Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
The first segment of today’s column is a forewarning of what is ahead as America reopens to business and begins socializing.
South Korea, until now, has shown the world how to keep businesses and factories open while controlling the COVID-19 pandemic. But this weekend, South Korea was rocked by a new outbreak linked to one person who visited five nightclubs and infected 43 people at those clubs who then, in a third step, infected at least a dozen more people. This one carrier is linked to more than 50 new COVID-19 cases after just one night.
This is the kind of up-and-down that we can expect as we reopen businesses. South Korea opened the nightclubs to an extent that, after visiting five nightclubs, one infected person might have come in contact with 1,500 patrons.
Observers only need look at Singapore — which in the beginning of April had less than 2,000 cases, and now has more than 23,000 — as to the potential risks of relaxing too soon and assuming the battle is won when it’s only just begun. The city-state is ramping up contact tracing, restrictions on movement, and even deploying robot dogs to encourage social distancing as it tries to get its outbreak under control.
Will any lessons from these countries be learned in the West, where countries are several weeks behind in their outbreaks, but many governments are already champing at the bit to relax lockdowns, despite sky-high infection rates?
The lesson here is that reopening too soon and to too great an extent has forced countries that have been successful at containing COVID-19 to clamp down again, test again and treat new outbreaks with the same seriousness as they did the initial outbreak.
New orders to close down won’t be a popular response, especially with people who pressed hard to get businesses open. But that is how pandemics unfold; steps forward, steps backward.
COVID-19 makes it even more difficult to find nursing home workers
Long-term care facilities — including rehabilitation centers, assisted living and nursing homes — struggled to find workers for their mostly low-paying and difficult jobs before the pandemic. The pay has not gone up but the hazards have.
By The New York Times’ calculation, “At least 27,700 residents and workers have died from the coronavirus at nursing homes and other long-term care facilities for older adults in the United States, according to a New York Times database. The virus so far has infected more than 150,000 at some 7,700 facilities.”
The Kaiser Family Foundation, which focuses on major health care issues, said:
While most (long-term care facility) workers are under 50 years of age, nearly 4 in 10 are 50 or older (38%), including 7% who are 65 and older. Among those LTC workers who most frequently come in direct contact with patients, 9% of direct contact support workers and 7% of aides and personal care workers are themselves age 65 or older, and based on their age alone are at risk of serious illness if infected.
The vast majority of LTC workers are female (82%), and a disproportionate share are Black (26%). Among workers overall, only 48% are female and 12% are Black.
Kaiser also pointed out that a big percentage of people working in long-term care make so little that, despite working full time, they qualify as living in poverty.
Nearly one-third of LTC workers live in low-income families (families with combined earnings below twice the poverty level, or $26,200 for a family of four in 2020), and many have limited education to facilitate job opportunities.
Nearly one-third (32%) live in a family with income below 200% of the poverty level, and nearly four in 10 (39%) have a high school diploma or less.
Aides and personal care workers are more likely to live in poverty than other types of workers (15% versus 6%).
A larger share of both aides and personal care workers and direct contact support workers have a high school diploma or less than LTC workers overall (48%, 60%, and 39%, respectively).
A new word for you: ‘infodemic’
A new Knight Foundation poll found most people think reporters are feeding them a lot of information about the coronavirus, maybe more than they can handle:
Fifty-eight percent believe they are well-informed about the virus. Separately, 36% indicate they feel overwhelmed.
And this will light some people up:
Asked to identify the two most common sources of misinformation, a combined 68% name social media and 54% the Trump administration.
But the poll found that American adults believe the No. 1 source of misinformation is “the Trump administration.”
There is plenty in the poll for journalists to be concerned about, too. Next to the Trump administration, Americans told the pollsters that “the national news media” is the second-biggest source of misinformation about COVID-19.
Household garbage is up, office garbage is, of course, down
If the guys who pick up your garbage seem a bit more frazzled than usual it may be because while we are all home, we produce more garbage. A lot more.
Waste Management said household garbage has risen 15 to 25% but, as you might expect, the waste produced by offices is down by about the same percentage. The Wall Street Journal reported that the company’s contracts with cities are based on historic trends of how much we usually toss out from home. Now that we produce more household trash, trucks have to make more trips to landfills, jacking up the company’s operating costs. That means Waste Management and other such companies may be going back to local governments to say, “Hey. We need to reconsider this contract.”
The Journal pointed toward another story worth exploring:
“Other waste haulage companies have reduced additional services, for example yard collections, to bring down costs, said Jeff Silber, a managing director at BMO Capital Markets. “Higher residential volumes will not go away for a while,” he said.
The Association of Cities and Regions for Sustainable Resource Management generated a graphic that explores emerging practices for when a household has a known COVID-19 case. Worldwide, cities are asking that garbage be double-bagged and even kept at home for a while before depositing it in the trash.
The solid waste disposal industry reported it has not seen an overwhelming increase in medical trash since the COVID-19 outbreak. Waste haulers have said, however, that trash from cruise ships and airlines is now treated just like medical waste.
HVAC companies hope COVID-19 will deliver big business
I heard the head of Carrier Global Corporation, a company that makes heating and air conditioning units, tell CNBC that he expects businesses and homeowners to spend money to improve filtration and the “exchange rate” of indoor air. Typical industry requirements, for a home, are in the range of four to six air changes per hour.
Perhaps you caught the report about an air-conditioned restaurant in China in which 10 people from three families at three tables were infected by the coronavirus. The Centers for Disease Control and Prevention investigated and found that the direction of the air flowing from the air conditioner determined who caught the virus.
We conclude that in this outbreak, droplet transmission was prompted by air-conditioned ventilation. The key factor for infection was the direction of the airflow.
The American Society of Heating, Refrigerating and Air-Conditioning Engineers issued recommendations for how to reduce the transmission of COVID-19 through heating, ventilation and air conditioning systems. It also said turning off these systems is a bad idea. Generally, the engineers said, higher ventilation rates lead to a reduced risk from airborne viruses.
One engineer who is part of the society’s epidemic task force, M. Dennis Knight, warned that buildings have to go through a thorough restart to have healthy enough air to return to:
I suggest that expanded maintenance efforts to prepare a building for re-occupancy begin one to two weeks before the date planned to open the building to reduced or normal occupancy levels. This will depend on the size of the building or owner’s portfolio of buildings and the number of maintenance staff or contractors available to do the work. The ASHRAE COVID-19 Resource webpage has an extensive set of recommendations located in the Frequently Asked Questions section on the page dedicated directly to preparing a shuttered building for re-occupancy.
The most common places where COVID-19 spreads
Drafting off the HVAC item above, let’s try a little quiz since you have been taking in COVID-19 info nonstop for months now.
Where do most COVID-19 patients get infected?
- Nursing homes
- Jails and prisons
- Airplanes and cruise ships
It is a trick question. It depends on where you are and how much contact tracing your local governments are doing.
In 15 states, residents and workers at nursing homes and long-term care centers account for more than half of deaths from the virus. But in other places, the answer is “C,” home. In Utah, for example, KUTV reported:
Numbers from the state health department, from “known contact types,” said households were linked to nearly 60% of coronavirus cases, more than social settings (25%), unspecified locations (11%), and just about 5% in the workplace.
How is it that you can be safer in a crowded supermarket with good ventilation than in a sparsely populated office space with poor ventilation? Erin S. Bromage, an associate professor of biology at the University of Massachusetts Dartmouth, explained it.
So far, most known COVID-19 cases start when one member of a household contracts the virus in the community and brings it into the house, where sustained contact between household members leads to infection. About 44% of known cases have been traced to people who were not showing symptoms of the illness, which leads researchers to estimate that you can pass the virus along to others for five days before you actually feel sick yourself.
The outbreak that was traced to 60 choir members who were in a room about the size of a volleyball court shows us the standing-6-feet-apart guideline is not alone enough. We also have to consider how often the air handling system for the room recirculates the air in that room.
In short, you can have a sanitized and sparsely populated workspace, classroom, church or store and the virus will still spread if the space is poorly ventilated.
Two factors that just have not gotten enough attention are “ventilation” and “length of exposure.”
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Al Tompkins is senior faculty at Poynter. He can be reached at email@example.com or on Twitter, @atompkins.