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People stimulus

Why Some People May Get Stimulus Checks in 2021 – Newsweek

Even without another coronavirus relief package, some Americans may receive another economic impact payment in 2021.

Most people have either received all the money they’re going to see from the first round of stimulus checks or will get the remainder of their money by the end of the month. However, for some, including those who amended their tax return after economic impact payments were issued, it’s possible they could receive additional money next year.

There are at least four scenarios in which a person could receive a payment in 2021, according to the Taxpayer Advocate Service (TAS), an independent organization within the Internal Revenue Service designed to assist taxpayers. Without a process in place to adjust distributions, in these instances, people must file their 2020 tax returns before receiving any additional money.

When issuing the first round of stimulus checks, the IRS based payments on the most current information it had on file. Given that payments started being sent in early April and the tax filing deadline was pushed to July 15, the IRS’ use of a 2018 return and not a 2019 return may have resulted in a reduced payment.

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For example, if a person gave birth to a child in 2019 but hadn’t filed their return when payments were sent, they wouldn’t have qualified for the additional $500 granted to children under 17 years old. The only way to receive that money is to adjust the difference with the filing of a 2020 tax return, according to TAS.

stimulus check 2src21 payment
President Donald Trump’s name appears on the coronavirus economic assistance checks that were sent to citizens across the country April 29 in Washington, D.C. Even without another coronavirus relief package some Americans may see another payment in 2021 if their first payment was not the proper amoun
Chip Somodevilla/Getty

Another reason a person may have to wait until 2021 for a full payment is if the economic impact payment was based on a return that was later amended or if a person receives certain benefits, such as veterans affairs or social security, but were deemed ineligible because they were claimed as a dependent on someone else’s return.

A fourth situation in which a person could receive additional money in 2021, according to TAS, is if the IRS based payments on an information return, social security or veterans affairs benefits. If a person filed a 2019 tax return or used the Non-Filer tool after economic impact payments were calculated, they can reconcile the differences on their 2020 return.

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As people await full compensation for the economic impact payments afforded under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, legislators on Capitol Hill reached an agreement on another round of payments. One of the few things Democrats and White House officials agree on including in a fifth stimulus package, Treasury Secretary Steve Mnuchin said a second round would likely resemble the first payments.

The CARES Act issued $1,200 payments to individuals earning $75,000 or less and $2,400 to joint-filers with incomes of $150,000 or below. An additional $500 was allocated for each child under 17 years of age, a provision that may be expanded if there’s a second round.

The GOP-backed Health, Economic Assistance, Liability Protection and Schools (HEALS) Act would keep payments at $500 but change eligibility to include dependents of all ages. Democrats included the expansion in their House bill, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, and Mnuchin told reporters on August 2, that both sides were on board with a plan for stimulus checks.

While TAS can help taxpayers resolve certain issues with their economic impact payment, they can’t help with any of the situations that require a person to file a 2020 return, according to TAS.

“This is not a good answer for taxpayers,” National Taxpayer Advocate Erin M. Collins wrote of the 2020 return solution in a blog on Monday. “Congress authorized EIPs to assist the tens of millions of Americans who are suffering financial hardships as a result of COVID-19 closures, and many of these individuals need their stimulus payments now.”

Newsweek reached out to the IRS for comment but did not receive a response in time for publication.

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million People

At least 1 million people may not get Trump’s $400 unemployment boost – CNBC

U.S. President Donald Trump takes questions during a briefing on the coronavirus disease (COVID-19) pandemic at the White House in Washington, August 11, 2020.

Kevin Lamarque | Reuters

An extra $400

Trump’s executive order was one of four measures signed on Saturday to address jobless benefits, evictions, student loans and payroll taxes.

Top Democratic lawmakers and White House officials have struggled to compromise on another round of broad coronavirus relief since negotiations began about two weeks ago.

Unemployment aid was among the thorny issues holding up talks.

A $600-a-week federal supplement to state unemployment benefits, offered by a prior round of relief, lapsed at the end of July, throwing jobless Americans’ income off a cliff overnight.

House Democrats passed a $3 trillion bill in May that would extend those $600 payments through early next year. Senate Republicans proposed a $1 trillion bill two weeks ago seeking to lower the relief to $200 a week in the short term.

Instead, Trump’s executive order offers an extra $400 a week — a $300 federal benefit and a $100 state benefit.

Significant questions remain as to how — and even if — states will implement the measure. Some workers, for example, may get just the $300 federal payment.

The benefit would last until Dec. 6 or a $44 billion disaster-relief fund runs dry, whichever comes first.

But many may not see extra aid at all.

Restrictions

That’s due to a restriction stipulating that eligible recipients must be getting at least $100 a week in state unemployment insurance benefits.

But most states set minimum weekly benefit payments far below that threshold.

Roughly 3% of those collecting unemployment insurance get less than $100 a week — implying about 1 million people, according to an analysis by Ernie Tedeschi, an economist at Evercore ISI.

Forsythe estimates the figure to be around 6%.

It’s hitting people who were already vulnerable and low-income before this job loss.

Eliza Forsythe

labor economist and assistant professor at the University of Illinois at Urbana-Champaign

These workers are disproportionately low-wage, part-time and female workers (who were more likely than men to have low-wage or part-time jobs), Forsythe said.

“It’s hitting people who were already vulnerable and low-income before this job loss,” she said.

But the real figure of people omitted from the federal aid may be much higher.

For one, Forsythe’s analysis doesn’t factor in workers receiving partial unemployment benefits because their hours were cut.

Pandemic Unemployment Assistance

Many workers currently receiving federally funded unemployment assistance may also miss out on the extra aid, according to Michele Evermore, a senior policy analyst at the National Employment Law Project.  

That could be the case for the Pandemic Unemployment Assistance program, created by the CARES Act in March, for example. The federal program expanded the pool of workers eligible for unemployment benefits to include self-employed, gig, freelance and contract workers, among others.

There were about 13 million people getting benefits through that program as of mid-July, according to most recent Labor Department data — representing more than 40% of all recipients of jobless aid.

Trump’s order says states may satisfy their financial obligation ($100 a week) by counting their current benefit outlays. (In other words, a state wouldn’t have to put in additional funds if it already pays a worker $100 a week in state benefits.) But PUA is a federally funded program, meaning recipients don’t getting state money.

So, for PUA recipients to be eligible for the federal $300-a-week, states may have to kick in an extra $100 for these workers — which isn’t a given considering current state budget shortfalls, Evermore said.

The same would be true for other workers, like those getting aid through work-sharing programs and extended benefits, Evermore said.

However, this scenario is still the “subject of much speculation,” Evermore said. 

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People protection

Do some people have protection against the coronavirus? – CNN

(CNN)We’re now more than seven months into the coronavirus pandemic that has upended the lives of most of Earth’s inhabitants. And while it is true that the scientific community has learned many things about the SARS-CoV-2 virus and the disease it causes, Covid-19, there are also many gaps in our understanding.

One big mystery: Why do some people get very sick and even die from their illness, while other similar people show no symptoms and may not realize they’ve been infected at all?
We know some of the big factors that put people at higher risk of having a severe, even fatal, course of disease: being over 60; being overweight or obese; having one or more chronic diseases such as diabetes, cardiovascular disease, kidney or lung disease, and cancer; and being a person of color — Black, Latinx or Native American.
But might the opposite also be true: Could certain people actually have some type of protection?
A recently published summary article in the journal Nature Reviews Immunology put forth a tantalizing possibility: A large percentage of the population appears to have immune cells that are able to recognize parts of the SARS-CoV-2 virus, and that may possibly be giving them a head start in fighting off an infection. In other words, some people may have some unknown degree of protection.
“What we found is that people that had never been exposed to SARS Cov2 … about half of the people had some T-cell reactivity,” co-author of the paper Alessandro Sette from the Center for Infectious Disease and Vaccine Research at La Jolla Institute for Immunology, told CNN.

Immunology 101

To understand why that’s important, here’s a little crash course in immunology. The human immune system, which is tasked with keeping you healthy in the face of bacterial, viral, fungal, parasitic and other invaders, has two main components: the innate immune system and the adaptive immune system.
The innate immune system is the very first line of defense. Parts of it include physical barriers like your skin and mucosal membranes, which physically stop invaders from getting in. It also includes certain cells, proteins and chemicals that do things like create inflammation and destroy invading cells.
Where the innate immune system is immediate and nonspecific (it tries to stop anything from entering the body), the adaptive immune system is targeted against a specific and previously recognized invader. This takes a bit longer to kick into gear.
The adaptive immune system includes a type of white blood cell, called a B cell, which patrols the body looking for bad guys. B cells each have a unique antibody that sits on its surface and can bind to a unique antigen (the technical name for the foreign invader) and stop it from entering a host cell. When it finds and binds to a bad guy, the B cell gets activated: it copies itself and churns out antibodies, eventually creating a mega-army of neutralizers for that particular invader.
That’s where antibodies created by the immune systems of people who’ve had Covid-19 come from. Unfortunately, a few recent studies have found that antibodies to this particular coronavirus can fade away pretty quickly especially in people who have had mild cases of Covid-19. This has worried many researchers: because the antibody response appears to fade quickly, the scientific community is not sure how long a person who has been infected with this virus will stay protected from a new infection. This is also worrisome since we are relying on vaccines to trigger an antibody response to help protect us, and we want that protection to last a long time.
Fortunately, antibodies aren’t the only weapon our adaptive immune system uses to stave off an infection. Enter the T cell. T cells, which come in three varieties, are created by the body after an infection to help with future infections from the same invader. One of those T cells helps the body remember that invader in case it comes knocking again, another hunts down and destroys infected host cells and a third helps out in other ways.

Accidental discovery

It’s T cells like those, which reacted to the SARS-CoV-2 virus, that Sette and his co-author Shane Crotty discovered — quite by accident — in the blood of people collected several years before this pandemic began.
They were running an experiment with Covid-19 convalescent blood. Because they needed a “negative control” to compare against the convalescent blood, they picked blood samples from healthy people collected in San Diego between 2015 and 2018.
“There was no way these people had been exposed to SARS-CoV2. And when we ran those … it turns out the negative control was not so negative: about half of the people had reactivity,” Sette explained.
“Shane and I pored over the data; we were looking at it from the right, from the left, from the top, from the bottom — and it was really ‘real’; this reactivity was real. So, this showed that people that have never seen this virus have some T-cell reactivity against the virus.”
That paper was published at the end of June in the journal Cell.
Sette and Crotty note in their current summary article that they aren’t the only ones to have seen this.
“That has been now confirmed in different continents, different labs, with different techniques, which is one of the hallmarks of when you start to actually really believe that something is scientifically well-established because it’s found independently by different studies and different labs,” said Sette.
They speculate that this T cell recognition of parts of the SARS-CoV-2 virus may come in part from past exposure to one of the four known circulating coronaviruses that cause the common cold in millions of people every year.
“The assumption is that’s actually coming from common cold coronaviruses that people have seen before, and Alex’s side was working really hard to actually figure that out, because that’s still scientifically a major debate,” said Crotty.

Friend or foe?

But many questions remain — including whether this recognition to parts of SARS-CoV-2 by T cells helps or hurts.
“Would these memory T cells be helpful for protecting you against Covid-19 disease, that’s the huge question,” said Crotty. “We don’t know if [the T cells] are helpful or not, but we think it’s reasonable to speculate that they may be helpful. It’s not that we think they would completely protect against any infection at all, but if you already have some cells around, they can fight the virus faster and so it’s plausible that instead of ending up in the ICU, you don’t. And instead of ending up in the hospital, you just end up with a bad cold.”
Other researchers are also intrigued by the possibilities put forth by this discovery.
Dr. Arturo Casadevall told CNN his first thought was “Not surprising, important, good to know.” Casadevall chairs the department of molecular microbiology and immunology at the Johns Hopkins School of Public Health.
“Because these coronaviruses are all related, given that every year we run into one of them, it’s not surprising that we have T cells that are reactive with them,” he said. But, like Sette and Crotty, he questions whether this reactivity is a good thing or a bad thing.
A few months ago, Casadevall explored the idea of why some people get sick and some don’t in an opinion piece he co-wrote for Bloomberg.com. “One of the variables is what we call the immunological history. All the things that you have run into in your life, all the vaccines, the colds, all the GI upsets, have created a background knowledge that can help you or hurt you,” explained Casadevall.
“One of the things we know about this disease is that what kills you is an over exuberant immune response, in the lung… So, when you say, ‘They have T-cell reactivity,’ well that could help in some people, it could hurt in others,” he said.
Casadevall speculates that some of the asymptomatic people may be able to rapidly clear the virus thanks to this T-cell reactivity. “At the same time, some of the very sick people have that immunological history that instead of helping them, makes the immune system throw everything at it, and the net result is that you get this over-exuberant response,” he said, referring to the cytokine storm that some of the sickest of the sick with Covid-19 experience.
Sette and Crotty are looking into that possibility. But they say the overreaction of the innate immune system, not overreacting T cells, appears to set off the cytokine storm. “The data are still somewhat preliminary, but I think it’s in that direction. Certainly, we have not seen an immune response related to T cells in overdrive in the very severe cases,” said Sette.

Big implications for vaccines

So, assuming that a large portion of the population has some kind of T-cell reactivity to the SARS-CoV-2 virus, what does that mean for vaccine efforts?
There are several implications.
For Dr. Bruce Walker, an infectious disease physician-scientist who spends most of his time doing research in human immunology, it opens the door to a different type of vaccine, similar to the ones that are being used against certain cancers, like melanoma.
“What we know is that most vaccines that have been generated thus far have been based on generating antibodies. Now, antibodies should theoretically be able to prevent any cells from becoming infected — if you have enough antibodies around and any virus coming in, before it gets a chance to infect a cell, can be theoretically neutralized by the right kind of antibody,” explained Walker, who is the founding director of the Ragon Institute of Massachusetts General Hospital, MIT and Harvard.
“On the other hand, if some viruses sneak through and infect a cell; then the body is dependent upon T cells to eliminate the virus,” he said. “And therein lies the opportunity for us to rethink what we’re doing in terms of vaccination — because those T cells, at least theoretically, could be highly potent and could attenuate the disease. In other words, they wouldn’t protect against infection, but they might make infections so asymptomatic that you would not notice it yourself and, in fact, you would never have enough virus in your body to transmit it to somebody else. That’s the hypothesis.”
Another implication is that the results of a small, Phase 1 vaccine trial could be misinterpreted in one way or another if the T-cell reactivity status of participants isn’t taken into account. “For example, if subjects with pre-existing reactivity were sorted unevenly in different vaccine dose groups, this might lead to erroneous conclusions,” Sette and Crotty wrote in their paper.
Furthermore, Sette said upcoming vaccine trials could help uncover the effect of this T-cell cross-reactivity a lot more cheaply and easily than running other experiments. “It is a conceivable that if you have 10 people that have reactivity and 10 people that don’t have the pre-existing reactivity and you vaccinate them with a SARS CoV-2 vaccine, the ones that have the pre-existing immunity will respond faster or better to a vaccine. The beauty of that is that that is a relatively fast study with a smaller number [of people] … So, we have been suggesting to anybody that is running vaccine trials to also measure T-cell response,” said Sette.

The herd (immunity) grows stronger

There are also implications for when we might achieve “herd immunity” — meaning that enough of the population is immune to SARS-CoV-2, thanks either to infection or vaccination, and the virus can no longer be as easily transmitted.
“For herd immunity, if indeed we have a very large proportion of the population already being immune in one way or another, through these cellular responses, they can count towards the pool that you need to establish herd immunity. If you have 50% already in a way immune, because of these existing immune responses, then you don’t need 60 to 80%, you need 10 to 30% — you have covered the 50% already. The implications of having some pre-existing immunity suggests that maybe you need a small proportion of the population to be impacted before the epidemic wave dies out,” said Dr. John Ioannidis, a professor of medicine and epidemiology and population health at Stanford University.
In other words, if there is a level of herd immunity, that changes how fast the virus ripples through different communities and populations.
In fact, Sette and Crotty wrote in their paper, “It should be noted that if some degree of pre-existing immunity against SARS-CoV-2 exists in the general population, this could also influence epidemiological modelling …”
Crotty points to a SARS-CoV-2 epidemiology paper that appeared in the journal Science at the end of May that tried to model transmission of the virus going forward. “We thought it was really striking that a number of the major differences in their models really came down to immunity, one way or another,” he said.
For example, Crotty said when the authors added a hypothetical 30% immunity to their epidemiological model of how many cases there would be in the world over the next couple of years, the virus faded away in the near future before returning in three or four years.

More questions than answers for now

And that brings us to another question raised by Sette and Crotty’s paper: because the common circulating coronaviruses (CCC) appear in different places, at different times, could some countries, cities or localities be disproportionately affected (or spared) because the population had less exposure to those CCCs, thus creating less opportunity to develop cross-reactivity?
“If the pre-existing T-cell immunity is related to CCC exposure, it will become important to better understand the patterns of CCC exposure in space and time. It is well established that the four main CCCs are cyclical in their prevalence, following multiyear cycles, which can differ across geographical locations. This leads to the speculative hypothesis that differences in CCC geo-distribution might correlate with burden of COVID-19 disease severity,” Sette and Crotty wrote.
So, ultimately can it be said that some people have at least partial natural protection from SARS-CoV-2, the novel coronavirus, if they have T-cell cross-reactivity?
“The biggest problem is that everybody wants a simple answer,” said Johns Hopkins’ Casadevall. “What nobody wants to hear is that it’s unpredictable, because many variables play together in ways that you can’t put together: your history, your nutrition, how you got infected, how much [virus] you got — even the time of the day you got infected. And all these variables combine in ways that are unpredictable.”

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hospitalized People

At least 1 man hospitalized after 12 people in Delaware get incorrect Covid-19 results, state says – CNN

(CNN)At least one man is hospitalized in Delaware after 12 people were inadvertently given incorrect Covid-19 test results, according to the Delaware Health and Social Services and state Sen. Brian Pettyjohn.

“In partnership with Walgreens, 2,791 samples were collected for processing through the Delaware Public Health Lab in the first week of testing. In the process of results delivery, 12 persons who tested positive for COVID-19 were inadvertently given negative results by phone due to an internal DPH system error,” a statement from the health department said.
The department said the correct test results were reported into its surveillance system and included in statewide testing numbers and the state’s contact tracing system. The department said it wants to assure the public that this was not an error that occurred on site at the Walgreens testing sites.
Delaware resident Kevin Evans was among the 12 people who received false negative results and is currently hospitalized, Pettyjohn told CNN.
Pettyjohn said testing through the state’s public health lab started at the beginning of last week and that Evans was tested last Friday and got his incorrect test results on Tuesday.

Evans’ family members were told they were negative, wife says

Katey Evans, Kevin’s wife, said in a video posted to Facebook that her husband began feeling ill July 13. She and her husband thought his symptoms may be due to Lyme disease because of ticks on his body and a doctor initially prescribed “a very aggressive round of antibiotics.” The family eventually all got tested for Covid-19 after one of their three daughters was sent home from summer camp with a fever and tested positive.
Katey Evans said in her video that all of her family members received negative test results Tuesday, including the daughter who initially tested positive, leading her to believe that her daughter’s first test was a false positive. However, she said her husband was still feeling ill. On Thursday morning at around 2 a.m., Katey Evans said, he woke up vomiting.
“He got really dehydrated in the middle of the night. He got very dizzy. He was in and out of consciousness. At 3 or 4 o’clock in the morning, I said, ‘I think you need to go to the hospital,'” she recalled.
Kevin Evans was eventually brought to the local hospital by ambulance early Thursday morning. Katey Evans said in the video that she was not initially let inside. While sitting inside her car, she said, she received a call from the hospital saying his Covid-19 results were actually positive.
Pettyjohn told CNN Friday that the hospital had access to the state health department’s testing data and saw the true positive test result that was incorrectly conveyed to Kevin over the phone. Katey Evans said in her video that when she spoke to representatives with the Delaware health department, she eventually got confirmation that a mix-up caused the error and the results were read incorrectly.
“It’s not about reading it as something. It’s black and white. Is it positive or is it negative? This is not about how we interpret these results. They’re black and white on paper — what is right and what is wrong. Because my husband is laying in the hospital and he’s almost to the point of unresponsive right now. And you’re telling me, it’s how you interpreted it? That’s not acceptable, ” Katey Evans said through tears.
When reached for further comment, she referred CNN to a second video statement where she again shared the story of her husband’s ordeal, but also asked for privacy.
“I ask [the media] to respect our privacy so that I can focus on the care of my husband at the hospital, in the hopes that he can come home to us soon,” she said.

After another review, state says all 12 individuals were contacted

Katey Evans says she contacted Pettyjohn when she learned of the error, and he then raised the issue with the department. Pettyjohn said department representatives said they would manually audit the other samples taken where the Evans’ were tested.
Pettyjohn said that to his knowledge, Kevin Evans is the only person who has been hospitalized after receiving an incorrect test result.
The state said in its statement that all 12 people who got false negative results have been notified. It said that, after reviewing all 2,791 samples in question, it was determined that no patients who tested negative were given incorrect results.
Katey Evans said in her first Facebook video that she eventually learned that her daughter — who initially got a positive test result, then a negative test result when she tested together with their family — was confirmed to be truly Covid-19 positive. Her daughter was also among the 12 people who were given incorrect test results, but is doing well and not showing any symptoms, Katey Evans said in her second Facebook video.
The health department also said that the internal system error that led to the delivery of false results has been fixed.
“The problem was identified and internal system improvements have eliminated the possibility of this recurring. Additionally, DPH continues to work with its vendor to establish automated results delivery,” their statement said.
As far as her husband’s condition, Katey Evans posted on Facebook on Friday that his “voice sounded stronger this morning” and that he was “mentally more alert.”
“They’ve been testing for every possible infection under the sun and keeping him closely monitored — glad they are on top of all of this. Oxygen levels excellent and he’s sitting upright and continues moving around when he can. He sounds 10% better every time I talk to him which is amazing,” she wrote.
Katey Evans said she had a civic duty to speak.
“Somebody’s gotta be held responsible for this,” Katey said. “Our guard was let down because we were told he was negative.”

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People United

Most people in the United States are still susceptible to the coronavirus, CDC study finds – The Washington Post

Please Note

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Only a small proportion of people in many parts of the United States had antibodies to the novel coronavirus as of this spring, indicating most of the population remains highly susceptible to the pathogen, according to new data from the Centers for Disease Control and Prevention.

The agency also reported the number of actual coronavirus infections is probably far higher — by two to 13 times — than the reported cases. The higher estimate is based on the study on antibodies, which indicates who has had the virus. Currently, the number of reported cases in the United States now stands at 3.8 million.

The new data appeared Tuesday in JAMA Internal Medicine and on the CDC website. The information about antibodies was derived from blood samples drawn from 10 geographic regions, including New York, Utah, Washington state and South Florida. The samples were collected in discrete periods in two rounds — one in early spring and the other several weeks later, ending in early June. For two sites, only the earlier results were available.

The blood samples were collected during routine screenings such as cholesterol tests. Such serological surveys are being conducted throughout the country as public health experts, government officials and academics try to determine the virus’s course, how many people have been infected and how many have produced antibodies in response.

In New York City, almost 24 percent of the population had antibodies as of early May — the highest proportion by far of any of the locations but still far below the 60 to 70 percent threshold for herd immunity, the point at which enough people are immune to the virus, either through exposure or because they have been vaccinated. Herd immunity makes it far less likely the virus will be transmitted from person to person.

In the other areas, the percentages of people with antibodies were in the single digits in late May and early June. That included Missouri, at 2.8 percent; Philadelphia, at 3.6 percent; and Connecticut, at 5.2 percent.

The new data emerged as the nation struggles with a wily pathogen that can produce no symptoms at all, or sicken and kill — 138,000 Americans have died of the coronavirus to date. Large swaths of the nation are in turmoil as many communities debate how to reopen schools this fall, wrestle with rising virus-related hospitalizations and, in some cases, roll back restrictions to restart a flailing economy.

“Most of us are likely still very vulnerable to this virus and we have a long way to go to control it,” said Jennifer Nuzzo, an epidemiologist at the John Hopkins Center for Health Security. “This study should put to bed any further argument that we should allow this virus to rip through our communities in order to achieve herd immunity.”

With vaccines still months or years off, some people have suggested allowing large numbers of people to become infected to speed the process of herd immunity. Many call that idea dangerous.

“The study rebukes the idea that current population-wide levels of acquired immunity (so-called herd immunity) will pose any substantial impediment to the continued propagation” of the virus, at least for now, wrote Tyler S. Brown and Rochelle Walensky, infectious-disease specialists at Massachusetts General Hospital, in an accompanying editorial. “These data should also quickly dispel myths that dangerous practices like ‘COVID parties’ are either a sound or safe way to promote herd immunity.”

“Covid parties” refer to events where people get together in an attempt to infect themselves and develop immunity to the virus that causes covid-19. A 30-year-old man who believed the coronavirus was a hoax and attended a “Covid party” died recently after being infected with the virus, according to the chief medical officer at a Texas hospital, the New York Times reported. But the account, it said, has not been independently corroborated.

The new study gave details on the undercount: In Missouri, the estimated number of actual infections was 13 times the number of confirmed cases. In Utah, it was at least twice as high.

“The findings may reflect the number of persons who had mild or no illness, or who did not seek medical care or undergo testing but who still may have contributed to ongoing virus transmission in the population,” the study’s authors wrote. Researchers say more than 40 percent of people who are infected don’t have symptoms.

Because people often don’t know they are infected, the public should continue to take steps to reduce the risk of transmitting the virus, including wearing face coverings outside the home, remaining six feet from other people, washing hands frequently and staying home when sick.

Separately, in a report in the CDC’s Morbidity and Mortality Weekly Report, a study by Indiana University and the Indiana State Department of Health found that 2.8 percent of state residents had been infected as of late April. It was the first randomized study to determine the prevalence of coronavirus infection in the state. It also included members of minority communities who were not randomly selected. The study used nasal-swab tests to detect active infections and blood tests to find antibodies that indicated a past infection.

The 2.8 percent represented about 187,000 people, or 10 times the number of confirmed cases identified through conventional testing. About 44 percent of the infected people were asymptomatic, according to Nir Menachemi, the lead scientist on the study and a professor of public health at Indiana University. The percentage fell to a little over 2 in a second round of testing in early June, but in a change, more people had antibodies, indicating past infections, while fewer had active infections.

In a second report in MMWR, CDC researchers surveyed residents of two Georgia counties — DeKalb and Fulton — in late April and early May and found that 2.5 percent had antibodies to the coronavirus.

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figure People

It’s hard to figure out how often people without symptoms spread COVID-19 – The Verge

In January, early reports out of China started to hint that people infected with the coronavirus were contagious before they started to show symptoms. That’s unusual for a respiratory virus like this one, and it worried public health experts all over the world: it’s much harder to control the spread of a disease if someone who has it can pass it along before they know they’re sick.

It’s since become clear that, yes, it’s possible for people who don’t feel sick to infect other people. What scientists still don’t know, though, is how often it happens. And that matters for managing the pandemic: if only a few people spread COVID-19 when they’re symptom-free, missing them probably won’t have a big impact on the course of the pandemic. If most people do, though, it’s more important to track them all down.

For months, there have been regular dust-ups over just how likely it is for people without symptoms to spread COVID-19. The latest quarrel stemmed from vague comments by a World Health Organization expert at a press conference. After the expert suggested that asymptomatic transmission was “very rare,” the organization eventually stated that they just don’t have enough information yet. Getting a clear answer will be hard. It takes careful, meticulous detective work to figure out how often people carry the virus without symptoms and how likely they are to pass it onto others when they feel healthy.

That’s been done a handful of times in the past few months, says Mark Slifka, a professor at Oregon Health and Science University studying viral immunology. But it’s not enough, and we need far more data to settle the debate.

No symptoms — yet

The confusion started in January when a report in The New England Journal of Medicine said that a German businessman had caught COVID-19 from a colleague visiting from Shanghai. The colleague, the report said, didn’t have any symptoms while she was in Germany. Some experts took that report as the first sign that someone without symptoms (the Shanghai woman) could pass the coronavirus on to someone else (her German colleague).

It turned out, though, that she did have mild symptoms: she felt a bit feverish and tired, with minor aches, during those meetings.

The first challenge researchers face around virus spread from people with no symptoms is reflected in the NEJM mistake: it’s hard to tell if someone truly does not have any symptoms of COVID-19 or if they just have very mild symptoms. Some signs of COVID-19 might be easy to brush off, and someone with a slight tickle in their throat might not think that they’re sick. If scientists are trying to find out if someone with a positive test is symptomatic or not, they often rely on that person to say how they feel. Those self-reported symptoms may not be accurate.

If someone truly does not have symptoms, the next step is checking to see if they ever end up developing them. Many studies of COVID-19 cases check in on people just once, when they initially test positive. If those people don’t feel sick, they can sometimes get classified as “asymptomatic.” Many of them, though, eventually end up developing symptoms later on, which scientists classify as “pre-symptomatic.”

“We should not use the term ‘asymptomatic’ unless you come back at least 14 days later and ask that person, ‘Are you still okay?’” Slifka says.

In order to get good data on the number of people with the coronavirus who really, truly never feel sick, researchers have to track them for at least 14 days. (The latest people usually get sick after exposure to the virus.) Without that long-term information, the data is no good, said Muge Cevik, an infectious diseases researcher at the University of Saint Andrews, and other researchers in an open letter.

Infectious or just infected

Once scientists have that long-term data, they can start checking to see how often asymptomatic or pre-symptomatic people actually infect others. Studies show that people have high levels of the virus in their throats before they develop symptoms. People who never ended up developing symptoms also had copies of the virus floating around in their noses and throats, one study found, but at lower levels than people who eventually felt sick.

Those studies show that people without symptoms could, theoretically, pass an infection onto someone else. They have copies of the virus in their nose and throat, and those virus copies could make their way over to another person through droplets of spit or the occasional sneeze. That doesn’t mean, though, that they actually will. The amount of virus in a person’s nose is still just an indirect way to measure how contagious they are, Slifka notes. “It doesn’t mean they’re a good spreader.”

Someone who doesn’t feel sick probably isn’t coughing or sneezing, for example, says Abraar Karan, a physician at Harvard Medical School working on the COVID-19 response. “One may argue that once symptoms start, and you’re coughing more, and you’re expelling more respiratory droplets, that that may increase your transmission,” he says.

Information on the amount of virus floating around in people without symptoms and estimates on how many respiratory droplets they produce can be used to estimate how they could spread the virus. Those are just models, though, and they don’t directly answer the question. Finding out, conclusively, if anyone actually caught COVID-19 from someone without symptoms requires detailed tracking and even more testing.

If a group of people is being tested regularly — like in a sports league, for example — it’s easier to re-create the order in which an infection passed from one person to another and when that happened, Karan says. “If this player became positive on this day, and then played in a game, and these other players became positive on days four and five, you can really trace it,” he says.

Re-creating events within a household where everyone was only tested once is harder. If two members of a family test positive on the same day, and one has symptoms and the other does not, it’s impossible to know which direction the virus spread.

In order to say a person got sick because of someone else who tested positive but didn’t have symptoms, researchers also have to exclude all other ways they could have possibly gotten sick, noted Natalie Dean, an epidemiologist at the University of Florida, on Twitter. That’s hard to do in places with high rates of infection. If the virus is circulating through a community, that person could have picked it up by touching a doorknob in a public place or at the supermarket, for example.

A few research groups have managed to sort through all the clutter. One such study followed people who contracted the virus while working at a call center in South Korea. During the investigation, some workers had symptoms, some developed symptoms later, and some never developed symptoms. No one who came into contact with the workers when they did not have symptoms ended up catching the virus. Another detailed study that carefully traced the path of infection for 157 people with COVID-19 in Singapore found that only 10 were infected by someone who hadn’t yet developed symptoms.

No good answers

That early data suggests that, even if they have the virus in their nose, people who don’t have symptoms yet or who never get symptoms spread the coronavirus less frequently than people with symptoms. The studies are small, though, and aren’t enough to say for sure who is or isn’t likely to spread COVID-19.

They also don’t change what scientists know: some people do spread the coronavirus before they develop symptoms or without developing symptoms at all. Before there’s more evidence, that’s enough for public health experts to recommend that everyone wear masks, even if they feel fine, in an effort to stop the spread of the virus. “We have to play it as conservatively as possible,” Karan says.

The coronavirus is still very new, and scientists still have a lot to learn about it.

“We’re still figuring this out, we don’t have complete certainty on the exact amount of spread from pre-symptomatic cases, or asymptomatic, or symptomatic,” Karan says. “That’s why, while we’re still learning about the proportion of transmission by these different groupings, that we wear masks in high risk situations very consistently.”

While we’re taking those steps, researchers should keep searching for better data, Slifka says. In areas with low rates of COVID-19, public health officials can do the detailed contact tracing necessary to figure out if someone caught the virus from someone without symptoms. The more testing states and cities do, the more likely they are to find the people who are walking around carrying the virus without any symptoms.

“We should be monitoring each of the cases, pre-symptomatic and asymptomatic and symptomatic, and checking for that secondary attack rate,” Slifka says. “Then we’ll have an answer.”

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People revolt

People revolt against coronavirus masks as California reopens – Los Angeles Times

As California rapidly reopens its economy, health officials have made clear the only way to avoid a wave of new coronavirus infections is with strict safety rules, including social distancing, limits on the capacity of businesses and wearing face coverings when around other people.

But a mask rebellion is underway in some parts of the state, with residents pushing back on mandatory face-covering rules even with coronavirus cases on the rise and as more businesses open their doors and some people yearn to return to old routines.

The potency of mask politics became clear this week in Orange County, where the health officer resigned after weeks of attacks — and a death threat — over her mandatory mask rules. Her replacement on Thursday rescinded the rules amid intense pressure from the Board of Supervisors.

Instead, Orange County “strongly recommends” wearing masks in public settings, and the county’s top health official was left to explain the change even while acknowledging face coverings could prevent more deaths.

“I want to be clear: This does not diminish the importance of face coverings,” said Orange County Health Care Agency Director Dr. Clayton Chau, who is now also the interim health officer. “I stand with the public health experts and believe wearing cloth face coverings helps to slow the spread of COVID-19 in our community and save lives.”

Other counties have also buckled to public pressure. Fresno County had a face mask rule for less than a day before it was pulled back. Riverside and San Bernardino pulled their orders after blowback. Stockton’s mayor, Michael Tubbs, proposed face covering rules but failed to get any support from the City Council this week.

Health experts expressed alarm at Orange County’s actions and the large rebellion about masks, saying it will make it harder to prevent new outbreaks of coronavirus.

“It’s the only way we get back to work — it’s to mask,” said Dr. Kirsten Bibbins-Domingo, UC San Francisco chair of the Department of Epidemiology and Biostatistics. “All of the data tells us … it’s pretty clear that masking is the element that changes the trajectories of the COVID pandemic.”

There’s increasing evidence that face coverings are essential to allowing a broader reopening. Places that have kept coronavirus transmission under control, such as Hong Kong and Taiwan, have virtually universal wearing of masks in public.

A recent study out of Germany found that face masks reduce the daily growth rate of reported infections by around 40%. Another study, published Thursday in the Proceedings of the National Academy of Sciences, concluded that “wearing of face masks in public corresponds to the most effective means to prevent interhuman transmission.”

In one Missouri salon, no customers became infected with the virus despite two hairstylists being sick — and scientists believe it was because they were wearing face masks. And many countries where masking is socially routine, including Japan, have not seen an out-of-control national epidemic.

“They haven’t seen the large spikes, because there’s a strong universal masking culture,” Bibbins-Domingo said.

Of California’s 15 most populous counties, Los Angeles, San Diego, Santa Clara, Alameda, Sacramento, Contra Costa, San Francisco and San Mateo require mask wearing in public, while Orange, Riverside, San Bernardino, Fresno, Kern, Ventura and San Joaquin do not.

The Orange County battle began in May, when then-county health officer Dr. Nichole Quick issued an order mandating that county residents and visitors wear cloth face coverings while in a public place, at work or visiting a business where they are unable to stay six feet apart.

The switch set off a firestorm of controversy as some residents and elected officials challenged the need for the widespread use of face coverings as more businesses in the region continued to reopen.

Quick herself became a target for criticism during county Board of Supervisors meetings, with some residents castigating her for the order. During one meeting, public speakers displayed a poster showing Quick’s photo with a Hitler mustache and swastikas.

The Orange County Sheriff’s Department provided a security detail for the doctor after she received what officials deemed to be a death threat during a meeting last month.

After several intense weeks defending her order, Quick resigned Monday.

On Tuesday, Chau stepped into Quick’s role and was immediately peppered with questions from elected officials about the need for a mandatory mask order. Members of the public could be heard shouting in the background as Chau responded to questions from the board.

Supervisors pushed Chau for a definitive answer about when he planned to lift the requirement.

“There’s always going to be community infection going on,” Supervisor Don Wagner said. “There’s always flu infection going on. Are you telling us masks, in your professional opinion, are going to be necessary until the end of time or until there’s a vaccine or what?”

The dispute over the requirement has unfolded as the number of COVID-19 cases and deaths continue to rise in Orange County.

Last week, Orange County reported 1,179 new coronavirus infections — a weekly record in the course of the pandemic, and up 22% from the previous week, according to a Times analysis.

Hospitalizations are up 34% from a month ago. Last week, there were an average of nearly 400 people in hospitals in Orange County daily for confirmed or suspected coronavirus infection; a month ago, it was nearly 300.

And last week, Orange County recorded 30 coronavirus deaths, the second-highest weekly toll. As of Thursday, there were a total of 7,987 confirmed cases and 202 deaths in Orange County.

The California Medical Assn., which represents doctors across the state, has said mandating face masks is an appropriate public policy, and its immediate past president, Dr. David Aizuss, said lawmakers should have supported Quick.

“On behalf of the California Medical Assn., it’s our opinion that mandatory face masking is appropriate and Orange County should’ve backed her up. Our position is that this is being driven by ignorance and politics instead of science,” Aizuss said. He also criticized the Board of Supervisors for not backing up her health orders.

“Local public servants should be supporting local health officers to do what they’re doing to protect the public and to protect public health,” Aizuss said.

The Orange County Medical Assn. this week called Quick’s resignation a “dangerous precedent that should concern all of us” and said that “we must … not allow bullying to drive the health recommendations that can keep us safe and healthy.”

“This public health crisis is not over. As we begin to reopen our county, the science is clear: wearing a face covering can help slow the spread of this deadly virus,” Dr. Diana Ramos, president of the Orange County Medical Assn., said in a statement.

Experts rejected the unfounded charge expressed by opponents of mandatory masks that face coverings pose a danger to people’s oxygen levels. “No, there’s nothing to that. There’s all sorts of conspiracy theories about low oxygen and high CO2 levels,” said Dr. Otto Yang, an infectious diseases expert at UCLA. “It’s really not an issue.”

Many health officials say that face coverings are an integral tool in the fight against COVID-19 — as they can block transmission of the respiratory droplets released by asymptomatic people when breathing or talking.

Research published by the journal Disaster Medicine and Public Health Preparedness in 2013 found that homemade cloth masks “significantly” reduced the amount of potentially infectious droplets expelled by the wearer.

L.A. County Public Health Director Barbara Ferrer has routinely touted the health benefits of wearing face coverings in public. That, along with other practices like physical distancing and regular hand-washing, can stave off a spike in coronavirus infections, she has said.

“Masks provide a hell of a lot of protection. And I’m more comfortable relaxing things if everybody is wearing masks than if they weren’t,” Dr. George Rutherford, a UC San Francisco epidemiologist and infectious diseases expert, said recently.

At the reopening Thursday of South Coast Plaza, many shoppers said they were not taking any chances — even some who were skeptical about the benefit of masks.

Pay Wykoff — a 65-year-old Irvine resident who waited weeks to come to mall to get a watch battery and find a Father’s Day present — wore a yellow hand-sewn mask but said she thought it was unnecessary.

“Not everyone agrees that masks are helpful,” Wykoff said. “I think masks are hurtful because you’re breathing in your own germs.”

Times staff writers Sandhya Kambhampati and Iris Lee contributed to this report.

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ethnic People

People from ethnic minorities are up to 50% more likely to die from coronavirus than white people, UK report finds – CNN

(CNN)People from the UK’s ethnic minority communities are up to 50% more likely to die with coronavirus than their white British peers, a government review has found.

The analysis, conducted by government agency Public Health England (PHE), found that people of Bangladeshi heritage who tested positive for the virus were around twice as likely to die as their white British peers.
People from other minority communities, including those of Chinese, Indian, Pakistani and Caribbean descent, also had a 10% to 50% higher risk of death when compared to white Britons, the report found.
Those from black ethnic groups were also more likely to be diagnosed with Covid-19. The diagnosis rate per 100,000 of the population was 486 for black females and 649 for black males, compared to 220 for white females and 224 for white males.
The document was published Tuesday — after the UK government denied British media reports that its release had been delayed due to protests in the US over the killing of George Floyd.
Commissioned by England’s Chief Medical Officer Chris Whitty in April, amid fears the coronavirus pandemic was “disproportionately” affecting black and ethnic minority communities, the analysis was due to be published at the end of May, according to PHE.
In response to questions from CNN on Tuesday morning about why the report had been delayed, a government health department spokesperson said: “Ministers received initial findings yesterday [Monday]. They are being rapidly considered and a report will be published this week.”
“It is not true to say this has been delayed due to global events,” the spokesperson added.
In an address to parliament later Tuesday, UK Health Secretary Matt Hancock said: “Being black or from a minority ethnic background is a major [Covid-19] risk factor.”
Hancock admitted that there was “much more work to do to understand the key drivers of these disparities, the relationships between the different risk factors and what we can do to close the gap.”
The health secretary said he was “determined that we continue to develop our understanding and shape our response.”
Hancock also stressed that the report did not just look at ethnicity but also found that age was the biggest Covid-19 risk factor, with older patients more likely to die than younger ones.
Among those who tested positive for the virus, those over 80 years old were deemed 70 times more likely to die than those under 40.

Combination of factors

The PHE analysis found that the link between ethnicity and health was “complex and likely to be the result of a combination of factors.”
“Firstly, people of BAME [Black and minority ethnic] communities are likely to be at increased risk of acquiring the infection,” it states.
“This is because BAME people are more likely to live in urban areas, in overcrowded households, in deprived areas, and have jobs that expose them to higher risk.”
“People of BAME groups are also more likely than people of white British ethnicity to be born abroad, which means they may face additional barriers in accessing services that are created by, for example, cultural and language differences,” it added.
The groups are “also likely to be at increased risk of poorer outcomes once they acquire the infection,” the agency’s report found.
“For example, some co-morbidities [the simultaneous presence of two diseases or conditions in a patient] which increase the risk of poorer outcomes from Covid-19 are more common among certain ethnic groups.”
“People of Bangladeshi and Pakistani background have higher rates of cardiovascular disease than people from white British ethnicity, and people of black Caribbean and black African ethnicity have higher rates of hypertension compared with other ethnic groups,” the report said.
The PHE analysis looked at the effect of sex, age, deprivation and region on survival among confirmed Covid-19 cases, but did not account for the effect of occupation, obesity or co-morbidities.
Its publication came as UN High Commissioner for Human Rights Michelle Bachelet warned that Covid-19 had exposed inequalities within society and was having a major disproportionate impact on racial and ethnic minorities, including people of African descent.
“The data tells us of a devastating impact from Covid-19 on people of African descent, as well as ethnic minorities in some countries, including Brazil, France, the United Kingdom and the United States,” Bachelet said.
“In many other places, we expect similar patterns are occurring, but we are unable to say for sure given that data by race and ethnicity is simply not being collected or reported,” she added.

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mistaking People

People are mistaking stimulus payments for junk mail or a scam – The Washington Post

The IRS has to explain, yet again, a glitch in issuing stimulus payments.

To help speed the delivery of up to $1,200 in economic impact payments to individuals made available under the $2 trillion Coronavirus Aid, Relief, and Economic Security (Cares) Act, the Treasury Department last week began mailing prepaid debit cards to 4 million Americans.

The prepaid debit cards allow recipients to make purchases online and at any retail location where Visa is accepted. Recipients can also receive cash from in-network ATMs and transfer funds to their personal bank accounts without a fee. (Fees may apply if an out-of-network ATM is used.)

The cards, issued by Treasury’s financial agent, MetaBank, were intended to speed the process of getting out the payments. Tens of millions of others have received their money by direct deposit, check or the Direct Express prepaid debit cards used to deliver Social Security payments and other federal benefits.

Here’s the problem. Like so many other glitches that have plagued the distribution of the stimulus payments, communication has been confusing and conflicting. The debit card is arriving in a plain envelope that doesn’t indicate it’s coming from the federal government.

Included in the letter is information indicating that the debit card is being sent on behalf of the Treasury Department in place of a paper check.

But some taxpayers still thought it was a scam or junk mail, which may have prompted the IRS to issue a release Wednesday explaining the prepaid debit cards.

“There is a website and 800 number, but I don’t want to activate anything,” one reader wrote. “If this is the stimulus money, they get a D- for marketing.”

Eric Green and his wife, who live in Arlington, Va., received a card in the mail last week. But they like so many others thought it was a con because they had expected their stimulus payment would be direct deposited into the same bank account where they received their recent federal refund.

“If you received direct deposit of your refund based on your 2019 tax return (or 2018 tax return if you haven’t filed your 2019 tax return), the IRS has sent your payment to the bank account provided on the most recent tax return,” the agency said on its Economic Impact Payment Information Center page, set up to answer questions about the stimulus money.

Green said the couple was reluctant to activate the debit card because of the previous guidance from the IRS — and that the two financial institutions where they bank were also unfamiliar with it. “They didn’t seem to know about it either,” he said. “We’ve since debated whether to follow what it says in the letter to activate the card.”

“The letter we received said it came from the Money Network Cardholder Services in Omaha, Nebraska,” Green said. “Is it a scam or legitimate? There were a number of steps involved in converting the card into money to be put in our bank. We wonder why we just didn’t receive a government check in the mail like other people have received?”

In response to a question about the confusion, a Treasury spokeswoman referred to a “Frequently Asked Questions” or FAQ page at eipcard.com, a website set with information on how to activate and use the card.

“Prepaid debit cards are secure, easy to use, and allow us to deliver Americans their money quickly,” Treasury Secretary Steven T. Mnuchin said in a statement last week about the new delivery method. “Recipients can immediately activate and use the cards safely.”

The Greens fell victim to a computer scam, and they didn’t want to take a chance of being conned again. The couple reached out to The Washington Post to verify the card was legitimate. After being reassured it was, they activated the card and found out they are getting the maximum allowed for a couple, which is $2,400.

Some people have reported they nearly threw the letter and card away — which could be a costly mistake. If you want to get a replacement card quickly it costs $17 for priority mail.

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Chops People

Pork Chops vs. People: Battling Coronavirus in an Iowa Meat Plant – The New York Times

After President Trump’s executive order, meat plants are reopening. Can they do so without endangering their low-wage workers and their communities?

Credit…Daniel Acker for The New York Times

On April 10, Tony Thompson, the sheriff for Black Hawk County in Iowa, visited the giant Tyson Foods pork plant in Waterloo. What he saw, he said, “shook me to the core.”

Workers, many of them immigrants, were crowded elbow to elbow as they broke down hog carcasses zipping by on a conveyor belt. The few who had face coverings wore a motley assortment of bandannas, painters’ masks or even sleep masks stretched around their mouths. Some had masks hanging around their necks.

Sheriff Thompson and other local officials lobbied Tyson to close the plant, worried about a coronavirus outbreak. In an April 14 phone call, county health officials asked Tyson to shut down temporarily, Tyson said. But Tyson was “less than cooperative,” said the sheriff, who supervises the county’s coronavirus response, and Iowa’s governor declined to shut the facility.

“Waterloo Tyson is running,” the company said in a text message to employees on April 17. “Thank you team members! WE ARE PROUD OF YOU!”

Five days later, the plant was closed. Tyson said the reason was “worker absenteeism” as well as a spike in cases and community concerns. As of Thursday, the county health department had recorded 1,031 coronavirus infections among Tyson employees — more than a third of the work force. Some are on ventilators. Three have died, according to Tyson.

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Credit…Daniel Acker for The New York Times

The plant didn’t stay closed for long. As meat shortages hit grocery stores and fast-food restaurants, political pressure built to get the dozens of plants across the country that had shut down because of virus outbreaks up and running again. After an executive order by President Trump declared the meat supply “critical infrastructure” and shielded the companies from certain liability, Tyson reopened its Waterloo facility on Thursday.

New safety precautions have been added, like plexiglass barriers along the production line, infrared temperature scanners to detect fevers, and face shields and masks for the workers.

Now the question is: Will America’s appetite for meat be sated without sickening armies of low-wage workers, and their communities, in new waves of infection?

Workers and their advocates say Tyson’s actions — and recent federal safety guidelines — have come far too late. They point to lapses that Tyson made in the first three weeks of April, as the virus tore largely unimpeded through the Waterloo plant.

As high-level executives lobbied the White House to help protect Tyson from lawsuits, the company was failing to provide adequate safety equipment to Waterloo workers and refusing the requests of local officials to close the plant, according to more than two dozen interviews with plant employees, immigrant-rights advocates, doctors, lawyers and government officials.

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Credit…Daniel Acker for The New York Times

While Tyson began changing its policies on short-term disability benefits in late March to encourage sick workers to stay home, many employees were not certain of the rules, and some went to work sick to avoid losing pay. Rumors and misinformation spread among workers, many of whom are not native English speakers. As the work force dwindled, fear gripped the plant.

Steve Stouffer, the head of Tyson’s beef and pork operations, said in an interview that the company had made the best safety decisions it could in a rapidly evolving situation. But he acknowledged that the company might have done more.

“Looking at it in the rearview mirror, you can always be better,” he said.

Sheriff Thompson said that he was thankful for the new safety precautions but that Tyson had been too slow to act.

“Which is more important?” he asked. “Your pork chops, or the people that are contracting Covid, the people that are dying from it?”

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Credit…Daniel Acker for The New York Times

A squat gray building branded with the slogan “A Cut Above the Rest,” the Waterloo plant is Tyson’s largest pork operation in the United States, responsible for almost 4 percent of the nation’s pork supply. Before the pandemic, it operated around the clock, breaking down up to 19,500 hogs a day into cuts of meat that traveled on a fleet of trucks across the country.

It is tough, demanding work, usually performed by workers standing close together.

During a conference call on March 9, union leaders in the meat industry discussed how to spread out workers in plants and take other precautions to prevent an outbreak. But at the time, the problem seemed a long way away from eastern Iowa, said Bob Waters, president of the local union for the Waterloo plant.

“We thought it might come, but we hoped it didn’t,” he said. Iowa, like several other Midwestern states, never issued a statewide stay-at-home order.

By early April, however, the Black Hawk County emergency operation center had started getting complaints about dangerous conditions at the plant.

Workers and their relatives reported a lack of protective gear and insufficient safety protocols, and said employees were starting to test positive for the virus.

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Credit…Daniel Acker for The New York Times

Tyson had put some precautions in place. In March, it began checking workers for fevers as they entered the plant and relaxed its policies so workers who tested positive or were feeling unwell would be paid a portion of their salary even if they stayed home.

But workers were still crowded together on the factory floor, in the cafeteria and in the locker room, and most did not wear masks. Tyson said it offered cloth bandannas to workers who asked, but by the time it tried to buy protective gear, supplies were scarce.

At least one employee vomited while working on the production line, and several left the facility with soaring temperatures, according to a worker who spoke on the condition of anonymity for fear of losing his job and local advocates who have spoken with workers at the plant.

Because of patient privacy laws, Tyson and the union had difficulty obtaining information about which workers had tested positive — hampering their efforts to isolate colleagues in close contact with them.

Older employees, as well as those with asthma or diabetes, became increasingly afraid of entering the plant.

“It was really a time of fear and panic,” said State Representative Timi Brown-Powers, who works at a coronavirus clinic in Waterloo. “They had not slowed the line down. They were not practicing any sort of social distancing.”

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Credit…Daniel Acker for The New York Times

On the night of April 12, she said, nearly two dozen Tyson employees were admitted to the emergency room at a hospital, MercyOne.

Tyson employed interpreters to communicate with its diverse work force, which includes immigrants from Bosnia, Mexico, Myanmar and the Republic of Congo. But misinformation and distrust spread.

One worker who died had taken Tylenol before entering the plant to lower her temperature enough to pass the screening, afraid that missing work would mean forgoing a bonus, said a person who knows the worker’s family and who spoke on the condition of anonymity to protect their privacy.

Workers at the plant were confused about why so many colleagues seemed to be getting sick and missing work. Supervisors told them that it was the flu, some said, or warned them not to talk about the virus at work.

In an emailed statement, Tyson said it had “worked with the information available to us at the time to help keep our team members safe.” The company said earlier information from the Black Hawk County Health Department would have helped its decision-making.

Dr. Nafissa Cisse Egbuonye, the director of the Black Hawk County Health Department, said that before the state changed the rules on April 14 to help speed public health investigations, she was legally prevented from sharing the names of employees who had tested positive with the company. But she said that she had been in constant communication with the plant and shared her concerns.

“I think they had enough information,” she said, “to take the necessary measures.”

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Credit…Daniel Acker for The New York Times

Iowa, an overwhelmingly white state, has long had a complicated relationship with meatpacking plants. While the industry is an engine of the state’s economy and the country’s food supply, it also employs many immigrants, who have faced periodic raids to enforce immigration laws.

Even with union representation, immigrants at the plant say they are afraid to raise concerns about working conditions.

“The narrative is shifting the blame to the workers, instead of focusing on the true incompetence, in my opinion, of the government, not just the governor, but also leaders here at Tyson,” said Nilvia Reyes Rodriguez, president of the Waterloo chapter of the League of United Latin American Citizens. “It was their responsibility to protect their workers.”

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Credit…Daniel Acker for The New York Times

She added, “Because of the population in those industries, I think there is a disregard for those communities.”

Tyson said in a statement that it took pride in its diversity and that its immigrant workers have advanced to management positions, including at the Waterloo plant. But some of those tensions simmered as local politicians became locked in a struggle with the state and then the federal government over closing the plant.

After Sheriff Thompson’s visit, he and other local politicians began lobbying Tyson and Gov. Kim Reynolds for a shutdown. The governor sided with Tyson. She issued an executive order on April 16 stating that only the state government, not local governments, had the authority to close businesses in northeast Iowa, including the Waterloo plant.

“We’re making sure that the work force is protected and, most importantly, that we’re keeping that food supply chain moving,” Ms. Reynolds said.

But the number of infections continued to increase. Tyson said it began winding down operations on April 20. But the plant did not fully shut down until April 22, after the company had processed the remaining hog carcasses in its cooler. After the plant closed, the company invited workers back for coronavirus testing. But that process may have infected more workers, said Christine Kemp, the chief executive of a local health clinic. Employees bunched together outside the plant and crowded the stairwells. Some left without being tested, afraid they would catch the virus in line.

The virus had already spread through the community, including to a nursing home where several workers are married to Tyson employees. The Tyson employees who have died included a Bosnian refugee survived by a grieving husband, and a man with three daughters. The mother died from cancer last year, and the oldest daughter, 19, will take guardianship of her sisters.

A maintenance worker at the plant, Jose Ayala, 44, is lying unresponsive on a ventilator. Zach Medhaug, 39, a fellow worker, has been calling him to talk to him and play his favorite music.

Mr. Medhaug also caught the coronavirus but has recovered and said he was ready to return to work. “But I’m also in a different position than some other people are,” he said. “I’m over Covid. For other people, it’s very scary.”

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Credit…Daniel Acker for The New York Times

The political stakes of the reopening in Waterloo are high.

With meat supplies disrupted nationwide, the White House has pushed Tyson and other meat companies to continue operating. And Tyson officials have had plenty of chances to air concerns, dining at the White House and participating in several calls with the president and vice president in recent months.

Since he issued the executive order on April 28, Mr. Trump has been quick to declare that the supply chain is back on track.

Asked Wednesday about a hamburger shortage at Wendy’s, he turned to the secretary of agriculture, Sonny Perdue. “Basically, you’re saying, in a week and a half, you think everything is going to be good, or sooner?” the president asked.

“Yes. These plants are opening as we speak,” Mr. Perdue said.

“You’re going to have to push them,” the president replied. “Push them more.”

But the reopening may have to proceed in fits and starts. Tyson executives cautioned that it would take time to return to normal. The Waterloo plant reopened on Thursday at about 50 percent capacity. And ramping back up could take weeks as workers return from quarantine.

Mr. Stouffer, the Tyson executive, said he hoped the worst was over. But health officials warn that a rush to full production could cause a second wave of infections.

“History will be the judge, eventually,” Mr. Stouffer said. “But we have attempted very hard, our entire team, our entire organization, from the chairman of the board on down, to do the right thing.”

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Credit…Daniel Acker for The New York Times
  • Updated April 11, 2020

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • When will this end?

      This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • Is there a vaccine yet?

      No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.


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