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| As Natural Disasters Strike, a New Fear: Relief Shelters May Spread Virus | As Natural Disasters Strike, a New Fear: Relief Shelters May Spread Virus |
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| WASHINGTON — Coast-to-coast storms. A spate of wildfires. Flooding in Hawaii. As the United States rushes into disaster season, federal officials now have an added crisis to worry about: How to stop tightly packed disaster-response shelters from becoming hot spots of coronavirus transmission. | WASHINGTON — Coast-to-coast storms. A spate of wildfires. Flooding in Hawaii. As the United States rushes into disaster season, federal officials now have an added crisis to worry about: How to stop tightly packed disaster-response shelters from becoming hot spots of coronavirus transmission. |
| The virus is forcing emergency managers to rethink long-held procedures for operating shelters like these in real time. That challenge comes as the nation’s crisis-response work force is already taxed by three years of brutal hurricanes, floods and wildfires, a trend that climate change promises to accelerate. | The virus is forcing emergency managers to rethink long-held procedures for operating shelters like these in real time. That challenge comes as the nation’s crisis-response work force is already taxed by three years of brutal hurricanes, floods and wildfires, a trend that climate change promises to accelerate. |
| “All of these activities that we do during and after disasters are activities that require a lot of people to be in close proximity to each other,” said Samantha Montano, assistant professor of emergency management and disaster science at the University of Nebraska, Omaha. “And that is the exact opposite of what we need to do to keep people safe from Covid-19.” | “All of these activities that we do during and after disasters are activities that require a lot of people to be in close proximity to each other,” said Samantha Montano, assistant professor of emergency management and disaster science at the University of Nebraska, Omaha. “And that is the exact opposite of what we need to do to keep people safe from Covid-19.” |
| “Any hazards that we’re concerned about on an annual basis, we need to be twice as concerned about them now,” she said. | “Any hazards that we’re concerned about on an annual basis, we need to be twice as concerned about them now,” she said. |
| The Federal Emergency Management Agency has begun encouraging workers to “practice social distancing” and to limit to four the number of disaster victims who can be in one of its field offices at any given time, a spokeswoman said Thursday. The agency has also halted training at its National Fire Academy and Emergency Management Institute, as well as other facilities. | The Federal Emergency Management Agency has begun encouraging workers to “practice social distancing” and to limit to four the number of disaster victims who can be in one of its field offices at any given time, a spokeswoman said Thursday. The agency has also halted training at its National Fire Academy and Emergency Management Institute, as well as other facilities. |
| It also said Thursday that it would let states seek reimbursement for sheltering victims individually, for example in hotels. However, in a disaster scenario, hotels themselves might be damaged or unusable because of the crisis, or simply not close enough to serve the immediate needs. | It also said Thursday that it would let states seek reimbursement for sheltering victims individually, for example in hotels. However, in a disaster scenario, hotels themselves might be damaged or unusable because of the crisis, or simply not close enough to serve the immediate needs. |
| So one of the most pressing challenges remains: What to do about shelters? | So one of the most pressing challenges remains: What to do about shelters? |
| When Americans are forced to leave their homes because of flooding or fires and have nowhere else to go, charitable organizations routinely open temporary shelters that usually consist of rows of cots in school gymnasiums, churches, convention centers or other large indoor spaces. | When Americans are forced to leave their homes because of flooding or fires and have nowhere else to go, charitable organizations routinely open temporary shelters that usually consist of rows of cots in school gymnasiums, churches, convention centers or other large indoor spaces. |
| Those shelters have offered a place of refuge, one that has become increasingly important as climate change causes more frequent and intense disasters. | Those shelters have offered a place of refuge, one that has become increasingly important as climate change causes more frequent and intense disasters. |
| On Thursday, the National Oceanic and Atmospheric Administration issued data predicting widespread flooding between now and the end of May, with major or moderate floods in 23 states. California has already been hit by nine wildfires this year; the National Interagency Fire Center reported 11 new large fires around the country this week alone. | On Thursday, the National Oceanic and Atmospheric Administration issued data predicting widespread flooding between now and the end of May, with major or moderate floods in 23 states. California has already been hit by nine wildfires this year; the National Interagency Fire Center reported 11 new large fires around the country this week alone. |
| A major storm stretched across much of the country this week, with FEMA warning Friday of heavy rain from the southern plains to the Tennessee Valley. And hurricane season is just 10 weeks away. | A major storm stretched across much of the country this week, with FEMA warning Friday of heavy rain from the southern plains to the Tennessee Valley. And hurricane season is just 10 weeks away. |
| The coronavirus has the potential to turn the shelters from a refuge into a danger of their own. | The coronavirus has the potential to turn the shelters from a refuge into a danger of their own. |
| The American Red Cross, which runs most of the temporary shelters around the United States, has set new guidelines for their operation, trying to curb the risk of transmission by screening evacuees and isolating those who show symptoms, as well as spacing cots six feet apart and emphasizing good hygiene. | The American Red Cross, which runs most of the temporary shelters around the United States, has set new guidelines for their operation, trying to curb the risk of transmission by screening evacuees and isolating those who show symptoms, as well as spacing cots six feet apart and emphasizing good hygiene. |
| Officials with the organization said they knew that wasn’t a perfect solution. | Officials with the organization said they knew that wasn’t a perfect solution. |
| Amid a pandemic, “a congregate shelter is not the best environment,” said Trevor Riggen, senior vice president for disaster services for the Red Cross, using the term for shelters that place groups of people in a single shared space. He said the Red Cross would try to move more people into hotels or motels, but added that there weren’t always enough available rooms close to a disaster, particularly if the number of people who need shelter extends into the hundreds. | Amid a pandemic, “a congregate shelter is not the best environment,” said Trevor Riggen, senior vice president for disaster services for the Red Cross, using the term for shelters that place groups of people in a single shared space. He said the Red Cross would try to move more people into hotels or motels, but added that there weren’t always enough available rooms close to a disaster, particularly if the number of people who need shelter extends into the hundreds. |
| Public health officials said it would be better to house disaster victims separately, despite the additional cost and logistical hurdles. | Public health officials said it would be better to house disaster victims separately, despite the additional cost and logistical hurdles. |
| “Congregate settings are clearly a higher infection-control risk, especially when dealing with a novel respiratory virus,” said Lucy Wilson, who ran infection control for Maryland and is now a professor in the emergency health services department at the University of Maryland Baltimore County. She compared group shelters to other crowded settings like dormitories, barracks, prisons and cruise ships, where “respiratory diseases are known to rapidly spread.” | “Congregate settings are clearly a higher infection-control risk, especially when dealing with a novel respiratory virus,” said Lucy Wilson, who ran infection control for Maryland and is now a professor in the emergency health services department at the University of Maryland Baltimore County. She compared group shelters to other crowded settings like dormitories, barracks, prisons and cruise ships, where “respiratory diseases are known to rapidly spread.” |
| Arnold Monto, a professor of epidemiology and global health at the University of Michigan School of Public Health, said he thought the Red Cross was taking reasonable steps to protect the health of people in its shelters. But he said it seemed likely, based on what is known so far about Covid-19, that people who don’t have symptoms may nonetheless have the disease — and, more important, can probably spread it to others. | Arnold Monto, a professor of epidemiology and global health at the University of Michigan School of Public Health, said he thought the Red Cross was taking reasonable steps to protect the health of people in its shelters. But he said it seemed likely, based on what is known so far about Covid-19, that people who don’t have symptoms may nonetheless have the disease — and, more important, can probably spread it to others. |
| “Being in a motel would give them more distance,” Dr. Monto said. “The more people you have, the more likely that one of them might be affected.” | “Being in a motel would give them more distance,” Dr. Monto said. “The more people you have, the more likely that one of them might be affected.” |
| The federal government’s Thursday announcement that states can seek federal reimbursement for the cost of sheltering people individually — provided it’s at the direction of a public health official — could help address that concern, assuming the rooms are available. Keeping people out of group shelters “may be necessary in this Public Health Emergency to save lives,” the agency said in a fact sheet, “as well as to lessen or avert the threat of a catastrophe.” | The federal government’s Thursday announcement that states can seek federal reimbursement for the cost of sheltering people individually — provided it’s at the direction of a public health official — could help address that concern, assuming the rooms are available. Keeping people out of group shelters “may be necessary in this Public Health Emergency to save lives,” the agency said in a fact sheet, “as well as to lessen or avert the threat of a catastrophe.” |
| Updated June 12, 2020 | Updated June 12, 2020 |
| 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. | |
| 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. | 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. |
| 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. |
| Mr. Riggen said the Red Cross would try to get people into hotels when the risk of contagion is particularly high. Following an apartment fire this month in Jacksonville, Fla., a state with a large number of coronavirus cases, the organization put 45 people in hotels on the advice of local health officials, he said. | Mr. Riggen said the Red Cross would try to get people into hotels when the risk of contagion is particularly high. Following an apartment fire this month in Jacksonville, Fla., a state with a large number of coronavirus cases, the organization put 45 people in hotels on the advice of local health officials, he said. |
| In the meantime, the Red Cross is continuing to rely on shelters, but with a few changes. | In the meantime, the Red Cross is continuing to rely on shelters, but with a few changes. |
| Its new guidelines call for taking the temperature of everyone coming into shelters, whether evacuees or volunteers, as well as checking for other symptoms of COVID-19. Once inside, everyone is supposed to be checked three times a day. Other steps include hand-washing stations, along with “enhanced cleaning of all hard surfaces.” | Its new guidelines call for taking the temperature of everyone coming into shelters, whether evacuees or volunteers, as well as checking for other symptoms of COVID-19. Once inside, everyone is supposed to be checked three times a day. Other steps include hand-washing stations, along with “enhanced cleaning of all hard surfaces.” |
| People are also told not to pull their cots together. | People are also told not to pull their cots together. |
| The Red Cross has already applied its new guidelines at two shelters, according to Mr. Riggen. One is in Hawaii, which was hit this week by flooding. That shelter housed 150 people on Tuesday night. | The Red Cross has already applied its new guidelines at two shelters, according to Mr. Riggen. One is in Hawaii, which was hit this week by flooding. That shelter housed 150 people on Tuesday night. |
| The other was at a school in Salt Lake City, which was set up following a 5.7-magnitude earthquake on Wednesday. A Red Cross spokeswoman, Greta Gustafson, said Friday that no one had stayed at the shelter. Workers at the shelter denied entry Thursday to a photographer for The New York Times. | The other was at a school in Salt Lake City, which was set up following a 5.7-magnitude earthquake on Wednesday. A Red Cross spokeswoman, Greta Gustafson, said Friday that no one had stayed at the shelter. Workers at the shelter denied entry Thursday to a photographer for The New York Times. |
| “We are not aware of any positive tests” for Covid-19 at either of the two shelters, Ms. Gustafson said. | “We are not aware of any positive tests” for Covid-19 at either of the two shelters, Ms. Gustafson said. |
| Despite the risk of the coronavirus, switching from a shelter model to putting people in hotels is more challenging that it might seem. And money isn’t the only problem. | Despite the risk of the coronavirus, switching from a shelter model to putting people in hotels is more challenging that it might seem. And money isn’t the only problem. |
| In addition to being expensive, having people dispersed across different locations makes it harder to provide them with food and supplies, Mr. Riggen said. In some places, particularly rural areas, there may not be enough hotels nearby. And it’s not always possible to get a hotel room if somebody is pushed from their home in the middle of the night. | In addition to being expensive, having people dispersed across different locations makes it harder to provide them with food and supplies, Mr. Riggen said. In some places, particularly rural areas, there may not be enough hotels nearby. And it’s not always possible to get a hotel room if somebody is pushed from their home in the middle of the night. |
| “We don’t want to leave people standing out on the curb waiting,” Mr. Riggen said. | “We don’t want to leave people standing out on the curb waiting,” Mr. Riggen said. |
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