was transformed into a surreal event, where in violation of the anti-gathering rules, groups of crowds formed,’’ Codacons said. SOUTH AFRICA’S RULE-BREAKING DINNER In April, Communications Minister Stella Ndabeni-Abrahams was placed on special leave for two months and forced to apologize by President Cyril Ramaphosa after she violated stay-at-home regulations. Ramaphosa directed police to investigate after a photo emerged on social media of Ndabeni-Abrahams and several others having a meal at the home of former deputy minister of higher education Mduduzi Manana. SPANISH HOSPITAL CEREMONY INVESTIGATED Madrid’s regional and city officials sparked controversy when they gathered on May 1 for a ceremony shuttering a massive field hospital at a convention center. Eager to appear in the final photo of a facility credited with treating nearly 4,000 mild COVID-19 patients, dozens of officials didn't follow social distancing rules. Spain’s restrictions banned more than 10 people at events like the one that honored nurses and doctors. The central government opened an investigation, and Madrid regional chief Isabel Díaz Ayuso apologized. She said officials “got carried away by the uniqueness of the moment.” Former Prime Minister Mariano Rajoy also defied strict stay-at-home orders, with a television station filming him power walking around in northern Madrid. The Spanish prosecutor’s office is investigating whether Rajoy, who was premier from 2011 to 2018, should be fined. INDIAN CRICKET GAME CRITICIZED In India, a top leader of Prime Minister Narendra Modi’s Bharatiya Janata Party drew flak last weekend after playing a game of cricket. Manoj Tiwari, also a member of India’s parliament, said he followed social distancing rules during the game. Videos circulating on social media showed Tiwati without a mask. He was also seen taking selfies with people. LEADERS WHO FOLLOW THE RULES Some leaders are setting a good example, including Portuguese President Marcelo Rebelo de Sousa. Media jokingly called him the most relaxed politician in the world after he was photographed queuing at a supermarket this month, wearing a mask and following social distancing measures. The photo was widely shared on social media. Another rule-follower is Dutch Prime Minister Mark Rutte, who did not visit his ill 96-year-old mother in a nursing home during the last eight weeks of her life because of coronavirus restrictions. He only came to her bedside during her final hours this month. “The prime minister has respected all guidelines,” according to a statement read by a spokesman. “The guidelines allow for family to say goodbye to dying family members in the final stage. And as such the prime minister was with her during her last night.' ___ Adamson reported from Leeds, England. Associated Press writers Dasha Litvinova in Moscow; Ilan Ben Zion in Jerusalem; Colleen Barry in Milan, Italy; Nick Perry in Wellington, New Zealand; Aritz Parra in Madrid; Mari Yamaguchi in Tokyo; Sheikh Saaliq in New Delhi; and Raf Casert in Brussels contributed. ___ Follow AP pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak
  • Only about half of Americans say they would get a COVID-19 vaccine if the scientists working furiously to create one succeed, according to a new poll from The Associated Press-NORC Center for Public Affairs Research. That’s surprisingly low considering the effort going into the global race for a vaccine against the coronavirus that has sparked a pandemic since first emerging from China late last year. But more people might eventually roll up their sleeves: The poll, released Wednesday, found 31% simply weren’t sure if they’d get vaccinated. Another 1 in 5 said they’d refuse. Health experts already worry about the whiplash if vaccine promises like President Donald Trump’s goal of a 300 million-dose stockpile by January fail. Only time and science will tell -- and the new poll shows the public is indeed skeptical. “It’s always better to under-promise and over-deliver,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “The unexpected looms large and that’s why I think for any of these vaccines, we’re going to need a large safety database to provide the reassurance,” he added. Among Americans who say they wouldn’t get vaccinated, 7 in 10 worry about safety. “I am not an anti-vaxxer,” said Melanie Dries, 56, of Colorado Springs, Colorado. But, “to get a COVID-19 vaccine within a year or two ... causes me to fear that it won’t be widely tested as to side effects.” Dr. Francis Collins, who directs the National Institutes of Health, insists safety is the top priority. The NIH is creating a master plan for testing the leading COVID-19 vaccine candidates in tens of thousands of people, to prove if they really work and also if they're safe. “I would not want people to think that we’re cutting corners because that would be a big mistake. I think this is an effort to try to achieve efficiencies, but not to sacrifice rigor,” Collins told the AP earlier this month. “Definitely the worst thing that could happen is if we rush through a vaccine that turns out to have significant side effects,” Collins added. Among those who want a vaccine, the AP-NORC poll found protecting themselves, their family and the community are the top reasons. 'I’m definitely going to get it,” said Brandon Grimes, 35, of Austin, Texas. “As a father who takes care of his family, I think ... it’s important for me to get vaccinated as soon as it’s available to better protect my family.” And about 7 in 10 of those who would get vaccinated say life won't go back to normal without a vaccine. A site foreman for his family’s construction business, Grimes travels from house to house interacting with different crews, and said some of his coworkers also are looking forward to vaccination to minimize on-the-job risk. The new coronavirus is most dangerous to older adults and people of any age who have chronic health problems such as diabetes or heart disease. The poll found 67% of people 60 and older say they’d get vaccinated, compared with 40% who are younger. And death counts suggest black and Hispanic Americans are more vulnerable to COVID-19, because of unequal access to health care and other factors. Yet the poll found just 25% of African Americans and 37% of Hispanics would get a vaccine compared to 56% of whites. Among people who don't want a vaccine, about 4 in 10 say they're concerned about catching COVID-19 from the shot. But most of the leading vaccine candidates don't contain the coronavirus itself, meaning they can't cause infection. And 3 in 10 who don't want a vaccine don't fear getting seriously ill from the coronavirus. Over 5.5 million people worldwide have been confirmed infected by the virus, and more than 340,000 deaths have been recorded, including nearly 100,000 in the U.S., according to a tally kept by Johns Hopkins University. Experts believe the true toll is significantly higher. And while most people who get COVID-19 have mild cases and recover, doctors still are discovering the coronavirus attacks in far sneakier ways than just causing pneumonia — from blood clots to heart and kidney damage to the latest scare, a life-threatening inflammatory reaction in children. Whatever the final statistics show about how often it kills, health specialists agree the new coronavirus appears deadlier than the typical flu. Yet the survey suggests a vaccine would be no more popular than the yearly flu shot. Worldwide, about a dozen COVID-19 vaccine candidates are in early stages of testing or poised to begin. British researchers are opening one of the biggest studies so far, to test an Oxford University-created shot in 10,000 people. For all the promises of the Trump administration’s “ Operation Warp Speed,” only 20% of Americans expect any vaccine to be available to the public by year’s end, the poll found. Most think sometime next year is more likely. Political divisions seen over how the country reopens the economy are reflected in desire for a vaccine, too. More than half of Democrats call a vaccine necessary for reopening, compared to about a third of Republicans. While 62% of Democrats would get the vaccine, only 43% of Republicans say the same. “There's still a large amount of uncertainty around taking the vaccine,” said Caitlin Oppenheimer, who leads NORC's public health research. “There is a lot of opportunity to communicate with Americans about the value and the safety of a vaccine.” ___ AP video journalist Federica Narancio contributed to this report. ___ The AP-NORC poll of 1,056 adults was conducted May 14-18 using a sample drawn from NORC’s probability-based AmeriSpeak Panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 4.2 percentage points.
  • These are children of the global pandemic. In the far-north Canadian town of Iqaluit, one boy has been glued to the news to learn everything he can about the coronavirus. A girl in Australia sees a vibrant future, tinged with sadness for the lives lost. A Rwandan boy is afraid the military will violently crack down on its citizens when his country lifts the lockdown. There is melancholy and boredom, and a lot of worrying, especially about parents working amid the disease, grandparents suddenly cut off from weekend visits, friends seen only on a video screen. Some children feel safe and protected. Others are scared. And yet, many also find joy in play, and even silliness. Associated Press reporters around the world asked kids about living with the virus and to use art to show us what they believe the future might hold. Some sketched or painted, while others sang, danced ballet, built with LEGOs. A few just wanted to talk. In the remote forests of northern California, one boy, a Karuk Indian, wrote a rap song to express his worries about how his tribe of just 5,000 will survive the pandemic. Their worries are matched in many places by resilience and hope, for a life beyond the virus. This is life under lockdown, through the eyes of children. ____ LILITHA JIPHETHU, 11, SOUTH AFRICA Lilitha Jiphethu has made a ball out of discarded plastic grocery bags to keep her amused during the lockdown. She and her four siblings play with that makeshift ball almost every day in a small scrub of ground that they’ve fenced off outside their home. The 11-year-old screams as her brothers throw the ball at her. Then she laughs, picks up the ball and throws it back at them. This happens again and again. Lilitha’s house is like hundreds of others in this informal settlement of families just outside Johannesburg, South Africa’s biggest city. It’s made of sheets of scrap metal nailed to wooden beams. Like many children under lockdown, she misses her friends and her teachers and especially misses playing her favorite game, netball. But she understands why school is closed and why they are being kept at home. “I feel bad because I don’t know if my family (can catch) this coronavirus,” Lilitha says. “I don’t like it, this corona.” She prefers singing to drawing and chooses to sing a church song in her first language, Xhosa, as her way of describing the future after the pandemic. She misses her choir but takes comfort in the song’s lyrics. She smiles as she begins. Her sweet voice drifts through the one-room home. “I have a friend in Jesus,” she sings. “He is loving and he’s not like any other friend. “He is not deceitful. He is not ashamed of us. “He is truthful, and he is love.” —Bram Janssen and Gerald Imray __ HUDSON DRUTCHAS, 12, UNITED STATES Hudson Drutchas waited and worried as his mom and sister recovered from coronavirus, quarantined in their rooms. Just a few weeks earlier, he was a busy sixth-grader at Lasalle II, a public elementary school in Chicago. Then the governor issued a stay-at-home order. Now, the soft-spoken 12-year-old receives school assignments by computer and looks to dog Ty and cat Teddy for comfort. “Since I don’t get to see my friends a lot, they’re kind of my closest friends,” he says. He giggles when Teddy, now 9, snarls. “He sometimes gets really grumpy because he’s an old man. But we still love him a lot.” When not doing schoolwork, Hudson jumps and flips on his trampoline and lifts himself around a doorframe outfitted so he can practice climbing, something he usually does competitively. He knows he’s fortunate, with a good home and family to keep him safe, but it’s difficult to be patient. “It makes me feel sad that I am missing out on a part of my childhood,” he says. When he draws his version of the future, Hudson makes a detailed pencil sketch showing life before the coronavirus and after. The world before looks stark and full of pollution in the drawing. In the future, the city is lush with clear skies and more wildlife and trees. “I think the environment might kind of, like, replenish itself or maybe grow back,” Hudson says. Still, he feels uncertain: “I’m worried about just how life will be after this. Like, will life change that much?” —Martha Irvine ___ ALEXANDRA KUSTOVA, 12, RUSSIA Hard times can have a silver lining. Alexandra Kustova has come to understand this during this pandemic. Now that all her studies are conducted online, she has more time for her two favorite hobbies -- ballet and jigsaw puzzles. The 12-year-old also able to spend more time with her family and help her grandmother, who lives in the same building, two floors down at their apartment in Yekaterinburg, a city in the Urals, a mountain range that partly divides Europe and Asia. Together, they take time to water tomato plants and enjoy one another’s company. Time has slowed down. “Before that I would have breakfast with them, rush out to school, come back, have dinner, go to ballet classes, come back -- and it would already be time to go to bed,” Alexandra says. Ballet has been her passion since she was 8. Now she does classes at home and sends videos of her drills to the trainer, who gives her feedback. The dance she shows for an AP reporter begins slowly and finishes with leaps in the air. Just like the pandemic, Alexandra says, it is “sad in the beginning and then it becomes joyful.” “I believe the end is joyful because we must keep on living, keep on growing,” she says. —Yulia Alekseeva ______ TRESOR NDIZIHIWE, 12, RWANDA No school. No playing with friends. Soldiers everywhere. That’s life during the coronavirus pandemic for Tresor Ndizihiwe, a 12-year-old boy who lives in Rwanda, one of seven brothers and sisters. Their mother, Jacqueline Mukantwari is paid $50 a month as a schoolteacher, but she used to earn extra money giving private lessons. That business has dried up, and the family gets food parcels from the government twice a month. The only regular outside time Tresor has is in a small courtyard next to his home. “The day becomes long,” he says in his native tongue, Kinyarwanda. “(You) can’t go out there” — he indicates the world outside his house — “and it makes me feel really uncomfortable.” Tresor draws a picture of the future that shows soldiers shooting civilians who are protesting, he says. He adds dabs of red paint next to one of those who has fallen. “There is blood,” he says, “and some are crying, as you can see.” It’s a stark image for a boy to produce. Rwanda was the first country in Africa to enforce a total lockdown because of the virus. It’s also a place where the security forces meant to be helping keep people safe have been accused of serious abuses of power. Yet he wants to be a soldier. Jacqueline says her son is a good student — “so intelligent.” She struggles to reconcile his own desire to join the military with the picture he has drawn. —Daniel Sabiiti and Gerald Imray ___ JEIMMER ALEJANDRO RIVEROS, 9, COLOMBIA Life in Colombia’s countryside has become even more difficult for the family of Jeimmer Alejandro Riveros. The price of herbs and vegetables his single mom and siblings cultivate on a farm in Chipaque have declined. A spotty internet connection makes virtual classes difficult, and a nationwide quarantine means less time outdoors. “Here is a mountain with a river,” Jeimmer, 9, says, pointing at each item in his drawing. In his mind, the future doesn’t look so different. “Here I am. Here’s my mommy. Here is my brother. Here is my house. Here is the sun and here is the sky.” The family recently launched a YouTube channel with videos showing how to grow and propagate plants that now has more than 420,000 followers. Their first video, introducing the Jeimmer’s mom, older brother and dog, has garnered, by now, more than 1 million views. “Let’s make this go viral!” Jeimmer says, as birds chirp in the background. Colombia is one of Latin America’s most unequal countries, and poverty abounds in rural areas where many still lack basic utilities like safe drinking water. Jeimmer’s family often walks 40 minutes a day to get fresh milk. Capital city Bogota — about an hour from the family’s farm — has the highest number of coronavirus cases in Colombia. But cases are increasingly being identified in rural areas with few hospitals. Chipaque reported its first case earlier this month. Despite the obstacles, Jeimmer maintains an upbeat outlook on life under quarantine. He feels safe from the virus with his mom and brother. And he imagines a future with more time spent outdoors and one day, a grown-up job. “It doesn’t matter that we’re in lockdown,” he says. “We can be happy.” —Christine Armario ___ ISHIKIIHARA E-KOR, 11, UNITED STATES Ishikiihara E-kor misses all the normal kid things during the pandemic: playing baseball, hanging out with friends and having a real party for his 11th birthday, which he instead celebrated with relatives on a Zoom call. The internet periodically goes out for hours, making it hard for him to complete his school work, so he plays with his dog, Navi Noop Noop. But Shikii, as his friends call him, also has bigger things on his mind. He’s a Karuk Indian, a member of California’s second-largest tribe, and has been reading about how the pandemic is rampaging through the Navajo Nation, another tribe hundreds of miles away. The virus can feel far away in the tribe’s tiny outpost of Orleans, California, where the crystal clear lower Klamath River winds through densely forested mountains south of the Oregon-California border. But in a rap Shikii wrote, he urged fellow tribal members not to get complacent. “Stay away, man, 6 feet at least. Social distancing, it’s a thing that could save us. What? Like 5,000 of us left, Karuk tribe, man, that’s it.” Ishikiihara, whose full name means “sturgeon warrior” in the Karuk language, later adds, “If we even just lost a few people, that would be really sad.' Rapping about his worries isn’t new for him. He has a song about how his tribe lost its tradition fishing salmon runs on the Klamath River, pondering in verse why the Karuk “needed permission to go fishin’.” —Gillian Flaccus __ BANEEN AHMED, 10, JORDAN Despite the harshness she has experienced, the quiet, studious girl is brimming with hard-won optimism. Her family’s suffering in war-time Iraq has taught Baneen Ahmed that outside events can turn life upside down in an instant. In the chaotic aftermath of the 2003 U.S.-led invasion of Iraq, an uncle was kidnapped, and a great-uncle was killed by armed militias, forcing her family to seek refuge in Jordan. By comparison, the coronavirus pandemic seems manageable, the 10-year-old says. Scientists will find a vaccine, she says, speaking in halting but vocabulary-rich English, her favorite subject of study at a private school in the Jordanian capital of Amman. “It’s going to take a year or a little bit to find a cure, so it’s going to end,” says Baneen, who prefers to talk and show how she’s studying at home under lockdown, rather than drawing a picture. “In Iraq, it’s not going to end,” she continues. “It’s like so hard to end it, the killing and the kidnapping.” In the future, she sees herself studying abroad, maybe in the United States or Turkey. She’s thought about a career in medicine, but is excited by any opportunity to learn. For her, school represents hope. “I want to go somewhere else because they will let us study good things,” Baneen says. “And my future is going to be good.” —Karin Laub __ ELENA MORETTI, 11, ITALY For Elena Moretti, the pandemic is not some faraway threat. Italy was the first European country to be hit by COVID-19, and her mother is a doctor in the public health system that has seen 27,500 personnel infected and more than 160 doctors dead nationwide. Elena, 11, is afraid of the coronavirus. Whenever a package arrives in the mail, she brings it out onto the terrace and disinfects it with a spray-bottle soap solution she made herself. It's a bottle, too, in Elena's drawing, capturing the virus inside. “The virus wanted to attack us, so instead of bringing us down, we counterattack and imprison it,” she said of her drawing. That fighting spirit has helped Elena get through more than two months of lockdown. After an initial spell of sleeping late because her teachers hadn’t transitioned to remote learning, Elena now does schoolwork, karate and hip-hop lessons online. Sometimes the internet connection goes out. But she’s still managed to keep in touch with friends, with some video chats lasting for hours. She’s also discovered a new hobby, baking sweets — apple tort, cupcakes and cream-filled pastry. Now that Italy’s lockdown has begun to ease, Elena is starting to go out again, but the fear remains. “I’m afraid it might spread even more and take all of us,” she said. —Paolo Santalucia __ NIKI JOLENE BERGHAMRE-DAVIS, 11, AUSTRALIA When she doesn’t move enough, she doesn’t sleep well. So, Niki Jolene Berghamre-Davis tries to go hiking in the forest whenever possible during this global pandemic. Even in the best of times, that’s where the 11-year-old from Port Melbourne, Australia, feels most at home. “She is our nature girl,” says her mother, Anna Berghamre. Her mom wasn’t surprised when Niki Jolene drew a self-portrait of herself facing a grove of trees. Within the drawing, there are signs of caution. “I have a face mask in my hand,” she says holding up the drawing, “because, well, I’ve just kind of taken it off, and I’m still aware.” She says that falling leaves she included in the sketch symbolize the lives that have been lost in this pandemic. Yet the roots of the trees — wide and prominent like those of the flowering red gum trees near her family’s townhome — represent “possibilities,” says the bubbly girl, known as “Snickers” to some of her friends. She smiles often, showing a full set of braces on her teeth. “After this corona pandemic, after this will end, I think it will be much more full of life,” she says, throwing her arms up for emphasis. She hopes, for instance, that people will walk more and drive less because she’s noticed how people in her neighborhood have often done without their cars during the shutdown. “I think people won’t take things for granted anymore.” —Martha Irvine ___ DANYLO BOICHUK, 12, UKRAINE Danylo Boichuk envies his cat, Kari, who is able to escape from the family home in a Kyiv suburb and run free. Because of the pandemic, his family had to cancel a summer camp in Bulgaria, and 12-year-old Danylo worries a lot about closed borders. Sitting on his back porch, he has used his LEGO blocks and figures to create his version of the future — a situation at the border. “Here is a vessel en route to Copenhagen, and border guards are inspecting it,” Danylo explains, pointing to particular pieces and holding up others. “This crew member shows medical evidence that everyone on board is healthy, except for one man in an isolation cell.” The plastic figure makes a rattling sound after he drops it into the makeshift jail. “There is a security guard restricting contact with the man,” he continues. “There are IT specialists at work. There are also people who lost their jobs — musicians, farmers, showmen.” The boy wonders if authorities in some countries will use the coronavirus crisis to tighten their grip on people’s lives. “For example, they may implant chips to track (people’s) whereabouts … ,” Danylo surmises. His parents say he has an analytical mind. Already, he wants to become a businessman in the future and create a start-up to develop online games. He’s been reading books about Steve Jobs, the founder of Apple, and other famous entrepreneurs, during self-isolation. After the pandemic, he says people will invest more in internet products and games. “This is an opportunity one should use,” he says. —Dmitry Vlasov __ ANA LAURA RAMÍREZ LAVANDERO, 10, CUBA Her drawing depicts a simple enough dream for a 10-year-old — “Viaje a la Playa,” a trip to the beach. On the page, she has colored a palm tree with three brown coconuts, a boat floating in the distance and a shining yellow sun. It is a scene representative of life on her island country, known for its white sand and aqua-blue waters. For now, however, Ana Laura Ramírez Lavandero can only dream of the beach. Under lockdown, she finds herself confined to the fourth-floor apartment she shares with her parents and grandmother. On the balcony, she watches life through a rusted iron trellis. It can seem like a jail. “My life changed,” says the girl, who’s accustomed to playing on the streets of her working and middle-income neighborhood in Havana. The only time she’s been able to go out in nearly two months has been for an emergency trip to the dentist. Schools are closed, and because many people in Cuba don’t have internet, the education ministry is broadcasting lessons on state television. Ana Laura dreams of becoming a famous drummer. This was her first year at a highly selective institute for students identified early on as musically talented. She is continuing with classes in math, history and Spanish, but not music. Her children’s chorus also can’t meet right now. Usually, her own choir meets alongside another one, with boys and girls of all ages. “People feel united in the chorus,” she says wistfully. She can’t wait to see them again. —Andrea Rodríguez ___ SANWERIA BROTHERS, 8 AND 9, INDIA Advait Vallabh Sanweria, age 9, grins as his younger brother lists all the things they’ve been doing during India’s extended shutdown. “We get spanked, scolded, watch movies, cook, sweep floors and use the phone and make Skype calls,” Uddhav Pratap Sanweria, age 8, says in Hindi. At times the brothers are a bit of a comedy routine, or at least a danger to the furniture in their home. They’ve turned one room into a cricket pitch, with one brother bowling, or pitching, the ball, while the other bats. Other times, they play quieter games, such as chess or Uno. Excited at first about school shutting down indefinitely, the brothers missed being able to go outside. “It is frustrating to stay locked inside our homes,” Advait Vallabh, the 9-year-old says of the lockdown, which have since eased a little. “When I get frustrated, sometimes I read a book. Sometimes I cry.” Recently, the brothers were excited to see a rainbow arching across blue skies outside their home. “The weather has changed so much,” says Advait Vallabh, noting the visibly fresh air in New Delhi, as pollution in the otherwise choked city has cleared drastically during the lockdown. Even with the ups and downs, the brothers believe the lockdown should continue for a year. “They shouldn’t reopen until the time there are zero cases left,” the younger Uddhav Pratap says. —Rishi Lekhi and Rishabh Raj Jain ___ OWEN WATSON, 12, CANADA Dressed in a puffy parka made by his mom and with cellphone in hand, Owen Watson gives a tour of his town, Iqaluit, in the far-north Canadian territory of Nunavut. There’s still snow on the ground in May, though the days are getting longer in this place known for its spectacular views of the northern lights. “That light blue place is the school that I used to go to,” 12-year-old Owen says of the shuttered structure behind him. Then he turns to a playground. “It’s not supposed to be played with right now.” Surrounded by rivers, lakes and the ocean, filled with Arctic char, his dad, Aaron Watson, says the name of their town means “fishes” in Inuktitut, the language spoken by this region's Inuit people, which includes Owen and his mom and sister. Dad is originally from Stratford, Ontario, and works in the tourism industry in Nunavut. Under nationwide shutdown, Owen has kept busy with packets of work from his teachers. He rides his bike around the even-quieter-than-usual town – and tries not to worry too much. His dad observes how much Owen has been watching news about the coronavirus and wonders if they’re raising a future scientist. So far, there have been no documented cases of the coronavirus in the town of about 8,000 people, many of whom work for the federal government and the city. When flights are running, they can fly to the Canadian capital, Ottawa, in three hours. So young Owen thinks it’s only a matter of time before the virus arrives. “If it gets here,” he says, “I’ll be more afraid.” He waits and watches. The sun sets to the west, as clouds reflect soft shades of pink and purple. It’s a lot for a boy to think about. —Martha Irvine
  • Nevada Gov. Steve Sisolak announced Tuesday night that he would allow casinos to reopen June 4, welcoming tourists to return to the glitzy gambling mecca of Las Vegas. “We welcome the visitors from across the country to come here, to have a good time, no different than they did previously, but we're gonna be cautious,' Sisolak told reporters. The governor said he would also allow in-person religious services of up to 50 people starting Friday. As part of a broad shutdown to stop the spread of the coronavirus, Sisolak took the unprecedented step 10 weeks ago of shutting casinos that typically draw millions of tourists to Las Vegas and power the state's economy. By allowing the casinos to reopen, with new rules on social distancing and sanitizing, Sisolak said Nevada would again welcome visitors but would be prepared to close down again if there is a spike in cases. “We’ve taken every precaution possible. I don’t think you’re going to find a safer place to come than Las Vegas by June 4, with the protocols that we've put in place, than the testing that we've put in place, with the contact tracing that will be in place by that time,' Sisolak said. “We're encouraging visitors to come and enjoy themselves and have a good time.” The governor’s announcement came after he canceled a planned news conference because he may have been potentially exposed to the coronavirus last week. Sisolak said he learned earlier Tuesday that a workplace he visited last week has since had a worker test positive for COVID-19. The worker was not in the building at the time and the governor has shown no symptoms of the virus in the five days since his potential exposure, he said. Sisolak said he planned to take a test for the virus Wednesday morning and would release the results when he has them. The Democratic governor instead released a statement of his prepared remarks and held a phone call with reporters Tuesday night from the governor’s mansion in Carson City, where he says he is quarantining until he gets results. Along with the announcement on casinos and religious gatherings, the governor said he would allow gatherings of up to 50 people, while still asking people to wear masks in public and socially distance. Gyms, fitness studios, movie theaters, shopping malls and bars would be allowed to reopen May 29, but with restrictions. Brothels, night clubs and strip clubs must remain closed. The Trump administration this week warned Sisolak that the initial phases of his reopening plan failed to treat religious and secular gatherings equally. That phased-in reopening restricted the size of in-person worship services, while allowing restaurants and other secular establishments to reopen with less stringent occupancy restrictions, the head of the Justice Department’s civil rights said in a letter sent to the governor Monday. Assistant Attorney General Eric Dreiband last week sent a similar warning letter from the Justice Department alleging discriminatory treatment in California, where Gov. Gavin Newsom later released guidelines for resuming in-person religious services in his state. Last week, one of the nearly 200 churches that asked Sisolak in a May 14 letter to lift the ban on in-person worship services filed a lawsuit in federal court seeking a restraining order prohibiting the state from enforcing the ban. Lawyers for Calvary Chapel Dayton Valley in rural Lyon County east of Reno said the Christian church has patiently waited more than two months for Sisolak to restore its First Amendment freedoms. But “instead of prioritizing religious freedom, the governor has moved `non-essential’ secular businesses and activities to the front of the line and pushed churches towards the back,” the lawsuit said. The lawsuit highlighted what it characterized as a disparity of limitations imposed on churches while retail establishments were allowed to reopen at 50% capacity, restaurants were given the go-ahead for resuming on-site dining and permission was granted to 'open the doors of nail care salons, hair salons and barber shops.” “This is unconstitutional and makes no sense,” the lawsuit said. The letter to Sisolak came three days after President Donald Trump declared houses of worship essential during the pandemic and vowed to try to override governors who don't abide by his call to permit religious organizations to resume in-person services. Holding faith-based gatherings to a different standard runs the risk of infringing upon constitutional rights if the state fails to meet certain legal prerequisites, Dreiband warned Sisolak in his letter. He urged the governor to amend his treatment of religious organizations in his order. ___ Associated Press writers Ken Ritter in Las Vegas, Scott Sonner in Reno and Elana Schor in New York contributed to this report. ___ This story has been corrected to say the governor was expected to speak later Tuesday, not Monday.
  • The author of a federal report that found U.S. hospitals faced severe shortages of coronavirus test supplies says she is not intimidated by criticism from President Donald Trump, even after he moved to replace her as chief watchdog of the Department of Health and Human Services. Christi Grimm, who has served as acting inspector general since January, told a House panel that there was no “chilling effect” from Trump's criticism of her last month and his subsequent move to replace her. “We are plowing ahead” with 14 new reports and audits on the health department's response to the virus, Grimm said during a videoconference briefing Tuesday with the House Oversight Committee. Democratic Rep. Jackie Speier of California asked Grimm if she believes there was a “chilling effect' from Trump's criticism: 'If you say something or do something that is offensive to the president that you will be removed from office?” Grimm said no, adding: “I personally and professionally cannot let the idea of providing unpopular information drive decision-making in the work that we do.'' Congress can be assured that 14 pending reports and audits of health spending related to the virus outbreak will continue unfettered 'to protect people, to protect funds, to protect infrastructure and to ensure effectiveness,'' Grimm said. “We are operating as we did on May 1” when Trump nominated a new inspector general to replace Grimm. Jason Weida, an assistant U.S. attorney in Boston, must be confirmed by the Senate before assuming the position. Grimm remains in charge of the office as principal deputy inspector general while Weida's nomination is pending. With coronavirus cases skyrocketing, the inspector general’s office reported April 6 that a shortage of tests and long waits for results were at the root of mounting problems faced by hospitals. Trump called the report, based on a late March survey of 323 hospitals nationwide, 'just wrong” and suggested that its conclusions were skewed by politics. “Give me the name of the inspector general,” Trump told reporters. “Could politics be entered into that?” Trump later dismissed the report on Twitter as “Another Fake Dossier!” Democratic Rep. Carolyn Maloney of New York, who chairs the Oversight panel, said Tuesday that Grimm “should not have had to endure these senseless personal attacks just for doing her job.'' Maloney thanked Grimm for “tolerating” Trump's attacks 'with dignity while she continues serving the American people.'' Grimm, a career government manager who has served under four presidents, told lawmakers that as acting IG, she has long been aware that she can be replaced at any time and does not let that fact affect her work. “I do think independence is the cornerstone of what any office of inspector general does,'' Grimm said. 'That allows us to be impartial in the work we do ... letting the facts take us where they may.'' Grimm called the report 'a snapshot in time,'' but said it offered “quick and reliable data from the ground” to document the nation's response to the novel coronavirus, which has killed nearly 100,000 Americans. Grimm also pushed back on a theory advanced by some critics that hospitals may have intentionally reported inaccurate COVID-19 data in an effort to win more federal money or equipment. “I do not believe hospitals were being misleading in providing us with this information,” Grimm said. Investigators did not “independently go behind and verify” the hospitals' claims, she added. Ohio Rep. Jim Jordan, the panel's top Republican and a close Trump ally, lamented what he said was the report's “flawed methodology” and noted that investigators did not ask hospitals to specify actions the Trump administration had taken to help them respond to the crisis. Rep. Gerry Connolly, D-Va., asked Grimm to investigate the federal Centers for Disease Control and Prevention, saying the agency failed to develop coronavirus tests in a timely fashion, and then saw its early tests plagued by a series of problems and false results. “Clearly lives were lost because of that failure,'' Connolly said, adding that a report on the CDC should be “a primary focus” of the inspector general's work. Grimm said the office is reviewing CDC's role in approving, producing and distributing test kits. Her office also is looking at the Food and Drug Administration's role in approving the test, Grimm said.
  • An American couple waited a lifetime plus 2 ½ months to visit the ancient ruins of Pompeii together. Colleen and Marvin Hewson, retirees from Michigan, were first in line when the archaeological site reopened to the public Tuesday following Italy's coronavirus lockdown. Their long-delayed visit capped an unlikely adventure that had stranded them in modern Pompeii, a small tourist town, since early March. “We have been patiently waiting since then for the ruins to open,” Colleen Hewson said as the couple got the chance to stroll through the ruins of the Roman city destroyed in A.D. 79 by a volcanic eruption, trailed by journalists capturing another milestone in Italy’s reopening. “Here we are, we finally made it inside. It only took 2 ½ months,' Marvin Hewson added. For the Hewsons, seeing Pompei was meant to be the highlight of a trip celebrating his 75th birthday and their 30th wedding anniversary. Marvin Hewson, a history buff, had visited once while serving in the U.S. Navy in the 1960s and always vowed to get back; the trip was his wife's gift to him. The couple from Clinton Township, Michigan, which is near Detroit, arrived in Rome on March 5 for the vacation of a lifetime, her first time overseas. By the time they made it to the gates of Pompeii several days later, the popular tourist site was closed and Italy was under lockdown due to the coronavirus epidemic that broke out more than 700 kilometers (500 miles) to the north. Attempts to book flights out failed, and they resigned themselves to life under lockdown. Back in the United States, their four adult children relaxed when they realized their parents were far from the epicenter of Italy's virus outbreak and in good local hands. “We made a great connection with our Airbnb host family,” Colleen, 63, said. The host, Fabio Sposato, translated news for her and her husband, and helped keep them busy, tasking them with picking oranges and lemons from trees near the condominium where they stayed and teaching them to make limoncello. “It helped to pass the time,” Marvin said. Under lockdown, they fell into a routine, walking more than 7,000 steps a day, often to a grocery store near the archaeological site that allowed time to sit on a bench and gaze upon the ruins, “wishing we could be inside,” Colleen Hewson said. In all those weeks, “our Italian never got better,” she quipped, and they would use charades to communicate things they were looking for in the grocery store. The couple was leaving Pompeii on Tuesday for Rome, where they planned to spend a couple of days sightseeing before returning home to Michigan at long last. Since Italy’s restrictions on movement have eased, Sposato hosted the couple for dinner with his family and drove them to the Amalfi coast. “We took care of them as if they were our parents,” Sposato said. “We did what we could to make them comfortable respecting the restrictions that were in place.” The couple said they feel lucky to have been able to spend the lockdown in such a beautiful setting. From their condominium’s rooftop, the couple could see Mount Vesuvius to one side, and the island of Capri to the other. “We looked at real estate. It would be a dream,” Marvin said. “We saved a lot of money because all of the stores were closed. We really are thinking of coming back. ____ Colleen Barry reported from Soave. ___ Follow AP pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak
  • J.K. Rowling is publishing a new story called “The Ickabog,” which will be free to read online to help entertain children and families stuck at home during the coronavirus pandemic. The “Harry Potter” author said Tuesday she wrote the fairy tale for her children as a bedtime story over a decade ago. Set in an imaginary land, it is a stand-alone story “about truth and the abuse of power” for children from 7 to 9 years old and is unrelated to Rowling’s other books. Rowling said the draft of the story had stayed in her attic while she focused on writing books for adults. She said her children, now teenagers, were “touchingly enthusiastic” when she recently suggested retrieving the story and publishing it for free. “For the last few weeks I’ve been immersed in a fictional world I thought I’d never enter again. As I worked to finish the book, I started reading chapters nightly to the family again,” she said. “’The Ickabog’s first two readers told me what they remember from when they were tiny, and demanded the reinstatement of bits they’d particularly liked (I obeyed).” The first two chapters were posted online Tuesday, with daily instalments to follow until July 10. The book will be published in print later this year, and Rowling said she will pledge royalties from its sales to projects helping those particularly affected by the pandemic.
  • First came a high fever, drenching sweats and muscle aches. Then, almost a month later, a weird numbness that spread down the right side of her body. Darlene Gildersleeve thought she had recovered from COVID-19. Doctors said she just needed rest. And for several days, no one suspected her worsening symptoms were related — until a May 4 video call, when her physician heard her slurred speech and consulted a specialist. “You’ve had two strokes,’’ a neurologist told her at the hospital. The Hopkinton, New Hampshire, mother of three is only 43. Blood clots that can cause strokes, heart attacks and dangerous blockages in the legs and lungs are increasingly being found in COVID-19 patients, including some children. Even tiny clots that can damage tissue throughout the body have been seen in hospitalized patients and in autopsies, confounding doctors’ understanding of what was once considered mainly a respiratory infection. “I have to be humble and say I don’t know what’s going on there, but boy we need to find that out because unless you know what the pathogenic (disease-causing) mechanism is, it’s going to be tough to do intervention,” Dr. Anthony Fauci, the nation’s top infectious disease expert, remarked during a medical journal interview last month. Doctors and scientists at dozens of hospitals and universities around the globe are seeking answers while trying to measure virus patients’ risks for clots and testing drugs to treat or prevent them. Gildersleeve said health authorities “need to put out an urgent warning about strokes” and coronavirus. Not knowing the possible link “made me doubt myself” when symptoms appeared, she said. Some conditions that make some COVID-19 patients vulnerable to severe complications, including obesity and diabetes, can increase clot risks. But many authorities believe how the virus attacks and the way the body responds both play a role. “COVID-19 is the most thrombotic (clot-producing) disease we’ve ever seen in our lifetime,” said Dr. Alex Spyropoulos, a clot specialist and professor at Feinstein Institutes for Medical Research in Manhasset, New York. Clotting has been seen in other coronavirus infections, including SARS, but on a much smaller scale, he said. Scientists believe the coronavirus enters the body through enzyme-receptors found throughout the body, including in cells lining the inside of blood vessels. Some theorize that it may promote clotting by somehow injuring those vessels as it spreads. That injury may cause a severe immune response as the body tries to fight the infection, resulting in inflammation that may also damage vessels and promote clotting, said Dr. Valentin Fuster, director of Mount Sinai Heart hospital in New York. It's unclear how many COVID-19 patients develop clots. Studies from China, Europe and the United States suggest rates ranging from 3% to 70% of hospitalized COVID-19 patients; more rigorous research is needed to determine the true prevalence, the National Institutes of Health says. Prevalence in patients with mild disease is unknown and the agency says there isn’t enough evidence to recommend routine clot screening for all virus patients without clotting symptoms, which may include swelling, pain or reddish discoloring in an arm or leg. Some hospitals have found 40% of deaths in COVID-19 patients are from blood clots. Spyropoulos said that’s been true at his 23-hospital system in the New York City area, Northwell Health, which has treated over 11,000 COVID-19 patients. Cases there have dropped by almost half in the past month, allowing more time for research before an expected second and maybe third wave of infections, he said, adding: “We’re racing against time to answer the key clinical questions.” Patients hospitalized with any severe illness face increased risks for clots, partly from being bedridden and inactive. They commonly receive blood-thinning drugs for prevention. Some doctors are trying higher-than-usual doses for prevention in hospitalized coronavirus patients. A few have used powerful clot-busting medicines typically used to treat strokes, with mixed results. In guidance issued May 12, the NIH said more research is needed to show whether that approach has any benefits. Fuster was involved in preliminary research on nearly 2,800 COVID-19 patients at five hospitals in the Mount Sinai system. A look at their outcomes suggests slightly better survival chances for virus patients on ventilators who received blood thinners than among those who didn’t. Although the results are not conclusive, all COVID-19 patients at Mount Sinai receive blood thinners for clot prevention unless they are at risk for bleeding, a potential side effect, Fuster said. Some COVID-19 patients, like Gildersleeve, develop dangerous clots when their infections seem to have subsided, Spyropoulos said. Patients treated at Northwell for severe disease are sent home with a once-a-day blood thinner and a soon to be published study will detail their experiences. Spyropoulos has been a paid consultant to Janssen Pharmaceuticals, makers of Xarelto, the drug’s brand name. In addition, Northwell is taking part in a multi-center study that will test using blood thinners for clot prevention in COVID-19 patients not sick enough to require hospitalization. In a small study published May 15, University of Colorado doctors found that combined scores on two tests measuring clotting markers in the blood can help determine which patients will develop large dangerous clots. One test measures a protein fragment called D-dimer, a remnant of dissolved clots. High levels sometimes indicate dangerous clots that form deep in leg veins and travel to the lungs or other organs. Dr. Behnood Bikdeli of Columbia University’s Irving Medical Center, said D-dimer levels in many of his COVID-19 patients have been alarmingly high, as much as 50 times higher than normal. Concerns about blood clots in COVID-19 patients prompted a recent 30-page consensus statement from an international group of physicians and researchers. Bikdeli is the lead author. It says that testing to find clots that require treatment includes X-rays or ultrasound exams, but poses a risk for health care workers because the virus is so contagious. Bikdeli said he fears when protective gear was more scarce, some dangerous clots were undiagnosed and untreated. Social distancing may make people more sedentary and more vulnerable to clots, particularly older adults, so doctors should encourage activity or exercises that can be done in the home as a preventive measure, the statement says. Warnell Vega got that advice after collapsing at home April 19 from a large clot blocking a lung artery. Doctors at Mount Sinai Morningside think it was coronavirus-related. Vega, 33, a lunch maker for New York City school children, spent a week in intensive care on oxygen and blood thinners, which he's been told to continue taking for three months. “I just have to watch out for any bleeding, and have to be careful not to cut myself,” Vega said. Gildersleeve, the New Hampshire stroke patient, was also sent home with a blood thinner. She gets physical therapy to improve strength and balance. She still has some numbness and vision problems that mean driving is out, for now. Doctors are unable to predict when or whether she’ll regain all her abilities. ’’I’m trying to remain positive about recovering,” she said. ’’I just have to be patient and listen to my body and not push too hard.” ___ Follow AP Medical Writer Lindsey Tanner at @LindseyTanner. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
  • Many Medicare recipients could pay less for insulin under a deal President Donald Trump announced Tuesday in a pivot to pocketbook issues important in November's election. “I hope the seniors are going to remember it,” Trump said at a Rose Garden ceremony, joined by executives from insurance and drug companies, along with seniors and advocates for people with diabetes. The deal comes as Trump tries to woo older voters critical to his reelection prospects. Medicare recipients who pick a drug plan offering the new insulin benefit would pay a maximum of $35 a month starting next year, a savings estimated at $446 annually. Fluctuating cost-sharing amounts that are common now would be replaced by a manageable sum. The insulin benefit will be voluntary, so during open enrollment this fall Medicare recipients who are interested must make sure to pick an insurance plan that provides it. Most people with Medicare will have access to them. Administration officials are hoping the announcement will provide a respite from the grim drumbeat of coronavirus pandemic news. Stable copays for insulin are the result of an agreement shepherded by the administration between insulin manufacturers and major insurers, Medicare chief Seema Verma told The Associated Press. The three major suppliers, Eli Lilly, Novo Nordisk and Sanofi, were all involved. “It was a delicate negotiation,” Verma said. Drugmakers and insurers have been at odds in recent years, blaming one another for high prices. “I do think this is a big step.” The cost of insulin is one the biggest worries for consumers generally concerned about high prices for brand name drugs. Millions of people with diabetes use insulin to keep their blood sugars within normal ranges and stave off complications that can include heart disease, blindness, kidney failure and amputations. People with diabetes also suffer worse outcomes from COVID-19. An AP-NORC poll this month found warning signs for Trump with older voters. Fifty-four percent of adults 60 and older said they disapproved of how Trump is handling his job as president, while 45% approved. On Tuesday, Trump tried to suggest former President Barack Obama was responsible for high drug prices. And he took a dig at former Vice President Joe Biden, who's running to deny him a second term. “Sleepy Joe can't do this,” Trump said. The president last week told Republican senators at a Capitol Hill meeting he still wants to pass a bill this year to lower drug costs, saying “I think you have to do it,” according to a summary from an attendee. Bipartisan legislation to limit price increases and reduce costs for older people with high drug bills is pending in the Senate. But the fate of drug pricing legislation seems to rest with House Speaker Nancy Pelosi, who has a much more ambitious plan for Medicare to negotiate prices for the costliest drugs, not just insulin. Pelosi would use expected savings to provide vision, dental and hearing coverage for older adults. Most Republicans oppose that approach as an expansion of government price-setting. Although the White House and Pelosi's office were in conversations last year about prescription drug legislation, the relationship between the two leaders has been tense and angry for months. White House Counselor Kellyanne Conway told AP the administration can't wait for the Democratic-controlled House on drug prices. “Waiting for them to act is very perilous,” Conway said. Verma, head of the Centers for Medicare and Medicaid Services, said 1,750 insurance plans that offer drug coverage to Medicare recipients have agreed to provide insulin for a maximum copay of $35 a month next year. It will be available through “enhanced” plans that may cost more per month but offer additional benefits such as reduced cost-sharing on certain drugs. The cap on copays is expected to lead to a small increase in premiums. Importantly for patients, the new benefit would cover a range of insulin products, including pen and vial forms for rapid-acting, short-acting, intermediate-acting and long-acting versions. One out of three people with Medicare have diabetes, and more than 3 million use insulin. At list prices, the drug can cost more than $5,000 a year. Although insured patients don't pay that, they do notice rising copays that are based on the full cost. People who can't afford their insulin may try to cope by reducing their doses, a dangerous calculation that can put their lives in jeopardy. Medicare's prescription drug benefit is offered by private insurers, either as a stand-alone “Part D” drug plan added to traditional Medicare, or as part of a managed care plan under Medicare Advantage. The taxpayer-subsidized private plans are closely regulated by the government, but by law Medicare is barred from negotiating drug prices — something Democrats including Biden want to change. Insurers and drugmakers welcomed the announcement. The industry group America's Health Insurance Plans called it an “excellent example of public-private partnerships where everyone wins.” The Pharmaceutical Research and Manufacturers of America said it's pleased to see the administration focused on lowering out-of-pocket costs for patients. Medicare estimates that about 6 in 10 beneficiaries are already in prescription drug plans that will offer the new insulin benefit. Those whose plans don't offer the new option can switch during open enrollment season, which starts Oct. 15. Medicare's online plan finder will help beneficiaries find plans that cap insulin copays. The insulin benefit will be available in all 50 states, Washington, D.C., and Puerto Rico. Participation is voluntary for insurers and Medicare recipients alike. ___ Associated Press writer Hannah Fingerhut contributed to this report.