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Trump wants to get back to the Oval Office. He may still be contagious.

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There’s a lot we still don’t know about President Trump’s Covid-19 case, starting with the basics: Is he having trouble breathing? Is he experiencing side effects, such as delirium or confusion, from the multiple experimental drugs for Covid-19 he’s taking? When was his last negative coronavirus test?

There’s another burning question about Trump’s health that matters more for the people around him, including his family members and staff at the White House who haven’t yet tested positive: Is the president still contagious?

Patients who have been diagnosed with Covid-19 are supposed to — per Centers of Disease Control and Prevention guidelines — isolate for at least 10 days since they first noticed they were sick or tested positive and since their symptoms have improved, including no fevers for at least 24 hours.

In cases like Trump’s that required hospitalization, that isolation period can last even longer. “For patients who had severe or critical illness, we wait up to 20 days to state they are noninfectious,” said Sigal Yawetz, an attending physician at Brigham and Women’s Hospital in Boston who has been caring for Covid-19 patients.

Doctors rely on clinical symptoms because there’s no clinically validated way to check if a patient is still contagious — even when the patient is the president.

But we don’t know exactly when Trump became symptomatic — one of the many basic facts about his case that’s been muddled by confusing reports. If we go by what his doctors and colleagues have suggested, he started experiencing symptoms on Thursday, a day before entering hospital.

That means Trump should probably still be isolating for at least four more days — or perhaps longer.

Instead, he rode in a car with others on day four of his symptoms, and on day five, took off his mask as he entered the White House. Now, the president reportedly wants to get back to working from the Oval Office — necessitating those around him to don N95 masks, gowns, and gloves.

Considering the White House’s colossal failure at basic coronavirus prevention measures — such as social distancing, mask-wearing, and contact tracing — it’s hard to imagine they’ll successfully turn the residence and Oval Office into a model of infection control. But if the White House wants to prevent more coronavirus cases, they’ll have to for this simple fact: Trump may still be contagious.

There’s no clinically validated way to test for Covid-19 contagion

The best research we have so far on Covid-19 transmissibility suggests that people can shed infectious virus for up to nine days after getting sick. In general, they are most contagious two days before symptom onset, and in the first five days after, as the graph in the tweet below, from this Oxford University Press study, shows.

But these are averages — and they hide a lot of the variability among patients. Some people are infectious for a shorter period, while others shed virus for up to 20 days after symptom onset.

That’s why doctors and public health officials ask patients to isolate for at least 10 days after their symptoms appear, or even longer in some cases.

As for Trump, “potentially he passed through that stage already,” said University of St. Andrew’s virologist Muge Cevik. It’s also possible the medications he’s on, including the antiviral remdesivir, brought down his viral load quickly. “But we don’t know exactly.”

That’s not just because we don’t know precisely when he became symptomatic. Doctors rely on the date of symptom onset, or the first positive test in cases where people don’t notice symptoms, because there’s actually no clinically validated way to prove that a person is no longer infectious. The diagnostics available to check for infection — PCR tests — “can’t distinguish between intact, infectious virus and degraded viral genetic material,” said Yawetz.

Doctors could use something called the CT, or cycle threshold, that’s part of the PCR test. It’s a measure of a person’s viral load, and if the number gets higher over time, the viral load in the sample is getting smaller. But the link between a person’s CT number and their transmissibility is still not fully understood, said University of Michigan infectious disease doctor Kevin Gregg.

“There are not completely established guidelines for [using CT values],” he added. So it’s not something doctors typically rely on to determine how long a patient should isolate.

“We don’t say, ‘it’s been 10 days you can take off your mask’”

There is one other, more advanced, way to check on a person’s contagiousness: cell culturing. That’s the technique scientists have used in many of the studies which informed the quarantine period. It involves infecting animal cells in Petri dishes with the SARS-CoV-2 virus, waiting for them to incubate, and seeing whether the virus can still grow in them.

One of Trump’s physicians, Jason Blaylock of Walter Reed National Military Medical Center, mentioned the president’s medical team was working with “various laboratories in the area, state of the art facilities … on obtaining advanced diagnostic testing to really inform the White House medical team of both the status of the president as well as his ability to transmit virus to others.”

He didn’t specify, but perhaps cell culturing was what he was referring to. Yet even that isn’t foolproof for use in patients. “There is a big difference between the virus being culturable in a Petri dish full of cells derived from a monkey’s kidney and being capable of infecting the respiratory epithelium of living people,” said Yawetz. “This test has absolutely not been validated for ruling out SARS-CoV-2 infectiousness in people.”

What’s more: it takes several days to grow the virus and get a reliable result. “So I don’t think they’d have that information yet,” said Gregg.

“[Trump] should be isolating,” he added, “so as not to infect members of his family, the staff of the White House and other people.”

Even after isolation, patients are still advised to wear a face mask. “If someone had Covid, after the contagious period is over, it doesn’t mean you go out and do things as usual,” said Preeti Malani, an editor at JAMA and infectious disease doctor who treats Covid-19 patients. “We don’t say — ‘it’s been 10 days you can take off your mask.’ We continue to treat people as if they might be infectious because the truth is we don’t know.”

Instead of mask-wearing, the White House has relied heavily on testing to prevent outbreaks. “Many White House officials have been feeling comfortable after receiving a negative test,” Cevik said, “but maybe they don’t necessarily understand or haven’t been told the negative test doesn’t give you 100 percent clearance.”

This means anyone who encountered Trump, who wasn’t wearing full personal protective equipment while Trump is infectious, could now be carrying the virus. According to guidelines, those people should be quarantining for 14 days, too — even if they test negative.

If the White House wants to prevent more coronavirus infections, they’ll have to change course. “Testing on its own is not going to prevent onward transmission,” Cevik said. But isolating — in addition to masks, contact tracing, social distancing, and testing — can.


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Luis Arce presumed winner of Bolivia presidential election

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Jubilation and disappointment took over the streets of Bolivia on Monday, after unofficial counts showed Evo Morales’s party sweeping the country’s presidential election without the need for a second round of voting.

After 11 months of political turmoil that bitterly divided the nation, two independent surveys late on Sunday showed Luis Arce, the candidate for Morales’s Movement Towards Socialism (MAS) party, with more than 50 percent of the vote – well above the second place centrist rival Carlos Mesa, who had slightly over 30 percent, and far more than the requirements to avoid a runoff.

“The result is overwhelming and clear,” Mesa said in a concession speech on Monday. “The difference is wide.”

“It is up to us, those who believe in democracy, to recognise the result,” he said.

Carlos Mesa ahead of a news conference during which he conceded in La Paz, Bolivia [Manuel Claure/Reuters]

On Monday the official count had reached nearly 23 percent of votes cast, with official results expected in several days, but candidates said that given the wide winning margin, the final count is unlikely to show a meaningful difference.

Observers said the results showed a clear rejection of the right-wing policies of the interim government of Jeanine Anez, a conservative senator who took office after Morales was ousted from power a year ago. Late on Sunday, Anez conceded and congratulated the winners.

“We still have no official count, but according to the data we have, Mr [Luis] Arce and Mr [David] Choquehuanca [his running mate] have won the election,” Anez wrote in a tweet late on Sunday.

“I congratulate the winners and I ask them to govern with Bolivia and democracy in mind.”

Arce, meanwhile, called for calm in the polarised nation, and vowed to form a government of national unity.

“We have recovered democracy and hope,” Arce said in a speech early on Monday. “We are going to govern for all Bolivians and construct a government of national unity,” he said.

Presidential candidate Luis Arce of the Movement Towards Socialism (MAS) party speaking during a press conference in La Paz, Bolivia [Ueslei Marcelino/Reuters]

Punishment vote

Analysts say the election outcome is chastening for the country’s right wing, and will likely boost the image of Morales, whose shadow still looms large over the country, despite him living in exile in Argentina since his narrow win in last year’s election was annulled amid bloody protests and allegations of fraud.

Morales and his supporters say he was the victim of an orchestrated coup.

“This was a punishment vote,” said Raul Penaranda, a journalist and political analyst based in La Paz.

“Those who abandoned the MAS last year were thinking ‘if this is the alternative, then no, we prefer what we had before,’” Penaranda said.

Morales, Bolivia’s first indigenous leader, was an iconic, popular figure during his 14 years as president. But he angered many Bolivians after insisting on running for a fourth term in office, in defiance of a referendum against extending term limits. His administration was also marred by allegations of corruption and overreach of power.

Anez, who declared herself interim president promising swift new elections, sought to consolidate her grip on power and announced her own bid for the presidency, after initially saying she did not plan to run.

Jeanine Anez voting at a polling station in Beni, Bolivia [Courtesy of Bolivian Presidency/Handout via Reuters]

She brought trumped-up terrorism charges against Morales, and clamped down on MAS officials and supporters – prompting allegations of human rights violations by rights groups, and further fuelling polarisation in the country.

Her administration has also been accused of corruption and mismanagement of the COVID-19 pandemic – a disease that has killed at least 8,481 people in Bolivia.

She dropped out of the race last month.

“The government has been very repressive, and for a lot of people there is now a sense of relief,” said Thomas Becker, a human rights attorney with the University Network for Human Rights, who was part of a group of academic observers who travelled to Bolivia.

“The MAS overwhelmingly won, but a lot of it was not necessarily a vote for a candidate but a vote against racism, repression and violence,” Becker told Al Jazeera from La Paz.

A member of the jury shows a marked ballot during vote counting at a school during the presidential election in La Paz, Bolivia [Manuel Claure/Reuters]

Sunday’s vote marks an important turning point for Bolivia, instilling a renewed faith in democracy in the South American nation, said Jorge Derpic, assistant professor in sociology, Latin American and Caribbean studies at the University of Georgia.

“This victory shows even in conditions of disadvantage for the MAS, for the majority of people who were clearly against this government, there is a possibility to produce change through the ballot,” Derpic told Al Jazeera.

“This is a return to the path of democracy, of respect for democratic results, this is something to celebrate in general,” he said.

People lining up to cast their votes at a polling station during the presidential election, in Cohoni, Bolivia [Wara Vargas/Reuters]

Strong, important leader

In a news conference in Argentina, Morales said the new government would “return our country on the path of economic, political and social development”.

Arce, who served as economics minister under Morales for more than a decade, oversaw policies that led to a surge in growth and a sharp reduction in poverty. Now, amid a pandemic that twice delayed the election, he is likely to face an uphill battle trying to reignite that growth.

The World Bank forecasts that Bolivia’s economy, largely led by farming and gas, will contract by about six percent this year.

“Economic recovery is going to be fairly slow,” said Eduardo Gamarra, professor of political science at Florida International University.

“Bolivia has a stagnant economy and exports are flat,” Gamarra said, adding that the country may turn to exporting its lithium deposits, which will take time.

Former Bolivian President Evo Morales speaking at a news conference, a day after Bolivians voted in the presidential election, in Buenos Aires, Argentina [Agustin Marcarian/Reuters]

During the news conference in Argentina, Morales said that he intends to return to Bolivia, “sooner or later” and that the charges against him were “part of a dirty war”.

“It’s a matter of time. My great wish is to return to Bolivia,” Morales said, noting that his intention is to settle in his home city of Cochabamba to become a “farmer and small producer”.

The result could further deepen divisions within Bolivian society, which cut along lines of race and class, Penaranda said. Morales is a polarising figure. Those who were hoping the MAS would be soundly defeated in this election are saddened and shocked by the results, while those who were hoping the MAS would return, are jubilant and relieved, Penaranda explained.

The results give MAS majority control in the Senate, as well as in the Chamber of Deputies – ample power to govern and pass legislation.

“We have to recognise the figure of Evo Morales as a very important leader of our recent history, and he will remain so,” Penaranda said, “and although his popularity suffered a bit during his third term in office, he continues to remain strong and he is a motor of the MAS, clearly.”

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The US is plagued by long voting lines. Here’s how other countries do it better.

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As voters from Ohio to North Carolina to Georgia wait in long lines for hours to cast their early vote for president, onlookers abroad were left scratching their heads. That’s because in most other advanced democracies, long lines like these just don’t happen.

Canadians said they spent more time standing at bus stops than they do standing in line to vote, while Australians noted lines for their voting-day “democracy sausage” are longer than for the ballot box.

America’s long lines aren’t necessarily a surprise. Increased enthusiasm to vote early, especially among Democrats who want President Donald Trump removed from office, have swollen queues. Enhanced safety and cleaning protocols due to the pandemic, mixed with fewer and less-experienced poll workers, have caused delays. And voter suppression, from a dearth of official voting sites to dried-up resources in districts with large minority populations, has made it harder to cast a ballot this year.

Still, the multi-hour wait times show the US has a lot of work to do to make it easier for Americans to vote. In 2014, a presidential commission said no one should have to stand in line for more than half an hour, stating that “any wait time that exceeds this half-hour standard is an indication that something is amiss and that corrective measures should be deployed.”

Some of those measures could come from abroad, experts say. Countries like Canada and France have national voting standards that take voting-day decisions away from local partisans. Australia allows citizens to vote at any polling station in their area, not just one designated site. And Estonia, believe it or not, votes entirely online.

Adopting some of these practices might shorten voting lines in America and make it easier for everyone to cast a ballot, said David Daley of the pro-reform advocacy group FairVote. But the problem, he said, is that “we have been unwilling to look around the world to see who does it more efficiently and more fairly than we do.”

Here are some ways other countries handle their national elections, and what the US could learn from them.

Have national election standards like Canada

The suggestion I heard most often from experts is that the US should have one single set of rules for how to administer elections in every state and territory.

“The US is unique in how decentralized our system is,” Ashley Quarcoo, a senior fellow at the Carnegie Endowment for International Peace in Washington, DC, told me. “We have approximately 10,500 jurisdictions administering elections. This is not necessarily a bad thing, but it does create challenges for ensuring electoral consistency, even service delivery, and a consistent — and ideally positive — experience for voters across the country.”

What’s more, local rules make it possible for the secretary of state — not the nation’s top diplomat, but a state’s lead official for voting — to stand for office while running the election. That’s led to controversies in Georgia and Kansas, with allegations swirling that both secretaries abused their power while simultaneously standing for another office.

In other words, the current American system increases the chances of corruption and a poorly run election. Having a federalized system — one where voting rules are the same across the country — could help fix that.

The US could look just over its northern border to Canada for inspiration. The country has a federal election system, which means that the voting process is the same from Halifax to Vancouver and difficulties are minimized (though there are still some related to voter ID).

One major reason it works so well is that Elections Canada, the government agency tasked with running national elections, is a nonpartisan, independent body. It can do its work without being tainted by partisan political concerns. The agency “is responsible for ensuring that election officers are politically neutral and non-partisan in all aspects of their work,” according to its website.

However, some experts are skeptical the US could have such an agency.

Staffan Darnolf, senior global adviser at the International Foundation for Electoral Systems, said central election authorities usually work well in countries that have them, but few nations have as divided a system as America’s. Instead, he proposes that each state’s most senior election administrator be a non-partisan election-administration professional.

“That’s a reform that could have a positive impact,” he told me.

Increase polling station options like Australia

In the US, a voter is typically required to cast their ballot at a specific location on Election Day. That’s not the case in Australia.

“You can vote at any polling place in your state or territory on election day,” reads the Australian Electoral Commission’s website. “Polling places are usually located at local schools, churches and community halls, or public buildings.”

And in case someone is traveling on Election Day, that person has another option at their disposal. “If on election day you are outside the state or territory where you are enrolled, you will need to vote at an interstate voting centre,” the website adds.

Put together, Australia makes it really, really easy for someone to vote by increasing the number of places they can stand in line to cast a ballot — which is a good thing since Australians are fined if they don’t vote.

Adopting this idea would make a lot of sense for the US as it would give voters the option to go elsewhere if they see a line getting too long. It also gives voters the flexibility to travel inside the country on Election Day without having to worry about being home to vote at their designated polling place (though they could alternately vote by mail).

But where Australia makes more polling sites available to voters, the US does the opposite. Last year, southern states closed around 1,200 polling sites; this year, Texas shuttered several official ballot drop-off locations.

Before America can have a conversation about providing more options to voters, it needs to first create more polling stations, period.

Vote online like in Estonia

One of the most controversial reform ideas comes from Estonia, the small Baltic nation where citizens have been able to vote for their political leaders online since 2005.

“I-voting is possible around the clock during the days of advance voting, from the 10th until the 4th day before the election day,” the country’s electoral agency says on its website, though it notes online voting isn’t allowed on Election Day.

About 64 percent of eligible voters cast their ballots online for parliamentary elections in 2011, 2015, and 2019, which means the actual in-person lines to vote on Election Day are shortened. If nearly three in five voters in America could vote for their preferred candidate from their own computers at home or work, the multi-hour waits we see now at the polls would practically vanish.

The challenge, though, is ensuring the safety and integrity of the vote. “Online voting is just a horrible, horrible idea in the United States,” said Jason Healey, a cybersecurity expert at Columbia University. “Estonia can get away with it because they’re so small and use their digital IDs for almost literally everything, so voting is just one, rare use.”

Indeed, the digital ID every Estonian has allows them to travel within the European Union, serves as a health insurance card, gives them access to their bank accounts, and much more. It’s a highly advanced, encrypted system the country works tirelessly to perfect and secure. That’s a hard thing to do, but it’s made easier when the nation’s population is only 1.3 million people.

Meanwhile, America’s population is over 250 times as big, and it’s nowhere close to having such an integrated digital system to prove everyone’s identity across nearly every facet of someone’s life. The US could invest in such a system, but it would require political will, tons of money, and time.

It doesn’t look like the US will fully go in that direction, though. It’s already dealing with election interference from the Russias and Chinas of the world, and top political leaders including Democratic vice presidential candidate Kamala Harris still tout the benefits of paper ballots over digital ones.

But if the US could find a way to make online voting secure and reliable, it could prove the greatest game changer of all.


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How to Turn Your Bedroom Back Into a Sex Zone if You’re Working From Home

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How to Turn Your Bedroom Back Into a Sex Zone if You're Working From Home

Photo by Cavan Images via Getty Images

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It’s not a set of rules—it’s a state of mind.

Whether your bedroom is your own meticulously decorated oasis or just somewhere you sleep, you might be spending a lot of extra time in it if you’re suddenly working from home, living with a partner, or living with a partner who also works from home. 

There’s nothing wrong with using your bedroom as a cozy, multipurpose eat/sleep/work area, but setting up your home office (the pile of pillows propping you up in bed) in the same place where you hope to have sex later isn’t always ideal when it comes to actually having sex later

After a long day of staring at a screen in bed or at a cluttered desk just a few feet away, switching to bone mode might not be easy. (And that’s OK! There’s a deadly pandemic going on outside, and sometimes you just need a nap.) If you do want your bedroom to also feel like a sex zone, you don’t have to resign yourself to a life of brushing crumbs of the bed before you bang (or, not all of the time, at least). Changing your mindset doesn’t require a total furniture/life overhaul, and you probably don’t have much space to install a stripper pole or a sex swing anyway. With a little planning, your bedroom will be ready to go when you are, whether you’re on your own or with someone else.  


Good lighting goes a long way, so try something softer and more natural after work.

“The first thing you should look at whenever you’re turning a space into a sexy getaway is the lighting,” said sexologist Megan Stubbs. “Consider [using] side lamps that cast softer light and shadows.” Warmer, more natural light feels more intimate, and it can also be relaxing, especially if you work in a bright room all day or usually use overhead switch lights. Turn down your dimmer switch if you have one, or drape a sheer scarf or shirt over a lamp.

As Gigi Engle, a sex coach and sexologist, said, “After staring at screens all day, the softer the lighting, the calmer you’ll be.” Engle also recommended just using candles rather than lamps, which can also add a nicer scent. No need to go full _Phantom of the Opera_—just one or two candles will do, and when you’re done, they can go in your nightstand drawer (which might help you associate them even more with sex). 

Set certain times to put away your laptop and other work stuff. 

Stow away your laptops, cords, electronics, or any work materials when you’re not using them, even if that just means tucking them under your bed for a while. “Make the space feel like a place for sex and sleep, not work and stress,” said Engle. “If possible, try to leave screens outside of the bedroom. I know this is easier said than done, but it can make a big difference in overall mood.

“Before the pandemic, I never worked in my room, so this has been a huge transition for me,” said Alison Stevenson, a writer in Los Angeles and co-creator of Thick Strip, a body-positive strip show. On performance nights, Stevenson transforms her bedroom from work space to virtual strip club. “I invested in a foldable desk that has been a huge benefit. What’s great about the desk being foldable is that at night I can put it away and my room instantly feels like just my room, with no office elements.” Try creating a designated space for your work stuff, or if you need extra storage, make it something you actually enjoy looking at. “I have a small dresser type thing reserved just for my ‘office’ supplies, but from the outside, it just looks like a vintage dresser,” Stevenson said.

Minimize clutter to help you feel less distracted in the moment—and free up more areas of the room.

“You never know what kind of ocular distress that pile of need-to-hang laundry in the corner might cause when you’re trying to get it on,” said Stubbs. “Tidy up the space so that the only things on your mind are you and your partner.” She also said that having a partner over is far from the only reason to straighten up before getting into it: A clean and comfortable space is just as important for solo time.

Once you minimize the clutter, you’ll also have more space to move around the room without getting grossed out or out of the moment, which can be useful for switching up your location. “You don’t have to always do it on the bed,” Stevenson said. “Lately, I’ve had a few sessions in front of my full-length mirror.” Consider what else yours might reflect, and whether you’ll care about that.

Stock sex essentials somewhere easy to reach.

In the name of less effort and disruption in terms of The Vibe, get your nightstand drawers in order and stock them with the things you typically like or need to have on hand during sex. Having to stop and dig around for batteries or discovering you’re out of protection can really take you out of the moment and back into the more humdrum aspects of life.

Within this, make sure you have your lube, condoms, or any other gear within easy reach. “I have a box with a variety of toys,” Stevenson said. “I make sure to have them charged, and I highly recommend having all those wires and plugs organized for easier access.”  Keeping baby wipes, tissues, or a towel in your sex drawer, shelf, or box near the bed are also essential for post-sex cleanup, or for putting down a surface layer beforehand if you think things might get messy.

Change little details, like bedding or music, to switch up the mood of the room.

Particularly if the bed is your work station by day, try changing up the sheets or bedding when you clock out. This can help differentiate between work time and sex time. “I have pink satin sheets and black satin sheets, both from Ross and under $20,” Stevenson said. “They’re soft, sexy, and a little tacky, which is just how I like it.”  

“The important thing is to pick colors that make YOU feel calm and sexy,” Engle said. And texture is key: No matter what they look like, make sure you choose fabrics that turn you on and feel good against your skin. 

You really don’t have to buy anything if you don’t want to, though. Make a go-to playlist of your favorite music that works well for hooking up—something you can put on shuffle and not worry about—for a non-visual way of instantly cueing up a different atmosphere, too.

However you use it, your sex-ready bedroom space should feel relaxed, relatively organized,  and well-stocked with the stuff that helps you get off. Just make sure you put it all away before your next video call with your boss.

Follow Sofia Barrett-Ibarría on Twitter.

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