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| No More Than 10 People in One Place, Trump Said. But Why? | No More Than 10 People in One Place, Trump Said. But Why? |
| (7 days later) | |
| As the new coronavirus continues to spread, state and local governments are shutting down schools and businesses and setting limits on the sizes of public gatherings. The latest recommendation announced Monday by the federal government to promote social distancing and limit the transmission of the coronavirus: no more than 10 people in one place. | As the new coronavirus continues to spread, state and local governments are shutting down schools and businesses and setting limits on the sizes of public gatherings. The latest recommendation announced Monday by the federal government to promote social distancing and limit the transmission of the coronavirus: no more than 10 people in one place. |
| “We’d much rather be ahead of the curve than behind it,” President Trump said at a White House news conference. “Therefore, my administration is recommending that all Americans, including the young and healthy, work to engage in schooling from home when possible, avoid gathering in groups of more than 10 people, avoid discretionary travel and avoid eating and drinking at bars, restaurants and public food courts.” | “We’d much rather be ahead of the curve than behind it,” President Trump said at a White House news conference. “Therefore, my administration is recommending that all Americans, including the young and healthy, work to engage in schooling from home when possible, avoid gathering in groups of more than 10 people, avoid discretionary travel and avoid eating and drinking at bars, restaurants and public food courts.” |
| But where did that number come from? The variations in crowd size requirements and recommendations from assorted government authorities may add to confusion about what people should do to protect themselves and prevent transmission of disease. | But where did that number come from? The variations in crowd size requirements and recommendations from assorted government authorities may add to confusion about what people should do to protect themselves and prevent transmission of disease. |
| “It feels like somebody is using a Magic 8-Ball to make these decisions,” said Kelly Hills, a bioethicist and co-founder of the consulting firm Rogue Bioethics. “There is no consistency. There doesn’t even seem to be consistency in who’s making these decisions.” | “It feels like somebody is using a Magic 8-Ball to make these decisions,” said Kelly Hills, a bioethicist and co-founder of the consulting firm Rogue Bioethics. “There is no consistency. There doesn’t even seem to be consistency in who’s making these decisions.” |
| Size limits for group gatherings in public and private settings have varied widely over the past week. | Size limits for group gatherings in public and private settings have varied widely over the past week. |
| St. Louis banned gatherings as large as 1,000 on Thursday. | St. Louis banned gatherings as large as 1,000 on Thursday. |
| As recently as Sunday, the federal Centers for Disease Control and Prevention recommended that events consisting of 50 people or more be canceled or postponed for the next eight weeks. | As recently as Sunday, the federal Centers for Disease Control and Prevention recommended that events consisting of 50 people or more be canceled or postponed for the next eight weeks. |
| Gov. Charlie Baker of Massachusetts prohibited gatherings of over 25 people on Sunday. | Gov. Charlie Baker of Massachusetts prohibited gatherings of over 25 people on Sunday. |
| On the same day, officials in San Mateo County, Calif., reduced their recommendation to 10 people while officially banning crowds of 50 or more. | On the same day, officials in San Mateo County, Calif., reduced their recommendation to 10 people while officially banning crowds of 50 or more. |
| That change came at a time when California state officials had declared 250 as the ceiling for gatherings. | That change came at a time when California state officials had declared 250 as the ceiling for gatherings. |
| Social distancing is a broad category of precautions that includes standing approximately six feet from others when possible, not shaking hands, applying self-quarantine or isolation for individuals who feel sick and avoiding mass gatherings. These precautions can help slow the spread of infections and cases of the sick pouring into hospitals that could potentially overwhelm their capacity to care for those who need help. | Social distancing is a broad category of precautions that includes standing approximately six feet from others when possible, not shaking hands, applying self-quarantine or isolation for individuals who feel sick and avoiding mass gatherings. These precautions can help slow the spread of infections and cases of the sick pouring into hospitals that could potentially overwhelm their capacity to care for those who need help. |
| Dr. Deborah Birx, the White House coronavirus response director, said during Monday’s news conference that the federal recommendation of no more than 10 was reached because officials had been working with researchers modeling the spread of the virus. | Dr. Deborah Birx, the White House coronavirus response director, said during Monday’s news conference that the federal recommendation of no more than 10 was reached because officials had been working with researchers modeling the spread of the virus. |
| “The most important thing was if one person in the household became infected, the whole household self-quarantined for 14 days because that stops 100 percent of the transmission outside of the household,” Dr. Birx said, without offering more detail about how they reached the number 10. | “The most important thing was if one person in the household became infected, the whole household self-quarantined for 14 days because that stops 100 percent of the transmission outside of the household,” Dr. Birx said, without offering more detail about how they reached the number 10. |
| One study from researchers at Imperial College London predicted that without action to stem the spread, the virus could cause more than two million deaths in the United States. It suggested that the most effective way to avert that outcome was to limit interactions between people for a period of time. | One study from researchers at Imperial College London predicted that without action to stem the spread, the virus could cause more than two million deaths in the United States. It suggested that the most effective way to avert that outcome was to limit interactions between people for a period of time. |
| But there is no standard or scientific definition of what a mass gathering of people is, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. And scientists who have studied the 1918 Spanish flu pandemic and more recent outbreaks have not found strong evidence that restricting mass gatherings alone is effective in controlling an outbreak, Dr. Osterholm said. | But there is no standard or scientific definition of what a mass gathering of people is, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. And scientists who have studied the 1918 Spanish flu pandemic and more recent outbreaks have not found strong evidence that restricting mass gatherings alone is effective in controlling an outbreak, Dr. Osterholm said. |
| In addition to the size of a gathering, public health experts may consider factors such as the density of people in one place when making recommendations on social distancing, Dr. Osterholm said. | In addition to the size of a gathering, public health experts may consider factors such as the density of people in one place when making recommendations on social distancing, Dr. Osterholm said. |
| Events where people congregate in a small space may increase the opportunity for person-to-person transmission of the virus. Gatherings that last for longer periods of time, such as rallies, concerts or conferences, may also increase the opportunities for transmission compared with brief encounters that may occur at a pharmacy or a grocery store. That is why the context of the gathering may be more important than the actual number of people in some situations. | Events where people congregate in a small space may increase the opportunity for person-to-person transmission of the virus. Gatherings that last for longer periods of time, such as rallies, concerts or conferences, may also increase the opportunities for transmission compared with brief encounters that may occur at a pharmacy or a grocery store. That is why the context of the gathering may be more important than the actual number of people in some situations. |
| “What is proper social distancing for a major metropolitan city with sustained community acquired transmission is going to be different from a sleepy farming community,” Ms. Hills said. “You wouldn’t want to just one-size things.” | “What is proper social distancing for a major metropolitan city with sustained community acquired transmission is going to be different from a sleepy farming community,” Ms. Hills said. “You wouldn’t want to just one-size things.” |
| The prevalence of a pathogen in the community is another important factor to consider. If a pathogen is extremely widespread, then it makes sense to limit gatherings to much smaller numbers, Dr. Osterholm said. | The prevalence of a pathogen in the community is another important factor to consider. If a pathogen is extremely widespread, then it makes sense to limit gatherings to much smaller numbers, Dr. Osterholm said. |
| Updated June 22, 2020 | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| “If 20 percent of the population is infected, you can have one meeting with 10 people in it and pretty well assume that there will be someone there who can transmit the virus,” Dr. Osterholm said. Because of a lack of testing, it is not yet clear what portion of the population is infected with the coronavirus. | “If 20 percent of the population is infected, you can have one meeting with 10 people in it and pretty well assume that there will be someone there who can transmit the virus,” Dr. Osterholm said. Because of a lack of testing, it is not yet clear what portion of the population is infected with the coronavirus. |
| Does that mean it’s safe to have up to 10 people in your home for a dinner party, a book club meeting or some other small gathering? | Does that mean it’s safe to have up to 10 people in your home for a dinner party, a book club meeting or some other small gathering? |
| The safest thing to do for the moment would be to cancel such plans, or perhaps shift them to videoconferencing. | The safest thing to do for the moment would be to cancel such plans, or perhaps shift them to videoconferencing. |
| And for those who go forward with guests, it is important to consider whether anyone in the household or among the invited guests may be elderly or have underlying health conditions. Research suggests that individuals in these categories are more likely to catch an infection, and they may develop more severe disease if they get sick. | And for those who go forward with guests, it is important to consider whether anyone in the household or among the invited guests may be elderly or have underlying health conditions. Research suggests that individuals in these categories are more likely to catch an infection, and they may develop more severe disease if they get sick. |
| Family-style meals and open buffets should be avoided in any case. | Family-style meals and open buffets should be avoided in any case. |
| “You might want to have one person in charge of dishing out all of the plates, rather than each person going in and interacting with the food,” Ms. Hills said. | “You might want to have one person in charge of dishing out all of the plates, rather than each person going in and interacting with the food,” Ms. Hills said. |
| And if you or one of your guests develops a fever or cough or simply feels fatigued, it is best to err on the side of caution and cancel plans, Ms. Hills said. “Everything can be rescheduled.” | And if you or one of your guests develops a fever or cough or simply feels fatigued, it is best to err on the side of caution and cancel plans, Ms. Hills said. “Everything can be rescheduled.” |