Executive Summary
It is likely that managers will have an employee tell you they have tested positive for Covid-19. Not only does the moment call for sensitivity and humanity, but it also requires you to act quickly as a manager. First, express sympathy. Ask the employee which other employees they have been in close contact with. Connect with your HR partner for guidance and inform those close contacts by phone or video if possible. While your employees will likely have questions, dont speculate. Encourage them to talk to their doctor. Respect the confidentiality of the employee who tested positive, as well as the close contacts. And encourage senior leaders to check in with any affected employees it is a gesture that will be universally appreciated.
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All leaders are trying to find their footing right now. You are probably shoring up your business plan, situating your team, and juggling your own constellation of remote working arrangements possibly alongside your spouse and children. On top of that, you will face a test you probably couldnt have imagined a few weeks ago:When one of your employees tells you they have tested positive for Covid-19. If you havent dealt with that already, youalmostcertainly will.
This is a particularly complexchallenge. Not only does the moment call for sensitivity and humanity, but it also requires you to act quickly as a manager. As an executive coach, I have coached many senior leaders on high-stakes topics that, like this, require both decisive action and emotional intelligence. Here are my recommendations for how to approach this situation, whether your employees are currently working from home or continuing to go into a workplace:
First, when the employee brings you the news, express sympathy. Even if the persons symptoms are mild, they are likely tobe anxious about what might happen or whether they might have spread the virus to their family or coworkers. Let the employee share their feelings. As you talk with them, clearly communicate that they can count on you and the team to be supportive.You could say, for example: I know that this is a scary thing to deal with. I am here for you if you need to talk, and certainly I understand that you may not be able to work for a little while or that your productivity may go down. Dont worry about that, I understand what youre dealing with.
Next, connect with your HR partner. You need to act quickly to minimize the risk of the disease spreading. At this point, most HR departments should have some protocols in place, and you will want to utilize their support and guidance.
Minimally, you will need to ask the employee which coworkers they have been in close contact with within the prior two weeks. (The CDC defines close contact as a person that has been within six feet of the infected employee for a prolonged period of time.) If everyone in your company has been working from home during the last two weeks, this may be unlikely, but you should still ask if the infected person had contact with any coworkers. You should alert those who have been in close contact with the employee as soon as possible, repeat the advice given on the CDC site for their situation and, of course, direct them to their own doctors. The law is clear about confidentiality here: You should tell everyone who was possibly exposed at work to the positive employee without revealing that employees identity.
Then, decide whether you or the HR partner should connect with any close contacts the employee has had. Since this is a sensitive topic, its ideal to alertthe coworkers by video or phone. But time matters here if you cant reach them personally, email them with important action required in the subject heading.
Either way, your message is the same: Someone in our workplace has tested positive for Covid-19, and they have identified you as a close contact according to the CDC definition. We are here to support you. If you are at work, please prepare to leave as quickly as you can. Once you get home or if you are already working from there find a place to self-isolate, monitor yourself for any symptoms, and talk to your doctors. How can I support you in doing all this?
You can expect people in the close contact group to be nervous and ask a lot of questions, especially if its the first time they are receiving such news. Since several days have passed between their exposure to the Covid-positive colleague, they may ask you if their family is at risk. Dont speculate. You are not a doctor, Instead, refer them to their own physician and to the CDC website. What you can do is reassure them that the company, and you, will be supportive.
Follow up this conversation by email. Its likely that the person you were talking to was feeling overwhelmed and did not catch everything you said. A written follow-up is always good practice, if only to help keep track of this process inside of your company.
Once you have spoken with both the employee who tested positive and their close contacts, consider alerting others in the workplace. The message you send here will showcase how your company treats people, so its important to be transparent and calming.
The ways you communicate this can vary. If the company is a startup with a few hundred employees, it may be appropriate tocommunicate the news to everyone in an all-hands meeting. If your company is much larger, its most important to communicate to the affected department or division. Respect the confidentiality of both the positive-tested employee and anyone in the close-contact group. Then simply give them the facts: The person tested positive on a certain date and is now self-isolating. The close contacts have been told and were asked to leave the workplace and self-isolate. If you were not already told you were a close contact, then you are not one. If you have questions about Covid-19 or your situation please call your doctor and look at the CDC website. The company is here to support everyone during this difficult time, and we all send our best wishes to the people affected.
Finally, it is helpful for a senior leader, including the CEO, to check in on an employee affected by the coronavirus. In the past week, a CEO I coach has called every one of their employees who tested positive and their close contacts even if they were showing no symptoms just to check in, a gesture they universally appreciated. If the cases at your company start to increase dramatically, it will not be realistic for the CEO to call all these people. However senior leaders can and should step in to make as many calls as possible so employees who are affected feel cared for during a difficult time.
These are not easy times for anyone, and it is a crucial job of leaders to reassure their employees and keep up their spirits. An employee who reports a positive Covid-19 test requires a sensitive and rapid response. That will help everyone who works for you feel more secure and be more able to focus on the important work at your company right now.
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New York University (NYU) professor Paul Romer speaks at a news conference after being named a winner of the 2018 Nobel Prize in Economics with professor William D. Nordhaus of Yale University. Spencer Platt/Getty Images hide caption
New York University (NYU) professor Paul Romer speaks at a news conference after being named a winner of the 2018 Nobel Prize in Economics with professor William D. Nordhaus of Yale University.
We just got off the phone with Paul Romer, the NYU economist who won a Nobel Prize in 2018 for his research on economic growth. We thought it might be a good time to talk about the future of the economy. He scared us. But he also had a plan.
He described the current national conversation over what to do about the coronavirus as a choice between health and wealth, between either shuttering the economy and saving lives; or opening the economy and endangering millions.
But Romer believes that if the federal government pursues a new strategy, where it coordinates industry, sets up and staffs testing sites, and buys virus-fighting equipment at massive scale, we can have a way better option within a month or two.
The way he sees it, the current two choices aren't nearly as good. One is continued social distancing until scientists deliver us a vaccine available for widespread use, which could take two years. Waiting that long, Romer says, would mean "the end of the economy and life as we know it."
The other choice is returning to normal before we get a vaccine, with everybody reintegrating into work and social life at the risk of hundreds of thousands of deaths. "We're either gonna keep destroying the economy or we're gonna start killing people," he says.
Romer and Alan Garber, an economist, physician, and the Provost of Harvard University, published their alternate plan last week in the New York Times. (We reached out to Garber as well, but he's currently got a lot on his plate running Harvard because the university's president recently caught COVID-19).
Romer and Garber advocate that the federal government mobilize the nation like it's a war and implement measures that might allow us to reenter a somewhat normally functioning economy without massive loss of life.
As others have been advocating, they want the government to make COVID-19 tests universally available, done frequently, and used as a green light for each of us to reenter economic and social life. The problem, Romer says, is there are only about a hundred testing machines in the U.S. and we need at least 5,000 of them. And that "isn't going to happen if we just sit around and pray and hope," he says. He thinks it's going to require massive government funding and centralized direction. He envisions government-sponsored testing sites throughout the country.
Romer and Garber also want mass production of face masks, gloves, full-body suits, hand sanitizer, ventilators, and everything it takes to make it safer for social interaction. "It's just a tragedy that we don't have enough masks and face shields and god help us we may not even have enough gloves soon for people to do their work at the hospital," Romer says.
Economists usually like it when the market provides solutions. But building factories, buying machines, training workers, and doing everything else it takes to produce massive quantities of medical equipment on an aggressively short timeline will cost a lot. And, Romer says, without government intervention, companies won't do this on their own.
That's because corporate America naturally worries that demand for this equipment will evaporate once the crisis recedes and that even during the crisis, they might not be able to charge much for it. With historically high demand and limited supply, the market's natural response is sky-high prices. Everybody hates them, but high prices provide an incentive for manufacturers to produce. Yet, Romer says, "the reality is our political system, our emotions, will not let companies charge like ten times as much for the masks right now as we're trying to get a surge in production. So that's why the market can't do its job. We won't let prices do what they have to do."
With corporate America caught between a short demand spike and price controls, Romer and Garber want the federal government to step in and do whatever it takes to increase the production of testing machines and protective equipment. Romer compares it to what the government did after Pearl Harbor.
But he's frustrated by what he sees as a lack of aggressiveness in tackling the threat. Washington recently passed a $2 trillion coronavirus response package aimed primarily at helping Americans as COVID-19 and social distancing shut down our economy. The bill includes about $180 billion for health-related efforts, including $16 billion for more medical equipment. It's not enough, Romer says. He wants the government to spend about $100 billion on medical equipment and allocate additional funds for testing sites and staff.
"I mean, the investments we're advocating here, they're not inconceivable," Romer says. "This isn't like John Kennedy saying, 'We're gonna go to the moon.'"
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Some patients with COVID-19 experience gastrointestinal symptoms, particularly diarrhea, as the first sign of illness, according to a new study.
Among this subset of patients who have mild disease overall respiratory symptoms show up only later in the illness, and some never develop respiratory symptoms at all, the authors said.
The findings are important because those without classic symptoms of COVID-19 such as cough, shortness of breath and fever may go undiagnosed and could potentially spread the illness to others, the researchers said.
Still, they note that digestive problems are common overall and don't necessarily mean that a person has COVID-19. But doctors should recognize that sudden digestive symptoms in people with a possible COVID-19 contact "should at least prompt consideration of the illness," the authors wrote in their paper, published ahead of print Monday (March 30) in The American Journal of Gastroenterology. "Failure to recognize these patients early and often may lead to unwitting spread of the disease."
The study is not the first to report digestive symptoms as a sign of COVID-19. For example, a study posted March 18 in the same journal found that, among about 200 COVID-19 patients at three hospitals in Wuhan, China, around 50% reported at least one digestive symptom, and 18% reported diarrhea, vomiting or abdominal pain. However, that study and others have tended to focus on patients with severe illness, rather than those with mild disease.
In the new study, the researchers analyzed information from 206 patients at Union Hospital, Tongji Medical College in Wuhan, which was designated as a hospital for COVID-19 patients. To be included in the study, patients needed to have a mild illness, without difficulty breathing or low blood oxygen levels.
Overall, 48 patients (23%) were admitted with digestive symptoms only, 89 (43%) with respiratory symptoms only and 69 (33%) with both respiratory and digestive symptoms.
Among all patients with digestive symptoms (117 patients), about 67 (58%) had diarrhea, and of these, 13 (20%) experienced diarrhea as the first symptom of their illness. Patients' diarrhea lasted from one to 14 days, with an average duration of five days, the report said. About one-third of patients with digestive symptoms never experienced a fever.
Patients with digestive symptoms tended to seek health care later than those with respiratory symptoms, an average of 16 days from the start of their symptoms, compared with 11 days for those with respiratory symptoms, the study found. Those with digestive symptoms also took longer to clear the virus from their body (test negative for COVID-19), taking about 41 days on average, compared with 33 days for those with respiratory symptoms only.
Finally, those with digestive symptoms were much more likely to have the new coronavirus, SARS-CoV-2, detected in their stool, with about 73% having positive stool samples, compared with 14% of those with respiratory symptoms only. This finding suggests, but does not definitely confirm, that that virus infects the gastrointestinal tract, the authors said.
Overall, "these data emphasize that patients with new-onset diarrhea after a possible COVID-19 contact should be suspected for the illness, even in the absence of cough, shortness of breath, sore throat or even fever," the authors concluded. "Optimally, testing for COVID-19 should be performed using both respiratory and stool samples, if available."
The authors note that their study was relatively small, and larger studies are needed to further describe digestive symptoms in patients with mild COVID-19.
Originally published onLive Science.
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Aetna was the first insurer to announce its plan to help shield patients with COVID-19 from high medical bills. But out-of-network charges and other surprise bills remain a risk, say advocates for patients. Michael Nagle/Bloomberg via Getty Images hide caption
Aetna was the first insurer to announce its plan to help shield patients with COVID-19 from high medical bills. But out-of-network charges and other surprise bills remain a risk, say advocates for patients.
Three major health insurance providers have now pledged to shield patients from high medical bills if they need treatment for COVID-19. Insurers Cigna and Humana announced Monday that they would waive consumer costs associated with COVID-19 treatment. Last week, CVS Health announced a more limited change that Aetna would waive costs to patients for hospital admissions related to the coronavirus.
These announcements are a "big deal" says Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University. She notes that, on average, people's deductibles for health policies in the U.S. run between $1,800 and $6,500. "That's for most families a lot more cash than they have sitting in their bank account," she says. "So that's really scary."
All three insurers have now pledged to waive the patient's portion of a medical bill what's called a patient's "cost sharing." That means, if your plan qualifies, you won't have to pay your full deductible before insurance will take over, or have to pay the usual fixed amount for a medical service or treatment (the copayment), or a percentage of the total bill (coinsurance).
These insurers have also pledged to waive costs to patients for coronavirus testing and telemedicine visits related to COVID-19 and its symptoms.
So far, Aetna and Cigna are pledging to waive COVID-19 treatment costs through qualified medical bills that are incurred until June 1, 2020. Humana's policy does not yet have an end date.
In the scheme of things, says Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, this move won't cost insurers much, since patient co-pays and deductibles usually account for only a fraction of expensive hospital stays.
"I think there's also a political element here," he says. "Insurers are likely going to be asking Congress for some kind of bailout, and they want to look like good community players when they make that ask."
Still, not every patient will be spared high medical bills if they get seriously ill with COVID-19. You have to have insurance 28 million people in the U.S. do not and, for now, your insurance provider needs to be one of these three companies, though others may follow their lead.
Levitt also notes that many people who are covered by an insurance company that has made a commitment like this might not be eligible to have their costs waived. "Most of the people who get insurance through employers are in what are called self-funded plans," he explains. For people in those plans, these announcements don't apply, since "it's the employers who are going to be deciding whether patients get cost relief here or not."
Levitt also warns that patients who can't get a test for the coronavirus, or whose test comes back as a false negative might still be on the hook for out-of-pocket costs. Until testing becomes more widely and readily available, he says, that hitch could be a substantial problem for patients hoping to have their medical bills covered.
There's also the issue of surprise bills. Even if you don't have to pay your health insurer, you could still be billed directly by the hospitals or doctors who provide your care if they are out of your insurance network. Nearly 1 in 5 inpatient admissions for pneumonia results in a surprise bill, according to a Kaiser Family Foundation analysis.
Loren Adler, associate director of USC-Brookings Schaeffer Initiative for Health Policy, says he's hopeful that Congress will act to protect patients from surprise bills in these situations, or that providers will refrain from balance billing, given the nature of the crisis.
"There is a very strong incentive on basically all actors not to let surprise bills happen here much stronger than in normal cases," Adler says. "I am hopeful folks will negotiate this without involving the patient, but the possibility is still there."
Overall, the insurer announcements on waiving patient cost sharing are good news, but there are caveats, and those caveats mean many people may still have to worry about their medical bills in the midst of this epidemic, says Levitt.
"On any normal day, the expense of a hospitalization for a patient even someone with insurance can be overwhelming," he says. "But now we're looking at these health care expenses coming on top of uncertainty about the economic future, people losing their jobs or getting their hours reduced it's a perfect storm."
Workers at Amazons Staten Island, New York, fulfillment center walked out today to protest the companys response to COVID-19 infections among its warehouse employees. Amazon has confirmed one case of COVID-19 at the New York facility, but workers say there have been at least 10 and that the company has failed to notify workers or properly clean the warehouse. Now, they are calling for Amazon to shut down the facility for two weeks for deep cleaning.
The goal is to get that building shut down, and they will shut it down, because no packages, nothing gets out the building without associates, says Derrick Palmer, who has worked at the facility, JFK8, for four and a half years. This is a pandemic. People are literally losing their lives because of this virus. And [Amazon is] not taking this seriously. Theyre not giving us our respect that we demand. Were not going to ask for it. Were going to demand it, because at the end of the day, were the heart and soul of that building, not the managers. Theyre back in the office. Were in the front lines working.
Workers at 19 US Amazon warehouses have tested positive for COVID-19, according to local news reports. So far, Amazon has closed facilities only when forced to do so by government order or worker protest. Last week, the company indefinitely closed a returns processing warehouse in Shepherdsville, Kentucky, after three workers tested positive and the governor ordered it shuttered. On March 18th, a sortation center in Queens, New York, was temporarily closed for cleaning after workers walked out upon learning of a positive COVID-19 case. Employees learned about the case from co-workers and say they had been expected to come to work.
The failure to notify workers when someone at a facility tests positive appears to be systemic. Last week, The Verge spoke with workers at several warehouses across the US who learned of COVID-19 cases from co-workers. At JFK8, Palmer says the first case was confirmed on March 12th, but workers were only told several days afterward when managers walked the floor and told employees in person. But the facility is staffed by more than 4,000 workers and is 855,000 square feet, so many learned of the incident through hearsay much later.
Amazon has a strong infrastructure for keeping its warehouse employees informed. For example, when the company announces mandatory overtime, Palmer points out, the company sends out texts and emails to every worker. With this incident, they have not sent out one text nothing at all, Palmer says.
Amazon says it has intensified the cleaning of its warehouses in response to the COVID-19 pandemic, but workers at JFK8 and elsewhere say the measures fall far short of whats needed. Palmer says shifts of about a dozen cleaners work at JFK8, too few to properly disinfect such an enormous building. (Workers in other warehouses in the US have expressed similar concerns about understaffing of cleaning crews.) While Amazon has stopped daily stand-up meetings and staggered schedules to minimize workers clustering together, certain roles in the warehouse, like the packing department, still require employees to stand in close proximity, and workers often pass items between each other.
The way that the department is set up, everyone is on top of each other, Palmer says. It is literally impossible to maintain the social distance within those departments, and they havent been practiced, they havent tried to adjust that at all because theres no way they can do it.
In Italy and Spain, where COVID-19 outbreaks have been spreading longer, Amazon refused to shut down facilities after workers became infected, prompting protests. Earlier this month, a group of senators wrote a letter to Amazon CEO Jeff Bezos expressing concern for the safety of Amazon workers and asking, among other things, whether the company would temporarily shut down facilities and provide paid leave for workers if someone tests positive for COVID-19. A petition among workers calling for a similar approach has garnered more than 1,500 signatures. The workers at JFK8 are also calling for paid leave while the facility is shut down for cleaning.
In a statement, Amazon called the workers claims unfounded and said its employees are heroes. The company is taking worker safety extremely seriously and has instituted several changes, the company said, including intensifying cleaning and screening worker temperatures. Regarding closing buildings, the company said it consults with health authorities and medical experts, and if a diagnosed worker hasnt been in the building for some time or if the area where they worked has already been cleaned during the regular course of business, the facility may not need to be closed.
The pandemic has shown a spotlight on the role of workers at Amazon, Instacart, and other goods-delivering tech companies. No longer laboring in the background of digital interfaces, theyre increasingly being recognized as frontline workers providing a vital service to millions of Americans who are being told to stay home. Both companies are trying to hire tens of thousands more people to meet surging demand. Amazon is giving its workers letters to carry saying they are essential employees, delivering critical supplies directly to the doorsteps of people who need them and should be allowed to continue their jobs amid shutdowns.
But the pandemic also exposes these workers to new risks, and workers say companies have been slow to adjust policies and protections. Instacart and Amazon now offer workers diagnosed with COVID-19 or placed into quarantine two weeks paid leave, but that doesnt help workers who have COVID-19 symptoms but cant get tested. Amazon warehouses have been optimized for speed and efficiency, and workers say the intense pace leaves them little time to use cleaning material that is often in short supply.
Today, Instacart workers are going on strike, calling for expanded sick leave, hazard pay, and protective equipment. Workers at Whole Foods, which is also owned by Amazon and faces unprecedented demand for delivery, are striking tomorrow. JFK8 marks the first major action at an Amazon fulfillment center, and workers at Amazon warehouses across the country have expressed similar concerns.
Shutting down a fulfillment center for a prolonged period would threaten Amazons ability to continue delivering products, but refusing to do so and failing to assure employees their safety is being taken seriously pose potentially greater threats to the company. Already, workers are staying home rather than venturing into crowded warehouses, choosing to forgo pay that Amazon recently increased rather than risk getting infected. Delivery times for some items now stretch to a month or more. Now, at JFK8, workers frustrated with the companys coronavirus response are trying to shut down the facility themselves.
Around 1PM on March 30th, workers filed out of the New York warehouse, many wearing masks and bandanas over their faces. Alexa, please shut down and sanitize the building, read one of the signs. On a live stream of the protest, workers expressed frustration with not being told about infections at the warehouse and said many were choosing to stay home without pay.
Were not done here. Today was a cry for help, said Chris Smalls, a worker at the facility and one of the walkout organizers, wearing a black bandana as he addressed protesters. Today was a win for us, but its a battle and the war is not over. Were going to go to City Hall possibly tomorrow morning. Weve got to get the governments attention. Just like in Kentucky, the government has to step in and close the building down.
Update March 30th, 8:00PM ET: After the protest, Amazon fired Chris Smalls, one of the organizers of the walkout. The company said Smalls was fired for violating safety regulations, including violating a 14-day quarantine after coming in contact with an employee diagnosed with COVID-19. Smalls disputed the companys claim and said he was fired for retaliation. I am outraged and disappointed, but Im not shocked, Smalls said in a statement. As usual, Amazon would rather sweep a problem under the rug than act to keep workers and working communities safe.
An idea that has been doing the rounds on social media suggests that certain heart and kidney medications make people more susceptible to COVID-19. A new commentary strongly disputes this.
The commentary warns that discontinuing these hypertension and kidney medications would seriously endanger the health of those taking the drugs for high blood pressure, congestive heart failure, and chronic kidney disease.
A. H. Jan Danser, from the Department of Internal Medicine at the Erasmus Medical Centre in Rotterdam, The Netherlands, is the first author of the commentary, which appears in Hypertension, a journal of the American Heart Association (AHA).
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Danser co-authored the paper with Dr. Murray Epstein, from the Division of Nephrology and Hypertension at the University of Miami Miller School of Medicine in Florida, and Daniel Battle, from the Division of Nephrology/Hypertension at the Northwestern University Feinberg School of Medicine in Chicago.
As Danser and colleagues explain in their paper, the idea that some heart and kidney medications may raise the risk of complications and death from a SARS-CoV-2 infection arose when it became known that the angiotensin-converting enzyme 2 (ACE2) receptor facilitates the entry of the virus into healthy cells.
Namely, some researchers that Danser and colleagues quote have suggested that taking the renin-angiotensin system (RAS) blockers specifically, angiotensin II type 1 receptor blockers (ARBs) might raise the risk of developing a severe and potentially fatal form of COVID-19.
RAS blockers are drugs doctors use to treat hypertension. ARBs also treat hypertension, congestive heart failure, and kidney disease, among other conditions.
In their commentary, the authors talk about studies that have raised the concern that such a preexisting hypertension treatment may elevate the risk of severe COVID-19. However, as Danser and colleagues find, there is insufficient evidence to sustain such a notion.
Amplified by social media and the mass circulation of inaccurate medical information, this idea led to some people not taking their medication.
Danser and associates say that at the crux of the [] prevailing confusion and panic that we are witnessing in the medical community is the question how do RAS blockers affect ACE2?
Firstly, they explain, Part of the confusion in social media and the public in general stands because, at times, ACE inhibitors are confused with ACE2 inhibitors.
The two are different enzymes with different active sites and the effect of ACE inhibitors on ACE2 activity is unlikely to affect the binding of the SARS-CoV-2 virus, explain Danser and colleagues.
Secondly, however, the authors do note some limited reports in animal models that suggest ARBs may affect ACE2 activity in the heart and kidney, but these results are diverse, they vary by ARB and organ, and required very high doses of the drug.
Even if the reported upregulation of tissue ACE2 by ARBs in animal studies and, generally, with high doses could be extrapolated to humans, this would not establish that it is sufficient to facilitate SARS-CoV-2 entry, they write.
Having reviewed more than 29 studies, the authors stress their conclusion: the findings are inconsistent.
People are making an unadvised leap, Dr. Epstein explains. The logic goes that, if [the drug] enhances penetrability, it enhances susceptibility to the disease, but thats a dangerous conclusion.
What investigators have found varies widely, depending on the organ studied, the experimental animal model, and the ARB being used in the study. In summary, there is a complete lack of consistency.
The only thing we can conclude definitively, based on all the known data, is that there is no credible evidence whatsoever that ARBs enhance susceptibility to COVID, says Dr. Epstein.
In fact, discontinuing treatment with ARBs and ACE inhibitors could cause a great deal of harm, particularly in these times where healthcare systems everywhere are under a lot of strain already.
This would be a double tragedy, because it would be happening precisely at a time when our hospital and ICU resources are stressed to the limit [] It will further tax our medical facilities and hospitals, and it will be truly tragic.
Dr. Murray Epstein
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A domestic cat in Belgium has been infected with COVID-19, the disease caused by the new coronavirus that's spreading across the globe, the government's FPS Public Health, Food Chain Safety and Environment announced March 27, according to news reports.
This is the first human-to-cat transmission of the novel coronavirus (SARS-CoV-2). About a week after its owner got sick with COVID-19, after returning from a trip to Northern Italy, the cat developed coronavirus symptoms: diarrhea, vomiting and respiratory issues, Steven Van Gucht, virologist and federal spokesperson for the coronavirus epidemic in Belgium, told Live Science.
The owner sent samples of vomit and feces to Dr. Daniel Desmecht's lab at the Faculty of Veterinary Medicine of Lige. Genetic tests showed high levels of SARS-CoV-2 in those samples, he said. "The cat recovered after 9 days," Van Gucht said.
Related: 13 Coronavirus myths busted by science
Cats and humans appear to have a similar "doorknob" on the surfaces of respiratory cells that lets the SARS-CoV-2 virus get inside, according to Van Gucht.
In humans, scientists have figured out that the SARS-CoV-2 virus attaches to a receptor protein called ACE2 that's on the outside of respiratory cells. Once inside of these cells, the virus hijacks certain machinery so it can replicate.
"The feline ACE2 protein resembles the human ACE2 homologue, which is most likely the cellular receptor which is being used by Sars-CoV-2 for cell entry," Van Gucht said.
During the 2003 SARS outbreak, cats were infected with a coronavirus as well, Van Gucht said.
The only other pets thought to have "caught" the novel coronavirus from owners were two dogs in Hong Kong. The first dog, a 17-year-old Pomeranian, tested a weak positive for the virus at the end of February, Live Science reported. The dog died in mid-March, though the exact cause of death is not known, as the owner didn't allow an autopsy.A second dog, a German shepherd, tested positive but showed no symptoms of the disease, Bloomberg reported.
During the outbreak of another coronavirus, severe acute respiratory syndrome (SARS), dogs and cats contracted low levels of that virus, animal health expert Vanessa Barrs from City University told the South China Morning Post.
There have been no reports of pets passing the virus to their human owners, and Van Gucht stressed that even human-to-pet transmission is not a significant path of viral spread.
"We think the cat is a side victim of the ongoing epidemic in humans and does not play a significant role in the propagation of the virus," he said.
To prove definitively that the cat was infected with SARS-CoV-2, scientists will need a blood test to look for antibodies specific to this virus, Van Gucht said. Those tests will happen once the cat is no longer under quarantine.
Originally published on Live Science.
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The economic impacts of COVID-19 are already shaping up to be significant, yet uneven, across the country. Not only are workers and businesses affected, but so too is the fiscal capacity of governments that rely on a healthy economy for their revenue. As the crisis unfolds, the impact on cities bottom line will be driven not only by overall economic conditions but specifically the parts of the economy where revenue is generated: retail sales, income and wages, and real estate.
To understand when cities can anticipate the brunt of COVID-19s impact on their general fund revenues, we examined the extent to which a city relies on general tax sources that respond quickly to economic swings. An important factor is whether the citys underlying regional economy is composed of industries that are more immediately exposed to coronavirus-related employment declines.
The results indicate an uneven geography of fiscal impact, with many heartland cities likely to be hit harder and more quickly than others.
Download the appendix table
Cities in the U.S. generate the majority of their revenue by designing their own tax and fee structures within the limits imposed by their states (e.g., property tax limits, debt limits, constraints on access to some tax sources). As a consequence, cities tax structures vary across the country, with some relying heavily on property taxes and others primarily on sales taxes. Only a few citiesapproximately one in 10rely most on income or wage taxes.
Federal aid amounts to some 5% of total municipal revenue, while state aid is 20% to 25%. In other words, a citys tax structure accounts for 70% to 75% of what it can spend to meet the health, safety, and welfare needs of its residents and visitors.
After less than a month of shelter-at-home edicts, its clear that retail sales have plummeted and unemployment is skyrocketing. A city that generates the majority of its revenue from sales or income taxes will be hit hard and immediately when it experiences such consumer declines and job losses.
A city that relies on property taxes, however, will not experience such an immediate collapse in its revenues. Local assessment practices require that cities wait to estimate the value of land and property until the property is exchanged on the market or an assessment is conducted. Current property tax bills, therefore, typically reflect values of the property anywhere from 18 months to several years prior to collection. Property tax collection is less responsive, or elastic, in the short termbut over time, as rising unemployment dampens real-estate demand, even these property-tax-dependent cities will feel COVID-19s impact.
In addition to taxes, approximately one-third of city-sourced revenues are derived from fees and charges for services such as trash collection and water. Although COVID-19 will adversely affect some fee-driven services (think transit and parking) because demand is reduced, it will affect other services (water, sewer, etc.) less severely, as residents remain in place and continue to use them.
To illustrate the impact of tax structures on city-revenue responses to COVID-19, we evaluated the share of regional employment in high-risk industries (mining/oil and gas, transportation, employment services, travel arrangements, and leisure and hospitality) and the share of general fund revenues from sales and income taxes across 139 cities. These cities are diverse in their geographies, economies, and revenue structures.
Cities with both a vulnerable economic composition (greater than 15% share of employment in high-risk industries) and a tax structure that is highly reliant on elastic sources of revenue (greater than 25% share of general fund revenues) will feel a dip in revenues more quickly than those with alternative economic and fiscal structures.
Map 1. Heartland Cities Stand to Be Most Fiscally Impacted More Immediately
Source: Authors' calculations of city budget data; Zandi, "Covid-19: A Fiscal Stimulus Plan," Moody's Analytics 2020; Brookings analysis of Emsi data.
Note: High risk industries include mining (NAICS 21), transportation (NAICS 48), employment services (NAICS 5613), travel arrangements (NAICS 5615), and leisure & hospitality (NAICS 71 & 72)
This analysis reveals that many of the most fiscally impacted cities in the shorter term are in Americas heartland. For example, 76% of Columbus, Ohios general fund comes from income taxes, and 16% of regional employment is in highly vulnerable industries. Cities in Ohio rely heavily on the flat income tax, which correlates immediately to changes in employment.
In places that rely heavily on sales taxessuch as Tulsa, Okla., Lincoln, Neb., and Denverthe closing of retail sales outlets will generate an immediate reduction in city revenue. Oklahoma Citys sales tax contributes 54% of its general fund revenues, for example, while 20% of its workers are in vulnerable industries.
A reliance on income taxes (as in Columbus) or sales taxes (as in Oklahoma City) will generate a strong shock to a citys fiscal system as the COVID-19 pandemic continues. The fiscal impacts will likely appear within a month or two, and require those cities to adjust their budgetary expenditures in short order.
Those cities likely to feel mid- to longer-term impact are more reliant on property taxes and have a less-exposed local economy. Durham, N.C., for example, does not have a local sales or income tax, and less than 12% of regional employment is in high-risk industries.
It is possible, however, that foreclosures in property-tax-dependent cities (due to unemployment and the inability to pay taxes and mortgages) might happen more quickly than anticipated, driving property tax revenue down sooner than the typical 18 to 24 months.
The immediately impacted citiesthose reliant on sales and incomes taxes with a high share of vulnerable industriesare likely to feel fiscal declines within the next month or two. Others are more likely to feel COVID-19s economic effects in the next few quarters to a year. Although higher reliance on property tax revenue is generally more favorable in the short term, a less-diversified structure will limit the resilience of city budgets in long term.
The fiscal capacity of local governments to manage public health and economic resilience in the face of COVID-19 is uncertain at best. The federal government has committed to providing much-needed assistance to cities to meet the immediate needs of residents, households, and small businesses on the economic margins. This includes expanded funding for Community Development Block Grants, transit, education, broadband, and housing and homelessness. Notably, cities with a population over 500,000 will also receive direct financial assistance via a stabilization grant program, the Coronavirus Relief Fund.
Unfortunately, the potential impact on most local budgets is largely unknown, because states will have maximum discretion to allocate resources to cities as they see fit based on population size. Future federal bills should consider much lower population thresholds for direct local funding.
Under the current bill, states and cities should coordinate in unprecedented ways to ensure that measures of local fiscal capacityincluding tax structures and the share of high-risk workersare considered in funding distribution.
States should also allow their local governments to modify tax structures so they are in line with their underlying economic bases. Flexibility to collect a better mix of sales, income, and property taxes will offer cities the tools they need to respond in the short and long term as economic conditions and the needs of their residents change. This flexibility will be especially important in the months ahead, as state revenues and aid to cities begin to take a hit.
American cities will face very different situations as COVID-19s economic impact becomes clear. The most effective solutions to this unprecedented situation will take into account the uneven magnitude and timing of the fiscal impact that cities will experience across the country.
Martha Lackritz-Peltie works from her living room in Oakland, California, this month. (Julie Jammot/AFP via Getty Images)
As the spread of COVID-19 upends work, classes and even doctor appointments across the country, a majority of Americans are turning to digital means to stay connected and track information about the outbreak.
Amid this increased reliance, about nine-in-ten U.S. adults (93%) say that a major interruption to their internet or cellphone service during the outbreak would be a problem in their daily life, including 49% who foresee an outage being a very big problem for them and 28% who believe it would be a moderately big problem.
But while digital connections may provide an alternative during a time of social distancing, only a minority (27%) thinks interacting via these technologies will be as effective as in-person contact. Some 64% of Americans think the internet and phones will help but are not a replacement for face-to-face encounters.
These are key findings from a Pew Research Center survey of U.S. adults conducted online between March 19-24 on the Centers American Trends Panel.
Pew Research Center conducted this study to understand how Americans in different parts of the country are responding to the new coronavirus outbreak. This analysis focuses in particular on the role digital technology plays in peoples day-to-day lives during the outbreak. For this analysis, we surveyed 11,537 U.S. adults from March 19 to 24, 2020. Everyone who took part is a member of Pew Research Centers American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses (see our Methods 101 explainer on random sampling). This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATPs methodology.
Here are the questions used for this report, along with responses, and its methodology.
Asked about a range of activities they have performed in response to the coronavirus outbreak, roughly three-quarters (76%) of Americans say they have used email or messaging services to communicate with others, while 70% report that they have searched online for information about the coronavirus. By comparison, fewer Americans though still about four-in-ten say they have shared or posted information about the outbreak on social media.
As more companies move to encouraging or requiring telework, one-quarter of those surveyed say they have used video calling or an online conferencing service, like Zoom or WebEx, to attend a work-related meeting due to the coronavirus outbreak. Smaller shares of Americans (16%) report using the internet or email to connect with doctors or other medical professionals as a result of the outbreak.
There are some differences by education level, age, and race and ethnicity when it comes to how these digital activities are used as the country copes with the virus.
For example, it is far more common for college graduates to hold virtual meetings than those with less formal education. Nearly half of college graduates (46%) say they have participated in a work meeting by using video calling or online conferencing, compared with 21% of those with some college experience and 11% who have a high school education or less. College graduates are also more likely than those who have some college experience or a high school education or less to say they have used email or messaging services to communicate with others or look up information online related to the outbreak.
There are also age differences across most of these experiences. The largest gap is evident when it comes to seeking outbreak-related information online. Some 52% of adults ages 65 and older say they have used the internet to search for information about the coronavirus, but that share rises to 64% among those ages 50 to 64 and 80% among adults under the age of 50.
Across each measure, rural Americans are less likely than those living in urban areas to report using these digital tools. And Hispanic adults (49%) are more likely than black (37%) or white adults (34%) to report using social media to share or post coronavirus-related content.
Previous Center surveys have found that Americans widely view a high-speed internet connection as essential or important. Mobile technology is also playing a large role in how people go online particularly for Americans who rely on their smartphone to do everything from getting news or searching for health information to looking for a job.
The new survey shows that majorities across demographic groups believe that losing internet or mobile connectivity during the outbreak would be disruptive to their daily lives, but how big of problem they foresee this causing varies substantially across demographic groups.
Roughly nine-in-ten Americans (93%) say that a major interruption in their internet or cellphone service during the coronavirus outbreak would be a problem for daily life in their household. This includes 49% who foresee this being a very big problem for them and 28% who believe this would be a moderately big problem. A smaller share says this would be a small problem (16%), and just 6% say it would not be a problem at all for daily life.
Roughly six-in-ten Americans who have a bachelors or advanced degree (59%) say a major interruption in their internet or cellphone service during the outbreak would be a very big problem in their daily lives, compared with 50% of those who have some college experience and 40% of those who have a high school diploma or less.
Adults under the age of 65 (53%) are far more likely than those 65 and older (38%) to see this kind of disruption as a very big problem for their daily life. On the other hand, those living in rural areas (39%) are far less likely to believe a major interruption to their internet or cellphone service would a very big problem for them than those living in urban (57%) or suburban (50%) areas.
There are also differences by race and ethnicity, as well as by gender. Black and Hispanic adults are more likely than white adults to view an interruption to their internet or cellphone service as a very big problem. And women are more likely than men to believe this would cause a significant issue in their daily life.
It is important to note that previous Center studies have shown that Americans digital connectedness and reliance on technology varies across demographic groups. For example, younger adults as well as those living in cities or suburbs use the internet more frequently. They are more likely to own a smartphone and to use that technology to perform digital tasks.
Even as the public describes a major interruption to their internet or phone service as disruptive, only a minority thinks interacting via these technologies would be just as good as face-to-face contact with others.
Asked what will happen if many of the everyday interactions they have in person have to be done online or by phone because of the coronavirus outbreak, 27% say these technologies will be just as good as in-person contact. By comparison, the largest share (64%) says these tools will be useful, but will not be a replacement for face-to-face communications, and just 8% say the internet or phones wont help much at all during this time. This pattern holds true across each major demographic group.
Still, there are some notable differences by educational attainment. Roughly three-quarters of college graduates (73%) say that if their everyday in-person interactions have to be done online or by phone, it will help but not be a replacement for in-person contact. That share falls to 63% among those who have some college experience and 56% among Americans with a high school education or less.
By contrast, there are more modest differences by age or race and ethnicity. White or Hispanic adults (65% each) are more likely than black adults (56%) to say interacting online or through a phone will be useful but wont be a full substitute for face-to-face communication. And adults under the age of 30 are somewhat more likely to express this view than those ages 30 and older (69% vs. 63%).
Note: Here are the questions used for this report, along with responses, and its methodology.
