New York Times “What You Can Do About Coronavirus Right Now”

You have an essential role to play in slowing the spread of the new coronavirus. The good news is that small changes in personal behavior can buy time — slowing the outbreak, preventing hospitals from becoming overwhelmed and reducing cases until scientists develop treatments and, eventually, a vaccine. Here’s some practical advice from doctors and public health experts to protect yourself and your community.

Prevent Infection

Slow the outbreak by keeping yourself and others from getting sick.

Prepare

Stock up on food responsibly and create a household plan.

Stay Home

Stay at home to protect others, and use these strategies to keep life as normal as possible.

Recover From Illness

What to do if you or a family member gets sick.

1You Can Prevent Infection

The impact just one person can have on spreading the virus — or tamping it down — is exponential. In the space of a month, one infected person leads to about 400 additional cases, according to Adam Kucharski, a mathematician who specializes in disease outbreaks.

See more here.

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From Gale Brewer Manhattan Borough President

A list that is full of helpful links and information:

Friends,

It’s Thursday, March 19, and this is my fourth COVID-19 newsletter.

As you might imagine, the New York Blood Center is experiencing critically low blood and platelet appointments– making it difficult to meet patient needs and hospital demand. If you’re able to donate blood, please visit www.nybloodcenter.org for information on scheduling an appointment.

Over 680,000 New Yorkers have signed up for the City’s COVID text notification system to get regular updates on the latest developments with coronavirus in New York City. Text COVID to 692-692.  Spanish speaking (or reading) New Yorkers can text COVIDESP to 692-692 for updates in that language.

The City Dept. of Health is now posting a daily health status report here.  (Scroll to “Daily Syndromic and Case Data Update” and click “COVID-19 Daily Case Data Summary (PDF)”.

Similarly, the Johns Hopkins University of Medicine has established a Coronovirus resource webpage with a dashboard showing the global counts by nation, with an interactive (ie clickable) map that shows caseloads by jurisdiction.

You can sign up for COVID-19 updates from Governor Cuomo here.

Over 1,500 medical providers have signed up to aid the City’s response efforts to COVID-19 by completing a survey at nyc.gov/helpnownyc. (Yesterday’s survey link broke after we published it, but it’s back up and running now.)

You can apply for an NYPL library card online and check out e-books to read on your device.  Now’s the time to dive in to “War and Peace”!!

Banks in New York will waive mortgage payments for 90 days and suspend foreclosures based on financial hardship, Gov. Cuomo said. The 90 days constitutes a grace period– those who participate in the program will still owe their payments but be allowed to pay them at a later date.

Keith Powers published an op-ed in the NY Post, “New York State needs to throw our bars and restaurants an urgent lifeline” And Chalkbeat reported that “Thousands of crossing guards, substitutes worry they won’t be paid during NYC school shutdown”.

Food Bank for New York City has established a COVID-19 webpage which outlines their efforts to stay open and solicits community support.  Notably, their Harlem Community Kitchen and Food Pantry remains open at 252 W. 116th St. in Harlem.

Target stores are reserving their first hour every Wednesday for seniors and high-risk customers. I’m working on an updated list of supermarkets which have done the same– stay tuned.

I saw a tweet worth mentioning here:  “For a lot of folks, the difference between social distancing and social isolation is going to be a critical one. Folks, check in on each other, there are still walks and bike rides and conversations to be had.”

On the local front:

This morning I learned that a 180-resident low-income senior building in Hamilton Heights needed on-site meal delivery– and fast! Reportedly an adult day care center that many of the residents relied on had closed up without providing grab-and-go meals.  Within hours, LiveOn and Citymeals coordinated a multi-meal drop off directly to the building lobby. So  a big THANK YOU to the staff at LiveOn New York and Citymeals on Wheels!

CaringKind is in operation remotely, with their staff continuing to serve families caring for their relatives with Alzheimer’s. Social workers and dementia care specialists are providing one-on-one and family consultations and support via phone, and support groups are taking place via teleconferencing. Their “Understanding Dementia for Family Caregivers” workshop is available online. Contact their Helpline at 646-744-2900 for more information.

The City and State now mandate that no business have more than 25% of their workforce report to offices. NYPD, FDNY, DOB, and the Sheriff’s Offices are enforcing the City’s closure of movie theatres, museums, cinemas, clubs, concert venues, and commercial gyms, as well as the limitations placed on restaurants, bars, cafes, and catering halls to pick up and delivery food service only. So far, the City has inspected 8,150 businesses and religious institutions and has observed overwhelming compliance. Six violations have been issued.

Monday, the DOE is set to begin distance learning. They have launched a form for those parents whose kids need tablets. For children who will be learning at home, here is a helpful portal.

If you’re a small business owner in NYC affected by COVID-19, visit nyc.gov/covid19biz or call 311 for info on grants, updates & more.

New York City has launched the Employee Retention Grant Program to help NYC small businesses and nonprofits retain employees as they face decreased revenue from the impact of the CoronaVirus (COVID-19). Eligible applicants will receive a grant covering up to 40% of their payroll for two months, up to $27,000. This program is available to NYC small businesses and nonprofits with 1-4 employees that can demonstrate at least a 25% decrease in revenue as a result of COVID-19. The applicant must also have been in operation for at least 6 months and have no outstanding tax liens or legal judgments. To apply go to the NYC program website and be prepared to upload supporting financial documents for 2019 and 2020 to demonstrate the revenue impact, and two months of payroll records to calculate the grant amount. Be sure to click on the document checklist for specific requirements.

The federal Small Business Administration has declared New York State (and NJ and PA) businesses eligible for Coronavirus (COVID-19) disaster loans. FInd out more here or at SBA.gov/Disaster. (Inexplicably, the webpage does NOT list New York State as eligible, but I’m told the application form DOES. Their site is running very slowly, understandably, but patience might be rewarded!

The Pace University Small Business Development Center has no-cost virtual meetings/calls with a Pace SBDC Business Advisor. Email sbdc@pace.edu for an appointment and check their website for updates on available small business resources.

Start Small Think Big specializes in providing small businesses in underserved communities with free legal, marketing, and financial assistance. They are hosting free virtual office hours for small businesses with their team of legal and finance professionals this week daily from 4-5 pm.  Downbload the ZOOM application to your computer and visit https://zoom.us/j/381661126 (if you go directly to this meeting link without downloading the app, it will prompt you to download it– the prompt is not a virus!!) or dial in at 929 436 2866. Use the meeting ID 381 661 126.

NYC Health + Hospitals today announced expanded, appointment-only COVID-19 testing capacity across 10 acute-care hospitals, seven Gotham Health community-based health centers, and four drive-thru test sites for New Yorkers with moderate-to-severe symptoms. With this expansion, H+H anticipates serving 150 people per day at each of its 10 centers;   50-75 people per day at the Gotham clinics; the drive-thru sites will be able to accommodate 100 people per day. It’s a start. New Yorkers who have high priority because of age, pre-existing conditions and symptoms, call 1-844-NYC-4NYC for more information. Patients who obtain appointments will receive an expedited consultation with a primary care physician to capture their medical history before their sample is collected for testing. This will ensure that the appropriate medical treatment is provided should a test come back positive. This is all part of a private-public partnership between the City’s public health system and BioReference. All COVID-19 testing is being provided at no cost to patients.

MetroPlus health insurance clients can now interact by phone: 855-809-4073

Social Security offices are closed, naturally, but many SSA services can be accessed online.
Visit their COVID-19 web page here.

To ensure New Yorkers who use Section 8 rental assistance vouchers have undisrupted access to housing, the City is taking the following steps:
• The City will automatically extend any Section 8 voucher set to expire. Voucher holders do not need to reach out
to the City for an extension.
• All subsidy terminations that are in process are suspended until further notice.
• Any HPD Section 8 voucher holders facing rent hardships due to decreases in income should contact HPD.
• NYCHA encourages households experiencing a loss of income to visit the NYCHA Self-Service Portal.
The HPD Section 8 team is still available to the public by email at DTRAI@hpd.nyc.gov. (The HPD Section 8 Customer Service Office at 100 Gold Street is closed until at least March 30)

Today’s Manhattan senior center meal distribution update is posted on my website here.
Many new centers have been added and changes made to other times and locations.

That’s it for Thursday; do contact me at (212) 669-8191 if you have questions or concerns.

Stay safe,

P.S.  Please forward this newsletter to anyone you think might be interested, or have them subscribe to my enews here.  Also, follow my social meadia accounts on Twitter, Facebook, and/or Instagram (where you’ll see my Women’s History Month gallery!)

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Audubon Society on Harriet Tubman’s Naturalist Expertise

An original environmental justice advocate.

“Many people are aware of Harriet Tubman’s work on the Underground Railroad and as a scout, spy, guerrilla soldier, and nurse for the Union Army during the Civil War. Fewer know of her prowess as a naturalist.

“She used bird calls to help guide her charges, eventually helping some 70 people, including her parents and four brothers, escape slavery.”

“… she used the call of an owl to alert refugees and her freedom seekers…the Barred Owl, or ‘hoot-owl.'” – Park Historian Kate Clifford Larson, author of the Tubman biography Bound for the Promised Land

Listen to the sounds of Barred owl on the Audubon Society website

 

“she grew up in an area full of wetlands, swamps, and upland forests, giving her the skills she used expertly in her own quest for freedom in 1849” 

– Kate Clifford Larson

“in…timber fields..she learned the skills necessary to be a successful conductor on the Underground Railroad,..including how to read the landscape, how to be comfortable in the woods, how to navigate and use the sounds”

– Kate Clifford Larson

“Tubman was an astronomer, too”

– Eola Dance, former coordinator for the National Park Service’s Network to Freedom program.”

Botany proved another necessary skill; people used plants for food and other survival needs.

“Whether it was using certain plant life to quiet babies, or it could be relieving pain or cleaning wounds, this was the type of knowledge that Tubman had”  

– Eola Dance

“…after her Underground Railroad days when she served in the Union Army…Her experience with the waterways she crossed repeatedly while shepherding freedom seekers was essential again.”

“Tubman would have had to cross several rivers, creeks, and streams, and that would have been important not only directionally..”

“Freedom seekers would have been tracked by dogs, and by traveling through the water and knowing these waterways, it would have aided them in throwing off their scent so that the dogs would not be able to find them.”

– Eola Dance

” the knowledge and skills she had to have,..in order to accomplish the impossible.”

– Eola Dance

 

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From Virology Down Under: So you think you’re about to be in a pandemic?

From Virology Down Under Go to their website!

Photo by Daria Volkova on Unsplash

We’re not in a pandemic now so let’s get ahead of what’s coming.

 

Assumptions and severity

This post is based on the assumption that a pandemic will occur at some point and that Wave 1 will impact us, wherever we live, in the coming weeks and months.

Planning now and doing something means we can control how well we cope with some of what may be coming.

While closures and cancellations are possible, they are by no means a sure thing. We don’t know how mild or severe SARS-CoV-2 will be, and each region will make their own – probably slightly differing – decisions about what is appropriate – and enforceable. Having a think now about how we might respond in these situations will help decisions come faster if we get to that point.

What we might see happen if many get sick

If we enter into a pandemic, large numbers of people will be sick. Even if that’s just staying home with a fever and bad cough for a week. If COVID-19 is more severe, that will have a greater impact.

Authorities will try to slow the speed of COVID-19 to prevent hospitals – which are essential to care for the sickest people – from being overloaded. Public gatherings – sports events and concerts – as well as schools and childcare centres, could be postponed or closed. All of which aims will be to keep people apart, making it harder for the virus to spread quickly.  Again, these decisions will differ between places, and may not even have to be made.

Measures which slow the peak (1) and “flatten the curve” (2) will delay and spread out the pressure on essential healthcare function and supply chains. [3]

Once we have a vaccine, we can mitigate the impact of SARS-CoV-2, but we’re quite some way from having a safe vaccine.

Planning for everything

It seems to take a while to get to around talking to the community about what they can do. Part of that’s because of how consumed with work many are right now because this epidemic is still only 8 weeks old; an infant, yet one that moves like a teenager who just discovered caffeine. And yet, late last week and over the weekend, the signal fires of pandemic awareness and increased communication started to light.

But what can we plan for and do?

Let’s break this into two main categories.

  • Reducing our risk of being infected
  • Reducing the chance we will run out of essential foods and goods

Reducing our risk of being infected

We can do a few things and we’ve probably heard them all before. They won’t guarantee to protect us from infection, but they can reduce our risk of infection. These are just as useful for avoiding influenza (flu) virus infection during flu season and for dodging SARS-CoV-2, once your local community is known to have it circulating.

These are things we can do to reduce our risk of SARS-CoV-2 infection.

  • Stay at least 2meters (about 6feet) away from obviously sick people.
  • We’re trying to avoid receiving a cough/sneeze in the face, shaking hands, or being in the range of droplet splatter and the “drop zone”
  • Wash your hands for 20 seconds & more frequently than you do now
  • Soap and water and then dry, or an alcohol-based hand rub, and air dry
  • Try not to touch your face.
  • There is a chance your unwashed fingers will have a virus on them and if you touch/rub your mouth, nose or eyes, you may introduce the virus and accidentally infect yourself. Practice this; get others to call you out when you forget. Make it a game.

While a mask seems like a good idea, and when used by professionals it does protect from infection, it can actually give inexperienced users a false sense of security. There isn’t a lot of good evidence (still!) that shows a mask to reliably prevent infection when worn by the public at large. They are useful to put on a sick person to reduce their spreading of the virus.

If you or a loved one becomes sick, follow the practices of the day.

Call ahead before going to a Doctor, fever clinic or hospital and get advice on what to do. Hopefully, this message is already out there and we’ll see it more once transmission of the virus is widespread.

Reducing our risk of running short of food and important goods – the 2-week list

What we’re looking at here is trying to minimize the impact of any shortages of goods we rely on having at the grocery store or at the end of an online ordering system.

Dried fruit. It lasts and is nutritious.

But don’t panic buy and don’t hoard!

 Don’t buy things you won’t eat later, don’t hoard and don’t buy more than you’ll need for a 2 week period. We’re not talking zombie apocalypse and we very probably won’t see power or water interruptions either.

Below we list things we’ll need to have in case of a more major interruption to supply; a stock that will last 2 weeks. Some of these things will last much longer and include items that may not be a top priority for authorities to keep stocked:

  • Extra prescription medications, asthma relief inhalers
  • Some of these may be a problem, so talk to your doctor soon.
  • Over-the-counter anti-fever and pain medications
  • paracetamol and ibuprofen can go a long way to making us feel less sick
  • Feminine hygiene products
  • Family pack of toilet paper
  • Vitamins
  • In case food shortages limit the variety in your diet
  • Alcohol-containing hand rub and soap
  • Household cleaning agents
  • Bleach, floor cleaner, toilet cleaner, surface cleaning spray, laundry detergent
  • Tissues, paper towel
  • Disposable nappies
  • Cereals, grains, beans, lentils, pasta
  • Tinned food – fish, vegetables, fruit
  • Oil, spices and flavours
  • Dried fruit and nuts
  • Ultra-heat treated or powdered milk
  • Ian is not drinking black coffee, no matter what
  • Batteries for anything that needs batteries, powerbanks
  • Think about elderly relative’s needs
  • Their medications, pets, pandemic stash, plans for care (see later)
  • Pet food and care
  • Dry and tinned food, litter tray liners, medicines, anti-flea drops
  • Soft drink or candy/chocolate for treats

The last-minute fresh list

In a more severe pandemic, supply chain issues may mean fresh food becomes harder to get. So this list is an add-on to the one above, and its items should be the last things to buy if you have a hint of when supplies might slow or stop for a (hopefully short) time.

  • Bread, wraps
  • Meat for freezing
  • Milk
  • Eggs
  • Yogurt
  • Vegetables, fruit
  • Fuel for your car

The elderly and COVID-19

To date, looking at data from China (below), most (94%) deaths from COVID-19 have occurred in those aged over 50 years of age, with more than half (51%) in those aged over 70 years. The age group most at risk for death are those aged over 80 years.

Older people with comorbidities have experienced higher proportions of death than those with no comorbidities. Most cases proportions of death than those with no comorbidities. Most cases identified in mainland China – 80.9% of them – even with the more severe case catching that China has favoured – have been classified as mild. This is good news although 20% is still a lot of “severe” disease. Mild cases recover in about 2 weeks from the time they showed symptoms, while severe cases can take 3 to 6 weeks to recover.

Infographic of the largest study of cases from China.[1]

Because of this, we may see a big impact on our elderly population, both in terms of hospitalisation and death. Residential aged care is likely to suffer and visits to loved ones may be restricted to keep them safe. If you have loved ones in an aged care facility, ask the facility about its plans for keeping their residents safe from flu (a similar situation) and whether they have thought about what they will do if SARS-CoV-2 is spreading widely.

Pandemic is a word, how we react to it is down to us

We all want to have some control over our lives but when a virus comes knocking as this one is, we feel the loss of that control. The lists above are something we can actually do.

 The lists have helped us all focus on how that “thing going on in that faraway country” will impact us when it comes to our neighborhood. This process has already made things a little more familiar and a little less unknown and scary. We’ve done some things that will help. We know there are still risks but we’ve talked about them, calmly, as a family.

Of course, this doesn’t remove the many unknowns, but we’re sure we’ll gradually reduce those as science gets us more answers. Hopefully, these answers will bring good news; lower death rates, effective antiviral drugs, and new vaccines.

We do have some experience of a pandemic and it wasn’t panic-worthy. The pandemic of H1N1 “swine flu” in 2009 had some unhappy consequences, but it was by no means a zombie apocalypse.

China has bought us time to prepare. Let’s not waste any more of it. Instead, let’s get our planning hats on and all work the problem together. This is one of those rare times when we’re unarguably all in this together.

SARS-CoV-2 doesn’t care about our beliefs, our sex or gender, our colour or our clothes – it just wants to make a home in our human cells.

It’s perfectly okay to be anxious about this.

But work the problem.

References

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Scientific America: Preparing for the Coronavirus to Strike the US

“Getting ready for the possibility of major disruptions is not only smart; it’s also our civic duty”

By Zeynep Tufekci on 

Scientific America for full article.

Excerpts:

“Preparing for the almost inevitable global spread of this virus, now dubbed COVID-19, is one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind.

We should prepare, not because we may feel personally at risk, but so that we can help lessen the risk for everyone. We should prepare ..because we can alter every aspect of this risk we face as a society.

“…your neighbors need you to prepare—especially your elderly neighbors, your neighbors who work at hospitals, your neighbors with chronic illnesses, and your neighbors who may not have the means or the time to prepare because of lack of resources or time…”

..”As a species, we live and die by our social world and our extensive infrastructure—and there is no predicting what anybody needs in the face of total catastrophe.”

“the real crisis scenarios we’re likely to encounter require cooperation and, crucially, “flattening the curve” the only path to flattening the curve for COVID-19 is community-wide isolation of the crisis exactly so the more vulnerable can fare better, so that our infrastructure will be less stressed at any one time.

What does “flattening the curve” mean for the current COVID-19 threat facing us: the emerging pandemic of this human coronavirus?

“.. epidemiological numbers are not fixed or immutable. ….By preparing now, we can alter both of those key numbers and save many lives.”

The infectiousness of a virus…depends on how much we encounter one another; how well we quarantine individuals who are ill; how often we wash our hands; whether those treating the ill have proper protective equipment; how healthy we are to begin with—and such factors are all under our control.

“… if we can slow the transmission of the disease—flatten its curve—there will be many lives saved even if the same number of people eventually get sick, because everyone won’t show up at the hospital all at once. Plus.. there is more time to develop a vaccine or find antivirals that help.”

“…Here’s what we know: no doubt to the relief of parents everywhere, this disease is mild to nonexistent in children. There are almost no pediatric deaths and very few kids even seem to fall sick (though children may still be having clinically barely detectable cases, thus infecting others).

On the other hand, for the elderly or for people who have other diseases or comorbidities, it’s very serious, with death rates reaching up to 15%.

It’s also a great threat to health workers who handle people with the virus every day, with thousands of cases already.

Overall, it appears to have a case fatality rate around 2%, which is certainly very serious: seasonal flu, a serious threat in and of itself, has a case fatality rate around 0.1 percent in the United States, so this coronavirus is about 20 times as deadly (though again, this number may get much better or worse depending on the kind of care we can provide).*

There are also enough examples of mild or barely symptomatic COVID-19 cases and a long enough incubation period that this disease will almost certainly not be contained: we can’t expect to reliably detect everyone who’s ill and infectious, as we could with the SARS 2003 epidemic where the victims always exhibited high fever and thus were easier to identify and isolate.

the only path to flattening the curve for COVID-19 is community-wide isolation

All of this means that the only path to flattening the curve for COVID-19 is community-wide isolation: the more people stay home, the fewer people will catch the disease. The fewer people who catch the disease, the better hospitals can help those who do. Crowding at hospitals doesn’t just threaten those with COVID-19; if emergency rooms are overwhelmed, more flu patients, too, will die because of lack of treatment, for example.

“..there are only so many delivery workers and while deliveries are better than people going shopping, it’s still a risk to everyone involved. So if fewer people need deliveries, then fewer people will get sick, and more people who need help such as the elderly can still get deliveries as the services will be less overwhelmed.

Here’s what all this means in practice: get a flu shot, if you haven’t already, and stock up supplies at home so that you can stay home for two or three weeks, going out as little as possible. The flu shot helps decrease the odds of having to go to the hospital for the flu, or worse yet, get both flu and COVID-19; comorbidities drastically worsen outcomes.

Staying home without needing deliveries means that not only are you less likely to get sick, thus freeing up hospitals for more vulnerable populations, it means that you are less likely to infect others (while you may be having a mild case, you can still infect an elderly person or someone with cancer or another significant illness) and you allow delivery personnel to help out others.

“..here’s a handy, one-page guide on what you need, with up-to-date information on top..essentially this: potable water (that’s a general just-in-case item for all emergencies), shelf-stable food (no need for refrigeration..), your prescription medication and a few basic medical supplies (first aid/your usual over-the-counter meds).

“..  don’t worry if you cannot find masks…are most important for health care workers. For non–health care people, washing your hands often, using alcohol-based hand-sanitizer liberally and learning not to touch your face are the most important clinically-proven interventions there are (and teaching this to kids is priceless, as they may well be healthy but they are quite the germ vectors!). Clinical studies show amazing results to just washing hands regularly and well (at least 20 seconds!). ..don’t sneeze or cough on people!

“..food, you can just buy 2 or 3 weeks’ worth of shelf-stable food..canned food like beans and vegetables, pasta, rice, cereals or oats, oils/fats, nuts and dried fruits. 

“..have some potable water in the house just in case there is some sort of temporary hiccup.

A portable power bank for your phone that is kept charged is similarly generally useful anyway.

If you need prescription or other medications, it’s a good idea to stock up if possible—if for no other reason than to avoid pharmacies, both to reduce their burden and also to not be in the same line as people who may be ill.”

“As a society, there are much larger conversations to be had: about the way our health care industry runs, for example. How to handle global risks in our increasingly interconnected world. How to build resilient communities. How to reduce travel for work.”

Read more about the coronavirus outbreak here.

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