'In Detroit She’s a Hero. In Canada She’s Seen as a Potential Risk' diff viewer (11/12)

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In Detroit She’s a Hero. In Canada She’s Seen as a Potential Risk	In Detroit She’s a Hero. In Canada She’s Seen as a Potential Risk
2020-06-17 06:41:04 UTC	2020-06-17 15:09:20 UTC (about 8 hours later)
OTTAWA — For most people, the pandemic has turned border crossing into an impossibility. But for Laurie Dufresne, who lives in Canada and works in the United States, it remains part of her daily commute.	OTTAWA — For most people, the pandemic has turned border crossing into an impossibility. But for Laurie Dufresne, who lives in Canada and works in the United States, it remains part of her daily commute.
Ms. Dufresne is one of about 1,600 nurses and other health care workers who leave Windsor, Ontario, a city of 217,000, for daily work in Detroit, a metropolitan area of more than four million people. In Windsor, infections remain comparatively under control. Detroit, though, has one of the most severe coronavirus outbreaks in the United States.	Ms. Dufresne is one of about 1,600 nurses and other health care workers who leave Windsor, Ontario, a city of 217,000, for daily work in Detroit, a metropolitan area of more than four million people. In Windsor, infections remain comparatively under control. Detroit, though, has one of the most severe coronavirus outbreaks in the United States.
For health workers like Ms. Dufresne, fulfilling desperately needed medical duties across the border means being in an uncomfortable position. Canadian officials have been blunt about the risks, and health workers have found themselves under scrutiny at home as potential vectors of the pathogen, not just to Windsor but to all of Canada, which so far has not been hit as hard as the United States.	For health workers like Ms. Dufresne, fulfilling desperately needed medical duties across the border means being in an uncomfortable position. Canadian officials have been blunt about the risks, and health workers have found themselves under scrutiny at home as potential vectors of the pathogen, not just to Windsor but to all of Canada, which so far has not been hit as hard as the United States.
In other countries, health care workers have also found themselves grappling with a community afraid they will spread the virus when they leave their hospitals to come home.	In other countries, health care workers have also found themselves grappling with a community afraid they will spread the virus when they leave their hospitals to come home.
In Mexico, government officials have reported several instances of discrimination and violence against medical personnel motivated by such fears. Nurses have been kicked off public transportation, doused with chlorine and assaulted.	In Mexico, government officials have reported several instances of discrimination and violence against medical personnel motivated by such fears. Nurses have been kicked off public transportation, doused with chlorine and assaulted.
In Canada over the past few days, Windsor’s border-crossing caregivers have also been used in thinly veiled threats by Prime Minister Justin Trudeau and other Canadian politicians challenging an effort by President Trump to cut off exports of medical supplies to Canada.	In Canada over the past few days, Windsor’s border-crossing caregivers have also been used in thinly veiled threats by Prime Minister Justin Trudeau and other Canadian politicians challenging an effort by President Trump to cut off exports of medical supplies to Canada.
The dilemma facing officials in Windsor is how to help a neighbor in crisis while also protecting their citizens.	The dilemma facing officials in Windsor is how to help a neighbor in crisis while also protecting their citizens.
“I think it is important that we do not abandon our neighbor in this difficult time,” said Dr. Wajid Ahmed, the medical officer of health at the Windsor-Essex County Health Unit.	“I think it is important that we do not abandon our neighbor in this difficult time,” said Dr. Wajid Ahmed, the medical officer of health at the Windsor-Essex County Health Unit.
“But we also need to make sure that we are taking every step that we can to protect our community, protect our health care workers and ensure that we are reducing the risk as much as possible,” he added.	“But we also need to make sure that we are taking every step that we can to protect our community, protect our health care workers and ensure that we are reducing the risk as much as possible,” he added.
The Canada-U.S. border has been closed to everyone except essential workers, truck drivers and airplane, ship and train crews since March 21.	The Canada-U.S. border has been closed to everyone except essential workers, truck drivers and airplane, ship and train crews since March 21.
Detroit sits across the Detroit River from Windsor, just a few minutes’ drive by bridge or tunnel. The current outbreak has created an extraordinary contrast, though: In Detroit and its surrounding counties, there are 17,543 Covid-19 cases, and 926 people have died. Across all of Canada, 20,748 people have been infected, and 509 have died.	Detroit sits across the Detroit River from Windsor, just a few minutes’ drive by bridge or tunnel. The current outbreak has created an extraordinary contrast, though: In Detroit and its surrounding counties, there are 17,543 Covid-19 cases, and 926 people have died. Across all of Canada, 20,748 people have been infected, and 509 have died.
Metropolitan Detroit, with about 20 times the population of Windsor, has reported about 67 times the number of infections and 132 times the number of deaths. Dr. Ahmed said about a third of Windsor’s infections had been traced to health care workers returning from the United States.	Metropolitan Detroit, with about 20 times the population of Windsor, has reported about 67 times the number of infections and 132 times the number of deaths. Dr. Ahmed said about a third of Windsor’s infections had been traced to health care workers returning from the United States.
For Ms. Dufresne, who has worked at various Detroit-area hospitals and as a traveling nurse for 11 years, the shutdown of the border has both eased and complicated her commute.	For Ms. Dufresne, who has worked at various Detroit-area hospitals and as a traveling nurse for 11 years, the shutdown of the border has both eased and complicated her commute.
“The border guards are being much more respectful,” she said. And the Canadian border authorities have given all health care workers special car placards to speed their passage.	“The border guards are being much more respectful,” she said. And the Canadian border authorities have given all health care workers special car placards to speed their passage.
But Ms. Dufresne has a new post-work ritual when she gets home: deep disinfection.	But Ms. Dufresne has a new post-work ritual when she gets home: deep disinfection.
After pulling into her garage and closing the door, she immediately takes off and bags all her clothes for laundry, sanitizes the van and then showers.	After pulling into her garage and closing the door, she immediately takes off and bags all her clothes for laundry, sanitizes the van and then showers.
“It’s scary if you look at the numbers in Windsor compared to the numbers in Michigan,” Ms. Dufresne said. “I’m aware of the risks, and we try to limit them. But I’m not going to not take care of my patients.”	“It’s scary if you look at the numbers in Windsor compared to the numbers in Michigan,” Ms. Dufresne said. “I’m aware of the risks, and we try to limit them. But I’m not going to not take care of my patients.”
Similarly, Ms. Dufresne is determined not to be separated from her two school-aged children for weeks or months by moving to a hotel in Detroit, as some in Windsor have suggested.	Similarly, Ms. Dufresne is determined not to be separated from her two school-aged children for weeks or months by moving to a hotel in Detroit, as some in Windsor have suggested.
Detroit’s hospitals have long actively recruited in Windsor. Ms. Dufresne said Detroit’s large and sophisticated hospitals offer more and a greater variety of career opportunities than Windsor’s two comparatively small hospitals, which often send patients to a regional hospital about 120 miles away if they need complex treatments or special procedures.	Detroit’s hospitals have long actively recruited in Windsor. Ms. Dufresne said Detroit’s large and sophisticated hospitals offer more and a greater variety of career opportunities than Windsor’s two comparatively small hospitals, which often send patients to a regional hospital about 120 miles away if they need complex treatments or special procedures.
Updated June 16, 2020	Updated June 16, 2020
	The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.	The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
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.
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.
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.
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.
Dr. Ahmed said that despite the large number of health workers who travel daily from Windsor across the border, no agency keeps statistics on these commutes. Numbers posted by The Henry Ford Health System, a nonprofit that oversees six hospitals in the Detroit area, show that 538 of its 6,200 nurses are Canadians.	Dr. Ahmed said that despite the large number of health workers who travel daily from Windsor across the border, no agency keeps statistics on these commutes. Numbers posted by The Henry Ford Health System, a nonprofit that oversees six hospitals in the Detroit area, show that 538 of its 6,200 nurses are Canadians.
Ms. Dufresne, a surgical nurse, said she had worked in groups where upward of 40 percent of her colleagues also lived in Windsor.	Ms. Dufresne, a surgical nurse, said she had worked in groups where upward of 40 percent of her colleagues also lived in Windsor.
Dr. Ahmed said Canadian officials should consider limiting the number of times health care workers can cross the border, encouraging more of them to stay in Detroit hotels, barring part-timers from crossing and possibly requiring that international commuters isolate themselves from their families within their homes.	Dr. Ahmed said Canadian officials should consider limiting the number of times health care workers can cross the border, encouraging more of them to stay in Detroit hotels, barring part-timers from crossing and possibly requiring that international commuters isolate themselves from their families within their homes.
“It’s not about saying, ‘Just stop everything and we shouldn’t provide any service,’” Dr. Ahmed said. “It’s about how do we minimize the risk.”	“It’s not about saying, ‘Just stop everything and we shouldn’t provide any service,’” Dr. Ahmed said. “It’s about how do we minimize the risk.”