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| C.D.C. Stresses Need for Coronavirus Testing at Homeless Shelters | C.D.C. Stresses Need for Coronavirus Testing at Homeless Shelters |
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| According to a new study of homeless shelters in four major American cities, it is crucial to broadly test residents and staff for the coronavirus at the detection of the first case — or sooner — and to isolate those who test positive in order to prevent a wide spread of infection. | According to a new study of homeless shelters in four major American cities, it is crucial to broadly test residents and staff for the coronavirus at the detection of the first case — or sooner — and to isolate those who test positive in order to prevent a wide spread of infection. |
| Even in two shelters in Atlanta, which had no known coronavirus cases, comprehensive testing of residents and staff found that 4 percent of the residents and 2 percent of staff members tested positive, suggesting that some people were spreading the disease through the shelters before they had symptoms. | Even in two shelters in Atlanta, which had no known coronavirus cases, comprehensive testing of residents and staff found that 4 percent of the residents and 2 percent of staff members tested positive, suggesting that some people were spreading the disease through the shelters before they had symptoms. |
| And in 12 Seattle shelters, which each had only one known previous case, 5 percent of the residents and 1 percent of staff members tested positive. | And in 12 Seattle shelters, which each had only one known previous case, 5 percent of the residents and 1 percent of staff members tested positive. |
| But by the time there was a cluster of cases (meaning two or more) at shelters, the extent of the spread was far greater, according to the study released on Wednesday by the Centers for Disease Control and Prevention. | But by the time there was a cluster of cases (meaning two or more) at shelters, the extent of the spread was far greater, according to the study released on Wednesday by the Centers for Disease Control and Prevention. |
| The study’s researchers took data from tests administered at shelters in Atlanta, Boston, San Francisco and Seattle from late March through early April. The program sought to test every resident and staff member at 19 shelters in those cities, but in some cases residents were not available or declined to participate. | The study’s researchers took data from tests administered at shelters in Atlanta, Boston, San Francisco and Seattle from late March through early April. The program sought to test every resident and staff member at 19 shelters in those cities, but in some cases residents were not available or declined to participate. |
| After a cluster was detected in a shelter in Boston, testing found that more than a third of the residents had the virus, while two-thirds tested positive at a shelter in San Francisco. | After a cluster was detected in a shelter in Boston, testing found that more than a third of the residents had the virus, while two-thirds tested positive at a shelter in San Francisco. |
| “If you wait for a cluster to develop, you are almost too late,” said Dr. Jim O’Connell, the president of the Boston Health Care for the Homeless Program, who took part in the study. “The lesson is that from the beginning of this epidemic, we should have been testing people in nursing homes, prisons and in shelters because that is where it is spreading asymptomatically, and it can be deadly before you know it.” | “If you wait for a cluster to develop, you are almost too late,” said Dr. Jim O’Connell, the president of the Boston Health Care for the Homeless Program, who took part in the study. “The lesson is that from the beginning of this epidemic, we should have been testing people in nursing homes, prisons and in shelters because that is where it is spreading asymptomatically, and it can be deadly before you know it.” |
| Dr. O’Connell noted that some shelters outside of the study have reported very high rates of positive test results with little prior indication of infection. He said that 49 residents out of 114 (43 percent) tested positive at a shelter in Worcester, Mass., and very few of them had noticeable symptoms beforehand. | Dr. O’Connell noted that some shelters outside of the study have reported very high rates of positive test results with little prior indication of infection. He said that 49 residents out of 114 (43 percent) tested positive at a shelter in Worcester, Mass., and very few of them had noticeable symptoms beforehand. |
| “That was before they had a cluster,” he said. “What we really need to be doing is testing early and often in shelters.” | “That was before they had a cluster,” he said. “What we really need to be doing is testing early and often in shelters.” |
| The C.D.C. study said that approximately 1.4 million people nationally use homeless shelters each year. It added that infection-control practices at shelters are especially important, but they can be challenging because of overcrowding, the older age and underlying health conditions of many homeless people, a lack of hand sanitizers and the difficulty of keeping guests sheltering in place. | The C.D.C. study said that approximately 1.4 million people nationally use homeless shelters each year. It added that infection-control practices at shelters are especially important, but they can be challenging because of overcrowding, the older age and underlying health conditions of many homeless people, a lack of hand sanitizers and the difficulty of keeping guests sheltering in place. |
| Dr. Georgina Peacock, a leader of the C.D.C.’s Covid-19 Response At Risk Task Force, noted that many of the study’s findings also apply to the population at large: Early and regular testing, followed by isolation, is vital to controlling the spread of the disease. | Dr. Georgina Peacock, a leader of the C.D.C.’s Covid-19 Response At Risk Task Force, noted that many of the study’s findings also apply to the population at large: Early and regular testing, followed by isolation, is vital to controlling the spread of the disease. |
| But she said these issues are magnified at shelters because of the conditions found at many of them. | But she said these issues are magnified at shelters because of the conditions found at many of them. |
| “This is a vulnerable population,” she said, “and it is difficult in homeless shelters to do some of the things that we know are important to contain spread.” | “This is a vulnerable population,” she said, “and it is difficult in homeless shelters to do some of the things that we know are important to contain spread.” |
| In all, officials tested 1,192 residents and 313 staff members. Five of the 19 shelters had clusters of two or more people known to have contracted the virus before the testing was done. Those were the ones with high rates of infection. | In all, officials tested 1,192 residents and 313 staff members. Five of the 19 shelters had clusters of two or more people known to have contracted the virus before the testing was done. Those were the ones with high rates of infection. |
| Updated June 24, 2020 | |
| Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | |
| 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. | 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. |
| 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. |
| Dr. O’Connell noted that the overall rate of infection in a region should be factored in to any conclusions. The more cases there are in a particular city, the more cases would be expected to be found in shelters there. The study said that Boston had the highest rate of infections among the four cities, at 14.4 cases per 100,000 residents at the time of the testing period. San Francisco had the lowest rate, at 5.7. | Dr. O’Connell noted that the overall rate of infection in a region should be factored in to any conclusions. The more cases there are in a particular city, the more cases would be expected to be found in shelters there. The study said that Boston had the highest rate of infections among the four cities, at 14.4 cases per 100,000 residents at the time of the testing period. San Francisco had the lowest rate, at 5.7. |
| Another study, also released Wednesday by the C.D.C., examined how public health officials, in coordination with the C.D.C., tested 233 residents and staff members at three affiliated shelters in Seattle, where staff and residents had been moving regularly from one shelter to another. It found 18 percent of the residents at those shelters and 21 percent of the staff members tested positive for the virus. | Another study, also released Wednesday by the C.D.C., examined how public health officials, in coordination with the C.D.C., tested 233 residents and staff members at three affiliated shelters in Seattle, where staff and residents had been moving regularly from one shelter to another. It found 18 percent of the residents at those shelters and 21 percent of the staff members tested positive for the virus. |
| Aggressive isolation measures after the testing helped to mitigate the spread, Dr. Peacock said. Residents who tested positive were transported to hospitals or brought to isolation areas away from the shelters to avoid further contamination. | Aggressive isolation measures after the testing helped to mitigate the spread, Dr. Peacock said. Residents who tested positive were transported to hospitals or brought to isolation areas away from the shelters to avoid further contamination. |
| Both reports recommended that service providers apply physical distancing measures where possible, including ensuring that residents’ heads are at least six feet apart while sleeping, and promote the use of cloth face coverings for everyone in a facility. | Both reports recommended that service providers apply physical distancing measures where possible, including ensuring that residents’ heads are at least six feet apart while sleeping, and promote the use of cloth face coverings for everyone in a facility. |
| “Sometimes you don’t have that ability to do some of that social distancing,” Dr. Peacock said, “so you have to plan for how to reduce crowding.” | “Sometimes you don’t have that ability to do some of that social distancing,” Dr. Peacock said, “so you have to plan for how to reduce crowding.” |
| Sharon Bogan, a spokeswoman for Public Health — Seattle & King County, said there are currently 74 people in isolation, quarantine and recovery sites around King County. | Sharon Bogan, a spokeswoman for Public Health — Seattle & King County, said there are currently 74 people in isolation, quarantine and recovery sites around King County. |
| According to the C.D.C. report, 147 of 408 residents at a Boston shelter had tested positive for Covid-19. Dr. O’Connell said that, like the shelter in Worcester, many of them were asymptomatic. Once they tested positive, they were moved to other locations, including a temporary field hospital in a Boston convention center with 500 beds set aside for homeless people. Other homeless guests, who did not test positive, were moved to dormitories at nearby Suffolk University to ease overcrowding. | According to the C.D.C. report, 147 of 408 residents at a Boston shelter had tested positive for Covid-19. Dr. O’Connell said that, like the shelter in Worcester, many of them were asymptomatic. Once they tested positive, they were moved to other locations, including a temporary field hospital in a Boston convention center with 500 beds set aside for homeless people. Other homeless guests, who did not test positive, were moved to dormitories at nearby Suffolk University to ease overcrowding. |
| “Large cities need to make sure they incorporate the homeless shelters and homeless population into their overall plan to treat the virus,” he said. “Cities have not done that, so this is a good clarion call for everyone.” | “Large cities need to make sure they incorporate the homeless shelters and homeless population into their overall plan to treat the virus,” he said. “Cities have not done that, so this is a good clarion call for everyone.” |