Category: Covid-19

Over a normal two-week period wed expect around half a million U.S. workers to file claims for unemployment insurance. Over the past two weeks weve seen almost 10 million filings. Were facing an incredible economic catastrophe.

The question is whether were ready to deal with this catastrophe. Alas, early indications are that we may be handling fast-moving economic disaster as badly as we handled the fast-moving pandemic thats causing it.

The key thing to realize is that we arent facing a conventional recession, at least so far. For now, most job losses are inevitable, indeed necessary: Theyre a result of social distancing to limit the spread of the coronavirus. That is, were going into the economic equivalent of a medically induced coma, in which some brain functions are temporarily shut down to give the patient a chance to heal.

This means that the principal job of economic policy right now isnt to provide stimulus, that is, to sustain employment and G.D.P. It is, instead, to provide life support to limit the hardship of Americans who have temporarily lost their incomes.

There is, to be sure, a strong risk that well have a conventional recession on top of the induced coma; more on that in subsequent columns. But for now, the focus should be on helping those in need.

Paul Krugmans Newsletter: Get a better understanding of the economy and an even deeper look at whats on Pauls mind.

The good news is that the $2 trillion CARES Act (Coronavirus Aid, Relief, and Economic Security Act) Congress passed last week does, on paper, provide a lot of economic life support. The bad news is that it looks as if it could be weeks, maybe even months, before serious amounts of money flow to those who need aid right now.

Journalists keep referring to the CARES Act as a stimulus package, but mainly its disaster relief. The best piece of the legislation which, by the way, Democrats forced unwilling Republicans to include is a major enhancement of unemployment benefits. Not only will laid-off workers get much more than they normally would, but many workers who werent previously covered by unemployment insurance, such as freelancers and independent contractors, are supposed to receive full benefits.

The legislation also provides loans to small businesses loans that will be forgiven, that is, turned into straight subsidies, if businesses use the money to maintain their payrolls.

Both of these programs are very good ideas. The trouble is that both are having a hard time getting started and time is one thing millions of distressed Americans, many of whom were already living on the edge, dont have.

On unemployment benefits: State unemployment offices, already overwhelmed by the surge in applications, arent ready to disburse these extra benefits, and may not be ready for quite a while a disastrous delay for families already in dire financial straits.

Small business loans are also facing a crippling lag in processing, with potential borrowers either unable to complete the forms or being told that they will have to wait three weeks. Furthermore, for some reason the federal government, instead of lending money directly, is channeling small-business lending through private banks and the banks are complaining that they have yet to receive crucial guidelines and that the administration is setting unworkable requirements.

In other words, it may be a long time before the economy starts getting the life support it needs right away.

And even when workers and businesses finally get the promised aid, the CARES Act doesnt provide remotely enough money to state and local governments, which are seeing revenues plunge and expenses soar. This is likely to force big cuts in government services precisely when theyre needed most.

So what do we need right now? First, we need an all-hands-on-deck effort to resolve the bottlenecks that are holding up unemployment benefits and small-business loans.

The obvious parallel here is to the crash of healthcare.gov when the Affordable Care Act was first going into effect; things looked terrible at first, but an Obama administration expert task force, working around the clock, resolved the problems more quickly than anyone imagined possible, and new enrollments ended up exceeding expectations.

I dont see any reason, in principle, a similar effort couldnt rescue the CARES Act. But heres the thing: Were talking about the Trump administration, which disdains expertise of every kind, and in which every effort somehow ends up being directed by Jared Kushner.

Second, we need another relief bill to fill the holes in the CARES Act, especially inadequate aid to state and local governments.

But will Republicans be willing to provide that aid? Donald Trump is talking, as he has many times before, about a giant infrastructure bill. But Senate Republicans are notably unenthusiastic. And while going big on infrastructure is a good idea, right now its less pressing than providing aid to states facing huge budget gaps.

And going back to the bill that Congress already passed: Im fairly sure that well eventually get the kinks worked out. But when youre losing six million jobs a week, eventually isnt good enough.

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The Covid-19 Slump Has Arrived - The New York Times

A medical worker administers a COVID-19 test at a facility in Camden, N.J., on Wednesday. Matt Rourke/AP hide caption

A medical worker administers a COVID-19 test at a facility in Camden, N.J., on Wednesday.

The new coronavirus is killing hundreds each day and swamping hospitals around the world. But catching the disease does not mean you will end up in the ICU.

"There are many patients that are fine and that are at home," says Michelle Ng Gong, the chief of critical care medicine at the Montefiore Health System in New York City. Those who don't need a hospital make up "I would dare say, in fact, the vast majority of people," she says.

Doctors like Gong are seeing many dozens of patients walk through their doors each day, and they're getting a better idea of who is at risk for severe illness. Here's their advice for what to watch out for if you think you or a loved one might have COVID-19.

Know who's at high risk of developing complications

Anyone can be made very sick by the coronavirus, but there are risk factors that increase your chances of developing serious disease.

By far the biggest factor is age. Data from several nations suggest that hospitalization and death rates rise in people older than 60. Those stats seem to be borne out by what Gong is seeing on the ground in New York City. "We've seen over and over again that our elderly patients are faring poorly," she says.

Additionally, there are a number of other health conditions that also put a person at risk. According to recent data from the Centers for Disease Control and Prevention, diabetes is a leading factor as is cardiovascular disease. Those two diseases often go hand-in-hand with obesity, and that means heavier people should also be vigilant, says Daniel Griffin, chief of the division of infectious disease for ProHEALTH Care Associates, a group of physicians that serves the New York City area.

Because COVID-19 is fundamentally a respiratory disease, anyone with lung ailments also needs to be careful. Asthma, chronic obstructive pulmonary disease and emphysema are all risk factors, the CDC says.

Finally, patients who have undergone transplants or who are immunocompromised can also get into trouble, Gong says. "It's particularly difficult with regards to being able to control the disease," she says.

Some symptoms are more worrisome than others

Fever and dry cough are among the most common symptoms of COVID-19, and by themselves, they don't require immediate medical attention. Additionally, Griffin says, many patients may experience gastrointestinal problems such as diarrhea or loose stools.

But Griffin says other symptoms early on in the illness could spell trouble later. In particular, he says, experiencing shortness of breath, significant headache, abdominal pain and severe fatigue in the first few days of illness all appear to be signs that a patient may be in for a tough fight to beat COVID-19.

Trouble with breathing, eating and drinking are all red flags, Gong says. "Those are all cause for you to consider calling a physician and seeing if you need to be evaluated for admission."

Griffin says one easy way to check breathing is to monitor how many breaths somebody takes a minute. "If they're starting to breath 24, 26, 30 times a minute, those are the high-risk people," he says.

Anyone who is worried should call their doctor rather than visit. "We're doing a lot more telehealth medicine," says Pavan Bhatraju, an assistant professor of medicine at the University of Washington. "Patients should use that as a resource."

Be vigilant, especially as the illness drags into the second week

A unique and unfortunate feature of COVID-19 is that some patients who are starting to feel better suddenly take a turn for the worst. The downturn usually comes between five to seven days into the illness.

A recent study by Bhatraju found that patients who need intensive care tend to arrive at the hospital around this time in the progression of their illness, and their deterioration can be extremely rapid. He says he's seen patients that "initially were just requiring a little bit of oxygen in 24 hours they're on a ventilator."

Doctors are still unsure what causes these late turns for the worse, but it may be the body's own immune system overreacting to the disease.

"We're all still trying to figure it out," Gong says. "But it does seem like some subset of these patients, they have a resurgence of an inflammatory response."

Regardless, if a week or so into the illness a high fever returns or a person suddenly feels short of breath, they should seek help immediately.

If you're not too sick, you may be better off at home

"As a general rule, people should stay out of the hospital if they don't need to be in the hospital," Gong says. "Fortunately, most cases of COVID seem to be able to be managed at home."

According to the CDC, the most important thing to do if you're sick at home is to quarantine yourself from others in your household. That may mean living in a separate room from loved ones or avoiding common spaces. When around other people, the CDC recommends wearing a face mask or scarf to reduce the chance of sickening others, and always try to keep six feet apart.

In terms of self-care, Gong says acetaminophen (Tylenol) and cold compresses can help with fever, and she sometimes recommends trying to sleep on your stomach to open up the lungs.

Beyond that, Griffin says the same remedies we use for other viral illnesses like the flu will also work for COVID: "Warm beverages, stay hydrated, take it easy, continue to eat healthy foods," he says. "You know, all the things your mother and grandmother probably told you."

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Think You've Got COVID-19? Here's What Doctors Say About When To Seek Help - NPR

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The goal of COVID19info.live is to provide the latest information on the COVID-19 coronavirus and to make that information more accessible.

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A doctor wearing a face mask looks at a CT image of a lung of a patient at a hospital in Wuhan, China. AFP via Getty Images hide caption

A doctor wearing a face mask looks at a CT image of a lung of a patient at a hospital in Wuhan, China.

Updated on March 17 at 6:43 p.m. ET:

Thousands of people have now died from COVID-19 the name for the disease caused by the coronavirus first identified in Wuhan, China.

According to the World Health Organization, the disease is relatively mild in about 80% of cases.

What does mild mean?

And how does this disease turn fatal?

The first symptoms of COVID-19 are pretty common with respiratory illnesses fever, a dry cough and shortness of breath, says Dr. Carlos del Rio, a professor of medicine and global health at Emory University who has consulted with colleagues treating coronavirus patients in China and Germany. "Some people also get a headache, sore throat," he says. Fatigue has also been reported and less commonly, diarrhea. It may feel as if you have a cold. Or you may feel that flu-like feeling of being hit by a train.

Doctors say these patients with milder symptoms should check in with their physician to make sure their symptoms don't progress to something more serious, but they don't require major medical intervention.

But the new coronavirus attacks the lungs, and in about 20% of patients, infections can get more serious. As the virus enters lung cells, it starts to replicate, destroying the cells, explains Dr. Yoko Furuya, an infectious disease specialist at Columbia University Irving Medical Center.

"Because our body senses all of those viruses as basically foreign invaders, that triggers our immune system to sweep in and try to contain and control the virus and stop it from making more and more copies of itself," she says.

But Furuya says that this immune system response to this invader can also destroy lung tissue and cause inflammation. The end result can be pneumonia. That means the air sacs in the lungs become inflamed and filled with fluid, making it harder to breathe.

Del Rio says that these symptoms can also make it harder for the lungs to get oxygen to your blood, potentially triggering a cascade of problems. "The lack of oxygen leads to more inflammation, more problems in the body. Organs need oxygen to function, right? So when you don't have oxygen there, then your liver dies and your kidney dies," he says. Lack of oxygen can also lead to septic shock.

The most severe cases about 6% of patients end up in intensive care with multi-organ failure, respiratory failure and septic shock, according to a February report from the WHO. And many hospitalized patients require supplemental oxygen. In extreme cases, they need mechanical ventilation including the use of a sophisticated technology known as ECMO (extracorporeal membrane oxygenation), which basically acts as the patient's lungs, adding oxygen to their blood and removing carbon dioxide. The technology "allows us to save more severe patients," Dr. Sylvie Briand, director of the WHO's pandemic and epidemic diseases department, said at a press conference In February.

Many of the more serious cases have been in people who are middle-aged and elderly Furuya notes that our immune system gets weaker as we age. She says for long-term smokers, it could be even worse because their airways and lungs are more vulnerable. People with other underlying medical conditions, such as heart disease, diabetes or chronic lung disease, have also proved most vulnerable. Furuya says those kinds of conditions can make it harder for the body to recover from infections.

"Of course, you have outliers people who are young and otherwise previously healthy who are dying," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told NPR's 1A show. "But if you look at the vast majority of the people who have serious disease and who will ultimately die, they are in that group that are either elderly and/or have underlying conditions."

Estimates for the case fatality rate for COVID-19 vary depending on the country. But data from both China and Lombardy, Italy, show the fatality rate starts rising for people in their 60s. In Lombardy, for instance, the case fatality rate for those in their 60s is nearly 3 percent. It's nearly 10 percent for people in their 70s and more than 16 percent for those in their 80s.

Del Rio notes that it's not just COVID-19 that can bring on multi-organ failure. Just last month, he saw the same thing in a previously healthy flu patient in the U.S. who had not gotten a flu shot.

"He went in to a doctor. They said, 'You have the flu don't worry.' He went home. Two days later, he was in the ER. Five days later, he was very sick and in the ICU" with organ failure, del Rio says. While it's possible for patients who reach this stage to survive, recovery can take many weeks or months.

In fact, many infectious disease experts have been making comparisons between this new coronavirus and the flu and common cold, because it appears to be highly transmissible.

"What this is acting like it's spreading much more rapidly than SARS [severe acute respiratory syndrome], the other coronavirus, but the fatality rate is much less," Fauci told 1A. "It's acting much more like a really bad influenza."

What experts fear is that, like the flu, COVID-19 will keep coming back year after year. But unlike the flu, there is no vaccine yet for the coronavirus disease.

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How Patients Die After Contracting COVID-19, The New ...

The city of Berkeleys health officer and other health officers around the region and state recommend that everyone cover their noses and mouths with cloth when leaving home for essential visits to doctors offices, supermarkets or pharmacies.

A bandana, fabric mask, neck gaiter or other cloth barrier helps prevent those who have mild or no COVID-19 symptoms from unknowingly spreading it to others. To protect yourself from others, use physical distance.

Do not use surgical masks or N-95s. Preserve the limited supply of medical-grade masks such as an N-95 for health care workers or first-responders, who cannot use physical distance to protect themselves, especially from people at their most symptomatic, infectious periods.

This new recommendation from the city of Berkeley, state and regional officials comes as scientists and doctors rapidly learn more about this new type of coronavirus, which was detected only four months ago and has no known medicine or vaccine.

Wear a bandana to protect others from an infection you might have, said Dr. Lisa Hernandez, the city of Berkeley health officer. When you see others wearing a cloth covering, know that they are protecting you.

Face coverings should cover the nose and mouth. Cloth materials can be improvised and should be washed repeatedly with detergent and dried on a hot cycle. Ideally, use a dedicated laundry bin so they are washed after each use.

Make sure the covering is comfortable you dont want to have to keep adjusting the mask, which means touching your face. Always wash your hands, or use hand sanitizer, before AND after touching your face or face coverings.

Health officials stress that staying home, frequent hand washing and physical distancing are the best ways to prevent the spread of COVID-19. Face coverings may also serve as a reminder to the critical order to shelter in place except for essential activities.

If you have sealed packages of masks, gloves, and other protective equipment to support Berkeleys emergency response youre able to donate, let us know.

Stay home except for essential activities, said Hernandez. When you must leave, help care for our community by keeping distance from others and covering your face.

Visitcityofberkeley.info/covid19for additional information on COVID-19, recommendations from Berkeley Public Health, andchanges to City services.

Berkeleyside relies on reader support so we can remain free to access for everyone in our community. Donate to help us continue to provide you with reliable, independent reporting.

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Message from Berkeley health officer: Cover face to limit COVID-19 spread - Berkeleyside

N95s are the gold standard in protecting health care workers from particles and droplets in the air. (Mladen Antonov/AFP via Getty Images)

Here's the scenario: your loved one is in a nursing home on lockdown, you know people there are sick with COVID-19, you have no way to visit or see for yourself how it's being handled.

That's Debra Hoffman's reality. Her 74-year-old aunt is a resident at the Cedar Mountain nursing home in Yucaipa, where a COVID-19 cluster is occuring. So far 51 residents and six staff members have tested positive for the new coronavirus and two infected residents have died.

Hoffman said her aunt, who suffered a stroke, needs full-time care.

"The hardest thing is that I can't physically go up there and control this situation," Hoffman said. "I can't go in to see what's really going on and I'm not getting accurate information."

Hoffman learned of the outbreak at Cedar Mountain only after it was reported in a local TV newscast, she said, adding that a representative from Cedar Mountain called the following day to let her know the situation at the nursing home.

"It's frustrating because I don't know what's going to happen," Hoffman said. "I don't know how they're treating it, I don't know what their procedures are to keep this from spreading, other than my aunt told me they're not allowed out of their room."

Hoffman wants her aunt and all residents and staff at Cedar Mountain to be tested for COVID-19 and she said she's getting conflicting information on whether or not that's happened.

Lana Culp, a spokeswoman for the San Bernardino County Department of Public Health, said most of the residents had been tested, but not all.

"There isn't much value in testing everyone at this point now, just because it should be assumed that their whole facility has been exposed due to the large number of confirmed cases," Culp said.

Cedar Mountain staff were not immediately available to provide comment.

THE STATE'S RESPONSE

"Infection control specialists from CDPH [California Department of Public Health], along with county staff, have been at the facility to provide assessments and work in real time on infection control measures," the California Department of Public Health said in an emailed statement to LAist.

According to the state's guidance for skilled nursing facilities: "symptomatic residents and exposed roommates must limit movement outside their room; if they need to leave the room, they should wear a facemask."

That means other families across California and the nation are finding themselves in Hoffman's shoes unable to see for themselves how their loved ones are being treated.

To prevent the spread of the virus, CDPH guidelines say residents with confirmed or suspected COVID-19 infection should be kept in the same wing or building and that communal dining areas should be closed. They also say 'high touch' surfaces should be cleaned and disinfected with Environmental Protection Agency-registered, healthcare-grade disinfectants.

'DIRE' NEED FOR MORE PROTECTIVE EQUIPMENT

As nursing homes across California brace for more outbreaks among their vulnerable populations, a coalition of nurses, skilled nursing facility operators and a union which represents thousands of nursing home workers in California is pleading with the federal government to urgently get millions of masks and gowns to the front lines.

"Unfortunately, Yucaipa... it is the tip of the iceberg," April Verrett, President of Service Employees International Union (SEIU) Local 2015, said on a call this week with reporters.

Verrett said nursing home workers don't have enough protective equipment to keep themselves and residents from getting infected should we see more outbreaks and clusters in these close-quarters settings.

"The need is so acute and so dire, the solution must come from the federal government," Verrett said.

State leaders, including California State Senator Richard Pan and Assemblywoman Eloise Reyes are also demanding the federal government do more to insure production of personal protective equipment is made in the U.S. and distributed to facilities in need.

"We're sending our frontline workers to a war zone without protection," Reyes said. "And that cannot continue."

MORE ON CORONAVIRUS:

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COVID-19 Cluster In Yucaipa Is 'Tip Of The Iceberg,' Nursing Home Union Leader Says - LAist

For Immediate Release: April 02, 2020 Statement From:

Statement Author

Leadership Role

Director - Center for Biologics Evaluation and Research (CBER)

As part of the U.S. Food and Drug Administrations ongoing commitment to fight the Coronavirus Disease 2019 (COVID-19) pandemic, today the agency issued guidance for immediate implementation to address the urgent and immediate need for blood and blood components.

The COVID-19 pandemic has caused unprecedented challenges to the U.S. blood supply. Donor centers have experienced a dramatic reduction in donations due to the implementation of social distancing and the cancellation of blood drives.

Maintaining an adequate blood supply is vital to public health. Blood donors help patients of all ages accident and burn victims, heart surgery and organ transplant patients and those battling cancer and other life-threatening conditions. The American Red Cross estimates that every two seconds, someone in the U.S. needs blood.

People who donate blood are part of our critical infrastructure industries. More donations are needed at this time and we hope people will continue to take the time to donate blood. We have also encouraged, and continue to encourage, state and local governments to take into account the essential nature of donating blood - and that it can be done safely and consistently within social distancing guidelines - when considering travel and business restrictions, and we encourage them to communicate that to their citizens.

At the FDA, we want to do everything we can to encourage more blood donations, which includes revisiting and updating some of our existing policies to help ensure we have an adequate blood supply, while still protecting the safety of our nations blood supply.

Based on recently completed studies and epidemiologic data, the FDA has concluded that current policies regarding certain donor eligibility criteria can be modified without compromising the safety of the blood supply. Therefore, the FDA is revising recommendations in several guidances regarding blood donor eligibility. These changes are being put forth for immediate implementation and are expected to remain in place after the COVID-19 pandemic ends, with any appropriate changes based on comments we receive and our experience implementing the guidances. At this time, the alternatives to certain donor eligibility requirements being provided generally will apply only for the duration of the declared pandemic.

Revised Recommendations for Reducing the Risk of Human Immunodeficiency Virus Transmission by Blood and Blood Products

Among others, the FDA is making the following changes, for immediate implementation, to the December 2015 guidance:

Revised Recommendations to Reduce the Risk of Transfusion-Transmitted Malaria

The FDA is making the following changes, for immediate implementation, to the August 2013 guidance:

Recommendations to Reduce the Possible Risk of Transmission of Creutzfeldt-Jakob Disease and Variant Creutzfeldt-Jakob Disease by Blood and Blood Components

The FDA is finalizing the January 2020 draft guidance, which includes the following change from the previous guidance:

To help address this critical need, the FDA is also providing notice of alternatives to certain requirements regarding blood donor eligibility for the duration of the COVID-19 pandemic. Blood establishments are not required to implement the changes in the FDA recommendations or the alternative procedures.

We expect that the updated guidance and alternative procedures will help increase the number of donations moving forward, while helping to ensure adequate protections for donor health and maintaining a safe blood supply for patients.

We believe these updated recommendations will have a significant and positive impact on our blood supply. As noted above, the changes being announced to the HIV, vCJD and malaria guidances are being put forth for immediate implementation. The updated recommendations in these guidances are based on data and analysis that the FDA believes are applicable to circumstances outside of (and after) the COVID-19 pandemic and reflect the agencys current thinking on this issue. These recommendations are expected to remain in place after the COVID-19 pandemic ends, with any appropriate changes based on comments we receive and our experience implementing the guidances.

The FDA will provide notification when the alternative procedures are no longer in effect. The FDA will monitor these changes in policy, alongside the National Institutes of Healths National Heart, Lung and Blood Institute and major blood partners to ensure the continued safety of the blood supply.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nations food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

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Coronavirus (COVID-19) Update: FDA Provides Updated Guidance to Address the Urgent Need for Blood During the Pandemic - FDA.gov

HOUSTON There's new information on how COVID-19 spreads and it's a lot easier than scientists expected. New research suggests coronavirus can spread through talking and even breathing.

The troubling news was delivered in an overnight letter to the White House from Dr. Harvey Fineberg and the National Academy of Sciences.

The CDC says COVID-19 spreads when people are within six feet of one another through tiny droplets produced by an infected person's coughs or sneezes. Experts now saying talking and something as simple as breathing could transmit the virus too.

In other words, the six foot rule may not cut it.

Research at a Chinese hospital found traces of coronavirus suspended in the air when doctors or nurses took off protective gear.

Researchers at the University of Nebraska noted they found traces of the virus too airborne in a patient's room even they were more than six feet away from the patient.

All this means it's possible aerosolized coronavirus droplets released by talking or even breathing could hang in the air and yes potentially infect a person who walks by later.

How long the virus is in the air can depend how much virus was released by a person breathing or talking and whether or not there's circulation in the air.

All this is pushing the White House Coronavirus Task Force closer to recommending the general public wear masks when not in their homes. Cities like Los Angeles have put that recommendation in place.

OTHER COVID-19 STORIES ON KHOU.COM

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New warning to White House: COVID-19 can spread through talking and breathing - KHOU.com

48 Million Americans live in poverty. What will happen to them during the coronavirus pandemic?

The coronavirus pandemic has ushered in a new phraseWe are all in this together. The first time I saw the phrase I thought about the 48 million Americans living below the poverty line and tens of millions more who are one paycheck away from it. I thought about underserved black and brown communities that perpetually face health inequities and higher rates of chronic health conditions. And what about the grocery store clerks, truck drivers and others who keep the essentials of society humming while the rest of the world is hunkered down staying home? Is Were all in this together really a moment of togetherness or is it just a nice, supportive sentiment?

Interviews with three leaders of health and social service-related organizations for the underserved highlight how we are not quite all in this together. Pandemic policies do not give full consideration to the unique needs of underserved communities, particularly the homeless. Consequently, they are unintentionally omitted from our moment of national COVID-19 solidarity.

When asked why we so often forget about the needs of underserved communities,Dionne Reeder, the CEO ofFar Southeast Family Strengthening Collaborative, a family support agency in Washington, DCsaid, Its not that we forget about the poor. The problem is we dont plan for the poor.

The impact of this failure to plan is tangible in the stories Reeder shared about the challenges they are seeing on the ground. She says her staff spends most of their time helping people navigate the financial impact of the pandemic which leads to other health consequences like anxiety, depression and frustration with the drastic change in daily routines. Last week a working mother, forced to be home with children, reached a breaking point and asked for their support to help cope with her new way of living. As with many other working parents experiencing a sudden cultural shift in their way of living, shed never been in this situation before with children home all day and was not equipped for home schooling. Reeders organization helped her navigate the situation emotionally and psychologically.

Reeder recalled a news story that for her, highlighted the disconnect between how the mainstream media portrays and discusses the pandemic and the realities her clients face. The news story advised people to quarantine in a room with a private bathroom. Reeder noted this is an impossibility for millions of people not just the poor. She also believes culturally the idea of social distancing is different among her clients because so many live in social environments in which social distancing is not feasible.

Christy Respress, the Executive Director ofPathways to Housing DCagrees with Reeder and highlighted a range of social issues impacting the homeless that are probably not top of mind for most Americans. She says, It is difficult to tell clients to stay home, socially isolate and wash their hands throughout the day when many of them live in shelters and have no home. When they hear those things, they may feel its impossible for them to stay safe from the virus. Some of Pathways clients housed in shelters feel its safer to sleep outside because it is impossible to practice social distancing in a shelter. There is also a concern social distancing and stay home orders exacerbate the baseline social isolation experienced by many homeless people.

Respress says closing non-essential businesses led to an unintended domino effect that collapsed the informal support infrastructure for their clients. When social distancing and stay home orders were implemented, the social safety net gradually disappeared. Many homeless people rely on the unspoken social cooperation sustained by neighborhood activity like people shopping and going to and from work. Altruistic gestures from strangers passing by each day whether buying a meal or offering pocket change, weave a thread of support that doesnt exist right now.When people dont shop and dont go to work, no one is around to help. Respress also worries this decrease in support may destabilize some emotionally and result in spikes in substance use. In addition, bathroom access, something most take for granted, becomes a challenge when the usual sources at retail establishments and restaurants are no longer available.

Another challenge related to pandemic mitigation efforts is adhering to advice to stock up on food. People on fixed incomes cannot stock up on food and for many the food supply will be depleted by months end.

Luckily, organizations likeMarthas Tablehave been able to help address food scarcity during the pandemic. Since the pandemic onset, the organization has seen a 300% increase in the need for food support.Kim Ford, Marthas Table CEO says, COVID-19 has hit the underserved very hard because this community has no cushion to absorb an economic downturn. Ford says most of their clients are not as concerned about infection from coronavirus as they are about job loss resulting in unexpected loss of financial security.

Having agencies like these on the frontlines is a gift for those with little means to protect themselves from coronavirus. As this pandemic rages on with unknown speed and devastation, we cant forget the most vulnerable who need even more support. Being in this pandemic together means leaving no one behind and acknowledging the slightest twist of fate could shift the financial and social circumstances for any one of us. So if we are all in this together, this cant be just a slogan. We must include, plan for and protect our most vulnerable too.

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Covid-19 And The Underserved: We Are Not All In This Together - Forbes

Welcome to the first of what will be regular chapters of a living oral history of the Covid-19 pandemic, an attempt to capture in real time the stories playing out across our country, in the words of those who are experiencing the crisis. This installment focuses on people who are ill right now (or suspect they are sick) because of the virus, along with the voices of doctors and health care workers taking care of them.

The project grows out of my work writing and researching an oral history of September 11th, a world-changing disaster that rewrote our geopolitics, our economy, and our society. Now, of course, were all living through another once-in-a-century crisisone that appears to have the potential to rewrite even more of our geopolitics, our economy, and our society.

Capturing the evolution of the Covid-19 pandemichow this crisis unfolds and how our thinking about it changesis critical both to understanding it now as well as to the stories we someday will tell about it. Each Friday, WIRED will publish a new chapter, weaving together as many stories as we can from across the country about living through this Covid Spring, trying to capture the story of American government, American business, and American life, and the titanic task ahead for our health care system.

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Some fine print, required by WIRED: By submitting your Covid Spring story you are agreeing to WIRED's User Agreement and Privacy Policy found at WIRED.com. All submissions become the property of WIRED, must be original and not violate the rights of any other person or entity. Submissions and any other materials, including your name or social media handle, may be published, illustrated, edited, or otherwise used in any medium.

To tell this story, though, I need your help. Please write in and share your own storiestell me how your life has been affected, how your family is handling this moment, how your work has changed, tell me what youre seeing in your home, on the streets, at the grocery stores, in the parks where youre walking or runningat an appropriate social distance, of course.

Email your stories to me at covid@wired.com, write as much or as little as you wish, and stay tuned each week for additional chapters of our series: Covid Springan oral history of a pandemic. None of us knows how many chapters it may take until were out of this.

Editors note: The following oral history has been compiled from original interviews, social media posts, and online essays. Quotes have been lightly edited, copy-edited, and condensed for clarity.

I: Living With Covid-19

As of Thursday afternoon, the United States overtook China as the country with the most confirmed Covid-19 cases in the world, more than 85,000 total. Yet that number still represents what is almost surely a fraction of the actual number of cases in the US, as testing has lagged nationwide and many who are ill and wish to be tested dont meet the strict criteria to receive a test still in place across much of the country. The scale of the nations epidemic also means that public health officials have quickly abandoned attempts to trace the contacts of those infected, leaving those sickened by the virusor those who think theyve been sickened by the viruswondering not only if they have it, but how they caught it.

Amee Vanderpool, writer and lawyer, Washington, DC: People are in total denial about this. I even did that for the first three days. The 21st was a Saturday. Saturday is when I came out of denial. I definitely had something that Id never had before. I could get really sick.

Anne Kornblut, director, news and new initiatives, Facebook, Palo Alto, California, via Facebook: I tested positive for Covid-19 [last week]. Im relatively fine; lucky, even. Around here, officials have been preparing, so much so that I was able to get a test when I needed it. Facebook sent us home many days ago, so its unlikely I affected a big group of colleagues. I went supply shopping weeks ago. Heres what I didnt prepare for: telling my kids to back away from me, while informing them that this scary thing upending the entire planet is now inside our house. Inside their mom. My daughter cried and asked if I will get better. I couldnt hug her. My son wrote an account of it for our home newspaper. Anne Kornblut has the coronavirus but do not worry it is not the bad kind, he wrote on the front page. Please note that you should not be within 10 feet of Anne.

Morgan Madison, age 18, Chandler, Arizona: I really wasnt paying attention at allI didnt really care [about the virus]. Trump told us it was never going to hit the United States. He said there were like three cases. I thought I definitely wouldn't get itif there are just a handful of cases, why would I be one? I work at a car dealership, and my GM got back from a seven-country tour, and four or five days after he got back I had a sore throat. Our receptionist got a horrible cough too. She just stopped coming to work. Last Monday, I got to my desk and just started hacking up a lung. My GM came in and said, Clorox wipe your office and go home. I woke up the next day and felt like trash. I felt I had inhaled glue. My throat was sticky. I was coughing. Lots of migraines. Horrible migraines. It just went from feeling great to taking a five-hour nap in the afternoon. There was dizziness and confusion. Sometimes I feel fine, then the coughing up a lung came back. There were a couple of times Ill just be sitting on the floor hitting my inhaler.

Howard Yoon, literary agent, Washington DC: A week prior to getting a fever, Id developed a sore throat and a runny nose. That was the seventh of March. The idea of the coronavirus was creeping into everyones minds when they got sore throats. Out of an abundance of caution, I stayed home. I felt fine the next day. That might have just been a cold or maybe that was the onset of the virus? Since I felt fine after that first day, I went to New York that Wednesday. I tried to take some precautionsavoided the subway, walked most places. That night, I had drinks with some friends and colleagues. I knew I had it [four days later] on Sunday the 15th. All the days leading up, I dont know whether I had it and was developing all week or it came on full-blown after catching it in New York. One of the people I had drinks with, she has tested positive for the coronavirus. I dont know if I gave it to her or she gave it to me.

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First Denial, Then Fear: Covid-19 Patients in Their Own Words - WIRED