The Brief

In a sparse multi-purpose room, a handful of middle-aged Chinese American women have rolled out black yoga mats and are studying the moves of a qigong instructor gently giving instructions.

Inhale. Gather. Exhale. 

Qigong — a mind-body-spirit practice using simple, repetitive exercises — is being offered at a new center in Monterey Park with a grimly-specific mission: tending to survivors and community members after the deadliest shooting in L.A. County history took place in their city.

The Monterey Park Resiliency Center offers mindfulness and stress-relief activities like qi gong.

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Stretch through your wrists, and relax. 

Less than a mile from where the women focus on breath work, a gunman entered the Star Dance Ballroom Studio on Jan. 21 and fired on a crowd of mostly older Asian Americans celebrating the start of Lunar New Year. Eleven people died and nine others were injured.

Up until the shooting, Monterey Park was best-known for being America’s first suburban Chinatown, with a population of 62,000 that is two-thirds Asian.

Now it’s on a long list of places reeling from mass gun violence — and part of a smaller but growing network of cities that are opening federally-funded “resiliency centers” to help with recovery.

Triage, then healing 

Mass shootings are not only increasingly commonplace in the U.S. — 550 so far this year — they've grown in lethality over the past decade. Shootings in which four or more people are killed have nearly doubled.

Typically after the deadliest incidents, a crisis response team from the FBI parachutes into a community to set up a family assistance center, drawing help from local nonprofits with community ties. That was particularly key in Monterey Park with its large immigrant population. The lead nonprofit on the ground was the Chinatown Service Center, which typically provides medical and behavioral health services, but found itself helping victims’ families with burial services.

“That's really important to be able to speak the language and to understand how communities respond culturally when events like this happen,” said Kristina Rose, who heads the Office for Victims of Crime in the Department of Justice.

More and more communities have been transitioning their family assistance centers into long-term operations. Over the last decade, the Department of Justice has met the demand by awarding millions of dollars in grants to about 20 communities that want to provide ongoing legal aid, victim's advocacy and mental health counseling to survivors.

Over the last two years, resiliency centers have opened in Uvalde, Texas and Buffalo, New York. A few years earlier, a resiliency center opened in Las Vegas after the nation’s deadliest mass shooting.

An investigator works at the scene of a mass shooting in Monterey Park, California, on Jan. 22, 2023.

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When it became evident there was support for a resiliency center in Monterey Park, the Chinatown Service Center was a clear choice to operate the center, said Rose, whose office is currently working on the grant process with the nonprofit.

The MPK Hope Resiliency Center, as it is officially called, has been averaging about 80 visits a week since it fully opened in September. It’s a number that staff want to increase, given the hundreds of people they could be potentially serving along with partner organizations such as Asian Americans Advancing Justice Southern California and the L.A. County District Attorney’s Office.

Bringing mental health awareness

Notice how you feel, anything starting to open up. 

The qigong instructor, Dr. Sara Ptasnik is a physician at the Chinatown Service Center. She doesn’t speak Mandarin or Cantonese like her students, so the center’s case management coordinator, Janet Yu, interprets the best she can, toggling between both languages.

Offering in-language help is a priority at the Monterey Park center, but cultural competency extends beyond translating materials, according to its director Nina Loc.

“When it comes to the Asian population, it's more of the lack of awareness, lack of willingness to accept that there could be mental health issue within a family or within the culture,” said Loc who also serves as the behavioral health director at Chinatown Service Center.

The center's case management coordinator Janet Yu provides live interpreting as Dr. Sara Ptasnik teaches a qi gong class.

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Loc said the inclination for many in the community is to not seek out counseling, which research bears out. A 2018 study by the federal Office of Minority Health found Asians were 60% less likely to have received mental health treatment than white people.

The Monterey Park center offers both individual and group therapy with the understanding that it’s not for everyone, especially an older, foreign-born generation.

That’s why there’s so much emphasis on offering stress-reduction activities such as yoga, Buddhist chanting, beading, cooking or journaling.

“We have heard a lot of individuals that don't feel comfortable going out,” Loc said. “These are signs that they're affected by [the shooting]. Hopefully coming through to the center, they could learn coping skills to be more comfortable with the new norm.”

And, Loc added, they may become more receptive to trying therapy in the future.

Open “essentially forever”

The Monterey Park resiliency center is temporarily being housed inside the Sierra Vista Community Center.

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For some survivors, it may take months, if not years, to recognize they need help.

That’s the experience of staff at the resiliency center in Las Vegas. In 2017, a gunman killed 58 people and injured hundreds at a country music festival on the Las Vegas Strip. Years later, two more people died from shooting-related injuries.

Tyler Winkler, a victim right’s attorney at the center, said the five-year anniversary of the shooting last year served as a prompt for some survivors.

“That brought in a lot of folks who were like, ‘Wow, I think maybe I'm ready to see what you guys have going on,'” Winkler said.

Winkler said survivors’ trauma can stay buried for years — until it doesn’t.

A man writes a note on a 'Vegas Strong' banner on the Las Vegas Strip, after a gunman in 2017 killed 60 people at a country music festival.

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“They know lots of people were really affected by it but they don’t see it in themselves,” Winkler said. “Maybe they start noticing, ‘I’m snapping at my family more or I’m drinking more. I feel numb.'”

The center has worked with more than 10,000 people so far — survivors, first responders, their families — but estimates there are still many other people experiencing trauma who haven’t used their services. Winkler said that’s why the Vegas center is staying open for “essentially forever” — to be there for those people who need more time.

When the federal grant ended after four years, the Nevada state and Clark County government ponied up funding to keep the center open, and to extend services to other crime victims who were not part of the shooting, Winkler said.

Still, other centers have determined they've outlived their purpose and have wound down like the one in Newtown, Conn. Many of the child survivors of the 2014 Sandy Hook Elementary School shooting are now graduating high school, its executive director noted.

When the world doesn’t feel safe 

Kung fu master Benson Lee spars with an assistant during a self-defense course at the Monterey Park resiliency center.

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For the staff at the center in Monterey Park, staying open long-term is the goal.

The center is being run out of several rooms provided by the city at the Sierra Vista Community Center. But staff are hoping to lease a larger, permanent home to accommodate newcomers such as Maria Liang, the former owner of the Star Ballroom Dance Studio.

Liang, an avid dancer herself, wasn’t there the night of the shooting. But her brother was overseeing the Lunar New Year event at the studio, where he was injured, along with close friends and patrons she’d known for years.

“Some died and some were injured and now I decide that I close my business,” Liang said.

Liang visited the center this month to take a class for the first time. She followed the self-defense moves of kung fu instructor Benson Lee with ease. “It’s like dancing,” she explained.

Benson Lee, a kung fu master, teaches self-defense moves to Maria Liang, the former owner of the Star Dance Ballroom Studio at the Monterey Park Resiliency Center.

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Liang, switching to Mandarin, said she tried the class because the world doesn’t feel safe and she wanted to learn better awareness and ways to protect herself.

She plans to return; another class has piqued her interest. Qigong, she said brightly, is good for your body.

A place of their own

Liang had been handed a calendar of activities the night before when she attended a private event for survivors held at the community center.

Hung in the lobby were blue paper hearts honoring the shooting victims. They had been displayed outside Monterey Park City Hall on signposts for months before being moved to their permanent home with the center.

The lobby of the Sierra Vista Community Center is hung with blue hearts honoring the victims of the Monterey Park shooting.

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The lobby of the Sierra Vista Community Center is hung with blue hearts honoring the victims of the Monterey Park shooting.

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As soft music tinkled in the background, some of the survivors took part in a painting activity. Then, a few spontaneously started to dance, Loc said.

“I'm getting goosebumps,” Loc said, recalling the night. “It was really, really touching.”

But, she added, “our work is not done yet.”

“Some can go back to dancing, some cannot,” she said. “We're not here to force anybody in any direction but you can provide them with tools.”

The online education platform Canvas went offline after a data breach on Thursday, temporarily leaving students and faculty at thousands of U.S. colleges — and K-12 schools — without access to course materials and communications during finals period.

"I'm sure somewhere in the country when the outage happened, there probably were people actually taking final exams on the platform when it crashed," says Damon Linker, a senior lecturer in political science at the University of Pennsylvania.

Thirty million users — including at half of the higher education institutions in North America — rely on Canvas to manage courses, submit assignments, view grades and facilitate communication, according to its parent company, Instructure.

But when Linker and many other users tried to do so on Thursday afternoon, they met a black screen and a warning message.

"ShinyHunters has breached Instructure (again)," it read. "Instead of contacting us to resolve it they ignored us and did some 'security patches.'"

ShinyHunters is the same entity that took credit for a massive Ticketmaster data breach in 2024. Like many such groups, it's a cluster of young people working remotely together, "kind of like a ransomware gang," says Rachel Tobac, the CEO of SocialProof Security, which trains people and companies to defend themselves against hackers.

ShinyHunters wrote on a threat intelligence website earlier this week that the initial breach on Saturday involved data — including private messages — from 275 million students, teachers and staff at nearly 9,000 schools worldwide. The group said Thursday that affected schools can prevent the release of their data by consulting with cyber advisory firms and negotiating settlements through the encrypted chat platform Tox.

"You have till the end of the day by 12 May 2026 before everything is leaked," the hackers wrote.

Instructure has confirmed a series of cybersecurity breaches this week and provided status updates on its website. It said the breach only appeared to involve identifying information like names, email addresses, student ID numbers and user messages — no passwords, birth dates, government identifiers or financial information.

Instructure confirmed on an FAQ page that it started an investigation after it first detected unauthorized activity in Canvas on April 29, and took Canvas offline on Thursday after that same unauthorized actor "made changes that appeared when some students and teachers were logged in." They said the actor exploited an issue with its Free-for-Teacher accounts, which it has temporarily shut down.

"This gives us the confidence to restore access to Canvas, which is now fully back online and available for use," it said in a statement to NPR. "We regret the inconvenience and concern this may have caused."

It's not clear whether Instructure paid a ransom or what the return of Canvas access could mean for the hackers' May 12 deadline.

Tobac says Canvas could be back online because of a successful negotiation, or because the hackers "didn't get super far in their attack." Either way, she says users should stay vigilant, especially for phishing messages — whether it's someone posing as Canvas prompting a password change, or pretending to be a professor sending course materials.

"I would operate under the assumption that there's going to be some knock-on effects here," she says.

Not everyone got back online immediately 

Just before midnight on Thursday, Instructure posted online that "Canvas is now available for most users," though two separate services, Canvas Beta and Canvas Test, remained in maintenance mode.

Students and faculty at at least some schools were still unable to access Canvas on Friday — either because service had not yet been restored or because administrators warned them to stay away.

Penn State University, for example, said Friday morning that while the school's Canvas access had been partially restored, it was "not yet ready for use."

"Technical teams at Penn State are actively working to prepare the system for our community," it added. "As access is restored, Canvas integrations and related services will be brought back online in phases."

Several schools have taken similar approaches, either temporarily disabling Canvas access or outright asking users to steer clear. The University of California said across its schools, "Canvas access will not be restored until we are confident the system is secure."

And it's not just higher education: The Montgomery County Public School system in Maryland alerted families on Friday morning that even as service returned, it is "continuing to test and review systems before restoring access."

Tobac says this could mean that schools think the attackers might still be within their systems, potentially stealing information like passwords and messages.

"The attackers probably got some sensitive information and … [schools] don't want this information out online," she says.

Many schools are urging users to be on high alert for any unsolicited emails or messages that appear to come from Canvas, especially those requesting login credentials, as Georgetown University warned. The University of Amsterdam — which says it's one of 44 Dutch educational institutions affected — also recommends people change their passwords on any other sites where they use the same one.

Tobac also recommends using a password manager — to generate long, random passwords for each login — and turning on multi-factor authentication for all online accounts, not just Canvas. She says any student or professor who gets a suspicious call, text or email should "use another method of communication to verify what is authentic."

"Even if there was no breach yesterday, I would say these are the things that I recommend you do," she adds, urging people to "be politely paranoid."

The breach disrupts finals, highlights vulnerabilities

Several schools affected by the breach have already postponed or outright scrapped some final exams, with others warning students and professors that they might need to do so.

The University of Illinois is postponing all final exams and assignments scheduled through Sunday. Penn State canceled certain exams scheduled for Thursday night and Friday, saying it was working with faculty to "determine next steps for final grading" and urging students to check their emails (not Canvas) regularly in the meantime. And Baylor University delayed Friday exams and asked all faculty to send students "whatever study materials they have on their local computers to students as soon as possible."

The breach has underscored how much of academia relies on a single, centralized platform.

Linker, of UPenn, told NPR that he received an influx of panicked messages from students on Thursday afternoon when they suddenly couldn't access PowerPoints, readings and previous exams as they tried to study for Monday's final.

"The problem with using a platform like Canvas is that most [students] are not going to have the readings available printed out or on their laptops," he explains. "It all lives on the online platform, and if that platform goes down, they have no way to access them."

He told students on Thursday that he would upload the course materials to another platform (like Dropbox or Google Docs) if Canvas access wasn't restored by Friday morning. Fortunately, he says, it came back online shortly before 9 a.m. ET.

But Linker says he has concerns about relying fully on Canvas in the future.

"Given what this has exposed, the vulnerability involved and also the concern with the data breaches, I'm starting to rethink whether this is really a wise way to proceed," he says.

One example of that is grading. Linker says Canvas makes it so easy to calculate and weigh students' scores — on individual assessments and overall — that it's come to function as a digital grade book. Going forward, he says he may start keeping an analog record of students' grades just in case.

While Canvas does have competitors like Blackboard, Linker says he doesn't think any would be less vulnerable to a future breach. And Tobac agrees.

"The problem is not that this one website had this cyber event, right? Because nothing in this world is unhackable," she says. "The thing that we have to think about is disaster recovery: How do we continue doing business when there is a cyber event, and how do we do our very best to keep the bad actors out?"

Tobac says this week has shown that many institutions did not have a clear plan for how students and professors can be in touch and access course materials without Canvas. She said those plans should vary based on schools' different circumstances and schedules — which might explain why some are proceeding with finals as usual while others are scrapping exams altogether. But she'd like them to approach the immediate aftermath with one common goal.

"We have to treat people with dignity and respect," Tobac says. "And I hope that that is something that the institutions do, within their timelines and constraints."

Copyright 2026 NPR

This story first appeared on The LA Local.

Rabbi Amy Bernstein says the wind-whipped fire in January 2025 that scorched much of the Pacific Palisades, destroying her home and damaging her synagogue, “blew everything open” for the community’s faith leaders.

“If our hearts must break, let them break open,” said the rabbi, who leads Kehillat Israel where 300 families out of 900 lost their homes. “This tragedy has really pushed us closer to one another. We’re working to change the things we need changed.”

Faith leaders both in the Pacific Palisades and in Altadena and Pasadena — devastated by the pair of fires that tore across Southern California — have relied on interfaith and community partnerships to rally congregants who are picking up the pieces 16 months later.

They’ve had to learn on the fly about insurance coverage and local land use regulations while still trying to keep their scattered flock together and raising money for basic needs. Pastors in Altadena have had to fight to protect the rights of Black people who decades ago found pathways to home ownership in that community despite redlining — but now risk losing their land to outside developers who sense an investment opportunity.

And throughout this span, faith leaders have had to cater to the emotional and spiritual needs of their communities and think about how they want to rebuild their sanctuaries that were lost or damaged in the fire. More than a dozen houses of worship burned to the ground or were damaged.

Interfaith relationships have become stronger after the fires

This would have been difficult for faith leaders to handle but for the interfaith relationships that became closer and stronger after the fires, said the Rev. Grace Park, associate pastor at Pacific Palisades Presbyterian Church, which burned down.

Methodists, Presbyterians, Catholics, Jews and yogis have not just found common ground in human suffering and loss, but have learned how to lean on one another in a time of dire need, she said.

“It’s a sense of mutual affection and respect, learning from each other and leaning on one another,” Park said. “We’re sharing the joys and the deep valleys of what it means to lead through a time of tragedy.”

Brother Satyananda, a senior monk at the Self Realization Fellowship, lost his living quarters and belongings in the fire. Much of the campus, started by Paramahamsa Yogananda who brought ancient spiritual practices from India to the West, fortunately survived the fire.

Satyananda recalls one day when Bernstein picked up on his sadness and offered him “motherly compassion.”

“We share the same profession where we’re tuned to people in need,” he said. “Now, our relationship has changed because we’re tuning into each other. There’s a greater level of trust.”

Pastor BJ King, who leads LoveLand LifeCenter, worked with the late Rev. Cecil B. Murray to heal communities and build interfaith coalitions after the 1992 Los Angeles riots.

“Back then, there was a choice whether or not to get involved,” he said. “But with these fires, there is no choice. It has affected everybody.”

Pastors have had to acquire new skills

King’s congregation has switched to online services after their leased church building in Altadena suffered smoke damage. Twelve families lost their homes. In addition to helping meet people’s basic needs, King has created a program organizing gatherings to connect therapists with those in need of mental health.

“Many people didn’t even know they needed that,” he said.

One of the most powerful roles faith leaders have played after the fire is to “continue to talk with power, people in charge,” said Pastor Jonathan DeCuir, who leads Victory Bible Church in Pasadena. He and others in the region have continued to meet with local officials and even conferred with Gov. Gavin Newsom to keep things moving for their communities.

DeCuir chairs the board of a nonprofit called Legacy Land Project, which provides financial aid, legal support and guidance on building contractors, as well as medical care to those affected by the fires.

The disaster has brought a level of camaraderie that DeCuir says he has never seen among the region’s clergy.

“Denominational lines have been crossed,” he said. “Even if we have different theological stances or approaches to ministry, we are all now looking at how to care for our people and community. If we don’t come together, Altadena will never ever be the same. The people won’t be there anymore. That, to me, is terrifying.”

While a church is more than a building, physical churches do appear as “beacons of hope” in traumatized communities, said Pastor Mayra Macedo-Nolan, executive director of Clergy Community Coalition in Pasadena. Her group has lobbied for houses of worship to be prioritized on the same footing as businesses in the rebuilding plan.

“When people start seeing churches rebuilding in Altadena, they’re going to feel like it’s going to be OK because the churches are coming back,” she said.

Reimagining a purposeful future

Pastor Jonathan Lewis, fourth from right, holds a groundbreaking service at the site of the burned Fountain of Life Nazarene Church to mark the beginning of its rebuilding in Altadena, Calif., April 26, 2026.

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Members of the congregation join in prayer during the groundbreaking ceremony at the site of the burned Fountain of Life Nazarene Church, marking the beginning of its rebuilding, April 26, 2026, in Altadena, Calif.

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Pastor Jonathan Lewis poses for a photo with his congregation during a groundbreaking service at the site of the burned Fountain of Life Nazarene Church, marking the beginning of its rebuilding, April 26, 2026, in Altadena, Calif.

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On April 26, the Altadena Fountain of Life Church broke ground to build a new sanctuary after their house of worship, which had stood for over three decades, was destroyed in the fire. Pastor Jonathan Lewis, who ministers to about 75, hopes the church will be ready in time for Easter next year.

“It’ll be a Resurrection Sunday for our church, too,” he said.

Alexis Duncan, who grew up in Altadena attending that church, came to the groundbreaking with her 6-year-old daughter. She lost both her home and her church building.

“It means everything to me that they’re rebuilding because I want the church to be there for my daughter as she grows up,” she said. “This new beginning gives me and my family hope and the encouragement to come back.”

Some churches like Altadena Community Church, a United Church of Christ congregation, are pausing to rethink their future purpose. The Rev. Michael Lewis, who took over in February after the previous pastor retired, said the congregation is looking into several possibilities for the one-acre lot, including affordable housing.

“We know that a church is not intended to be a landlord and the pastor is no property manager,” he said. “But, we’re also thinking about who is able to return to Altadena? How will this rich, economically diverse community that was scattered by the fire come back?”

The church has been around since the 1940s. A haven for actors, poets and musicians, the former sanctuary also served as a vibrant performance space. Lewis said they hope to incorporate a performance stage into the new facility.

“It’ll look different from what we had before,” he said. “Once we figure out how to build community, we can decide what physical structures will help us support that community.”

As for Kehillat Israel, on May 15, members will carry their Torah scrolls back to their sanctuary, marking one of the first returns by a house of worship to the Palisades since the disaster.

Judaism has had “a long history of starting over,” Bernstein said.

“It’s encoded in our cultural approach to the world, that there are things that can always be taken away from you,” she said. “But what you become can never get taken away.”

Gov. Gavin Newsom announced Friday that he has requested a yearlong extension of FEMA funding for L.A. fire survivors. Without the extension, the money will run out July 9.

Now the decision on FEMA support lies with the federal government.

The funds have allowed many survivors to afford temporary housing and other daily needs. Most have yet to return home — 2 in 3 survivors who were living in Altadena or Pacific Palisades at the time of the fires are still displaced, according to the latest survey of more than 2,100 survivors by the nonprofit Department of Angels. Nearly 40% of respondents reported they will either soon run out of temporary housing insurance coverage or have already.

The situation is particularly dire for low-income households: Nearly 80% of respondents making $50,000 or less said they didn’t think they could afford housing for three months once coverage ended.

“The data is clear: This recovery is not over,” said Angela Giacchetti of the Department of Angels at a news conference organized by the Eaton Fire Collaborative in Altadena on Thursday. “If you are a survivor, you know this in your bones. For many families, it has barely begun. People have just begun to stabilize. We need federal support that reflects the scale of this disaster and systems that survivors can actually navigate and access over time.”

FEMA assistance isn’t reaching most survivors

The FEMA Individuals and Households Program can provide funding for survivors of disasters to pay for temporary housing, repair their homes, and respond to other challenges that insurance may not cover. It can also help cover costs if a survivor has no insurance.

Gil Barel has been relying on FEMA funds to pay rent on a small back house for herself and her son for the last year. She said they still haven’t been able to return to their rent-controlled Pasadena apartment because of smoke damage, though she still has to pay the rent for it.

Gil Barel is paying rent on a smoke-damaged apartment in Pasadena while FEMA funds have helped her cut the cost of temporary housing.

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Barel doesn’t know what they’ll do if the FEMA funding runs out.

“ I'm really stressed out,” she said. “I think I'm just kind of trying to put that thought aside and hope for the best.”

But in the 15 months since the fires, most survivors have not accessed FEMA funding. About 60% have received no FEMA assistance beyond the initial $770 payments dispersed in the immediate aftermath of the fires, according to the Department of Angels survey.

Many have faced denials, according to disaster case manager workers with Catholic Charities of L.A. and lawyers with Legal Aid Foundation of L.A.

That’s the situation for Gayle Nicholls-Ali and her husband, Rasheed, who lost their Altadena home of 15 years in the Eaton Fire. They’ve relied on their insurance to pay for a rental in Montrose, but that’s rapidly running out. And because they have that insurance, FEMA has denied further support.

Gayle Nicholls-Ali and her husband, Rasheed, lost their home in the Eaton Fire. They plan to rebuild, but the cost is a major hurdle.

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“A lot of our ALE [Additional Living Expenses insurance] is going to run out before we even are able to get into a house,” Nicholls-Ali said.

Without FEMA or insurance support, they’ll have to find a way to pay rent on top of a mortgage. They also face a big gap in the cost of their rebuild versus how much their insurance covers. Nicholls-Ali said without the help of FEMA and other sources of funding, recovering feels further out of reach.

Funds for long-term recovery still in limbo

FEMA funding extensions have been routine in past disasters, including the 2023 wildfires in Hawaii and after devastating flooding in North Carolina in 2024.

But the agency has faced significant cuts during the second Trump administration, and there are indications that disaster aid is becoming increasingly political. For example, President Donald Trump has approved aid for just 23% of requests from states with a Democratic governor and two Democratic senators, compared to 89% for states that with Republican governors and senators, according to an analysis by Politico.

The state has also not received more than $33 billion for long-term recovery, which can help pay for infrastructure upgrades and repairs, as well as help rebuild schools, parks and homes. That money was requested by state and local leaders shortly after the January 2025 fires and hasn’t been appropriated by Congress.

An international team of disease detectives is now racing to connect with the more than two dozen passengers who disembarked the MV Honius cruise ship on the Atlantic island of St. Helena before the hantavirus outbreak was identified.

These individuals have flown across the world, including to the United States.

The risk of further spread of this virus is low since it requires close and prolonged contact with an infected individual — and those infected seem to transmit the virus for only a brief period of time. But public health officials want to make sure the outbreak is contained.

Here's how authorities are using the practice of contact tracing to contain the outbreak and keep the hantavirus from spreading.

Contact tracing 101

The concept of modern contact tracing dates to the 1930s and was part of an effort to stop the spread of syphilis. It involves locating the close contacts of anyone who may have been infected. "By identifying people who are at risk of infection," says Preeti Malani, an infectious disease physician at the University of Michigan, "you try to get ahead when people don't have symptoms yet with the goal of preventing the infection from continuing to propagate."

This is a well-tested approach for containing an infectious disease. "It's the oldest tool in the epidemiologic toolbox," explains Malani. "We thought about this a lot early in the pandemic with COVID. But we also do contact tracing for sexually transmitted infections, for things like meningitis and even measles."

Malani likens contact tracing to monitoring ripples in a pond, "trying to prevent those outer rings from propagating by isolating individuals and by identifying individuals who might be at risk of infection."

The idea that "there's a time period where people don't have symptoms but could be harboring the virus, that's what contact tracing helps identify," says Malani.

It starts by pinpointing someone with an infection or suspected infection of the disease in question — in this case, hantavirus. Epidemiologists then look to see with whom they've recently had close contact since these individuals are more likely to have been infected.

This hunt for those with the greatest probability of infection is important. "Otherwise, it becomes an impossible web to contain because everyone is connected to everyone," says Boghuma Titanji, an infectious diseases doctor at Emory University. "So you have to stratify by high, intermediate and low-risk contacts."

The next step involves public health agencies ordering precautions for those who are infected or who may be infected but aren't showing symptoms yet. Such measures may include quarantine, so that an individual doesn't come into contact with even more people — who may then become infected.

One challenge that hantavirus presents is that its incubation period can last up to several weeks. In other words, "people take a long time to become symptomatic after they've been exposed," says Titanji. "Some of these primary contacts would have to be monitoring themselves for symptoms for up to 45 days to be at the tail end of that very long incubation period."

Aboard and ashore

The work isn't high-tech but it is painstaking, requiring officials to reconstruct the many interactions someone may have had over days or weeks.

Onboard the cruise ship, "you might have an individual who is a source of an infection," says Titanji, laying out a hypothetical example. "And then they were sitting at a dinner table with one individual who then goes back to their cabin and shares a bed with their partner who has a conversation with someone else on the deck."

Once someone disembarks the ship, the number of potential interactions can grow quite quickly. This is why officials were concerned when a KLM flight attendant fell ill after being aboard a flight with one of the infected cruise ship passengers. Fortunately, the flight attendant ultimately tested negative for hantavirus.

Titanji is heartened by what she's seen playing out so far. "It seems like the international collaborative effort has been really robust and the mechanisms for containment are in place and underway," she says.

Public health officials argue that contact tracing is a powerful approach that will reduce further spread. "We can break this chain of transmission," said Abdi Mahmoud, the director of the World Health Organization's health emergency alert and response efforts, at a press conference on Thursday.

He has good reason to be confident. Contact tracing was vital during the fight against COVID-19 and helped end the Ebola crisis in Liberia, containing the epidemic there more than a decade ago. Some of the contact tracing even involved hours-long hikes through the jungle to a remote village.

Authorities are hoping for similar success with this hantavirus outbreak.
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