NORTH MANKATO Expanded testing at North Mankatos Oak Terrace Assisted Living recently identified COVID-19 in 27 residents and 20 staff members including the facilitys administrator.
Nicollet County health officials released the facilitys numbers Wednesday. The county has had four COVID-19 deaths since Monday and its seven total are the most in south-central Minnesota since the pandemic began.
Oak Terrace had been grappling with some COVID-19 exposures among staff and residents since April, but the testing in recent weeks revealed a concerning number of asymptomatic cases, said Administrator Drew Hood.
We have residents and staff who were completely asymptomatic who, if we didnt do the testing, we never wouldve known, he said.
Hood was one of the asymptomatic cases who has since recovered.
Nicollet County officials and Eric Weller from the South Central Minnesota Health Care Coalition recently helped coordinate testing for all residents on multiple occasions, which Hood said will help mitigation efforts.
The county and the assisted living facility are working together on ongoing mitigation. Their plans include continued testing of residents and staff, continuing to restrict visitors and isolating residents with symptoms.
Asymptomatic residents and staff also will be isolated, with the recent broad testing being the first real way to identify those more elusive cases. With no national testing strategy from the beginning of the pandemic, states have only recently been able to expand testing enough to offer it to asymptomatic people.
The potential for asymptomatic spread is why health experts are stressing the need for masks and other mitigation efforts for the public, said Cassandra Sassenberg, Nicollet Countys director of health and human services.
I think people are getting the idea that because theyre feeling well they can interact with vulnerable populations and things will be OK, she said. If youre asymptomatic, you could be spreading it to people who are at really high risk.
She praised Oak Terrace for working with the county to monitor residents and staff and isolate cases when they arise. Oak Terrace is using a dedicated wing to treat residents with COVID-19, which staff modified to make more room Wednesday.
The facility had a wing ready early in the pandemic, despite smaller numbers of cases identified on-site in April. Hood said hes thankful the facility prepared.
It sat empty for five weeks but Im glad we had it, he said. Weve been able to separate residents and have dedicated staff.
He commended staff for working long hours to care for residents during the pandemic. The facility isnt experiencing major worker shortages, despite some staff needing to isolate, although it did have to use staffing agencies to bring in help for the first time.
Oak Terrace includes memory care and independent living along with assisted living. Long-term care facilities have been hit hard by COVID-19 with 81% of Minnesotas 932 deaths occurring in people who resided in them.
The North Mankato facility was one of the first long-term care facilities in south-central Minnesota with COVID-19 exposures, and it wasnt the last. Pillars of Mankato in Blue Earth County, St. John Lutheran Home in Brown County, Friendship Court in Faribault County and Temperance Lake Ridge in Martin County are the other facilities with known cases so far the Minnesota Department of Health only lists facilities with at least 10 residents.
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Thousands of residents apply for SFPUC's COVID-19 discount on water, sewer, electricity bills San Francisco Examiner
As a boy, William L. Burch would have been the geek or the nerd of his generation, said one of his three sons.
He liked to deep dive into a topic, or the latest technology, and then tell others what he had learned, Roger Burch explained.
After a career as an engineer, working in Buffalo on some of the biggest projects of the 20th century including the Manhattan Project and the Apollo lunar module Burch lived since 2016 in the McAuley Residence, a nursing home hard hit by Covid-19.
In late April, McAuley detected its first case of the virus in a resident. Ten days later, Burch's fever spiked, and he, too, was tested. When his case of Covid-19 was confirmed on May 7, he was moved to the St. Joseph Post-Acute Center, a nursing home for Covid-19 patients in Orchard Park.
His son, who was able to Skype with him twice, doubts that his father recognized him.
Burch died May 11. He was 100 years old.
Roger Burch said his father had been in mostly good health before he caught the virus. He had avoided many of the ailments that often hit people at an advanced age: diabetes, heart disease, cancer. But dementia had "caught up with him,'' his son said.
Burch was born in Gary, Ind., and grew up in other places, including Denver, Colo. When he worked in a chemistry lab, he impressed a supervisor who suggested he study at the Colorado School of Mines. He graduated in 1944, after three years of coursework rather than four. He was part of an advanced program that tried to move engineers through quickly because they were needed for the war effort.
With his bachelor of science degree in metallurgical engineering, Burch began work at the Linde Corp. in Kenmore. His first engineering assignment was on the Manhattan Project, helping Linde develop methods to concentrate fissionable uranium isotopes for use in the first atomic bomb.
At Linde, Burch met his future wife, Olive Lightfoot, a chemical laboratory technician. When he died, they had been married for 72 years.
In July, Ronald Burch said he visited his father with a newspaper commemorating the 50th anniversary of the first Apollo mission that landed men on the moon. "That's the lunar excursion module," William Burch said as he saw that historic photograph. During a 35-year career with Bell Aircraft, Burch, among other tasks, trained welders to fabricate critical components for the lunar module.
In retirement, Burch threw himself into his passion for bird watching. When a pair of peregrine falcons nested atop Buffalo's Statler Hotel in the 1990s, he volunteered to help the state Department of Environmental Conservation install a camera to monitor them. He would watch the birds from street level, and when passers-by asked him what he was looking at, Burch would tell them all about the falcons, Roger Burch said.
Burch's oddest brush with history came in 1933. He was a teenager working in a radio repair shop in Joplin, Mo., where his family had lived for a while. A well-dressed customer had a radio installed in his car, then asked how it picked up police frequencies, Roger Burch said, repeating the story his father told his sons over the years.
William Burch told the customer that the radio could not pick up a police frequency, and such a radio could be installed only in police vehicles.
Days later, William Burch saw a news story of a shootout in Joplin where two police officers were killed when they tried to arrest a gang of suspected robbers in their hideout. The robbers got away but left behind undeveloped film in which they were pictured mugging for a camera.
Looking at the pictures, William Burch, his son said, realized he had installed a radio for Clyde Barrow, who was one half of the outlaw couple known as Bonnie and Clyde.
The worst pandemic in a century has claimed victims across the US.
Some groups have been particularly vulnerable, with those over 65 making up a large proportion of the fatalities, though all generations have been affected.
Three times as many black Americans have died compared with white Americans. Medical workers, grocery store employees and those in other essential jobs have been at increased risk.
Here, relatives and friends pay tribute to some of those they have lost.
Beatrice Ogu, a homemaker who immigrated to the US from Nigeria in 1990, died last month at a Washington DC nursing home. Ogu, 94, was easygoing, kind, always caring, said Keith Ogu, one of her seven grandchildren. When Beatrice Ogu saw them, she was full of joy.
When Beatrice Ogu watched her grandchildren, she let us do whatever we wanted. Sometimes it was a good thing, sometimes it wasnt such a good thing, he recalled fondly.
She came to the US after her son, Ethelbert Ogu, had immigrated and moved in with his growing family. Some of Keith Ogus most cherished recollections of her were when she walked him and his siblings to school. She was older even back when we were super young and rested a lot, so their walks together were like a special treat.
It was just the fact that we got a little bonding time with her, he said.
She was definitely a good cook, he also recalled, saying that she prepared traditional foods including okra and spinach soups and fufu, a staple made of pounded starch such as cassava.
In the last couple of years, Beatrice Ogus health had deteriorated to the point where she was moved into a nursing home. She could no longer walkand she had diabetes, he said.
The last time Keith Ogu and his siblings saw their grandmother was at Christmas. She was eating lunch when the family arrived, and they surprised her with gifts in the dining room.
When she fell ill, doctors initially said, its just a minor fever not coronavirus.
I had a sense of hope that this isnt going to kill her and that shed recover from this, Keith Ogu said. The diagnosis changed several days later. To be told it actually was coronavirus, all hope was taken away, he said.
The family have asked for help to pay for her burial and funeral. I still just cant believe that someone Ive known since birth, I wont ever be able to see again. VB
Outside Kings county hospital center in Brooklyn, New York, on a recent Friday night were dozens of healthcare workers, all still dressed in their scrubs, masks and protective gear, clutching white and blue balloons with messages written on them.
We love you Mama Guia! they shouted before releasing balloons, cheering as they floated into the sky in a city that has been hit hard by the virus.
The group gathered at 8pm, the time Maria Guia Cabillon would have started her typical 12-hour shift at the hospital, to pay tribute to the beloved nurse. Cabillon passed away from complications related to Covid-19 on 26 April at 63.
Across the US, dozens of healthcare workers like Cabillon have become victims of Covid-19 after taking care of patients who had the virus.
In mid-April, the Centers for Disease Control and Prevention estimated that 9,200 healthcare workers had tested positive for Covid-19 and at least 27 had died, though the count is probably much higher.
Cabillon was born and raised in Iloilo City, Philippines, eventually moving to New York to become a nurse. She worked at Kings county hospital for over 30 years.
Though she stood 5ft tall, Cabillons booming voice could be heard throughout the emergency room of Kings county hospital, where she worked on the frontline until she fell ill.
She was adored by colleagues throughout the hospital, earning the nickname Mama Guia for the love and care she showed to her patients and the nurses who worked under her.
Colleagues have paid tribute to her life and work, posting pictures and memories of Cabillon. An online fundraiser to help her family bring Cabillon back to the Philippines raised more than $60,000.
Your love for the work you do is evident in everything youve done and how much youve affected every single life that was to cross your path, wrote Shane DeGracia, a fellow nurse, on Facebook. Your death is not in vain. You did what you loved til the very end, which was to take care of others. LA
Lukenson Laguerre, described by those who knew him as one of the sweetest people you can imagine, died on 12 May. Laguerre, known as Lukey among those close to him, was 26.
Melissa Booker, a speech pathologist at the East Ramapo Central school district in New York who worked with Laguerre, said that his first job was at an after-school homework help center, Excellence in Education and Living Environments for Families (EELEF). Lukenson had once been a student at the center.
He really just did everything in our office that we needed, Booker said. He had an expertise in understanding the computer and the wizardry that he could just fix anything or create anything or find lost things.
For five years, Laguerre worked as production director on the Rockland Youth film festival, which was put on by EELEF. He was the technical support that glued all of the work together, she said.
We decided not to do the festival without him, she said. Theres no way that we could replace him. He is literally irreplaceable in our hearts in that role.
Laguerres most recent job was working as a clerical assistant in East Ramapo Central school districts special student services division. He dedicated his life to helping others, Booker said.
I loved singing with him. We would sing everything and harmonize perfectly, said Ruth Laguerre, his younger sister, in a statement emailed to the Guardian by one of his friends. I just want everyone to remember Luke being happy.
Emmanuela Laguerre, his older sister, said in a statement emailed by one of his friends: Luke was quiet but if you gave him the chance, he would talk to you about anything We know that he is happy and he is probably trying to talk God into putting in some wifi up there in heaven.
Laguerre is also survived by his mother, Claudette Leroy. VB
The first thing Roxanna Paisano saw each morning was her daughter Jackies smile.
The 16-year-old would pinch her mom to wake her up in the morning so they could get ready for school, where she loved to greet bus drivers, classmates and teachers with a big grin.
Its the glowing smile which family, friends and doctors continue to talk about, just over a month after Jackies death. The teenager died of Covid-19 complications on 20 April a month shy of her 17th birthday.
She would usually celebrate her birthday at school, where they would bring a cake and pizza, one of her favorite foods. In the classroom, they would put on music for her and her friends to dance to and used balloons to decorate.
We miss hugging her, Paisano said.
Jackie lost her ability to walk and talk after experiencing seizures because of a brain tumour starting at 18 months old.
She used a talking device to communicate and her mom said the buttons she pressed most were the ones which indicated she was happy. They were her favorites, she pushed them all the time, Paisano said.
After Jackie died, the school shared with her family a poem she had composed in class:
I am sassy and strong.
I dream about doing things with my family.
I hope to always be included.
I am sassy and strong.
I am a person and more than my disability.
Her engagement with school was also showcased in a Special Olympics video about her work in a physical activity training program.
There have been fewer cases of Covid-19 detected in children and they are dying from Covid-19 at a lower rate than other age groups, but Jackie is one of several children to succumb to the respiratory illness.
Health officials have also warned about a mystery inflammatory syndrome related to the virus which resembles the rare childhood illness Kawasaki disease and is tied to the deaths of three children in New York City. AH
To see Bobby Begay along the Columbia River in northern Oregon was to understand that the river was an extension of Begay himself. Whether he was navigating boats through the most impossible sections in search of sea lions, or plunging under the rushing waters of Willamette Falls to fish lamprey by hand, the river was part of his native heritage, and something that he spent his entire life sharing with others.
The river was his domain, said Jeremy FiveCrows, a spokesman for the Columbia River Inter-Tribal Fish Commission.
Begay, 51, died on 24 April from complications related to Covid-19. In his passing, the Columbia River lost one of its most ardent protectors. The native tribes that fish the river and live along its banks lost a leader. And a family lost a husband and father who always put them first.
Begay worked for 22 years for the Columbia River Inter-Tribal Fish Commission, an organization that oversees policy and fisheries services for the Yakama, Warm Springs, Umatilla and Nez Perce tribes. As a senior fishery technician, he was the organizations eyes and ears on the river, FiveCrows said. He just always had a humorous story, and never took himself seriously, FiveCrows said.
He was the ultimate tour guide because he loved what he did.
Begay, a member of the Yakama tribe nation, lived in Celilo Village, a small unincorporated Native American community about 90 miles east of Portland. He was a leader in the community, FiveCrows said, taking part in powwows, the annual First Salmon Feast, and the annual lamprey harvest.
The rivers salmon and lamprey hold cultural and spiritual significance to the local tribes, and Begay was committed to ensuring that their tradition of fishing would continue. He had a belief that if people understood more about the tribal culture, they would be more understanding of where the tribes were coming from and why it should be important for everyone to protect the river and the salmon, FiveCrows said.
One of Begays favorite stories to tell was about encountering a sea lion at Sea World that he swore recognized him from his time hazing sea lions along the river.
Begay would never hurt the sea lions, but he would fire off little firecrackers to spook them off. Hed come to recognize the repeat offenders, FiveCrows said and supposedly, the repeat offenders had come to recognize him.
One day, he and his family were on vacation at Sea World in Florida and he said they walked to the sea lions and all of the sea lions were going all over the place, but one just wouldnt take his eyes off him, FiveCrows said, laughing. Bobby just said, I knew that was the one. My mortal enemy.
Begay is survived by his wife, Megan, and his children Daisy, Steven, Jackie and Henry. VH
Health care workers protest hospital understaffing and insufficient personal protective equipment last week outside Providence St. Joseph Medical Center in Burbank, Calif. Ronen Tivony/Echoes Wire/Barcroft Media via Getty Images hide caption
Health care workers protest hospital understaffing and insufficient personal protective equipment last week outside Providence St. Joseph Medical Center in Burbank, Calif.
When President Trump took office in 2017, his team stopped work on new federal regulations that would have forced the health care industry to prepare for an airborne infectious disease pandemic such as COVID-19. That decision is documented in federal records reviewed by NPR.
"If that rule had gone into effect, then every hospital, every nursing home would essentially have to have a plan where they made sure they had enough respirators and they were prepared for this sort of pandemic," said David Michaels, who was head of the Occupational Safety and Health Administration until January 2017.
There are still no specific federal regulations protecting health care workers from deadly airborne pathogens such as influenza, tuberculosis or the coronavirus. This fact hit home during the last respiratory pandemic, the H1N1 outbreak in 2009. Thousands of Americans died and dozens of health care workers got sick. At least four nurses died.
Studies conducted after the H1N1 crisis found voluntary federal safety guidelines designed to limit the spread of airborne pathogens in medical facilities often weren't being followed. There were also shortages of personal protective equipment.
"H1N1 made it very clear OSHA did not have adequate standards for airborne transmission and contact transmission, and so we began writing a standard to do that," Michaels said.
HIV/AIDS rule set the standard for protecting workers
OSHA experts were confident new airborne infectious disease regulations would make hospitals and nursing homes safer when future pandemics hit. That's because similar rules had already been created for bloodborne pathogens such as Ebola and hepatitis.
Those rules, implemented during the HIV/AIDS epidemic, forced the health care industry to adopt safety plans and buy more equipment designed to protect staff and patients.
But making a new infectious disease regulation, affecting much of the American health care system, is time-consuming and contentious. It requires lengthy consultation with scientists, doctors and other state and federal regulatory agencies as well as the nursing home and hospital industries that would be forced to implement the standard.
Federal records reviewed by NPR show OSHA went step by step through that process for six years, and by early 2016 the new infectious disease rule was ready. The Obama White House formally added it to a list of regulations scheduled to be implemented in 2017.
Then came the presidential election.
An emphasis on deregulation
In the spring of 2017, the Trump team formally stripped OSHA's airborne infectious disease rule from the regulatory agenda. NPR could find no indication the new administration had specific policy concerns about the infectious disease rules.
Instead, the decision appeared to be part of a wider effort to cut regulations and bureaucratic oversight.
"Earlier this year we set a target of adding zero new regulatory costs onto the American economy," Trump said in December 2017. "As a result, the never-ending growth of red tape in America has come to a sudden, screeching and beautiful halt."
The impact on the federal effort to protect health care workers from diseases such as COVID-19 was immediate.
"The infectious disease standard was put on the back burner. Work stopped," said Michaels, now a professor at George Washington University.
A medical worker is assisted into personal protective equipment on May 8 before stepping into a patient's room in the COVID-19 intensive care unit at Harborview Medical Center in Seattle. Elaine Thompson/AP hide caption
A medical worker is assisted into personal protective equipment on May 8 before stepping into a patient's room in the COVID-19 intensive care unit at Harborview Medical Center in Seattle.
A deadly escalation of the H1N1 crisis
This spring, hospitals and nursing homes found themselves facing much of the same crisis they experienced during the H1N1 outbreak, with many facilities unprepared and unequipped. Only this time the scale was larger and deadlier.
The federal government reports that at least 43,000 front-line health care workers have gotten sick, many infected, while caring for COVID-19 patients in facilities where personal protective equipment was being rationed.
"Even just a few months ago, I couldn't have imagined that I would have been on a Zoom call reading out the names of registered nurses who have died on the front lines of a pandemic," said Bonnie Castillo, who heads the National Nurses United union.
"The memorial was not only about grief. It was also about anger."
OSHA's infectious disease rule debated in Washington
Castillo said Congress should immediately implement the infectious disease regulations shelved by the Trump administration as an emergency rule before a second wave of the coronavirus hits.
"Which obviously would mandate that employers have the highest level of PPE, not the lowest," she said.
Democrats in the House of Representatives passed a bill in mid-May that would do so, but the Republican-controlled Senate has blocked the measure, and the White House still opposes the rules.
The Trump administration hasn't responded to NPR's repeated inquiries about the infectious disease rule. But in a briefing call with lawmakers this month, the current head of OSHA, Loren Sweatt, argued enough rules are already in place to protect workers.
"We have mandatory standards related to personal protective equipment and bloodborne pathogens and sanitation standards," Sweatt said in a recording provided to NPR. "We have existing standards that can address this area."
The hospital industry also opposes the new safety rules. Nancy Foster with the American Hospital Association said voluntary guidelines for airborne pandemics are adequate.
"You're right; they're not regulations, but they are the guidance that we want to follow," Foster said. "They set forth the expectation for infection control, so in a sense they're just like regulations."
But the infectious disease standard would have required the health care industry to do far more. It sets out specific standards for planning and training. It would also have forced facilities to stockpile personal protective equipment to handle "surges" of sick patients such as the ones seen with COVID-19.
NPR also found the lack of fixed regulations allowed the Trump administration to relax worker safety guidelines. Federal agencies did so repeatedly this spring as COVID-19 spread and shortages of personal protective equipment worsened.
As a consequence, hospitals could say they were meeting federal guidelines while requiring doctors and nurses to reuse masks and protective gowns after exposure to sick patients.
UN News spoke to Susan Hayter, a Senior Technical Adviser on the Future of Work at the Geneva-based International Labour Organization, about how COVID-19 could change our working lives.
A few large companies have said employees need not commute to work again Susan Hayter, Senior Technical Adviser on the Future of Work, ILO
Before the pandemic, there was already a lot of discussion on the implications of technology for the future of work. The message was clear: the future of work is not pre-determined, it is up to us to shape it.
However, that future has arrived sooner than anticipated as many countries, companies and workers shifted to remote working in order to contain the transmission of COVID-19, dramatically changing how we work. Remote virtual meetings are now commonplace and economic activity has increased on a range of digital platforms.
As the restrictions are lifted, a question that is on everybodys mind is whether this business as unusual will become the new normal. A few large companies in developed economies have already said that what has been a large and unplanned pilot remote teleworking will become the standard way of organizing work. Employees need not commute to work again, unless they choose to do so.
This may indeed be cause to celebrate, for people and the planet. But the idea of an end to The Office is certainly overblown. The ILO estimates that in high-income countries 27 per cent of workers could work remotely from home. This does not mean that they will continue to work remotely. The question is how we can adapt work practices and reap the benefits of this experience with remote working for employers and workers while not losing the social and economic value of work as a place.
In celebrating the innovations in work organization that have supported business continuity during the health crisis, we cannot forget that many will have lost their jobs or gone out of business as the pandemic has brought some industries to a standstill. For those returning to their place of work, the quality of work will be a key issue, in particular safe and healthy workplaces.
Post-pandemic, workers like these at a factory in Addis Ababa, Ethiopia will want to be assured their workplace is safe, by Lin Qi
The degree of workers trust in the measures taken by employers to make workplaces safe, will no doubt have an impact on the return to work. Engagement with trade union representatives, where these exist, is a must.
Everything from protocols for social distancing, monitoring and testing, and the availability of personal protective equipment (PPE) need to be discussed to make this work.
For workers in the gig economy, such as food delivery and ride-hailing workers, work is not a place, but an activity performed for an income. The pandemic has revealed the false choice between flexibility and income security. These workers may have no or inadequate access to sick leave and unemployment-insurance benefits. We need to tap into the brave new world to ensure that their work is performed under conditions that are safe.
The ILO estimates a 60 per cent decline in the earnings of the almost 1.6 billion workers in the informal economy in the first month of the crisis. These workers are simply not able to work remotely and face the impossible choice of risking life or livelihood. Some countries have adopted measures to shore up this essential income while also ensuring adequate hygiene and PPE for employees and customers, informal enterprises and workers.
As companies begin to evaluate the effectiveness of the shift to remote work and their ability to tackle data security concerns, new opportunities may open up in services for developing countries with the necessary infrastructure.
However, these off-shoring opportunities in activities such as software development and engineering to financial services, may be accompanied by the reshoring in of other jobs as companies seek to improve inventory management and the predictability of supply chains.
This will have longer-term effects on employment in developing and emerging economies. The challenge is that while it will take time for new service sectors to mature, the negative impact of rising unemployment will be felt immediately. Inequalities in digital readiness may further inhibit countries from seizing these opportunities.
There may be opportunities for developing countries, like Nepal, to benefit from a global move to remote working., by World Bank/Peter Kapuscinski
The shift to remote work has enabled many companies to continue to operate and ensure the health and safety of their employees. Those able to make the transition to remote work during the health crisis have had the opportunity to share meals with their families. Work has become human-centred to accommodate homeschooling and child and elder care.
Yet, the lines between working time and private time have become blurred for these individuals, causing an increase in stress and exposure to mental health risks.
In the face of a dramatic economic downturn caused by the pandemic and surging unemployment figures, there are opportunities to leverage these changes in work organization to design new job-sharing schemes that allow for flexibility and save jobs. This may mean shorter work weeks or work-sharing arrangements to avoid furloughs in lean times, while reshaping working time arrangements to achieve better work-life balance in the longer-term.
The digital transformation of work and possibility to engage in remote work has also been accompanied by other benefits. It has presented possibilities for older, more experienced workers to prolong their working life on their terms and provided work opportunities for those in rural communities. However, for many others, it has compounded a sense of isolation and a loss of identity and purpose. The social value of work and the dignity and belonging we derive from it cannot be replaced by virtual rooms, no matter how casual our attire while we occupy them.
While the pandemic may represent a tipping point for the digital transformation of the workplace, it has also revealed deep fault lines. It is those in the upper income brackets who are the most likely to choose to work remotely, whereas those in the lowest have no choice; they will have to commute and are more likely to be time-poor as a result.
Looking to the future, as digital and online work becomes the new normal, the demand for skilled workers is likely to rise along with their wages. The contributions of care-workers and other workers (e.g. teachers and staff in grocery stores) will be more highly valued than before. Yet, many low-paid workers whose wages have been stagnating in the face of declining union power and a shifting employment relationship are likely to see their incomes eroded even further as the ranks of the unemployed increase.
Historically, economic shocks, pandemics and wars have exacerbated inequality. The remaining question is whether this one will be a tectonic shift with rising political and social instability, or a shock that leads us to reinforce the foundations of just societies and the principles of solidarity and democratic decision-making that move societies, labour markets and workplaces in the direction of equality.
We are in the midst of an historic event that will change many aspects of our world. There will be major impacts on the global economy, geopolitics and our societies. It is clear that these global impacts and risks are highly interdependent and are changing the current and future global risk landscape, a fact highlighted in the World Economic Forum's recently published COVID-19 Risks Outlook report.
We are already seeing record levels of unemployment due to lockdown measures to control transmission and have re-learned hard lessons, in particular that social deprivation determines health outcomes.
The long-term societal impacts, such as an exacerbation of inequality and changes in consumer behaviours, the nature of work and the role of technology - both at work and at home - will change our way of life forever, for us as individuals, as a workforce, and as a society. These social dimensions of the crisis, including generational frictions and continued stress on peoples wellbeing, will be felt by people worldwide and will create substantial societal consequences for the long term.
In the business community, we have made sure our employees are supported and our customers too. In some sectors and around the world, a combination of furloughing and fiscal policies have also helped put economies on hold. As countries emerge from the immediate health crisis and re-start their economies, changed working practices, attitudes towards travelling, commuting and consumption will change employment prospects. Already, the International Labour Organisation has identified that the SME and informal sectors will have particular difficulty in sustaining and recovering business.
How has the lockdown affected us?
Image: COVID-19 Risks Outlook 2020
Consumer behaviours are already changing, even during the stabilization phase that most economies are in right now. In March, global consumer spending decreased every week. In the last two weeks of April and early May, however, consumer spending recovered a little each week in anticipation of a move into a normalisation phase - where economies reduce lockdown measures and show signs of economic recovery. At first, the expenditure was on basics, such as groceries, but now spending is more focused on home improvements and clothing. There is not yet any significant expenditure on entertainment.
Human resources departments have rarely had such an important role. Working remotely increases the risk of isolation, as well as alcohol dependency, smoking too much, and bad backs through poor ergonomic posture. Whats fascinating is that the state was previously seen as the ultimate safety net; now, employers have had to accept that they too have to protect their workers in order to survive and thrive. This should be a long-term change in attitude in the historic public vs private debate.
For many, returning to work will be a psychological as well as a physical challenge
Image: COVID-19 Risks Outlook 2020
Getting back to a pre-COVID-19 growth phase is likely to be a long and difficult task, at least until there is an effective health crisis exit strategy that involves a combination of a widely available vaccine and therapeutic drugs. In the intervening period, there are likely to be continued cutbacks in travel and in the hardest-hit industries, such as tourism and hospitality. Not all those who have been laid off will return to work, and businesses will likely use fewer employees in the future. The challenge to return to the 'new normal' is, therefore, as much a psychological as economic choice.
We have to reconcile the natural fears we feel, which have been reinforced by government messages to help enforce the lockdowns, with acceptance of the uncertainties. The effectiveness of government messaging, combined with data on infection rates and the sad reality of the numbers of COVID-19 deaths, has made the challenge of changing those simple messages to stay at home confusing. The perceived lack of transparency may lead to an erosion of trust and greater complications in the long run.
The timing and speed of the economic recovery, dependent as it is on solving the health crisis, is likely to exacerbate inequality, mental health problems, and lack of societal cohesion. It is also likely to widen the wealth gap between young and old, as well as pose significant educational and employment challenges that risk a second lost generation.
Image: COVID-19 Risks Outlook 2020
The COVID-19 economic crisis has already hit poorer people and those in more socially disadvantaged groups disproportionately harder. In many places, people are having to face the moral dilemma of choosing between going to work to generate income for bare necessities or staying at home to protect their health - and that of their family. Continued exposure to health risks faced by essential workers, who are often among the lowest paid, raises the concern of heightened death rates amongst this group. This highlights societal, income and health inequalities. We need to focus on addressing this inequality during the COVID-19 recovery and normalization process.
The economic and societal disruptions of the lockdowns are taking a toll on young peoples mental health and wellbeing. As one teenager puts it: The life you thought was boring, is the life youre hoping to get back to right now.
Even more concerning are the long-lasting effects to their prospects. Youth employment in developed economies has only just recently returned to pre-2008 financial crisis levels. In developing economies, youth unemployment has risen steadily, creating a real risk of social unrest.
For young people in education, the pandemic is likely to cause new inequalities. Currently 80% of the worlds students - more than 1.6 billion young people - are not attending school. Many students in poorer communities lack the necessary tools to access online courses or face difficulties working at home. The consequences of these educational inequalities, especially for girls and young women, will disadvantage them in labour markets and further exacerbate inequality.
From a business perspective, companies generally cannot be successful in societies that are not functioning well. This is where stakeholder capitalism has a role to play.
Businesses need to bring their skills and assets to help invest in a better society. We see this very clearly in financial inclusion, where we have to bring the best of all sectors - both public and private - to bear on these problems.
Image: COVID-19 Risks Outlook 2020
We do have cause for optimism, but how we get out of this crisis is deeply concerning. We need to focus not only on a healthcare solution, but a recovery that is focused on the climate, sustainability, and on societal risks, such as inequality, mental health, the lack of societal cohesion and inclusion. If we do not do this, then the gaps in inequality - especially financial - are likely to remain and increase.
We have a chance at a clean, green and sustainable recovery that allows growth to return, but with people and communities at the centre of our efforts. As responsible businesses, we must grab this chance with both hands to help society to adapt and come back.
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Written by
John Scott, Head of Sustainability Risk, Zurich Insurance Group
The views expressed in this article are those of the author alone and not the World Economic Forum.
Development of an effective vaccine is the clearest path to controlling the coronavirus disease 2019 (COVID-19) pandemic. To accelerate vaccine development, some researchers are pursuing, and thousands of people have expressed interest in participating in, controlled human infection studies (CHIs) with severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) (1, 2). In CHIs, a small number of participants are deliberately exposed to a pathogen to study infection and gather preliminary efficacy data on experimental vaccines or treatments. We have been developing a comprehensive, state-of-the-art ethical framework for CHIs that emphasizes their social value as fundamental to justifying these studies. The ethics of CHIs in general are underexplored (3, 4), and ethical examinations of SARS-CoV-2 CHIs have largely focused on whether the risks are acceptable and participants could give valid informed consent (1). The high social value of such CHIs has generally been assumed. Based on our framework, we agree on the ethical conditions for conducting SARS-CoV-2 CHIs (see the table). We differ on whether the social value of such CHIs is sufficient to justify the risks at present, given uncertainty about both in a rapidly evolving situation; yet we see none of our disagreements as insurmountable. We provide ethical guidance for research sponsors, communities, participants, and the essential independent reviewers considering SARS-CoV-2 CHIs.
CHIs have a long, complicated history. They have contributed to substantial improvements in clinical and public health practice, including the recent licensure of two vaccines (5), but also involved some unethical research (3). The first step in justifying SARS-CoV-2 CHIs, especially as they would involve major uncertainty and controversy, is to demonstrate their high social value. Crucially, SARS-CoV-2 CHIs should address relevant, unresolved scientific questions in rigorously designed and conducted experiments.
SARS-CoV-2 CHIs could have high social value in several ways. For example, they could help prioritize among the almost 100 investigational vaccines and over 100 experimental treatments for COVID-19 currently in development. CHIs could help identify the most promising agents, which would inform the design of larger trials, guide decisions to scale up manufacturing early, and thereby accelerate product development and implementation. If they saved even a few months of vaccine development (1), SARS-CoV-2 CHIs would contribute to faster control of the pandemic and reduce the need for, and associated costs of, physical distancing measures, providing substantial benefits for much of the world's population (including the most vulnerable).
To achieve high social value in this way, coordination of stakeholders is essential. Sponsors of SARS-CoV-2 CHIs should delineate a credible path forward from CHIs to rigorous field studies, and eventually toward scaled-up production. This is a considerable challenge given the rapidly evolving research response to the pandemic; many approaches to accelerating product development are already appropriately being pursued in parallel. It is therefore essential to plan and evaluate SARS-CoV-2 CHIs as a complement, not an alternative, to these other approaches and ensure that CHI results are integrated into the dynamic COVID-19 research landscape. For example, the World Health Organization is convening sponsors of SARS-CoV-2 CHIs to increase transparency and promote coordination. Research sponsors should lead by establishing and enforcing standards for rapid data collection, dissemination, and sharing that permit aggregation of results across CHIs. Medical journals should require compliance with these standards before accepting manuscripts. Regulatory agencies should collaborate with sponsors, researchers, and policy-makers to define how CHI data will inform or modify larger trials, licensure, and manufacturing. Finally, sponsors and governments should implement mechanisms to ensure widespread, equitable access to proven products whose development was accelerated by SARS-CoV-2 CHIs. Such wide-ranging stakeholder coordination is difficult but important to demonstrate high social value. Though not achieved for proposed Zika virus CHIs during the 20152016 epidemic, it did occur later (6).
SARS-CoV-2 CHIs could have high social value in other ways, and individual CHIs could address multiple scientific questions. For example, CHIs could clarify dynamics of infection, viral pathogenesis, and risk of vaccine pathogenesis or identify correlates of protectionall of which could inform the development and implementation of vaccines. CHIs could also illuminate poorly understood parameters for modeling the pandemic and public health responses, including who is infectious and when and how infections occurred. This information is difficult to collect by observation alone, and existing animal models do not fully replicate clinical disease seen in humans. Additionally, if the pandemic wanes before larger trials are completed, SARS-CoV-2 CHIs could be critical for advancing research until the next outbreak, as with Zika virus (6). All of these paths to high social value would require similar, extensive coordination with relevant stakeholders.
SARS-CoV-2 CHIs admittedly have limited generalizability, as they would need to be conducted with low-risk populations (see below) with a non-natural mode of infection. Therefore, although some propose replacing efficacy trials with SARS-CoV-2 CHIs (1), it is more likely that CHIs accelerate vaccine or treatment development by informing larger trials, not by making such trials redundant. Yet almost all disease models or trial designs require some extrapolation or further testing. For example, field trials with frontline workers could also accelerate vaccine development, but they would not include older, retired individuals.
Thus, there are many potential ways in which SARS-CoV-2 CHIs could have high social value. Before their initiation, it is essential that the given social value is judged as compelling enough to justify its pursuit.
For SARS-CoV-2 CHIs to be ethically permissible, risks to participants, study personnel, and third parties should be minimized, reasonable in relation to the social value of the research, and below the upper limits of acceptable risk (7, 8). There are both scientific unknowns about SARS-CoV-2 and moral disagreements about upper limits to risk. Although research inherently involves uncertainty, this situation warrants a cautious approach to evaluating SARS-CoV-2 CHIs and revisiting risk/benefit judgments as new evidence emerges.
Risk minimization should focus primarily on reducing the likelihood of serious and irreversible harms. To minimize risks to participants, SARS-CoV-2 CHIs should recruit young people without underlying medical conditions who face lower mortality risks from COVID-19 (9). Key uncertainties remain regarding other potentially serious and irreversible harms of SARS-CoV-2 infection in young people, such as cardiac or neurological injury. Accordingly, long-term follow-up of CHI participants is critical.
To minimize risks to study personnel, participants should be in inpatient isolation, with contact reduced to the extent possible and robust personal protective equipment provided. Both participants and personnel should be carefully monitored, promptly managed when symptomatic, and provided any proven targeted treatments or offered enrollment into appropriate clinical trials. To minimize risks to third parties outside the research, researchers should notify public health authorities about the studies in advance and ensure that participants who withdraw take appropriate precautions to avoid spread to others.
Participants might benefit from controlled infection and/or vaccination if they become immune to SARS-CoV-2. However, the degree and duration of naturally acquired and vaccine-derived immunity are currently unknown. Some participants would also receive placebo vaccines, and most investigational vaccines prove ineffective. The potential benefits of participation thus should be given little, if any, weight. Instead, risks to participant should be justified by the social value of SARS-CoV-2 CHIs, with higher risks requiring higher social value.
Even when research has high social value and involves competent consenting adults, there is substantial consensus that risks to participants should not exceed an absolute upper limit. Regulations and ethics guidance do not clearly delineate this limit. Some commentators have argued that it should not exceed a 1% risk of death or the risks posed by activities that, like research, expose some people to risk to benefit others, such as living organ donation (8, 10). Although these are imperfect analogies to research, they provide helpful context for evaluating limits of acceptable research risk.
Current data on SARS-CoV-2 infection come from relatively small samples with missing data points and are still being scrutinized. Data suggest that 20- to 44-year-olds with diagnosed infectionincluding those with underlying conditionshave a mortality risk less than 0.2% (11). But diagnostic testing has been limited, making the number of undiagnosed infections unknown. One attempt to account for these limitations estimates that healthy adults aged 20 to 29 have a 0.03% risk of death and a 1.1% risk of hospitalizations (9). These risks could be further reduced by refining eligibility criteria based on emerging data. Recognizing the uncertainties, risks from SARS-CoV-2 CHIs appear comparable to the risks from some other research and activities similar to research (table S1). They also seem to fall below the upper risk limits proposed for research. For third parties who could be exposed to infection from CHI participants, there is no consensus on what level of risk is acceptable (12); however, with the above safeguards, these risks could be minimized to be negligible.
CHIs have a checkered history (3), and it can be counterintuitive for the public that researchers would infect people with disease-causing pathogens. Although the current pandemic context with widespread physical distancing might complicate public engagement, it remains important and feasible as SARS-CoV-2 CHIs are developed. For example, public opinion surveys could identify concerns and information deficits, and researchers could engage the media or convene virtual advisory groups. Maintaining transparency and accountability to diverse communities is important for mitigating potential mistrust, especially in a pandemic (13). As noted above, engagement with stakeholders in the research community, health professionals, and policy-makers is also critical for ensuring that the results from SARS-CoV-2 CHIs translate into social benefits.
Selecting suitable sites for SARS-CoV-2 CHIs requires considering risks to participants, study personnel, and third parties; feasibility of recruitment; availability of necessary infrastructure; and potential effects on local pandemic responses. Sites should be selected for sound scientific reasons while avoiding especially vulnerable populations. For example, performing CHIs in locations with high community spread of SARS-CoV-2 could be an acceptable way to reduce relative risks for participants, provided that high transmission is not due to underlying injustices. Given that participants would require testing, medical attention, and treatment, and research personnel would require personal protective equipment, sponsors should also demonstrate to ethics review boards or public health authorities that CHIs will not unduly compete for scarce resources and thereby compromise the local pandemic response. All sites should have sufficient capacity to conduct rigorous studies, provide high-quality care to participants, and minimize research risks. Sites experienced with conducting CHIs might be favored to ensure that studies and local public engagement can be launched quickly, effectively, and responsibly.
Selecting participants fairly for SARS-CoV-2 CHIs primarily requires considering fair distribution of research risks and burdens. Because of the uncertainty and potential high risk involved, participants who are at relatively low risk of serious and irreversible harm and have capacity to give their own consent should be selected (i.e., young, healthy and competent adults).
There is widespread consensus on obtaining high-quality informed consent for CHIs and using rigorous procedures to maximize participant understanding. Evidence-based approaches to consent include requiring participants to pass a test on key study information (14). Ongoing informed consent will be important as new data emerge, notably on the risks of SARS-CoV-2 infection.
Members of our group disagree about the ethical permissibility of offering payment to CHI participants, and there may be relevant regulatory limits in different jurisdictions. Nevertheless, as SARS-CoV-2 CHIs require confinement and follow-up, fairness seems to demand offering participants compensation for their time. This may total several thousand dollars in the United States, assuming compensation at a fair minimum wage for unskilled labor, as in other CHIs. By contrast, incentives beyond compensation could be avoided, given the number of people already indicating willingness to participate. Concerns that the undue influence of monetary compensation compromises risk judgments are unsupported by the available data, as financial motivations are associated with greater attention to risk (15). Moreover, a rigorous informed consent process could maximize understanding. In case payment tempts participants to withhold disqualifying information, eligibility criteria should be objectively verifiable.
Given the extraordinary nature of the pandemic, our framework and analysis support laying the groundwork for SARS-CoV-2 CHIsfor example, by developing a challenge strain, drafting consensus protocols that address ethical concerns, and engaging stakeholders to enhance their social value, minimize risks, and build public trust.
Acknowledgments: The opinions expressed in the article are the authors' and do not reflect the views of organizations with which the authors have affiliations, including the National Institutes of Health, the Department of Health and Human Services, or the United States government. This work was primarily supported by a Making a Difference Grant from the Greenwall Foundation (S.K.S., A.R., R.P., D.D.), along with support from the Wellcome Trust (S.K.S., E.J., D.K., M.K., R.P., M.J.S., V.V.), Brocher Foundation (S.K.S., A.R., R.P., D.D., T.C.D., H.F.L., E.J., N.S.J., D.K., J.K., D.M., S.C.M., T.L.R., M.R., A.S., M.J.S., V.V.), and NIH Clinical Center Department of Bioethics (A.R.). The authors also thank C. Chui, K. Littler, P. Pitisuttithum, and M. Yu for their contributions, and M. Danis, C. Grady, M. Nicolini, J. Ochoa, and H. Taylor for helpful discussion.
JACKSON, MI Only a handful of new positive COVID-19 cases have been diagnosed in Jackson County since last week, as health officials release data showing where positive cases have been located throughout the county.
The Jackson County Health Department reports Wednesday, May 27, that 439 residents have tested positive for COVID-19, which is 18 more positive cases than a week ago.
This comes on the heels of 17 new cases reported May 20 and and 36 new cases reported the week before that.
There have been no new COVID-19 deaths reported in Jackson County since May 20, keeping the number at 26. There was one new death reported the previous week and none the week before that.
The 439 confirmed positive cases, while spread throughout the county, are largely linked to residents living within the city of Jackson, Blackman Township, Leoni Township and Summit Township, according to a new data map created by the Jackson County Health Department.
The map, updated weekly, shows positive cases by township throughout the county. The city has the most cases at 94. With two cases each, Norvell and Waterloo townships have the fewest in the county.
Risk of the virus spreading in Jackson County is listed as medium with 5 percent of those tested getting positive results, according to a COVID-19 interactive database created by health professionals at the University of Michigan.
Michigan tests every state prisoner for coronavirus in less than 15 days
Positive COVID-19 results from the prisons in Jackson County are not included in the countys numbers.
The Michigan Department of Corrections reports 15 more new cases of the virus in prisoners serving sentences in Jackson Countys various prisons.
Eleven additional prisoners at the Parnall Correctional Facility have tested positive for COVID-19, bringing the number of confirmed cases to 191, with no new deaths beyond the 10 prisoners previously reported, according to the MDOC.
No new infections have been reported among staff at the facility, keeping the confirmed case count to 76, MDOC said.
No prisoners have tested positive at the Cooper Street Correctional Facility, though 1,397 prisoners are still waiting for test results. Of those with returned results, 128 prisoners have tested negative so far, MDOC said.
One new case of the virus has been confirmed at the G. Robert Cotton Correctional Facility, increasing its total at 689 cases and no new deaths beyond the one death already reported.
Four additional employees at the Cotton facility have tested positive for the virus, bringing its total to 40.
No additional prisoners have died and only two more have tested positive for COVID-19 at the Charles E. Egeler Reception and Guidance Center, bringing its coronavirus totals to six deaths and 106 confirmed cases, MDOC said.
There are 930 prisoners still waiting for test results.
Two additional employees of the reception center have tested positive, marking 32 staff cases.
One new case has been reported at the Duane Waters Health Center, bringing the total to 70, with no new deaths and no new staff members testing positive.
Statewide, officials reported 55,608 total confirmed cases of COVID-19 and a death toll of 5,334 Wednesday, May 27.
PREVENTION TIPS
In addition to washing hands regularly and not touching your face, officials recommend practicing social distancing, assuming anyone may be carrying the virus.
Health officials say you should be staying at least 6 feet away from others and working from home, if possible.
Use disinfecting wipes or disinfecting spray cleaners on frequently-touched surfaces in your home (door handles, faucets, countertops) and carry hand sanitizer with you when you go into places like stores.
Michigan Gov. Gretchen Whitmer has also issued an executive order requiring people to wear face coverings over their mouth and nose while inside enclosed, public spaces.
Read all of MLives coverage on the coronavirus at mlive.com/coronavirus.
Additional information is available at Michigan.gov/Coronavirus and CDC.gov/Coronavirus.
TOLEDO, Ohio Grocery stores like many businesses have taken precautions to keep us safe.
But even with safety measures in place, can the simplest actions like grabbing your grocery bags from the cashier spread the coronavirus?
The CDC has told us the virus can be transferred on surfaces, saying on May 22 "it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes."
"In theory, any surface can transmit this," ProMedica Dr. Brian Kaminski added. "So a plastic bag would be one of those things that could potentially a source or a contact surface where we could pick up the virus."
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That may concern you, but Dr. Kaminski explained the likelihood of catching the virus from your grocery bag is quite slim if you're being smart.
"If we're all maintaining those proper behaviors meaning that the cashier is performing frequent hand sanitation, not touching his or her face, handing it off to you who's also performed frequent hand sanitation, and then you take your groceries and go put them in your car, you hand sanitize again after you did that you've really virtually eliminated your risk at that point," Kaminski said.
So we can VERIFY: you can theoretically catch COVID-19 by touching grocery bags, but proper hygiene will almost definitely prevent it and person-to-person is still the primary way it's transmitted.
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