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‘We’ve Got a Monster That’s Looming’: West Virginia Is the Last State Without a Coronavirus Case ‘We’ve Got a Monster That’s Looming’: West Virginia Is the Last State Without a Coronavirus Case
(3 days later)
CHARLES TOWN, W.Va. — There are plenty of reasons West Virginia, as of Saturday afternoon, was the only state in the country with no confirmed cases of the coronavirus.CHARLES TOWN, W.Va. — There are plenty of reasons West Virginia, as of Saturday afternoon, was the only state in the country with no confirmed cases of the coronavirus.
It is a small state and mostly rural, much of its population already socially distanced by hollows and mountains. It is a state, as the West Virginia health secretary said at a news conference on Friday, that doesn’t “have a lot of international travel.”It is a small state and mostly rural, much of its population already socially distanced by hollows and mountains. It is a state, as the West Virginia health secretary said at a news conference on Friday, that doesn’t “have a lot of international travel.”
Still, at that same news conference, Gov. Jim Justice was bluntly realistic.Still, at that same news conference, Gov. Jim Justice was bluntly realistic.
“We know it’s here,” he said. “I mean, let’s be real. It has to be here. We just haven’t found it yet.”“We know it’s here,” he said. “I mean, let’s be real. It has to be here. We just haven’t found it yet.”
There is no running from the coronavirus, not even into the hills.There is no running from the coronavirus, not even into the hills.
So while West Virginia has maintained its official status as a virus-free island in a nationwide sea of infection, no one expects it to hold that place forever, if it even really has it now. The state has reported only 39 people tested as of Saturday evening, with 38 negative and one whose result was pending. State officials have acknowledged that the capacity for public testing has been limited, but said it is expanding.So while West Virginia has maintained its official status as a virus-free island in a nationwide sea of infection, no one expects it to hold that place forever, if it even really has it now. The state has reported only 39 people tested as of Saturday evening, with 38 negative and one whose result was pending. State officials have acknowledged that the capacity for public testing has been limited, but said it is expanding.
On Friday Mr. Justice went ahead and announced he was closing all schools, even before similar announcements came in the neighboring states of Virginia and Pennsylvania.On Friday Mr. Justice went ahead and announced he was closing all schools, even before similar announcements came in the neighboring states of Virginia and Pennsylvania.
State employees have been banned from traveling or holding large meetings. The state high school basketball tournament was suspended. Nursing homes have restricted visitors. Hospitals have been using the virus’s delayed arrival to track down extra ventilators and create emergency staffing schedules.State employees have been banned from traveling or holding large meetings. The state high school basketball tournament was suspended. Nursing homes have restricted visitors. Hospitals have been using the virus’s delayed arrival to track down extra ventilators and create emergency staffing schedules.
Beyond that, people are just making do.Beyond that, people are just making do.
Todd Coyle runs Bushel and Peck, a food market in Charles Town, a little town in the state’s eastern panhandle just a few miles from Virginia (30 cases so far) and Maryland (26).Todd Coyle runs Bushel and Peck, a food market in Charles Town, a little town in the state’s eastern panhandle just a few miles from Virginia (30 cases so far) and Maryland (26).
“The credit card signer thing, we’re not letting anybody sign that,” said Mr. Coyle, 59, who is washing down the grocery baskets after each use and constantly washing the freezer door handles.“The credit card signer thing, we’re not letting anybody sign that,” said Mr. Coyle, 59, who is washing down the grocery baskets after each use and constantly washing the freezer door handles.
“We’re doing everything we can think of,” he said, confirmed cases in the state or not. “We’re taking this very seriously.”“We’re doing everything we can think of,” he said, confirmed cases in the state or not. “We’re taking this very seriously.”
This has all been prudent but it is also grimly vital: While West Virginia may be more isolated than many other states, it is also, in many ways, much more vulnerable.This has all been prudent but it is also grimly vital: While West Virginia may be more isolated than many other states, it is also, in many ways, much more vulnerable.
A study released on Friday by the Kaiser Family Foundation, looking at state-by-state demographics as well as the rates of illness such as heart disease and diabetes, concluded that West Virginia had a greater share of adults at risk than any other state in the country. It was the only state, in fact, where over half of all adults were at heightened risk.A study released on Friday by the Kaiser Family Foundation, looking at state-by-state demographics as well as the rates of illness such as heart disease and diabetes, concluded that West Virginia had a greater share of adults at risk than any other state in the country. It was the only state, in fact, where over half of all adults were at heightened risk.
This was not only because West Virginians tend to be older, although that is true, said Jennifer Kates, a senior vice president at the foundation who worked on the study. West Virginians over 60 were in fact less likely than average to have underlying health conditions.This was not only because West Virginians tend to be older, although that is true, said Jennifer Kates, a senior vice president at the foundation who worked on the study. West Virginians over 60 were in fact less likely than average to have underlying health conditions.
“The factor that’s driving West Virginia,” Dr. Kates said, “is the share of adults under 60 who have these underlying conditions. That’s the factor that puts West Virginia over the top.”“The factor that’s driving West Virginia,” Dr. Kates said, “is the share of adults under 60 who have these underlying conditions. That’s the factor that puts West Virginia over the top.”
West Virginia has the highest share of smokers of any state, a habit that increases the odds of severity and death from coronavirus. It has the highest death rate in the nation from diabetes and among the highest for heart disease, cancer and chronic lower respiratory disease, all risk factors. Untold numbers of men throughout the Appalachian coal fields have black lung, leaving them dangerously exposed to the virus.West Virginia has the highest share of smokers of any state, a habit that increases the odds of severity and death from coronavirus. It has the highest death rate in the nation from diabetes and among the highest for heart disease, cancer and chronic lower respiratory disease, all risk factors. Untold numbers of men throughout the Appalachian coal fields have black lung, leaving them dangerously exposed to the virus.
Given all these risk factors, the lack of widespread testing has been particularly vexing.Given all these risk factors, the lack of widespread testing has been particularly vexing.
“Of course we have no confirmed cases,” said Sam Petsonk, a lawyer in the southern part of the state. “We essentially have no testing capacity.”“Of course we have no confirmed cases,” said Sam Petsonk, a lawyer in the southern part of the state. “We essentially have no testing capacity.”
State officials said testing was expanding, adding that they shared the frustration of the public.State officials said testing was expanding, adding that they shared the frustration of the public.
“What’s really challenging is — and I think we are all frustrated with it — there is just not a public supply of testing ability that we’d all love to have,” said Dr. Cathy Slemp, the West Virginia Public Health Commissioner, at the news conference on Friday. “Every one of us would love to say, ‘Let’s get everybody tested that has any kinds of symptoms.’”“What’s really challenging is — and I think we are all frustrated with it — there is just not a public supply of testing ability that we’d all love to have,” said Dr. Cathy Slemp, the West Virginia Public Health Commissioner, at the news conference on Friday. “Every one of us would love to say, ‘Let’s get everybody tested that has any kinds of symptoms.’”
Updated June 5, 2020Updated June 5, 2020
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.
For now, there is only getting ready.For now, there is only getting ready.
West Virginia has a higher ratio of beds to population than most other states, a situation helped by the expansion of Medicaid. And while some hospitals have closed in the region, as they have throughout rural America, there is a broad network of smaller critical access hospitals and clinics, many with 25 or fewer beds. While their presence in remote areas is perhaps now more valuable than ever, they may soon be forced into providing services they were not designed to provide.West Virginia has a higher ratio of beds to population than most other states, a situation helped by the expansion of Medicaid. And while some hospitals have closed in the region, as they have throughout rural America, there is a broad network of smaller critical access hospitals and clinics, many with 25 or fewer beds. While their presence in remote areas is perhaps now more valuable than ever, they may soon be forced into providing services they were not designed to provide.
“We might have to expand what we normally care for,” said Dr. Brent Watson, an emergency room doctor at Roane General Hospital, in a rural county north of Charleston. Dr. Watson said that they had been planning how to set up the hospital in the case of a local influx, with some areas cordoned off for those who show up with respiratory problems.“We might have to expand what we normally care for,” said Dr. Brent Watson, an emergency room doctor at Roane General Hospital, in a rural county north of Charleston. Dr. Watson said that they had been planning how to set up the hospital in the case of a local influx, with some areas cordoned off for those who show up with respiratory problems.
“We’re fortunate right now that we’ve had this lead time to do all this planning,” Dr. Watson said. They have acquired extra ventilators and worked out an emergency staffing schedule. They have enough protective gear for weeks. Though at some point, he said, everybody runs out.“We’re fortunate right now that we’ve had this lead time to do all this planning,” Dr. Watson said. They have acquired extra ventilators and worked out an emergency staffing schedule. They have enough protective gear for weeks. Though at some point, he said, everybody runs out.
And so while Dr. Watson prepares the hospital and Mr. Coyle washes the door handles at his store and thousands of children across the state sit at home, West Virginia watches that official case number and waits.And so while Dr. Watson prepares the hospital and Mr. Coyle washes the door handles at his store and thousands of children across the state sit at home, West Virginia watches that official case number and waits.
“Where we are is just plain simply this: We’ve got a monster that’s looming,” said Mr. Justice, the governor, insisting that the state was prepared for the inevitable. “There’s times in life where you got to stare down the monster,” he said. “That’s all there is to it.”“Where we are is just plain simply this: We’ve got a monster that’s looming,” said Mr. Justice, the governor, insisting that the state was prepared for the inevitable. “There’s times in life where you got to stare down the monster,” he said. “That’s all there is to it.”
Michael Wines reported from Charles Town, W.Va., and Campbell Robertson reported from Pittsburgh.Michael Wines reported from Charles Town, W.Va., and Campbell Robertson reported from Pittsburgh.