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How Coronavirus Infected Some, but Not All, in a Restaurant How Coronavirus Infected Some, but Not All, in a Restaurant
(3 days later)
In January, at a restaurant in Guangzhou, China, one diner infected with the novel coronavirus but not yet feeling sick appeared to have spread the disease to nine other people. One of the restaurant’s air-conditioners apparently blew the virus particles around the dining room.In January, at a restaurant in Guangzhou, China, one diner infected with the novel coronavirus but not yet feeling sick appeared to have spread the disease to nine other people. One of the restaurant’s air-conditioners apparently blew the virus particles around the dining room.
There were 73 other diners who ate that day on the same floor of the five-story restaurant, and the good news is they did not become sick. Neither did the eight employees who were working on the floor at the time.There were 73 other diners who ate that day on the same floor of the five-story restaurant, and the good news is they did not become sick. Neither did the eight employees who were working on the floor at the time.
Chinese researchers described the incident in a paper that is to be published in the July issue of the Emerging Infectious Diseases, a journal published by the Centers for Disease Control and Prevention. The field study has limitations. The researchers, for example, did not perform experiments to simulate the airborne transmission.Chinese researchers described the incident in a paper that is to be published in the July issue of the Emerging Infectious Diseases, a journal published by the Centers for Disease Control and Prevention. The field study has limitations. The researchers, for example, did not perform experiments to simulate the airborne transmission.
That outbreak illustrates some of the challenges that restaurants will face when they try to reopen. Ventilation systems can create complex patterns of airflow and keep viruses aloft, so simply spacing tables six feet apart — the minimum distance that the C.D.C. advises you keep from other people — may not be sufficient to safeguard restaurant patrons.That outbreak illustrates some of the challenges that restaurants will face when they try to reopen. Ventilation systems can create complex patterns of airflow and keep viruses aloft, so simply spacing tables six feet apart — the minimum distance that the C.D.C. advises you keep from other people — may not be sufficient to safeguard restaurant patrons.
The social nature of dining out could increase the risk. The longer people linger in a contaminated area, the more virus particles they would likely inhale. Eating is also one activity that cannot be accomplished while wearing a mask. Virus-laden droplets can be expelled into the air through breathing and talking, not just through coughs and sneezes.The social nature of dining out could increase the risk. The longer people linger in a contaminated area, the more virus particles they would likely inhale. Eating is also one activity that cannot be accomplished while wearing a mask. Virus-laden droplets can be expelled into the air through breathing and talking, not just through coughs and sneezes.
As the C.D.C. now advises, “Avoid large and small gatherings in private places and public spaces, such a friend’s house, parks, restaurants, shops, or any other place.”As the C.D.C. now advises, “Avoid large and small gatherings in private places and public spaces, such a friend’s house, parks, restaurants, shops, or any other place.”
On the other hand, all of the people who became sick at the restaurant in China were either at the same table as the infected person or at one of two neighboring tables. The fact that people farther away remained healthy is a hopeful hint that the coronavirus is primarily transmitted through larger respiratory droplets, which fall out of the air more quickly than smaller droplets known as aerosols, which can float for hours.On the other hand, all of the people who became sick at the restaurant in China were either at the same table as the infected person or at one of two neighboring tables. The fact that people farther away remained healthy is a hopeful hint that the coronavirus is primarily transmitted through larger respiratory droplets, which fall out of the air more quickly than smaller droplets known as aerosols, which can float for hours.
“I think it’s a well-done study with the limitations of being a field study,” said Werner E. Bischoff, the medical director of infection prevention and health system epidemiology at the Wake Forest School of Medicine in North Carolina. Dr. Bischoff was not involved with the research.“I think it’s a well-done study with the limitations of being a field study,” said Werner E. Bischoff, the medical director of infection prevention and health system epidemiology at the Wake Forest School of Medicine in North Carolina. Dr. Bischoff was not involved with the research.
On Jan. 24, a family went to lunch at the restaurant in Guangzhou, a sprawling metropolis in southern China located 80 miles from Hong Kong.On Jan. 24, a family went to lunch at the restaurant in Guangzhou, a sprawling metropolis in southern China located 80 miles from Hong Kong.
The family had left Wuhan, 520 miles to the north and the hot spot of the initial coronavirus outbreak, one day before Chinese officials imposed a lockdown on the city and the surrounding province of Hubei to slow the spread of the disease.The family had left Wuhan, 520 miles to the north and the hot spot of the initial coronavirus outbreak, one day before Chinese officials imposed a lockdown on the city and the surrounding province of Hubei to slow the spread of the disease.
At lunch, the five members of the family — designated Family A in the paper — appeared healthy. But later in the day, one of them, a 63-year-old woman, experienced a fever and a cough and went to the hospital where she tested positive for the coronavirus.At lunch, the five members of the family — designated Family A in the paper — appeared healthy. But later in the day, one of them, a 63-year-old woman, experienced a fever and a cough and went to the hospital where she tested positive for the coronavirus.
Within two weeks, nine others who ate lunch on that floor of the Guangzhou restaurant that day also tested positive. Four were relatives of the first infected woman. They could have been infected outside of the restaurant.Within two weeks, nine others who ate lunch on that floor of the Guangzhou restaurant that day also tested positive. Four were relatives of the first infected woman. They could have been infected outside of the restaurant.
But for the other five, the restaurant appears to have been the source of the virus.But for the other five, the restaurant appears to have been the source of the virus.
Family A’s table was on the west side of the 1,500-square foot dining room, between tables where two unrelated families, B and C, were also having lunch. Family B and Family A overlapped for a period of 53 minutes, and three of its members — a couple and their daughter — became sick. Family C sat next to Family A at the other neighboring table along the same side the room, overlapping for 73 minutes, and two of its members — a mother and her daughter — became ill.Family A’s table was on the west side of the 1,500-square foot dining room, between tables where two unrelated families, B and C, were also having lunch. Family B and Family A overlapped for a period of 53 minutes, and three of its members — a couple and their daughter — became sick. Family C sat next to Family A at the other neighboring table along the same side the room, overlapping for 73 minutes, and two of its members — a mother and her daughter — became ill.
An air-conditioning unit next to Family C blew air in the southward direction across all three tables; some of the air likely bounced off the wall, back in the direction of Family C.An air-conditioning unit next to Family C blew air in the southward direction across all three tables; some of the air likely bounced off the wall, back in the direction of Family C.
Updated June 2, 2020 Updated June 5, 2020
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.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
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.
Because the coronavirus had not yet spread widely beyond Wuhan, public health officials were able to trace the recent contacts of Families B and C and determine that the restaurant was the only likely place where they would have crossed paths with the virus.Because the coronavirus had not yet spread widely beyond Wuhan, public health officials were able to trace the recent contacts of Families B and C and determine that the restaurant was the only likely place where they would have crossed paths with the virus.
The researchers did not state in the paper whether any of the other diners who did not contract the coronavirus were members of the three affected families or if they were all customers at 12 other tables. The 73 people were quarantined for 14 days and did not develop symptoms.The researchers did not state in the paper whether any of the other diners who did not contract the coronavirus were members of the three affected families or if they were all customers at 12 other tables. The 73 people were quarantined for 14 days and did not develop symptoms.
“We conclude that in this outbreak, droplet transmission was prompted by air-conditioned ventilation,” the authors wrote. “The key factor for infection was the direction of the airflow.”“We conclude that in this outbreak, droplet transmission was prompted by air-conditioned ventilation,” the authors wrote. “The key factor for infection was the direction of the airflow.”
Harvey V. Fineberg, who leads the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats at the National Academies of Sciences, Engineering and Medicine, described the report as “provocative and eye-opening.”Harvey V. Fineberg, who leads the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats at the National Academies of Sciences, Engineering and Medicine, described the report as “provocative and eye-opening.”
He said restaurants should be mindful of the direction of airflow in arranging tables. Germicidal ultraviolet lights could also be installed to destroy floating virus particles, Dr. Fineberg said. And the paper’s findings could have implications beyond restaurants.He said restaurants should be mindful of the direction of airflow in arranging tables. Germicidal ultraviolet lights could also be installed to destroy floating virus particles, Dr. Fineberg said. And the paper’s findings could have implications beyond restaurants.
“It’s illuminating for the kind of thing we need to keep learning about as we try to configure safe work spaces,” Dr. Fineberg said. “Not just safe restaurant and entertainment venues but where you go to work.”“It’s illuminating for the kind of thing we need to keep learning about as we try to configure safe work spaces,” Dr. Fineberg said. “Not just safe restaurant and entertainment venues but where you go to work.”
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