The coronavirus pandemic has completely changed our way of life, shut down entire countries and shuttered businesses across the globe. After an initial outbreak of disease in Wuhan, China, that began in December 2019, the novel virus has spread to over 180 countries, with the US and the European nations of Spain, Italy and France the worst hit. As scientists and researchers race toward a vaccine, governments are attempting to mitigate the economic damage with stimulus checks and tax cuts and contain further spread of the disease with social distancing measures and lockdowns.
Researchers linked the pathogen to a family of viruses known as coronaviruses in January. That family contains viruses responsible for previous outbreaks of the respiratory diseases SARS and MERS, as well as some cases of the common cold. On March 11, Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, announced the outbreak of the disease, dubbed COVID-19, would be declared a pandemic. It is the first time any coronavirus has been characterized as such.
The situation continues to evolve as more information becomes available. We've collated everything we know about the virus, what's next for researchers, what steps you can take to reduce your risk, how to deal with quarantines and lockdowns, and how governments are providing assistance such as stimulus checks.
Our coronavirus pandemic hub will show you the latest stories. Clicking on the titles below will take you to the relevant section of the guide:
- What is a coronavirus?
- What is COVID-19?
- What is a pandemic?
- Where did the virus come from?
- How many confirmed cases and deaths have been reported?
- What is the fatality rate of COVID-19?
- How do we know it's a new coronavirus?
- How is coronavirus spread?
- Why do people keep saying "flatten the curve"?
- Can I get coronavirus from a package?
- What are the symptoms of the coronavirus?
- How infectious is the coronavirus?
- Should you make your own hand sanitizer?
- Is there a treatment for the coronavirus?
- Can you take ibuprofen for coronavirus?
- Is there a vaccine for coronavirus?
- How to reduce your risk of the coronavirus
- Should I wear a face mask?
- What's been canceled by coronavirus?
- Life in lockdown: Guides for your coronavirus quarantine
- Coronavirus stimulus checks: CNET guides
What is a coronavirus?
Coronaviruses belong to a family known as "Coronaviridae," and under an electron microscope they look like spiked rings. They're named for these spikes, which form a halo or "crown" (corona is Latin for crown) around the viral body.
Coronaviruses contain a single strand of RNA (as opposed to DNA, which is double-stranded) within their viral body (or "viral envelope"). As a virus, they can't reproduce without getting inside living cells and hijacking the machinery within. The spikes on the viral envelope help coronaviruses bind to cells, and then get inside them as if jimmying their way through a locked door. Once inside, they turn the cell into a virus factory -- the RNA and a handful of enzymes use the cell's machinery to produce more viruses, which are then shipped out of the cell and infect other cells. Thus, the cycle starts anew.
Coronavirus in pictures: Scenes from around the worldSee all photos
Typically, these types of viruses are found in animals ranging from livestock and household pets to wildlife such as bats. Some are responsible for disease, like the common cold. If they make the jump to humans, they can cause fever, respiratory illness and inflammation in the lungs. In immunocompromised individuals, such as the elderly or those with HIV-AIDS, such viruses can cause severe respiratory illness, resulting in pneumonia and even death.
Extremely pathogenic coronaviruses were behind the diseases SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) over the last two decades. These viruses were easily transmitted from human to human but were suspected to have passed through different animal intermediaries: SARS was traced to civet cats and MERS to dromedary camels. SARS, which showed up in the early 2000s, infected more than 8,000 people and resulted in nearly 800 deaths. MERS, which appeared in the early 2010s, infected almost 2,500 people and led to more than 850 deaths.
You're going to be inundated with new terms and phrases you may never have heard before during this pandemic -- if you're finding yourself confused, head to CNET's guide on the most commonly used phrases.
What is COVID-19?
In the early days of the outbreak, the media, medical experts and health professionals were referring to "the coronavirus" as a catch-all term to discuss the outbreak of illness. But a coronavirus is a type of virus, rather than the virus or the disease it causes.
To alleviate the confusion and streamline reporting, the WHO has named the new disease COVID-19 (for coronavirus disease 2019). "Having a name matters to prevent the use of other names that can be inaccurate or stigmatizing," said WHO's Tedros. "It also gives us a standard format to use for any future coronavirus outbreaks."
The Coronavirus Study Group, part of the International Committee on Taxonomy of Viruses, was responsible for naming the novel coronavirus itself. The novel coronavirus -- the one that causes the disease -- is known as SARS-CoV-2. The group "formally recognizes this virus as a sister to severe acute respiratory syndrome coronaviruses (SARS-CoVs)," the species responsible for the SARS outbreak in 2002-2003.
In the simplest terms:
- The novel coronavirus is officially named SARS-CoV-2.
- The disease caused by SARS-CoV-2 is officially named COVID-19.
What is a pandemic?
On March 11, the WHO classified the COVID-19 outbreak a pandemic.
"Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death," said Tedros at a press briefing.
So what is it?
Both the CDC and the WHO have different definitions, and if you look in a dictionary, you may find something different again. In the simplest terms, a pandemic can be defined as "a worldwide outbreak of a new disease."
The "new" is key here, because many diseases persist in the population and spread each year. For example, influenza (the flu) infects a lot of people every year and can be found across the world. Unlike COVID-19, it's been circulating in the community for centuries and there's some natural immunity to it, plus we know so much about it we can protect ourselves against common strains.
What does this all mean? The COVID-19 virus itself didn't change. It hasn't become more dangerous and hasn't mutated to infect people more quickly. And the risk of being infected doesn't exponentially increase now that the word "pandemic" is being used. But it's a way to describe what's happening and more succinctly understand the urgency of the situation.
Read more: Coronavirus is a pandemic: What that means for you
Where did the virus come from?
The virus appears to have originated in Wuhan, a Chinese city about 650 miles south of Beijing that has a population of more than 11 million people. Prestigious medical journal The Lancet published an extensive summary of the clinical features of some of the first patients infected with the disease stretching back to Dec. 1, 2019.
The Huanan Seafood Wholesale Market, which sells fish, as well as a panoply of meat from other animals, including bats, snakes and pangolins, was implicated in the original spread in early January. However, the very first patient identified had not been exposed to the market, suggesting the virus may have originated elsewhere and been transported to the market, where it was able to thrive or jump into new hosts -- whether human or animal. Chinese authorities shut down the market on Jan. 1.
Live animal markets have been implicated in the origin and spread of viral diseases in past epidemics. A majority of the people confirmed to have come down with the coronavirus in the early days of the outbreak had been to the Huanan Seafood marketplace in previous weeks. The market appears to be an integral piece of the puzzle, but research into the likely origin and connecting a "patient zero" to the initial spread is ongoing.
A group of Chinese scientists uploaded a paper to preprint website biorXiv, having studied the viral genetic code and compared it to the previous SARS coronavirus and other bat coronaviruses. They discovered the genetic similarities run deep: The virus shares 80% of its genes with the previous SARS virus and 96% of its genes with bat coronaviruses. Importantly, the study also demonstrated the virus can get into and hijack cells the same way SARS did, using a human receptor known as ACE2.
A paper published in the journal Nature Medicine on March 17 assessed the genome of the virus in great detail, coming to similar conclusions to the preprint, categorically stating that it arose due to natural evolution. "Our analyses clearly show that SARS-CoV-2 is not a laboratory construct or a purposefully manipulated virus," wrote the collaboration of researchers from institutions across the US, UK and Australia.
The ant-eating pangolin, a small, scaly mammal, has also been implicated in the spread of SARS-CoV-2. According to The New York Times, it may be one of the most trafficked animals in the world. The virus likely originated in bats but may have been able to hide out in the pangolin, before spreading from that animal to humans. Researchers caution that the full data hasn't yet been published, but coronaviruses similar to SARS-CoV-2 have been found in pangolins before.
All good science builds off previous discoveries -- and there is still more to learn about the basic biology of SARS-CoV-2 before we have a good grasp of exactly which animal vector is responsible for transmission -- but the genetic sequence of the virus is a clue: It tells us the virus must have originated in bats and may have jumped through an intermediary to a human.
How many confirmed cases and deaths have been reported?
The virus has spread to over 180 countries since its discovery in late 2019, and the numbers of cases and deaths have been steadily rising since early January. A number of nations have seen exponential increases in cases, including the US, which has the most confirmed cases in the world. Over 2 million people had been infected by mid-April.
The best way to keep track of the spread of the virus across the globe is a handy online tool that's collating data from a number of sources including the CDC, the WHO and Chinese health professionals and is maintained by Johns Hopkins University.
The bulk of the confirmed cases and deaths have been recorded outside of China's Hubei province where the outbreak originated. Italy, Spain, France and the US have the highest recorded death tolls.
What is the fatality rate?
One of the most pressing questions is "how many people who get COVID-19 actually die from it?" -- and that's also a tough question to answer. Getting an accurate fatality rate is important for policy makers and health experts to control and counter outbreaks, but determining the rate is quite complex.
Early estimates from the WHO put the rate above 3% based on the number of deaths in comparison to the number of cases.
"Globally, about 3.4% of reported COVID-19 cases have died," said WHO director-general Tedros during a press conference on March 3. "By comparison, seasonal flu generally kills far fewer than 1% of those infected." However, experts are unconvinced, because limited testing across the world, along with the mild symptoms that many infected experience suggests there may be many people undiagnosed with COVID-19 and this would push the fatality rate lower. On the other hand, if deaths are underreported, perhaps 3% is conservative.
COVID-19 also seems to affect older generations much more severely. A great piece at STAT news breaks down the demographics of the disease and which groups seem particularly at risk.
The bottom line: When looking for how deadly COVID-19 might be, a single number like 3.4% doesn't tell the whole story -- it's much more complex than that. The fatality rate will change over time, but the elderly (older than 60) and those with underlying health conditions, like cardiovascular disease and diabetes, are at higher risk.
How do we know it's a new coronavirus?
The Chinese Center for Disease Control and Prevention dispatched a team of scientists to Wuhan to gather information about the new disease and to perform testing in patients, hoping to isolate the virus. Their work, published in the New England Journal of Medicine on Jan. 24, examined samples from three patients. Using an electron microscope, which can resolve images of cells and their internal structures, and studying the genetic code, the team visualized and genetically identified the novel coronavirus.
Understanding the genetic code helps researchers in two ways: It allows them to create tests that can identify the virus from patient samples, and it gives them potential insight into creating treatments or vaccines.
The Peter Doherty Institute in Melbourne, Australia, was able to identify and grow the virus in a lab from a patient sample, and announced its discovery on Jan. 28. This provides laboratories with the capability to both assess and provide expert information to health authorities and detect the virus in patients suspected of harboring the disease. It's also a valuable step in crafting a viable vaccine.
How does the coronavirus spread?
This is one of the major questions researchers struggled to answer in the early days of the outbreak but now seems pretty settled. The first infections were potentially the result of animal-to-human transmission, but confirmation of human-to-human transmission was obtained in late January. As the virus spread, local transmission was seen across the world.
The WHO says the virus can move from person to person via:
- Respiratory droplets -- when a person sneezes or coughs.
- Direct contact with infected individuals.
- Contact with contaminated surfaces and objects.
A handful of viruses, including MERS, can survive for periods in the air after being sneezed or coughed from an infected individual. Although recent reports suggest the novel coronavirus may be transmitted in this way, the Chinese Center for Disease Control and Prevention have reiterated there is no evidence for this. Writing in The Conversation on Feb. 14, virologists Ian Mackay and Katherine Arden explain "no infectious virus has been recovered from captured air samples."
Further research has shown SARS-CoV-2 may linger in the air for extended periods of time, which is particularly notable for health workers. It's estimated the virus can stay suspended in the air for a period of about 30 minutes. Social distancing measures become ever more important here because only those close to infected individuals are expected to be exposed to large quantities of the virus in the air.
Why do people keep saying 'flatten the curve'?
The idea of "flattening the curve" relates to the way governments and citizens can take measures to prevent a huge spike in confirmed coronavirus cases. We have a full explainer on flattening the curve and social distancing. The critical idea at the heart of the saying is to reduce the load on the health care system by taking a number of steps to limit interactions with other people. In doing so, we can stop the spread of COVID-19 and, hopefully, keep our hospitals from becoming overcrowded.
How long can the coronavirus survive on surfaces?
There's still a lot to learn about the hardiness of this particular virus, but similar members of the coronavirus family have been explored in detail, including the coronaviruses responsible for the SARS and MERS outbreaks. Particularly notable is an article published on Feb. 6 in The Journal of Hospital Infection, which looked at a host of previous studies (22 in total) and found coronaviruses may persist on surfaces for up to nine days.
A study in the New England Journal of Medicine on March 17 took a deeper look at how stable the SARS-CoV-2 virus is in the air and on surfaces. There's a chance the virus survives on cardboard for up to 24 hours, while on copper surfaces it seems to only survive for around 4 hours. On plastic and steel, it might survive up to three days.
A chief concern for the public has been whether package shipments could help spread the virus. Different materials can keep the virus alive for longer outside the body, but a range of factors needs to be taken into account when evaluating virus survival. The CDC is still investigating this but has come up with numbers for certain surfaces.
The CDC will continue to investigate but believes the risk of contracting coronavirus from packages is still low. The WHO notes it is "very unlikely" you would see the coronavirus persist after being moved, traveled and exposed to different conditions.
Best tip? Wash your hands after handling any packages if you're concerned (and just wash your hands, a lot, in general).
What are the symptoms?
The new coronavirus causes symptoms similar to those of previously identified disease-causing coronaviruses. In currently identified patients, there seems to be a spectrum of illness: A large number experience mild pneumonia-like symptoms, while others have a much more severe response.
On Jan. 24, the prestigious medical journal The Lancet published an extensive analysis of the clinical features of the disease.
According to the report, patients present with this symptoms:
- Fever, elevated body temperature
- Dry cough
- Fatigue or muscle pain
- Breathing difficulties
Less common symptoms include these:
- Coughing up mucus or blood
- Kidney failure
As the disease progresses, patients also develop pneumonia, which inflames the lungs and causes them to fill with fluid. This can be detected by an X-ray.
How infectious is the coronavirus?
The "r nought" (R0) value of the coronavirus is an indicator of how successfully it spreads from person to person. This metric helps determine the basic reproduction number of an infectious disease. In the simplest terms, the value relates to how many people can be infected by one person carrying the disease.
Infectious diseases such as measles have an R0 of 12 to 18, which is remarkably high. The SARS epidemic of 2002-2003 had an R0 of around 3. A handful of studies modeling the COVID-19 outbreak have given a similar value with a range between 1.4 and 3.8. However, there is plenty of variation between studies and models attempting to predict the R0 of novel coronavirus due to the constantly changing number of cases. It seems to have settled on a figure around 2.2, meaning every infected person infects 2 others.
It should be stressed these studies are informative, but they aren't definitive and because the virus spreads differently depending on location and the severity of lockdown/quarantine measures, it can vary by country.
"Some experts are saying it is the most infectious virus ever seen -- that is not correct," says Raina MacIntyre, a professor of global biosecurity at the University of New South Wales in Australia.
Another aspect impacting the spread of the disease is whether it spreads before symptoms are present or without showing symptoms at all. This appears to be true, but it's more likely you'll have mild symptoms. This complicates matters because it allows people to spread the disease without even knowing. This also makes airport screening less impactful, because harboring the disease but showing no signs could allow it to insidiously spread further.
How many cases are asymptomatic? It's still hard to tell. Various analyses have been undertaken in the past three months to try to establish a figure, with the number of asymptomatic cases ranging from 10% up to 50% of cases. This is why there's been a move to screen and test people who aren't showing symptoms -- they might be spreading the disease unknowingly, so identifying them would prevent continuous spread through the community.
Should you make your own hand sanitizer?
A panic surrounding the spread of the coronavirus has gripped consumers, and store shelves have been emptied. Shoppers have raced out to buy up whatever they can: toilet paper, acetaminophen (also know as paracetamol), pasta and, of course, hand sanitizer. As CNET Wellness editor Sarah Mitroff reports, most places in the US have sold out of the latter, as have many online stores.
That led to widespread reports about making your own hand sanitizer -- but experts warn that you risk making a sanitizer that either isn't effective or is way too harsh.
In CNET's guide to DIY hand sanitizer, we also rule out using hard liquor. Recipes that call for vodka or spirits should be avoided entirely, because you need a high-proof liquor to get the right concentration of alcohol by volume. That's because most liquor is mixed with water, so if you mix an 80-proof vodka (which is the standard proof) with aloe, you'll have hand sanitizer that contains roughly only 40% alcohol.
The alternative is to wash your hands. As the CDC and WHO continue to suggest, washing your hands with soap and water for around 20 seconds is one of the best ways to protect yourself from getting sick right now. You should also avoid touching your face if you can, as the virus can be transferred into the body if you've been in contact with someone who's infected.
Is there a treatment for the coronavirus?
Coronaviruses are hardy organisms. They're effective at hiding from the human immune system, and we haven't developed any reliable treatments or vaccines to eradicate them. In most cases, health officials attempt to deal with the symptoms.
"There is no recognized therapeutic against coronaviruses," said Mike Ryan, executive director of the WHO Health Emergencies Programme, during a press conference on Jan. 29. That still holds true at present. "The primary objective in an outbreak related to a coronavirus is to give adequate support of care to patients, particularly in terms of respiratory support and multiorgan support."
Notably, because they are viruses, coronaviruses are not susceptible to antibiotics. Antibiotics are medicines designed to fight bacteria and don't do any damage to the SARS-CoV-2 virus. There are no specific treatments for COVID-19 as yet, though a number are in the works including experimental antivirals, which can attack the virus, and existing drugs targeted at other viruses like HIV which have shown some promise.
Read more: Coronavirus treatments: Hydroxychloroquine, vaccines and drugs for COVID-19
Can you take ibuprofen for coronavirus?
Ibuprofen, an anti-inflammatory drug sold under various names such as Brufen, Nurofen and Advil, has been linked with adverse outcomes for patients with COVID-19. It's important to stress there are no studies to point to specifically looking at ibuprofen usage and adverse outcomes for COVID-19, but French health officials have questioned whether it's a safe way to treat the fever associated with the disease.
There have been conflicting messages from the World Health Organization, which appeared to suggest on March 17 to avoid ibuprofen and use paracetamol instead. A Twitter thread on March 18 clarified there are concerns with using the drug to treat fever in people with COVID-19, but the organization is "not aware of reports of any negative effects, beyond the usual ones that limit its use in certain populations"
Those populations include people over 65 years of age and those suffering from conditions such as asthma, high blood pressure and liver or kidney problems. An article in The Lancet on March 11 showed the expression of the ACE2 receptor on human cells -- which the coronavirus uses to get inside and replicate -- may be increased due to ibuprofen use.
Mixed messages and misinformation have been spreading online in regard to ibuprofen use so it's important to remember to check in with official health sources like the WHO. The BBC, speaking to British health experts, notes it's probably best to stick to paracetamol as a first choice.
Is there a vaccine for coronavirus?
Developing new vaccines takes time and they must be rigorously tested and confirmed safe via clinical trials before they can be routinely used in humans. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the US, has frequently stated that a vaccine is at least a year to 18 months away. Experts agree there's a ways to go yet.
However, there is great progress being made, and a number of vaccine candidates have appeared in the time since COVID-19 was discovered. We've collated everything we know about potential vaccines and current treatment options that are being used around the world.
In developing a vaccine that targets SARS-CoV-2, scientists are looking intensely at the spike proteins. These proteins, which are present on the surface of the virus, enable it to enter human cells where it can replicate and make copies of itself. Researchers have been able to map the projections in 3D, and research suggests they could be a viable antigen -- a fragment that stimulates the human body's immune system -- in any potential coronavirus vaccine.
The protein is prevalent in coronaviruses we've battled in the past, too -- including the one that caused the SARS outbreak in China in 2002-03. This has given researchers a head start on building vaccines against part of the spike protein and, using animal models, they have already demonstrated an immune response.
Notably, SARS, which infected around 8,000 people and killed around 800, seemed to run its course and then mostly disappear. It wasn't a vaccine that turned the tide on the disease but rather effective communication between nations and a range of tools that helped track the disease and its spread.
"We learnt that epidemics can be controlled without drugs or vaccines, using enhanced surveillance, case isolation, contact tracking, PPE and infection control measures," MacIntyre said.
Read more: Coronavirus treatments: Hydroxychloroquine, vaccines and drugs for COVID-19
How to reduce your risk of coronavirus
The WHO recommends a range of measures to protect yourself from contracting the disease, based on good hand hygiene and good respiratory hygiene -- in much the same way you'd reduce the risk of contracting the flu. The novel coronavirus does spread and infect humans slightly differently to the flu, but because it predominantly affects the respiratory tract, the protection measures are similar.
In early February, the US State Department issued a travel advisory with a blunt message: "Do Not Travel. Avoid all international travel due to the global impact of COVID-19." A similar warning from the US Centers for Disease Control and Prevention advises people to "avoid nonessential travel."
A Twitter thread, developed by the WHO, is below.
You may also be considering buying a face mask to protect yourself from contracting the virus. You're not alone -- stocks of face masks have been selling out across the world, with Amazon and Walmart.com experiencing shortages. Reporting from Sydney in January, I found lines at the pharmacy extending down the street.
Should I wear a face mask?
The face mask has become a symbol of this pandemic. You'll see them no matter where you go these days, but the scientific underpinnings of using a mask to prevent coronavirus infection has been shaky. Advice has been revised time and again and varies depending on your location -- so check with your local health authority as to how you should proceed.
Read more: Homemade face masks and coronavirus: Everything you should know today
That said, the US CDC in March revised its official guidelines for wearing a face covering in public settings. Due to a shortage of personal protective equipment across the country, some have even turned to making their own face masks -- what's the advice here? CNET's How To team has put together a complete guide on whether to wear a face mask or face covering and the exact recommendations that need to be followed.
Read more: Coronavirus face masks: Here's what to know about making cloth coverings at home
What's been canceled?
To maintain social distancing and help flatten the curve, practically every event that involves more than a handful of humans in one place at one time has been called off.
It started with Mobile World Congress in February but continued on to affect festivals like SXSW and Burning Man, trade shows like E3 and Gamescom and major sporting codes across the world including the EPL, F1, NBA, NFL and AFL. Even Tokyo Olympics have been postponed until 2021.
Movies and TV shows have also taken a hit, with many of the biggest releases for 2020 being postponed indefinitely or pushed back until later in the year.
Life in lockdown: Guides for your coronavirus quarantine
CNET's How To team has been hard at work collating resources for those of us under shelter-in-place orders. We have a huge number of guides that speak to exercising, cooking and what you should do if you're in lockdown.
We've included them below:
- How to prepare and stock up for a coronavirus quarantine
- When will the coronavirus quarantine end, where can you go in lockdown and stay at home order
- The best free stuff while you're stuck at home
- This is the gear you need to work from home (and it's in stock now)
- Where to buy household goods if Amazon, Costco, Walmart are out of stock
- Toilet paper running low? Make your own bidet starting at $20 -- yes, really
- Coronavirus tips: 14 practical ways to stay safe when you leave the house
- COVID-19: Everything you need to know to stay healthy and entertained while stuck at home
- K-12 online classes and activities to continue school at home during coronavirus
- Make-ahead freezer meals to cook now and eat later
- How to safely order food delivery, takeout and groceries during coronavirus quarantines
- 5 easy steps to growing fresh herbs at home while you're in quarantine
Coronavirus stimulus checks
We've been hard at work keeping on top of everything to do with stimulus checks. Here you'll find a number of articles that will help US citizens sort through whether they're eligible for government assistance, how to get it and when the checks might arrive.
These one-time stimulus payments are part of a $2 trillion 2020 coronavirus relief package intended to help you pay your expenses and spur the flagging economy, as people lose their jobs and businesses shutter as a result of the pandemic. Here's a list of our guides, to guide you through:
- How to track your coronavirus stimulus check now: How to get your status
- Direct deposit your coronavirus stimulus check: How to set up payment with the IRS
- Coronavirus stimulus checks going out for up to $1,200 now. Find out if you're eligible
- Coronavirus stimulus check: How to be smart about using your $1,200
How to stay informed
As the virus spreads, it's easy to get caught up in the fear and alarmism rampant across social media. There's misinformation and disinformation swirling about the effects of the disease, where it's spreading and how. Experts still caution that the virus appears to be mild, especially in comparison with infections by other viruses, such as influenza or measles, and has a markedly lower death rate than previous coronavirus outbreaks.
Read more: CNET fact checks the coronavirus rumors and myths
Sarah Mitroff, Leslie Katz, Carrie Mihalcik, Edward Moyer, Andrew Morse, Corinne Reichert contributed to this report.