Category: Covid-19

Officials with the federal governments 401(k)-style retirement savings program announced last week that new loan and withdrawal options enabled by the passage of the Coronavirus Aid, Relief and Economic Security Act will be available to federal employees and retirees this summer.

The CARES Act, signed by President Trump in March, offers a number of avenues by which participants in 401(k) and equivalent programs can seek relief. The Thrift Savings Plan has already implemented some of those provisions, including the suspension of requiredminimum distributions andwaiving or delaying tax penalties associated with a variety of existing withdrawals and loans, provided a participant has experienced negative consequences of the coronavirus pandemic.

On May 14, the TSP announced that new temporary withdrawal and loan programs authorized by the CARES Act would be implemented this summer.

Under the new loan program, the maximum loan amount available to participants will increase from $50,000 to $100,000, and the portion of a participants available balance that can be borrowed will increase from 50% to 100%. Additionally, participants may elect to suspend payments on a TSP loan for up to 12 months, although it also will extend the life of the loan by 12 months.

This applies to existing loans and loans taken in the remainder of 2020, officials wrote. We will make a new form available for you to request this suspension. You have until December 31, 2020, to have your payments suspended.

The new loan options will be available by June 22, officials said.

Beginning in mid-July, the TSP will offer what is called a CARES Act Withdrawal, which allows qualifying participants to make a one-time withdrawal of up to $100,000 from their accounts. For current federal workers, the typical requirement that a participant be at least 59 1/2 years old or cite a specific financial hardship, as well as the 10% tax penalty, would be waived.

In order to qualify for these loan and withdrawal options, participants or their spouses must have been diagnosed with COVID-19 or SARS-CoV 2, or participants must beexperiencing adverse financial consequences as a result of being quarantined, furloughed or laid off due to the virus. Those who cannot work because of child care or other dependent care obligations, and business owners who have had to close or reduce their hours as a result of the pandemic also would qualify for these new transactions.

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TSP Announces Upcoming COVID-19 Loans, Withdrawals - GovExec.com

DAKAR, Senegal In the northern Nigerian city of Kano, some people say they now get four or five death notices on their phones each day: A colleague has died. A friends aunt. A former classmate.

The gravediggers of the city, one of the biggest in West Africa, say they are working overtime. And so many doctors and nurses have been infected with the coronavirus that few hospitals are now accepting patients.

Officially, Kano has reported 753 cases and 33 deaths attributed to the virus. But in reality, the metropolis is experiencing a major, unchecked outbreak, according to doctors and public health experts. It could be one of the continents worst.

The coronavirus has been slower to take hold in Africa than on other continents, according to the numbers released daily by the World Health Organization.

But blazing hot spots are beginning to emerge. Kano is only one of several places in Africa where a relatively low official case count bears no resemblance to what health workers and residents say they are seeing on the ground.

In Somalias capital, Mogadishu, officials say that burials have tripled. In Tanzania, after cases suddenly rose and the United States Embassy issued a health alert, the Tanzanian government abruptly stopped releasing its data.

Kanos state government, until recently, claimed a spate of unusual deaths was caused not by the coronavirus, but by hypertension, diabetes, meningitis or acute malaria. There is little social distancing, and few people are being tested.

The leadership is in denial, said Usman Yusuf, a hematology-oncology professor and the former head of Nigerias national health insurance agency. Its almost like saying there is no Covid in New York.

He said he thought a significant portion of the population was probably infected in Kano, a city with an estimated five million people (though there has been no census since 2006).

Though they have now acknowledged they have a problem with Covid-19, the disease caused by the coronavirus, the authorities in Kano spent precious weeks denying it, despite the surge in what Abdullahi Umar Ganduje, the state governor, called mysterious deaths.

So far, theres been nothing to suggest that they are linked with Covid-19, Mr. Ganduje posted on Twitter on April 27, when, according to doctors in Kanos hospitals, the city was already firmly in the grip of a serious coronavirus outbreak.

There was nothing mysterious about what doctors said they were seeing at Aminu Kano Teaching Hospital, the citys main public hospital. Starting well before Kanos first case was reported on April 11, the hospital saw a steady stream of older patients with fevers, coughs, difficulty breathing and low oxygen saturation levels, many of them with underlying health conditions.

Doctors at the hospital called the governments response team. Sometimes it took 24 hours to get a call back. Sometimes, the team refused to test or isolate patients, saying they did not qualify because they had not traveled recently.

About 60 to 70 percent of the elderly patients who went to the hospital and later died had arrived with full symptoms of Covid-19, said a doctor in the medical department, who, along with another doctor, spoke on condition of anonymity because they feared retribution.

One doctor said the departments death registers for April showed far more patients had died than normal. Most patients were sent home, he said, and the hospitals staff members often would hear later that they had died.

With no personal protective equipment except surgical masks, the doctors said they knew the risks they were running in treating these patients. They said that they begged the hospital management for N-95 masks, face shields, gloves and aprons, but that none came. They asked for an isolation center at the hospital, scared that patients with other ailments would be infected. They wanted the facilities fumigated. Nothing happened.

And then it was too late. The doctors began to get sick.

All of us were exposed, said the other doctor. Ultimately, what we feared has happened.

Twenty of the 91 doctors in the hospitals medical department tested positive, the doctors said. Overall in Kano, 42 doctors and 28 nurses have tested positive, and one doctor has died, according to Dr. Sanusi Bala, chairman of the Kano branch of the Nigerian Medical Association. Laboratory technicians in what was then Kanos only testing laboratory got sick too, and it closed for several days. The citys health system, already extremely limited, was crippled.

Nigeria, a country of about 200 million people, says it can in theory do 2,500 tests a day, and Kano up to 500. But it has been conducting far fewer tests, typically 1,000 to 1,200 daily. Test results in Kano can take two weeks. Doctors awaiting their test results cannot go to work. People in quarantine cannot leave.

If I say thousands of people are dying from Covid, I dont think I exaggerated the figure, said the doctor who begged for P.P.E. So many people are dying without being tested, without even going to the hospital.

While the government loosened lockdowns on May 4 in the capital, Abuja, and biggest city, Lagos, it extended the one in Kano. But few people observe it. The many funerals are well attended, residents said.

Many in the city think the coronavirus is a hoax, perhaps because public messaging about it is mostly in English, which most Kano residents do not speak, health experts said.

Others believe that a Covid-19 diagnosis is a death sentence, the experts said, and do not want their neighbors to think they are infected. So they avoid being tested, and try to behave as if all is normal.

They go to burials, and shake fellow mourners hands because it would be socially unacceptable not to. They shop, barefaced, in crowded markets. They hold soccer tournaments a recent one was called the Coronavirus Cup.

While the situation in Kano is grim, the picture varies greatly from one country in Africa to another.

From the numbers gathered by the World Health Organization and other groups, Djibouti, in East Africa, looks as if it has the highest infection rate per capita on the continent, at 1 in 746 people. But public health officials interviewed there attribute that to aggressive testing and contact tracing. Anyone who tests positive is hospitalized, even if no symptoms are apparent.

Tanzania has reported 509 cases, but it stopped releasing data two weeks ago, and the United States Embassy there said on Wednesday that the risk of contracting Covid-19 was extremely high. A government spokesman told the BBC that testing had been suspended while the authorities investigated the many testing kits, but denied that Tanzania was doing too little to stop the viruss spread.

In Somalia, more than 1,200 people have tested positive and, officially, 53 have died. But doctors, officials and humanitarian workers think these numbers are way off. Thousands of people with the virus are staying home and not getting tested, they say.

The office of the Somali prime minister, which is overseeing the response to the outbreak, has dismissed the notion of a hidden toll, saying Mogadishu has already reached its peak.

Dr. Mohamed Abdi Hassan, who is leading the medical response to Covid-19 at the prime ministers office, said that there might be cases here and there that abruptly died and then were buried, but that the number of instances in which people had died of the coronavirus without being tested had been exaggerated. We have as much as possible captured the real picture.

In Nigeria, some say that with the outbreak in Kano so widespread, the city may already be home to a giant, unintentional experiment in herd immunity.

The disease is taking its natural course, said Dr. Faruk Sarkinfada, a medical microbiologist who works in Kano.

Eighty percent of tests conducted in the city are coming back positive, a presidential task force sent to Kano in late April told the BBCs Hausa-language service.

But since no one trusts the official reports, Kanos citizens have come up with their own ways of gauging the toll of the virus.

Nazir Adam Salih, a writer and engineer, conducted an impromptu survey of more than 100 acquaintances. Almost all said they had fever, cough and loss of smell. Almost none had gotten tested or treated.

Doctors phone relatives of the dead to conduct verbal autopsies.

By late April, the Kano state government finally admitted there was a Covid-19 problem and asked the federal government for help. Dr. Sarkinfada, the medical microbiologist, said that the federal government focused its efforts on increasing Kanos testing capacity, and that test results were now coming in sooner.

The Kano situation has seen us through deception, denial, defiance, denunciation, disagreement and finally acceptance and action to control the disaster, said Oyewale Tomori, a virologist who leads a Nigerian government committee on Covid-19.

Kanos location, population and connectivity to the rest of the region mean the consequences of an uncontrolled outbreak could be severe.

Already there are reports of hundreds more people dying mysterious deaths in Nigerias northern states of Jigawa, Yobe, Sokoto and Katsina, including three emirs, or traditional Muslim rulers, and a former health minister.

If Kano falls, the whole of northern Nigeria falls. The whole of Nigeria falls, Dr. Yusuf said. It spreads into the whole of West Africa and the whole of Africa.

Abdi Latif Dahir contributed reporting from Nairobi, Kenya, and Simon Marks from Addis Ababa, Ethiopia.

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Covid-19 Outbreak in Nigeria Is Just One of Africas Alarming Hot Spots - The New York Times

The government is coming under pressure to provide back-to-work support for young people amid evidence that the under-25s have been hardest hit by the Covid-19 economic fallout.

In a report published on Tuesday ahead of unemployment figures expected to show the first signs of the pandemics impact on the labour market, the Resolution Foundation said younger and older workers were the most likely to have lost their jobs or had their incomes reduced.

The thinktank said ministers should be considering job guarantees to prevent young people being permanently scarred by the crisis.

Maja Gustafsson, researcher at the Resolution Foundation, said: Our research confirms fears that young people are being hardest hit in the current crisis. One in three young people have been furloughed or lost their jobs completely, and over one in three have had their pay reduced since the crisis started.

Large numbers of young people are employed in the sectors most severely affected by the lockdown such as leisure, retail and hospitality.

The Resolution Foundation said 23% of employees aged 18-24 had been furloughed and a further 9% had lost their jobs completely. By comparison, among the least affected age group those aged between 35 and 44 15% had been furloughed or lost their jobs.

Young people were also the most likely to have had their pay cut, with 35% earning less than they did at the start of the crisis and 9% earning more.

Employment and wages data to be released by the Office for National Statistics on Tuesday will cover the quarter ending in March and include the first few days of the lockdown.

Gustafsson said young people were not the only group who were experiencing big income shocks. Britain is experiencing a U-shaped living standards crisis, with workers in their early 60s also badly affected.

That is why the governments strategy to support the recovery should combine targeted support to help young people into work, with more general stimulus to boost demand across the economy and help households of all ages.

Stephen Evans, chief executive of Learning and Work Institute, said: Our research shows five years of employment growth was wiped out in one month. The governments actions have prevented things being worse. But we need to act now to prevent permanent damage to our economy: investing in young people; mobilising back-to-work support; and making sure we help those left behind before the crisis.

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Young workers most likely to have lost jobs during Covid-19 crisis - The Guardian

CEDAR RAPIDS, Iowa (KCRG) - Officials at a Linn County hospital have confirmed that they are treating the children with a rare inflammatory response to the novel coronavirus.

A spokesperson for UnityPoint Health-St. Luke's Hospital said that they are treating two patients with pediatric multi-system inflammatory syndrome, or PMIS. The syndrome appears to be related to post-infection inflammation of the body's blood vessels, including those in the heart, according to officials. It is similar in presentation to Kawasaki's disease, another rare post-viral illness that affects children.

Officials were not able to provide any more information about the patients, citing privacy concerns.

Symptoms of the syndrome include a persistent high fever for more than three days, rash, and abdominal pain. It can sometimes lead to hospital admission to manage low blood pressure and related complications in severe cases, the spokesperson for UnityPoint Health said.

Most children do not experience the same serious respiratory issues that adult cases have seen, according to UnityPoint Health, but this new syndrome has shown up in some children post-infection.

Earlier on Monday, state epidemiologist Dr. Caitlin Pedati confirmed that there were now two reported cases of the illness. UnityPoint did not specifically confirm that these were the same patients, though Pedati said both cases were in eastern Iowa.

Pedati and UnityPoint Health both stressed that the best way to avoid the risk, albeit rare, to children from this syndrome is to take proper steps to avoid potential exposure to the virus, including proper social distancing, hand washing, and keeping them away from people who have confirmed cases of COVID-19.

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Two children with rare COVID-19-related complication being treated at UnityPoint-St. Luke's - KCRG

Tens of thousands of cases of Covid-19 may have been missed because of delays in warning the public that loss of taste and smell is a key symptom that should lead to self-isolation or testing, experts say.

The four chief medical officers of the UK have finally made official what many scientists had been saying for weeks: that anosmia, or loss of smell, should be added to the other two main warning symptoms, a continuous cough and high temperature. Those who experience any of the three symptoms should isolate for seven days and their families for 14 days.

Prof Tim Spector from Kings College London and his team said data from 1.5 million people who downloaded their symptom-reporting app suggested 50,000 to 70,000 people in the UK had been missed. As early as 1 April, they warned that people with anosmia should self-isolate.

They were joined by ear, nose and throat surgeons, who said loss of taste and smell could be one of the few markers for people who were otherwise asymptomatic and potentially able to infect other people without realising they were a risk.

Their professional body, ENT-UK, said they had been calling for eight weeks for anosmia to be listed as a marker for asymptomatic carriers. It issued a joint statement with the British Rhinology Society (BRS) on 20 March, it said. We estimate that many hundreds of thousands of patients in the UK have developed anosmia as a result of Covid-19, said Prof Claire Hopkins, the BRS president.

Speaking on BBC radio hours before the announcement by the four CMOs of the change of guidance, Spector said the UK was out of step with other countries. He also said that anosmia was only one of 14 symptoms reported by the app users that could serve as warning signs.

[The app] tells us that weve got at least 100,000 cases at the moment of people who are infected and this is from our data, although the NHS would underestimate that because theyre not counting all the symptoms. We list about 14 symptoms which we know are related to having a positive swab test, and these are not being picked up by the NHS.

Between 24 and 29 March, data from the app showed that 59% of users who tested positive for Covid-19 experienced loss of smell and taste compared with 18% of those who tested negative. They were three times more likely to have contracted Covid-19 and should self-isolate to reduce the spread of disease, the team said on 1 April.

Spector said 17 other countries including the US had altered their list of symptoms, but not the UK. At the moment, people are being told to go back to work if theyre a care worker, and theyve got something like loss of smell or taste or severe muscle pains or fatigue things that we know and weve shown are related to being swabbed positive, he said.

This country is missing the ball in underestimated cases but also putting people at risk, and continuing the epidemic. So we really do need to tell Public Health England to get in line with the rest of the world, and make people more aware.

Someone has got to urgently ask this question of why were the only country in this crisis that isnt really widening our group of symptoms and get on with it and do something.

Other scientists agreed that the change of guidance was long overdue. The announcement that the CMOs have now recognised smell and taste disturbances is extremely welcome, albeit much later than other European counterparts and at least two weeks after the WHO added it to their list, said Carl Philpott, a professor of rhinology and olfactology at Norwich Medical School, UEA.

The World Health Organization (WHO) guidance on face masks has remained consistent during the coronavirus pandemic. It has stuck to the line that masks are for healthcare workers not the public.

Wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral diseases, including Covid-19. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted, the WHO has stated.

Nevertheless, as some countries have eased lockdown conditions, they have been making it mandatory to wear face coverings outside, as a way of trying to inhibit spread of the virus. This is in the belief that the face covering will prevent people who cough and sneeze ejecting the virus any great distance.

There is no robust scientific evidence in the form of trials that ordinary masks block the virus from infecting people who wear them. There is also concerns the public will not understand how to use a mask properly, and may get infected if they come into contact with the virus when they take it off and then touch their faces.

Also underlying the WHOs concerns is the shortage of high-quality protective masks for frontline healthcare workers.

Nevertheless, masks do have a role when used by people who are already infected. It is accepted that they can block transmission to other people. Given that many people with Covid-19 do not show any symptoms for the first days after they are infected, masks clearly have a potential role to play, especially on crowded public transport as people return to work..

Sarah BoseleyHealth editor

This will hopefully now be another measure by which the pandemic can be contained, especially as in some people it may be the only symptom or may precede other symptoms. This is particularly pertinent in healthcare workers where reports of smell and taste disturbances have been commonplace, meaning the transfer of infection from colleagues to each other and to uninfected patients will have been happening unchecked.

Englands deputy chief medical officer Jonathan Van-Tam said the governments new and emerging respiratory virus threats advisory group (Nervtag) began looking at the data on 27 March.

Van-Tam said the data had been kept under regular review but there were questions as to how significant the symptom was. There are multiple occasions when Nervtag has concluded the data are very preliminary and not the basis for action, he said.

As soon as they felt they had a position, they put it to the chief medical officers group and action has been taken within a few days.

Van-Tam said they did not know how many people experienced this symptom, nor whether it was more common in some groups than others. We have seen some signalling in some of the literature that anosmia may be more frequent in females, he said. There are also suggestions of higher proportions of young people experiencing it.

Prof Spectors estimate was over 50%, but that is certainly not true of all the reports I have read, he said.

The timing of the announcement is significant. As lockdown restrictions in England ease it becomes increasingly important to detect infections as early as possible and track contacts.

Clearly we are moving into a period, thankfully, where we have much lower disease activity in the UK, said Van-Tam. At a time when disease activity is going to be lower, it is going to be even more important to keep it that way by picking up all the cases we can.

He acknowledged that the three symptoms were not the only ones, but said fatigue and muscle pains, for instance, were too common to be included as triggers for tests at this point.

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Thousands of Covid-19 cases missed due to late warning on smell loss, say experts - The Guardian

The novel coronavirus pandemic has obliterated business for restaurants that already rely on slim margins to make ends meet. Reconfiguring operations to focus on takeout and delivery is difficult, expensive, and comes with diminishing returns. While the D.C. area hasnt seen a huge amount of restaurants announce permanent closures, its a safe bet that many more will be coming as bills pile up, federal stimulus loans run out, and governments gradually lift dine-in restrictions as part of phased reopening plans. Heres a running roundup of all the closures that have been reported so far:

Know of a D.C. restaurant that has closed permanently due to COVID-19? Send the details to dc@eater.com.

David Changs Momofuku CCDC closed after five years of business as part of a companywide overhaul. [EDC]

Wolfgang Pucks Asian restaurant the Source wrapped up its 13-year run inside the Newseum building in Penn Quarter. Pucks CUT steakhouse in Georgetown plans to reopen. [EDC]

The Lucky Strike bowling alley and bar in Chinatown appears to have closed for good, removing its Twitter account and its D.C. listing from the chains website. [Popville]

P.F. Changs pulled out of Montgomery County and permanently closed its Friendship Heights location, just over the D.C. line. [BM]

A pair of decades-old gay clubs closed in D.C.: Ziegfelds/Secrets near Nationals Park and leather bar DC Eagle in Northeast. [DCist]

Fado Irish Pub wont reopen after the novel coronavirus crisis is over. However, the 22-year-old essential Irish bar claims its demise is tied to lease issues, not the pandemic. [EDC]

NYC burger chain Bareburger permanently closed its sole D.C. location after four years in Dupont. [P]

Campono, the Italian restaurant inside the Watergate building, was told by its landlord to vacate by the end of April.

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The D.C. Area Restaurants That Have Closed During the COVID-19 Crisis - Eater DC

Remote Learning, EdTech & COVID-19

How the World Bank supports countries on remote learning in the immediate to short term and will help restore learning after the pandemic is over. CLICK HERE.

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Before the outbreak of the global coronavirus pandemic, the world was already dealing with a learning crisis, as evidenced by highnumbers of Learning Poverty. With the spread of the coronavirus, the education system is facing a new crisis, as more than 160 countries (as of March 24) mandate some form of school closures impacting at least 1.5 billion children and youth. Extended school closuresmay cause not only loss of learning in the short term, but also further loss in human capital and diminished economic opportunities over the long term.

As seen from previous health emergencies, most recently the Ebola outbreaks, the impact on education is likely to be most devastating in countries with already low learning outcomes, high dropout rates, and low resilience to shocks. While school closures seem to present a logical solution to enforcing social distancing within communities, prolonged closures tend to have a disproportionately negative impact on the most vulnerable students. They have fewer opportunities for learning at home, and their time out of school may present economic burdens for parents who may face challenges finding prolonged childcare, or even adequate food in the absence of school meals.

An empty classroom in India.

In addition to closing schools, countries are exploring options for remote learning and use of other educational resources to mitigate loss of learning. This involves capitalizing on work already started, and addressing ever-present challenges like degrees of accessibility within communities to ensure equity in access.

The World Banks education team is working to support countries as they manage and cope with the crisis today and is advising on remote learning at scale in the immediate to short term as well as supporting operations to facilitate learning after the pandemic is over. The Bank is also providing ongoing support to systemic education reform to ensure that when children do return to school, schools can provide the necessary environments to ensure children learn.

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Last Updated:May 13, 2020

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World Bank Education and COVID-19

Context

Countries around the world are working to contain the spread and impact of COVID-19 (coronavirus). Evidence from outbreaks similar to COVID-19 indicates that women and girls can be affected in particular ways, and in some areas, face more negative impacts than men. In fact, there is a risk that gender gaps could widen during and after the pandemic and thatgains in womens and girls accumulation of human capital, economic empowerment and voice and agency, built over the past decades, could be reversed. The World Bank Group is working to ensure that projects responding to COVID-19 consider the pandemic's different impacts on men and women.

Gender Dimensions of the COVID-19 Pandemic:This note summarizes different ways that COVID-19 and the accompanying economic crisis may affect gender equality outcomes and provides recommendations for action.

Guidance for Health COVID-19 (Coronavirus) Response Projects:This note was created by the World Banks Gender Group to provide guidance for World Bank teams on how client countries can respond to the different needs of men and women, with respect to health projects.

Childcare in the COVID-19 Era: A Guide for Employers: This IFC note outlines ways in which employers can support the care and family needs of their employees during the Coronavirus (COVID-19) pandemic.

Supporting Women Throughout the Coronavirus (COVID-19) Emergency Response and Economic Recovery:This brief highlights evidence from the Africa gender innovation lab that can help protect the lives and livelihoods of women and girls.

Last Updated:Apr 20, 2020

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Gender and COVID-19 (Coronavirus)

Jennifer English was sick, scared and confused. For two weeks, the Oregon City, Oregon, single mother had had no sense of taste, a fever that reached 102.5 degrees and an uncomfortable tightness in her chest.

English, 46, who helps manage a restaurant and bar, suspected she had the coronavirus and worried her health might worsen, leaving her incapable of caring for her son. But in phone calls and virtual doctor appointments, physicians downplayed her concerns.

When she then started experiencing dizziness so overpowering that it caused her to collapse on her bathroom floor in mid-April, English went to an emergency room and demanded a test for COVID-19. An ER physician gave her the test, but told her she had likely had a panic attack even though English has no history of anxiety and sent her home.

Full coverage of the coronavirus outbreak

Two days later, her coronavirus test came back positive, and English was relieved to finally have a diagnosis. But she did not get better, and doctors' suggestions to rest and take a prescription cough medicine did not help.

So she joined a Facebook coronavirus support group on a friend's suggestion, and felt instantly validated: People from all over the world were describing fevers that lasted for weeks, fatigue that wouldn't go away and a roller coaster of emotions as they coped with the unknowns of the novel illness, just as she was.

"That was huge, because I felt so alone at the time, and nobody was helping me," English, whose fever lingered for 31 days, said.

COVID-19 is as mystifying as it is isolating. Those who get it are often separated from their loved ones and seeking answers that the medical community does not yet have. As a result, millions of coronavirus survivors and family members of patients are turning to a different source for information and support: one another.

"These are people who are at the scariest, most frightening moment of their lives, and they're alone," said Diana Berrent of Port Washington, New York, a photographer who founded Survivor Corps, the Facebook group that English joined, while Berrent had the coronavirus herself.

Her group now has more than 45,000 members.

"We have your back," Berrent said. "We understand."

Survivor Corps is among the biggest of such Facebook groups, but it is far from the only one: More than 4.5 million people have joined 4,000 U.S.-based COVID-19 support groups, according to Facebook.

While medical professionals generally warn against relying on health information found online, in this case, some doctors have been open to crowd-sourced ideas especially as symptoms of the coronavirus persist for some patients.

Dr. Ashley Stoecker, a family medicine doctor with the Northwestern Medicine Regional Medical Group, joined a Facebook group, Long Haul COVID Fighters, at the suggestion of one of her patients who had been struggling with symptoms for weeks.

She posted a survey in the group to gather data about symptoms, duration of illness, and whether patients had tested positive or negative for COVID-19.

"Seeing my patients suffering for as long as they are and feeling like I dont have anything to do for them is really difficult."

The goal has been to "learn from the people experiencing these things on a day-to-day basis to see if there are things that can help us put together a picture in a puzzle that we don't have answers for at this point," Stoecker said.

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"We are basically just treating the symptoms, because we don't have clear studies that have shown what can be helpful," she said. "Seeing my patients suffering for as long as they are and feeling like I dont have anything to do for them is really difficult."

Like other social media platforms, Facebook has historically struggled to contain the spread of health misinformation and says it has taken an aggressive approach to moderating coronavirus content.

In April, the social networking giant put misinformation warning labels on about 50 million pieces of COVID-19-related content. The company is also directing any users who have liked or commented on coronavirus misinformation that it has flagged to a website that debunks coronavirus myths from the World Health Organization.

But dangerous misinformation is not the only problem patients can run into when heeding suggestions online, especially with the coronavirus, experts say.

Download the NBC News app for full coverage of the coronavirus outbreak

In addition to the symptoms caused by COVID-19, the disease can complicate underlying, chronic medical conditions. Primary care doctors are trained to account for both, and treat appropriately something Facebook commenters who "decide to become Dr. Google" cannot, Dr. Jacqueline Fincher, president of the American College of Physicians, said.

"If you're diabetic or hypertensive or have congestive heart failure, going through a major illness like this can certainly impact those," she said. "Maybe your blood sugar is out of whack, and that's why there's more fatigue."

In the Survivor Corps group, nearly 30 volunteer administrators work to make sure all posts adhere to the page's rules, Berrent said.

"You cant tell other people medical advice unless its 'you need to go to the emergency room right now.'"

"If you post a scientific theory that doesn't have a scientific source attached to it, or a YouTube video made in your kitchen, or anything that is self-published, that gets taken down," she said. "You can give your anecdotal information on your experience, but you can't tell other people medical advice unless it's 'you need to go to the emergency room right now.'"

Vicki Judd, 49, of Mohawk, New York, recently asked Survivor Corps for input not for medical advice, but for guidance on dealing with the mental health component of the coronavirus.

Judd, who works in information technology sales, had six weeks of severe coronavirus symptoms, including one week on a ventilator, and has been seeing a therapist to process the trauma of her experience. Three weeks into her recovery, she suddenly got a cough, headache and slight fever.

Terrified she could be relapsing, she polled the group on how to stay grounded. Responses came flooding in: Call the doctor to see if this could be allergies; do breathing exercises; and recognize that this could be from anxiety, given everything she has been through. Judd's doctor ended up switching her allergy medications, and the symptoms went away.

The group was comforting to Judd from the moment she joined.

"It just made me sob and sob," she said. "It was relief, excitement, sadness that somebody else knows what you're going through."

Others have found social media to sometimes be ahead of doctors' understanding of the disease.

Christy Canter, 48, of Dallas, Georgia, was hospitalized twice in one week for breathing difficulties from COVID-19, and got a rash shortly after she came home. The nurse she called said it was likely a reaction to the medication she was given in the hospital. Curious if others had gone through the same thing, Canter, a homemaker, asked the Survivor Corps group and was stunned when more than 100 people said they had and that it was also on their upper body like Canter's was and at the same point in their recovery.

"The group confirms all the things you went through or that you sensed or felt," she said. "It makes you realize, 'OK, I wasn't crazy, I'm not the only one.'"

Berrent conceived Survivor Corps as a service organization, and the group offers information on how and where to donate convalescent plasma, the antibody-rich blood product from individuals who have recovered from the disease that is being infused as an experimental therapy into patients still battling it.

Some members of Survivor Corps say they take as much comfort in reading others' stories as they do in sharing their own. Bill Cudnyj, 52, of Clifton, New Jersey, joined days after a three and a half week hospital stay during which he came so close to death, he called his wife at one point to share all his passwords with her and tell her his wishes for his burial. He is still on an oxygen machine 24/7 at home, but is actively participating in the group.

"I like commenting, sharing, talking," he said. "It gets you through things, because holding them in really doesn't help."

While these groups are overflowing with stories of triumph over the coronavirus, not all the posts are positive. Interspersed among them are tragic updates from people informing the groups that their loved one has died from the illness, often thanking members for their support.

They are heartbreaking for everyone, but for those who feared they too would die, they can also bring survivor guilt.

"The older people obviously hurt my heart, but I'll tell you, the younger people are what make me feel guilt-ridden," said Judd, the New York woman who has been seeing a trauma therapist. "It hurts me."

Canter, of Georgia, has found that the best outlet for the guilt is in helping others. She has her first appointment next week to donate convalescent plasma.

For her, it's personal: She recently found out that shortly after she was released from the hospital, the respiratory therapist who treated her died of COVID-19.

"I dont know if he got it from me or somebody else," said Canter, whose respiratory therapist died shortly after she left the hospital.

"I don't know if he got it from me or somebody else," she said. "It's just so many unanswered questions."

English, the single mother in Oregon, said the deluge of stories every day of those who are dying from the virus is overwhelming.

What has helped her the most is messaging friends she has made through social media: individuals in New York, Dubai and Italy whom she has dubbed her "virus buddies."

"The biggest thing with those three has been laughing and crying, just a release of energy and frustration and everything else," she said. "Depression is so bad with this."

She plans to keep in touch with the friends she has made as a result of her ordeal.

"I'm hoping, at some point, to go visit all of them," she said, "and go give them a big hug."

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Doctors couldn't help these COVID-19 patients with their endless symptoms. So they turned to one another. - NBCNews.com

At Development Impact weve been trying to wrap our heads around what Covid-19 means for researchers conducting evaluations in the field. As such, we thought it would be useful to do a series of posts on different dimensions. Todays post focuses on the immediate response in terms of what the virus might mean for both interventions and ongoing surveys. Later posts will focus on changing your research design and survey methods (we will revisit the efficacy of phone surveys).

First of all, there is a fair amount of thoughtful guidance out there. Annie Duflo lays out IPAs response in this blog, and Iqbal Dhaliwal provides J-PALs heartfelt approach here.

Both of us manage teams that are doing a fair number of field based evaluations and we thought it would be worth laying out a couple of thoughts. Well start with the more general ones.

Now your project isnt going to be the same. Were going to tackle this in two pieces - data collection and the intervention/research question.

In terms of data collection, one obvious move would be to switch to a slimmed down phone survey. J-PAL has a blog post on resources. Its important to keep in mind that this is a significantly imperfect substitute for most projects. However, as field operations are halted, phone surveys may be crucial in documenting intermediary outcomes along the causal chain (see more on monitoring below). And we will be revisiting the pros and cons in a forthcoming post. In the meantime, from the archives, there are a number of posts from DI that might be helpful:

Another option would be to delay data collection altogether. You are likely to be in better shape if you were about to go for a baseline. This post gives us some thoughts on the pros and cons of investing in baselines.

And, if you are doing lab-in-the-field work, Busara has this nice compilation of ideas and options.

As the pandemic prevents from organizing group meetings and most countries have instituted work from home, this poses additional challengeswe will blog and propose ideas in the coming weeks on that.

Your intervention is likely to change. The key thing will be to keep up with whats going on and adapt (as much as possible) the research to the changes. If implementation is continuing (e.g., because this is a fundamental part of a safety net or vital infrastructure) then be prepared for the implementation modalities to shift. Some implementation is just going to be flat out delayed. Some thoughts:

Anyhow, we will be posting more as things evolve and people (including us) get more of a sense of how things are changing. Stay safe out there!

We realize that this pandemic is a rapidly changing situation. This blog post contains research discussions, and should not be taken as reflecting any official view of the World Bank. Please seehttps://www.worldbank.org/en/who-we-are/news/coronavirus-covid19to learn about how the World Bank is helping countries to respond.

Here is the original post:

Impact evaluations in the time of Covid-19, Part 1