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| Major Outbreak in San Francisco Shelter Underlines Danger for the Homeless | Major Outbreak in San Francisco Shelter Underlines Danger for the Homeless |
| (3 days later) | |
| SAN FRANCISCO — Seventy people at San Francisco’s largest homeless shelter have tested positive for the coronavirus, Mayor London Breed said on Friday. | SAN FRANCISCO — Seventy people at San Francisco’s largest homeless shelter have tested positive for the coronavirus, Mayor London Breed said on Friday. |
| The outbreak, which included two staff members, is the largest reported at a single shelter in the United States. It reinforces a major fear that homeless people, many of whom have pre-existing respiratory illnesses, are especially vulnerable to the pandemic. | The outbreak, which included two staff members, is the largest reported at a single shelter in the United States. It reinforces a major fear that homeless people, many of whom have pre-existing respiratory illnesses, are especially vulnerable to the pandemic. |
| Advocates in San Francisco, where there are more than 8,000 homeless people, had expressed concern in recent weeks that the city had not moved quickly enough to use empty hotel rooms to thin out the shelter system. | Advocates in San Francisco, where there are more than 8,000 homeless people, had expressed concern in recent weeks that the city had not moved quickly enough to use empty hotel rooms to thin out the shelter system. |
| California has procured more than 8,000 hotel rooms for homeless people and those who need to quarantine themselves, far short of the more than 100,000 people in the state who sleep on the streets. | California has procured more than 8,000 hotel rooms for homeless people and those who need to quarantine themselves, far short of the more than 100,000 people in the state who sleep on the streets. |
| The shelter where the outbreak occurred, Multi-Service Center South, normally houses around 400 people. In recent weeks, the city had reduced that number of occupants to 144, all of whom were tested on Friday. | The shelter where the outbreak occurred, Multi-Service Center South, normally houses around 400 people. In recent weeks, the city had reduced that number of occupants to 144, all of whom were tested on Friday. |
| The outbreak underlined the breathtaking speed at which the virus can spread in a congregate setting. | The outbreak underlined the breathtaking speed at which the virus can spread in a congregate setting. |
| Dr. Grant Colfax, the director of the San Francisco Department of Public Health, said the city tested residents of the shelter on Wednesday and again on Friday. | Dr. Grant Colfax, the director of the San Francisco Department of Public Health, said the city tested residents of the shelter on Wednesday and again on Friday. |
| “On Wednesday there were five positive cases,” Dr. Colfax said. “Today there are 70.” | “On Wednesday there were five positive cases,” Dr. Colfax said. “Today there are 70.” |
| New York City, which has the country’s largest homeless population, has identified coronavirus cases in dozens of shelters. In Silicon Valley, a homeless person living in an encampment died of the disease. At least a dozen homeless people have tested positive for the virus in Los Angeles County, according to authorities. | New York City, which has the country’s largest homeless population, has identified coronavirus cases in dozens of shelters. In Silicon Valley, a homeless person living in an encampment died of the disease. At least a dozen homeless people have tested positive for the virus in Los Angeles County, according to authorities. |
| San Francisco has deployed a dual strategy in trying to protect its homeless population, spacing out beds in homeless shelters and lifting its ban on tent encampments. Many streets, largely empty of other residents, are now lined with camping tents that city workers make sure are kept at least six feet apart. | San Francisco has deployed a dual strategy in trying to protect its homeless population, spacing out beds in homeless shelters and lifting its ban on tent encampments. Many streets, largely empty of other residents, are now lined with camping tents that city workers make sure are kept at least six feet apart. |
| “We are no longer trying to break up encampments, whether it’s one tent or 15 tents,” said Jeff Kositsky, a city official charged with managing the coronavirus response for the roughly 5,000 people in San Francisco who sleep on the streets. | “We are no longer trying to break up encampments, whether it’s one tent or 15 tents,” said Jeff Kositsky, a city official charged with managing the coronavirus response for the roughly 5,000 people in San Francisco who sleep on the streets. |
| “We are trying to stay focused on letting people shelter in place.” | “We are trying to stay focused on letting people shelter in place.” |
| Experts say cities face a dilemma in addressing the homelessness crisis during the pandemic. Bringing people indoors offers access to showers and bathrooms but might also make the virus more transmissible. | Experts say cities face a dilemma in addressing the homelessness crisis during the pandemic. Bringing people indoors offers access to showers and bathrooms but might also make the virus more transmissible. |
| “The shelters present a greater risk of transmission because you have people interacting and sleeping in close quarters,” said Linsey Marr, an expert in airborne disease transmission at Virginia Tech. “You have much greater density of people.” | “The shelters present a greater risk of transmission because you have people interacting and sleeping in close quarters,” said Linsey Marr, an expert in airborne disease transmission at Virginia Tech. “You have much greater density of people.” |
| Mr. Kositsky said that in addition to homeless people, hundreds of city employees charged with looking after them were also vulnerable to the virus. | Mr. Kositsky said that in addition to homeless people, hundreds of city employees charged with looking after them were also vulnerable to the virus. |
| “I’m out with the outreach workers and none of us have protective gear,” he said. | “I’m out with the outreach workers and none of us have protective gear,” he said. |
| Last week in downtown San Francisco, Melvin Caldwell, who works in homeless outreach, asked a dozen people sitting on a sidewalk whether they had enough food. As he handed out fliers urging people to be mindful of hygiene and social distancing, a voice came from inside a nearby tent: “People are dying from this thing?” | Last week in downtown San Francisco, Melvin Caldwell, who works in homeless outreach, asked a dozen people sitting on a sidewalk whether they had enough food. As he handed out fliers urging people to be mindful of hygiene and social distancing, a voice came from inside a nearby tent: “People are dying from this thing?” |
| Mr. Caldwell said he was concerned about contracting the virus because his wife had an autoimmune disease. | Mr. Caldwell said he was concerned about contracting the virus because his wife had an autoimmune disease. |
| 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. |
| “Her thing right now is to be super cautious,” he said. “She wants me to keep my distance from people.” | “Her thing right now is to be super cautious,” he said. “She wants me to keep my distance from people.” |
| With most commuters no longer coming into the city and residents sheltering in their condominiums, homeless people make up the vast majority of people on downtown San Francisco sidewalks. | With most commuters no longer coming into the city and residents sheltering in their condominiums, homeless people make up the vast majority of people on downtown San Francisco sidewalks. |
| “I didn’t think it would come to this,” said Dawn Koch, who sat on a sidewalk on Main Street last week. “To see nobody walking around — it’s weird.” | “I didn’t think it would come to this,” said Dawn Koch, who sat on a sidewalk on Main Street last week. “To see nobody walking around — it’s weird.” |
| Ms. Koch, 44, who has been homeless for most of her adult life, said the shuttered shops and restaurants in the city had reduced the number of places where people could use bathrooms. San Francisco has placed portable handwashing stations around the city. | Ms. Koch, 44, who has been homeless for most of her adult life, said the shuttered shops and restaurants in the city had reduced the number of places where people could use bathrooms. San Francisco has placed portable handwashing stations around the city. |
| The announcement of the outbreak on Friday was in contrast to encouraging signs in California that stay-at-home orders have succeeded in reducing the number of hospitalizations. Gov. Gavin Newsom said he would soon announce how the stay-at-home orders would be modified. | The announcement of the outbreak on Friday was in contrast to encouraging signs in California that stay-at-home orders have succeeded in reducing the number of hospitalizations. Gov. Gavin Newsom said he would soon announce how the stay-at-home orders would be modified. |
| The state reported a 1.1 percent increase in admissions to intensive care units a day after recording a slight decrease. There were 49 deaths over the past 24 hours, bringing the state’s total to 541. | The state reported a 1.1 percent increase in admissions to intensive care units a day after recording a slight decrease. There were 49 deaths over the past 24 hours, bringing the state’s total to 541. |