In the Pandemic Era, Is It Safe to Go to Work?

In the Pandemic Era, Is It Safe to Go to Work?

Waiter serves meal to customers wearing PPE

A waiter wearing a face shield and mask to protect himself and others from the coronavirus serves diners at a restaurant in Santa Monica, California, on June 21, 2020. Photo: David Livingston / Getty Images

Stories that caught our attention.

It’s a scary thing to go back and know you have low immunity.

—Patti Hanks, Virginia furniture store worker

Twelve million adults who are not working live with those higher risks in households with at least one full-time worker, thereby exposing them indirectly to the infection risks of housemates doing customer-facing or other service jobs during a pandemic.

The ability to earn income from home is a privilege, and the “impossible choice between lives and livelihoods falls mainly to lower-wage workers in service industries,” KFF President and CEO Drew Altman wrote in Axios. Here’s what it’s like to work in four jobs that require face-to-face interaction during the worsening COVID-19 crisis.

Patti Hanks, Virginia

Soon after finishing chemotherapy for ovarian cancer, Patti Hanks had to go back to her job processing transactions at a furniture and appliance store in Virginia. She was nervous about returning to work during the pandemic, but she couldn’t afford to lose employer-sponsored health insurance.

“It’s a scary thing to go back and know you have low immunity,” Hanks, 62, told Sarah Kliff in the New York Times. “But when it all boils down to it, I don’t think COVID-19 is going away any time soon. I don’t think you can hide from it.”

Nearly 60% of Americans under 65 have employer health coverage, according to the Peterson-KFF Health System Tracker. For people like Hanks, that makes work and health interdependent. Even without her furniture store job, she likely makes too much income from other sources (rental properties and raising cattle) to qualify for Medicaid.

So Hanks continues reporting to work. She wears a mask in the store, maintains distance from customers, and sanitizes shared objects like chairs and pens frequently. Still, there’s only so much she can control. The store has been busy since Virginia began lifting stay-at-home restrictions in May, and Hanks has assisted at least one customer who appeared to be unwell.

“You can’t crawl into a hole,” she told Kliff. “I think we’ve done everything we can to protect ourselves. . . . So I’ll just keep going.”

David Smith, Michigan

In normal times, David Smith, co-owner of the European-style eatery Café Muse in the Detroit suburb of Royal Oak, has one of his younger employees seat customers for dine-in service. But times are certainly not normal — nor are interactions with customers.

“I’ve been trying to do most of the seating, because it’s just really difficult when you have like an 18- or 19-year-old [employee] at the front having to enforce mask wearing,” he told Brenna Houck for her article in Eater Detroit.

The restaurant has been open for dine-in service for a only few weeks, and Smith has already had to call the police on an irate customer who refused to wear a mask when picking up a to-go order. Smith’s business partner, Greg Reyner, stepped in to ask the customer to wait for his food outside, and when the man refused, Reyner asked him to leave. The customer later called the restaurant and allegedly threatened the staff, leading Smith and Reyner to call the police.

The state of Michigan allowed restaurants and bars to reopen for indoor and outdoor dine-in service on June 8. Governor Gretchen Whitmer mandated that each customer must “wear a face covering over his or her nose and mouth . . . when in any enclosed public space, unless the individual is unable medically to tolerate a face covering.” Additionally, businesses are permitted to deny entry or access to anyone who refuses to comply with the mask rule.

That doesn’t mean it’s easy or pleasant to enforce the rule for the safety of staff and customers. “It is very upsetting,” Smith told Houck. “You’re shaking after having these conversations with people, because you just don’t know. What if someone got killed because they told [a customer] to wear a mask? You worry about it all the time.”

Amanda, Missouri

Nursing homes and assisted living facilities are hot spots for COVID-19 cases. Amanda (who asked that her last name be withheld) is a receptionist at a nursing home in St. Louis, and the last few months have been extremely stressful as she and her colleagues work to keep the facility free of COVID-19.

“I can’t sleep nowadays because I dream about being the cause of people dying,” she told Vox’s Luke Winkie. “That’s a horrifying thought for me. I’ve written up my resignation several times. But I don’t have the heart to do it because they need me there.”

So far, the nursing home has not had any cases, and Amanda attributes this to the facility’s early adoption of safety precautions. In February, the administrators advised staff to use personal protective equipment at work, regularly disinfect surfaces, and shelter in place at home when they weren’t working. The facility stopped admitting visitors, and when families dropped off presents for Mother’s Day, staff put the presents on hold for 24 to 72 hours before giving them to the residents.

[My family and I] never even hugged one another when I went to the emergency department because I don’t want to infect them.

—Marcial Reyes, emergency room nurse

Amanda and her colleagues take precautions not only at work, but also at home. “I won’t let my kids see their friends,” she told Winkie. “A lot of people are letting their kids see other kids, but I nipped that in the bud right away. My colleagues have done the same.”

As states reopen, Amanda is increasingly worried about the health of senior citizens like the ones she cares for. “I believe that our government hasn’t done anything,” she said. “Why don’t we have rapid testing in our facility right now? They should be in every hospital, every nursing home, and they should continue to produce them until they’re in schools and courthouses.”

Marcial Reyes, California

Fourteen years ago, Marcial Reyes emigrated from the Philippines to the US on a work visa to become a nurse. He’s been a US citizen for eight years. He was working as an emergency room nurse in Fontana, California, when the COVID-19 crisis struck, Josie Huang reported in LAist.

Reyes knew he was at high risk of contracting the coronavirus. When he started experiencing shortness of breath, he quarantined himself on the first floor of his house, away from his wife Rowena, who is also a nurse, and their five-year-old son. But the symptoms kept getting worse, and eventually he drove himself to the hospital — to the same emergency room where he usually cares for patients.

His health deteriorated so rapidly over the next few days that his doctors put him in a medically induced coma and hooked him up to a ventilator for 10 days. “[My family and I] never even hugged one another when I went to the emergency department because I don’t want to infect them,” he told Huang.

In California, nearly one in five registered nurses is of Filipino descent, according to a 2016 survey (PDF) by the California Board of Registered Nursing. California hospitals have recruited heavily from the Philippines for more than a century. Filipino nurses have stepped up to work in underserved areas and work on the front lines of health crises like the AIDS epidemic and COVID-19.

“It’s not uncommon for many Filipino families to produce multiple health care workers,” Huang wrote. The Reyes family is just one such example. Rowena Reyes and their son both also tested positive for COVID-19, though they recovered without hospitalization.

Marcial Reyes’ recovery will be much slower and more complicated. He needs to regain strength in his legs, and he still struggles with writing, Huang reported. Still, he is looking forward to the day when he can return to the emergency room as a nurse.

 

 

 

 

Fauci testifies new coronavirus cases could ‘go up to 100,000 a day if this does not turn around’

https://www.washingtonpost.com/nation/2020/06/30/coronavirus-live-updates-us/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most

Coronavirus update: Fauci testifies new U.S. cases could 'go up to ...

Anthony S. Fauci, the nation’s top infectious-diseases expert, gave a dire warning Tuesday in a Senate committee hearing held as coronavirus infections surge in many parts of the United States.

“We are now having 40-plus thousand new cases a day. I would not be surprised if we go up to 100,000 a day if this does not turn around. And so I am very concerned,” Fauci said in response to questioning from Sen. Elizabeth Warren (D-Mass.) on what the overall U.S. death toll is likely to be.

While the U.S. wrestles with safely reopening, the European Union confirmed Americans will not be allowed to travel to the bloc of 27 countries when it reopens to some foreign travel Wednesday. The United States is leading the world in both officially confirmed infections and fatalities as it continues to see surges in new cases, hospitalizations and deaths in many states.

Nearly 10.3 million coronavirus cases have been detected worldwide, with roughly 2.6 million infections reported in the United States. At least 124,000 people have died of covid-19 in the United States, and the global death count is hovering near 505,000.

Here are some significant developments:

  • Former vice president and presumptive Democratic presidential nominee Joe Biden said during a speech that President Trump ‘failed’ Americans in his response to the coronavirus pandemic. Biden also released a plan to combat the virus: beefed-up testing and contacting tracing, using the Defense Production Act and organizing a global, coordinated approach for treatment and vaccines.
  • More Republican leaders advocated for the use of face masks in public, including House Minority Leader Kevin McCarthy (Calif.) — who encouraged President Trump to don one — and Senate Majority Leader Mitch McConnell. In addition, Health and Human Services Secretary Alex Azar said the rise in cases can be stopped if Americans wear facial coverings in public, along with practicing social distancing and proper personal hygiene.
  • Social distancing will not be enforced July 3 at the Mount Rushmore fireworks display that Trump will attend, South Dakota Gov. Kristi L. Noem (R) said Monday. Noem also said masks will be provided to the 7,500 participants, but they will not be required to wear them.
  • The number of people hospitalized for covid-19 is surging in seven states, according to data tracked by The Washington Post. In Texas, Arizona, Nevada, South Carolina, Montana, Georgia and California, seven-day averages are up at least 25 percent from last week.
  • Chinese researchers announced the discovery of a new strain of swine flu among workers at a slaughterhouse and warned it should be monitored in case human-to-human transmission starts.

 

 

 

Labs warn COVID-19 testing demand will top capacity soon as new hotspots emerge

https://www.healthcaredive.com/news/labs-warn-covid-19-testing-demand-will-top-capacity-hotspots-new-surge/580730/

Dive Brief:

  • With the spike in coronavirus cases in Southern and Western states, commercial laboratories say they do not have the capacity to keep up with growing demand for their testing services and predict longer turnaround times for results over the coming weeks.
  • The American Clinical Laboratory Association, which represents LabCorp, Quest Diagnostics and other labs, said Saturday its members have seen a steady increase in the volume of COVID-19 test orders recently, specifically calling out the fact that critical testing materials are in short supply.
  • Quest on Thursday issued its own warning that despite the rapid expansion of its testing capacity, demand has been growing faster. In particular, the lab giant noted that orders for molecular diagnostic services have increased by about 50% over the past three weeks.

Dive Insight:

U.S. commercial labs had made “significant strides” during the coronavirus pandemic by expanding testing capacity from about 100,000 tests per day in early April to more than 300,000 currently, according to ACLA.

But newly emerging hotspots like Arizona, California and Texas are putting a strain on labs and an already limited supply of testing materials, the group said.

While labs nationwide are trying to increase capacity by purchasing more testing machines and attempting to secure additional test materials from suppliers, ACLA President Julie Khani cautioned, “the reality of this ongoing global pandemic is that testing supplies are limited” and “every country across the globe is in need of essential testing supplies, like pipettes and reagents, and that demand is likely to increase in the coming months.”

Khani said ACLA has been in talks with the Trump administration and supply chain partners about the challenges labs face as they try to increase their level of respective COVID-19 testing abilities to meet the anticipated increase in U.S. demand for tests over the coming weeks.

In the absence of a solution, Khani warned that significant demand “will likely exceed” labs’ testing capacities and “could extend turnaround times for test results.”

For its part, Quest’s statement on Thursday described the U.S. coronavirus outbreak as an “evolving” situation that is putting a “strain” on the company’s COVID-19 testing resources.

“Today, we have the capacity to perform approximately 110,000 of these tests a day (770,000 a week). Despite the rapid expansion of our testing capacity, demand for testing has been growing faster,” according to Quest.

Currently, Quest’s average turnaround time for test results are one day for hospital patients, pre-operative patients in acute care settings, and symptomatic healthcare workers, and two to three days for all other patient populations. However, the company warned that “given increased demand, we expect average turnaround times near term to extend in excess of 3 days.”

Nonetheless, Quest said it is taking actions to try to increase COVID-19 testing scale, with the goal of being able to perform 150,000 tests per day. Toward that end, the company is installing additional testing platforms in its network of U.S. labs and said it is collaborating with independent labs who currently have underused capacity.

Quest’s rival LabCorp was not immediately available for comment on its testing capacity amid reports of demand increasing across the country.

 

 

 

 

Pandemic Graphic of the Day

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Live updates: U.S. sets another single-day record for new coronavirus cases, surpassing 40,000 for first time

https://www.washingtonpost.com/nation/2020/06/26/coronavirus-live-updates-us/?fbclid=IwAR2rv7BC74tY4bLlGXlh70tcuv3V3vGz52MCFrCX2FYdMvhkOxd_XJoUsgM&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

Coronavirus latest: Global coronavirus infections top 1 million ...

The United States has set a record for new covid-19 cases for the third time in three days, passing the 40,000 mark for the first time, according to tracking by The Washington Post.

Twelve states set their own records for the average number of new cases reported over the past seven days: Arizona, California, Florida, Georgia, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas, Idaho and Utah.

Six states set new single-day highs, led by Florida with 8,942 cases, more than 60 percent higher than its previous high set on Wednesday. Georgia, South Carolina, Tennessee, Idaho and Utah also set new single-day records.

Florida announced Friday morning that bars must close immediately, a move echoed by Texas, a state also dealing with a surge in cases and nearing its capacity to care for those suffering.

“The trajectory that we’re on right now has our hospitals being overwhelmed, probably about mid-July,” Austin Mayor Steve Adler (D) said during an appearance on CNN.

Texas Gov. Greg Abbott (R) issued an executive order that revives restrictions on bars, restaurants and certain types of outdoor recreation, one day after suggesting he would not.

Here are some significant developments:

  • The Dow Jones industrial average slid 730.05 points, about 2.8 percent, as rising coronavirus infections roiled investors Friday.
  • Vice President Pence said during a White House coronavirus task force news briefing that it is “very encouraging news” that half of the increasing cases in Florida and Texas are among Americans under 35, because younger people tend to have less-serious outcomes.
  • The Trump administration official coordinating tests for the novel coronavirus did a partial pivot Friday, announcing that the government would briefly extend its management of five testing sites in Texas, a state with a recent spike of cases and hospitalizations.
  • Anthony S. Fauci, the nation’s leading infectious-disease doctor, urged Americans to see their role in taking safety precautions as a “societal responsibility.” He begged them not to let their guards down even if the risk to their own health is considered minimal, because they can still transport it.
  • In another sign that hopes of a swift economic recovery may be losing steam, the number of homeowners delaying their mortgage payments shot up by 79,000.
  • Portugal is reinstating lockdown measures for about 700,000 people in 19 civil parishes around Lisbon next week after a worrying rise in cases in communities in the capital’s outskirts.

Six states set record number of new cases

As the United States logged a record number of infections Friday, six states announced their own new single-day high case totals: Georgia, Utah, South Carolina, Tennessee, Idaho and Florida.

Georgia reported four straight days of more than 1,700 new infections and two days in a row of records. The 1,900 cases reported by state health officials Friday surpassed the previous record, 1,714 cases, announced Thursday.

The seven-day average of new infections also hit a new high — 1,569 — and has been rising steadily since late May. That figure is up about 77 percent from a week ago and nearly 115 percent since Memorial Day.

In Utah, the single-day case total hit 676 and set a record for the fourth day in a row. The rolling average has also been on a steady upward swing for 10 days.

Current hospitalizations of Utah’s confirmed covid-19 patients are rising quickly, from 149 a week ago to 174 on Friday. Hospitalizations were at 102 when the month began.

South Carolina’s 1,301 new cases and 1,094 rolling average also set records. The state started the month with an average of 281 daily cases.

Tennessee announced 1,410 new infections, surpassing its previous record number of single-day cases by more than 200.

Current hospitalizations are also rising in South Carolina and Tennessee.

In addition to the states that set records, Louisiana has joined the states with rapidly increasing case numbers. Health officials announced 1,354 new cases Friday, compared with 523 two weeks ago and none two weeks before that.

 

 

 

Florida reports massive single-day increase of 9,000 coronavirus cases

https://www.axios.com/florida-single-day-increase-coronavirus-cases-a6d5578b-527c-4be4-88e6-eb7289a7be97.html?stream=health-care&utm_source=alert&utm_medium=email&utm_campaign=alerts_healthcare

Florida reports massive single-day increase of 9,000 coronavirus ...

Florida on Friday reported nearly 9,000 new coronavirus cases in 24 hours totaling 122,960 cases.

Why it matters: The state is one of many that are experiencing a fresh surge of infections.

Go deeper: The coronavirus surge is real, and it’s everywhere

 

 

 

Coronavirus Cases may be 10x higher than official count says CDC

https://www.axios.com/newsletters/axios-vitals-59e9ac1a-ab86-4f8a-917a-8c9d52f5835f.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top

NC coronavirus update June 25: North Carolina's mask mandate goes ...

The real number of U.S. coronavirus cases could be as high as 23 million — 10 times the 2.3 million currently confirmed cases — the Centers for Disease Control and Prevention told reporters yesterday, Axios’ Marisa Fernandez reports.

Between the lines: The new estimate is based on antibody testing, which indicates whether someone has previously been infected by the virus regardless of whether they had symptoms.

  • “This virus causes so much asymptomatic infection. The traditional approach of looking for symptomatic illness and diagnosing it obviously underestimates the total amount of infections,” CDC director Robert Redfield said.

The agency also expanded its warnings of which demographic groups are at risk, which now include younger people who are obese and who have underlying health problems.

  • The shift reflects what states and hospitals have been seeing since the pandemic began, which is that young people can get seriously ill from COVID-19.

The new guidance also categorizes medical conditions that can affect the severity of illness:

  • Conditions that increase risk: Chronic kidney disease; chronic obstructive pulmonary disease; obesity; weakened immune system from solid organ transplant; serious heart conditions, such as heart failure, coronary artery disease or cardiomyopathies; sickle cell disease; Type 2 diabetes.
  • Conditions that may increase risk: Chronic lung diseases, including moderate to severe asthma and cystic fibrosis; high blood pressure; a weakened immune system; neurologic conditions, such as dementia or history of stroke; liver disease; pregnancy.

 

 

 

 

Coronavirus Dashboard

https://www.axios.com/coronavirus-latest-news-quick-highlights-57a186a3-7547-45bf-852a-83019849d8d5.html

Coronavirus dashboard: Catch up fast - Axios

 

  1. Global: Total confirmed cases as of 9 a.m. ET: 9,635,935 — Total deaths: 489,922 — Total recoveries — 4,861,715 — Map.
  2. U.S.: Total confirmed cases as of 9 a.m ET: 2,422,312 — Total deaths: 124,415 — Total recoveries: 663,562 — Total tested: 29,207,820 — Map.
  3. Public health: America’s workers still aren’t protected from the coronavirus — Gilead says coronavirus drug should likely cost no more than $2,800.
  4. White House: Trump administration asks Supreme Court to overturn ACA during pandemic.
  5. Sports: Universities cut sports teams, as they struggle with coronavirus fallout.

 

 

 

 

The U.S. divide on coronavirus masks

https://www.axios.com/political-divide-coronavirus-masks-1053d5bd-deb3-4cf4-9570-0ba492134f3e.html

Politics, not public health, drive Americans' attitudes toward ...

Mask-wearing has become the latest partisan division in an increasingly politically divided pandemic.

Why it matters: It’s becoming increasingly clear that wearing even a basic cloth mask is one of the most effective ways to prevent the spread of COVID-19. But whether or not people are willing to wear one has less to do with the risk of the pandemic than their political affiliation.

By the numbers: Results from months of the Axios-Ipsos coronavirus polls show a clear and growing political divide between Democrats and Republicans on mask-wearing habits.

  • Nationally, the percentage of Democrats who reported wearing a mask all the time when leaving home rose from 49% between April 10 and May 4 to 65% between May 8 and June 22.
  • During the same time period, the percentage of Republicans who reported constant mask-wearing rose from 29% to just 35%.

Context: The political divide Americans are reporting on mask use echoes one seen within nearly all levels of the government.

  • President Trump has not been seen to wear a mask, and he told Axios last week that attendees at his Tulsa campaign event on June 20 should “do what they want” on masks, which were not required at the rally.
  • Governors in many red states like Nebraska have refused to mandate facial masks in public, even as cases have begun to rise in recent weeks. At the same time, leaders in blue states — especially those that grappled with large outbreaks of COVID-19 — have urged residents to wear masks, with California Gov. Gavin Newsom mandating their use last week as cases in the state passed 4,000 a day.
  • The situation is even more divided at the local level, with leaders of red towns in blue states pushing back against mask mandates, and vice versa.

Flashback: Some of the blame for the divide can be traced back to muddled public health messaging on mask use in the early stages of the pandemic, when Americans were urged not to go out and buy masks in bulk because of concerns that there wasn’t enough personal protective equipment for front-line health care workers.

  • Those fears were real, as government virus expert Anthony Fauci pointed out in congressional testimony on Tuesday. And public health officials worried that pushing masks would inadvertently encourage Americans to continue going out in public at a moment when lockdowns demanded they stay inside.
  • Like the divide among experts on whether mass protests would increase coronavirus cases, just the perception that health advice might be based on politics rather than science gives cover to those who would forego masks, especially since the outbreak itself initially seemed like a blue state problem.

Health experts now know that cloth masks are most effective not so much at protecting individuals from infection as protecting the community from infected individuals. But that makes masks as much about social signaling as they are about public health.

  • Conservatives who prize individual autonomy over social responsibility experience “a massive pushback of psychological resistance” when presented with mask mandates, says Steven Taylor, the author of “The Psychology of Pandemics.”
  • That reaction is reinforced “if leaders like Trump downplay the significance of COVID-19 or if they won’t wear masks,” says Taylor. As a result, wearing a mask in conservative communities means visibly going against public opinion, while the opposite is true in communities where mask use is common.
  • The Axios-Ipsos data reflects this reality, showing that while Republicans in blue states use masks less than Democrats, they wear them at higher rates than Republicans in red states, just as Democrats in red states use masks at lower rates than Democrats in blue states.

What to watch: The one factor that seems capable of breaking the political deadlock is the outbreak itself. As cases have skyrocketed in red states like Arizona recently, there’s been a significant increase in Google searches for masks.

 

 

 

 

America’s workers still aren’t protected from the coronavirus

https://www.axios.com/americas-workers-vulnerable-coronavirus-944e3451-4458-4f1d-83d2-c86a1beb1117.html

America's workers still aren't protected from the coronavirus - Axios

Essential workers have borne the brunt of the coronavirus pandemic for months, but the U.S. is still doing relatively little to protect them.

Why it matters: With no end to the pandemic in sight, America’s frontline workers still must choose between risking their health and losing their source of income.

Driving the news: The Trump administration said this week that health insurers aren’t required to cover coronavirus diagnostic tests performed as part of workplace safety or public health surveillance efforts.

  • It didn’t say who is supposed to pay for these tests. If employers are stuck footing the bill, that makes the testing less likely to happen.

The big picture: There’s been no national effort or initiative to protect essential workers, and America is still failing to implement basic public health measures as new cases skyrocket.

  • Masks have become a political flashpoint and aren’t required in many of the states that are emerging coronavirus hotspots.
  • That means essential workers go to work each day without any guarantee that the people they’re interacting with will take one of the most basic and effective steps to prevent transmission of the virus.
  • No one is even talking about mass distribution of personal protective equipment beyond health care workers. And even some health care workers — particularly those who work in nursing homes — don’t have the protective gear that they need.

More broadly, the financial incentives for frontline workers, particularly those who are low-income, to keep working make it nearly impossible for them to avoid health risks.

  • At least 69 million American workers are potentially ineligible for the emergency paid sick leave benefits that Congress passed earlier this year, per the Kaiser Family Foundation.
  • An estimated 25-30 million people — particularly lower-wage workers in service industries — are unable to work from home but also face a high risk of severe infection, KFF’s Drew Altman wrote earlier this week.

What we’re watching: The line between essential workers and those who are required to return to the office by their employer has become blurry, and millions more Americans are facing dilemmas similar to those faced by grocers and bus drivers.

  • The sickest — and thus most vulnerable — Americans may feel the most pressure to return to work, as that’s often where they get their health insurance, the NYT points out.
  • Nearly a quarter of adult workers are vulnerable to severe coronavirus infections, per KFF.

The bottom line: Essential workers and their families will continue to feel the impact of America’s coronavirus failures most acutely.

Go deeper: “Disposable workers” doing essential jobs