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Told to Stay Home, Suspected Coronavirus Patient Attended Event With Dartmouth Students Told to Stay Home, Suspected Coronavirus Patient Attended Event With Dartmouth Students
(1 day later)
BOSTON — When an employee of the Dartmouth-Hitchcock Medical Center in New Hampshire showed signs of possible coronavirus last week, a medical worker who had examined him told him to avoid contact with others, pending further tests. Instead, he went to a mixer at a crowded music venue.BOSTON — When an employee of the Dartmouth-Hitchcock Medical Center in New Hampshire showed signs of possible coronavirus last week, a medical worker who had examined him told him to avoid contact with others, pending further tests. Instead, he went to a mixer at a crowded music venue.
Three days later, he was confirmed as the state’s first coronavirus case.Three days later, he was confirmed as the state’s first coronavirus case.
And now a second case has been confirmed — a “close contact” of the patient’s — raising new questions about what should happen when suspected coronavirus patients ignore requests to self-quarantine.And now a second case has been confirmed — a “close contact” of the patient’s — raising new questions about what should happen when suspected coronavirus patients ignore requests to self-quarantine.
The man, who had come down with flu-like symptoms after a trip to Italy, has now been officially ordered by New Hampshire’s health commissioner to isolate himself at home.The man, who had come down with flu-like symptoms after a trip to Italy, has now been officially ordered by New Hampshire’s health commissioner to isolate himself at home.
“The individual is complying now,” said Jake Leon, communications director for the New Hampshire Department of Health and Human Services.“The individual is complying now,” said Jake Leon, communications director for the New Hampshire Department of Health and Human Services.
News that a health care worker could have exposed students at the event last Friday night, a mixer for doctors and Dartmouth College students, swiftly reverberated on the nearby campus.News that a health care worker could have exposed students at the event last Friday night, a mixer for doctors and Dartmouth College students, swiftly reverberated on the nearby campus.
Students learned of a possible exposure in an email sent out by the university on Tuesday, which revealed that a man who later tested positive for coronavirus had attended the mixer held for students at the college’s Tuck School of Business on Feb. 28. The event occurred on the same day that the federal Centers for Disease Control and Prevention had issued a new Italy travel advisory, warning all those who had recently been to the country to stay home and monitor their health for 14 days.Students learned of a possible exposure in an email sent out by the university on Tuesday, which revealed that a man who later tested positive for coronavirus had attended the mixer held for students at the college’s Tuck School of Business on Feb. 28. The event occurred on the same day that the federal Centers for Disease Control and Prevention had issued a new Italy travel advisory, warning all those who had recently been to the country to stay home and monitor their health for 14 days.
Across the country, thousands of travelers returning from places with substantial outbreaks of the virus have been asked to stay home and avoid contact with others for 14 days, a request that largely relies on the honor system. As the virus spreads, many worry that the recommendations are not always followed.Across the country, thousands of travelers returning from places with substantial outbreaks of the virus have been asked to stay home and avoid contact with others for 14 days, a request that largely relies on the honor system. As the virus spreads, many worry that the recommendations are not always followed.
In the New Hampshire case, the man went to the doctor on Friday with a fever and respiratory symptoms and was tested for a range of possible ailments, health authorities said. Doctors advised him to quarantine himself, but did not test him for coronavirus until Monday, after other viruses were ruled out. He arrived at the social event hours after the warning on Friday.In the New Hampshire case, the man went to the doctor on Friday with a fever and respiratory symptoms and was tested for a range of possible ailments, health authorities said. Doctors advised him to quarantine himself, but did not test him for coronavirus until Monday, after other viruses were ruled out. He arrived at the social event hours after the warning on Friday.
Dartmouth College officials, in a message to students, said an investigation was underway to trace the close contacts of the individual, and said no Dartmouth students were considered close contacts to the patient at this time. It was unclear whether the second patient who tested positive had attended the mixer or was exposed at another time.Dartmouth College officials, in a message to students, said an investigation was underway to trace the close contacts of the individual, and said no Dartmouth students were considered close contacts to the patient at this time. It was unclear whether the second patient who tested positive had attended the mixer or was exposed at another time.
“The general vibe is we are all pretty concerned that this medical professional showed up to the event, despite being told to self-isolate,” said Christie Harrison, a first-year Tuck student who sang with the band that performed at the mixer on Friday night. She estimated that about a hundred business school students attended, along with 30 or 40 resident physicians associated with Dartmouth-Hitchcock, an academic medical center located near Dartmouth College.“The general vibe is we are all pretty concerned that this medical professional showed up to the event, despite being told to self-isolate,” said Christie Harrison, a first-year Tuck student who sang with the band that performed at the mixer on Friday night. She estimated that about a hundred business school students attended, along with 30 or 40 resident physicians associated with Dartmouth-Hitchcock, an academic medical center located near Dartmouth College.
“We all were just excited to have one of the last few parties of the quarter and be off campus,” Ms. Harrison said. She said investigators appear to have made efforts to trace those who interacted with the man at the mixer, and have asked them to self-quarantine. Those who did not interact with him, like herself, were simply told to monitor their health and alert authorities if they came down with symptoms, she said.“We all were just excited to have one of the last few parties of the quarter and be off campus,” Ms. Harrison said. She said investigators appear to have made efforts to trace those who interacted with the man at the mixer, and have asked them to self-quarantine. Those who did not interact with him, like herself, were simply told to monitor their health and alert authorities if they came down with symptoms, she said.
“The college was really great at communicating all of that to us, in a timely manner,” Ms. Harrison said. “The college has been really transparent with us throughout the process.”“The college was really great at communicating all of that to us, in a timely manner,” Ms. Harrison said. “The college has been really transparent with us throughout the process.”
Gunnar Esiason, a Tuck student who considered going to the mixer on Friday night, but did not, said he nonetheless felt distressed about the potential exposures because he has underlying health issues. “In my opinion, it is shocking that a health care worker would do this, if it is in fact true,” said Mr. Esiason. He has since left campus and was planning to take exams remotely.Gunnar Esiason, a Tuck student who considered going to the mixer on Friday night, but did not, said he nonetheless felt distressed about the potential exposures because he has underlying health issues. “In my opinion, it is shocking that a health care worker would do this, if it is in fact true,” said Mr. Esiason. He has since left campus and was planning to take exams remotely.
The mixer was hosted at the Engine Room, a music and comedy venue in White River Junction, just across the border in Vermont. According to a message on the club’s Facebook page, owners received a call from Dr. Benjamin Chan, an epidemiologist with the New Hampshire Department of Health and Human Services, informing them that an individual who tested positive for coronavirus had attended the event on Friday night. Vermont health authorities had also been in touch.The mixer was hosted at the Engine Room, a music and comedy venue in White River Junction, just across the border in Vermont. According to a message on the club’s Facebook page, owners received a call from Dr. Benjamin Chan, an epidemiologist with the New Hampshire Department of Health and Human Services, informing them that an individual who tested positive for coronavirus had attended the event on Friday night. Vermont health authorities had also been in touch.
The management said it was in the process of professionally cleaning the facility and had canceled at least three events that were to be held there this week.The management said it was in the process of professionally cleaning the facility and had canceled at least three events that were to be held there this week.
Angry patrons wrote back on Facebook that the coronavirus patient should be jailed or fined.Angry patrons wrote back on Facebook that the coronavirus patient should be jailed or fined.
But it appears that the patient was under no legal obligation to stay home at the time. Under New Hampshire law, a person who refuses to comply with a formal isolation order issued by the health commissioner is guilty of a misdemeanor. In other states, refusing to comply is a felony. But on Friday, the patient had not been diagnosed, and had merely been advised by a health care worker to stay home. The formal isolation order was issued after the mixer, after the patient was tested on Monday and the results were determined “presumed positive,” state authorities said.But it appears that the patient was under no legal obligation to stay home at the time. Under New Hampshire law, a person who refuses to comply with a formal isolation order issued by the health commissioner is guilty of a misdemeanor. In other states, refusing to comply is a felony. But on Friday, the patient had not been diagnosed, and had merely been advised by a health care worker to stay home. The formal isolation order was issued after the mixer, after the patient was tested on Monday and the results were determined “presumed positive,” state authorities said.
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
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.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.
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.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.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
New Hampshire officials have made clear in their public statements that they feel the patient acted irresponsibly. But he does not appear to have broken the law.New Hampshire officials have made clear in their public statements that they feel the patient acted irresponsibly. But he does not appear to have broken the law.
“You can’t bring criminal charges for being a bonehead or just not doing what you were told was advisable to do,” said Wendy Parmet, faculty director of the Center for Health Policy and Law at Northeastern University. “It’s not illegal to ignore the advice of your health care provider, or even the health department, until officials follow the particular procedures to issue a formal health order, and those procedures vary by state.”“You can’t bring criminal charges for being a bonehead or just not doing what you were told was advisable to do,” said Wendy Parmet, faculty director of the Center for Health Policy and Law at Northeastern University. “It’s not illegal to ignore the advice of your health care provider, or even the health department, until officials follow the particular procedures to issue a formal health order, and those procedures vary by state.”
There is a downside to punishing a single individual in such a case, she said.There is a downside to punishing a single individual in such a case, she said.
“We certainly don’t want people to think that they shouldn’t get tested because if they do, they’ll open themselves up to criminal liability, or a policeman at the door enforcing quarantine,” she said. “Those are consequences that deter testing, treatment and compliance.”“We certainly don’t want people to think that they shouldn’t get tested because if they do, they’ll open themselves up to criminal liability, or a policeman at the door enforcing quarantine,” she said. “Those are consequences that deter testing, treatment and compliance.”
The second New Hampshire patient who tested positive for coronavirus, also a man from Grafton County, is also under isolation at home.The second New Hampshire patient who tested positive for coronavirus, also a man from Grafton County, is also under isolation at home.