'Rhode Island Pushes Aggressive Testing, a Move That Could Ease Reopening' diff viewer (1/2)

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Rhode Island Pushes Aggressive Testing, a Move That Could Ease Reopening	Rhode Island Pushes Aggressive Testing, a Move That Could Ease Reopening
2020-04-28 21:44:20 UTC	2020-06-29 08:38:18 UTC (2 months later)
Rhode Island gives the appearance of a state where the coronavirus is a fire raging, the average number of daily infections more than quadrupling since the start of this month.	Rhode Island gives the appearance of a state where the coronavirus is a fire raging, the average number of daily infections more than quadrupling since the start of this month.
The reality is more complicated and encouraging, as state health workers have tested more residents per capita in Rhode Island than in any other state, leading them to discover many infections that might have gone overlooked elsewhere.	The reality is more complicated and encouraging, as state health workers have tested more residents per capita in Rhode Island than in any other state, leading them to discover many infections that might have gone overlooked elsewhere.
Extensive testing is seen as an essential tool, experts say, as states contemplate restarting public life, and search for ways to keep a handle on the virus’s path and signs of new outbreaks in the days and weeks that follow. Five percent of Rhode Island’s residents have undergone a test, compared with about 1 percent of people in states like Texas and Georgia, where reopening efforts are taking shape.	Extensive testing is seen as an essential tool, experts say, as states contemplate restarting public life, and search for ways to keep a handle on the virus’s path and signs of new outbreaks in the days and weeks that follow. Five percent of Rhode Island’s residents have undergone a test, compared with about 1 percent of people in states like Texas and Georgia, where reopening efforts are taking shape.
“Rhode Island is shining a light into the dark in a way that very few other states are doing,” said Mark Lurie, a professor of epidemiology at Brown University in Providence. Rhode Island has been conducting an average of 283 tests per 100,000 residents a day, compared with 79 tests per 100,000 people in the United States over all.	“Rhode Island is shining a light into the dark in a way that very few other states are doing,” said Mark Lurie, a professor of epidemiology at Brown University in Providence. Rhode Island has been conducting an average of 283 tests per 100,000 residents a day, compared with 79 tests per 100,000 people in the United States over all.
To be sure, Rhode Island’s relatively small population — just over a million people — makes it easier to carry out testing on a high percentage of residents, but the state’s focus has grown intense.	To be sure, Rhode Island’s relatively small population — just over a million people — makes it easier to carry out testing on a high percentage of residents, but the state’s focus has grown intense.
“All I hear is testing, testing, testing,” said Dr. Ashish Jha, who is director of Harvard’s Global Health Institute and is helping Rhode Island’s government. “The bottom line is that there is no magic formula and the federal government is too often absent. But there are common lessons from states that have done a good job.”	“All I hear is testing, testing, testing,” said Dr. Ashish Jha, who is director of Harvard’s Global Health Institute and is helping Rhode Island’s government. “The bottom line is that there is no magic formula and the federal government is too often absent. But there are common lessons from states that have done a good job.”
On Monday, Gov. Gina Raimondo said that she intended in two weeks to begin the painstaking process of reopening Rhode Island’s economy, depending on how the situation looks in the coming days. “It’s not going to be a flick of the switch,” she said, cautioning that an uptick in hospitalizations could force her to delay. “It’s going to be slow, pinpointed, gradual.”	On Monday, Gov. Gina Raimondo said that she intended in two weeks to begin the painstaking process of reopening Rhode Island’s economy, depending on how the situation looks in the coming days. “It’s not going to be a flick of the switch,” she said, cautioning that an uptick in hospitalizations could force her to delay. “It’s going to be slow, pinpointed, gradual.”
And all decisions going forward, Ms. Raimondo said, will rest on a foundation of testing and more testing, and tracing infections.	And all decisions going forward, Ms. Raimondo said, will rest on a foundation of testing and more testing, and tracing infections.
For the moment Rhode Island, the nation’s smallest state, walks an uncertain path. The mayors of its densely packed and polyglot cities speak of rising rates of infection. Last week, health officials announced that workers at Taylor Farms New England, which packs salads and produce for supermarkets in North Kingstown, had tested positive for the virus. By Sunday, 133 cases had been reported in connection with the facility.	For the moment Rhode Island, the nation’s smallest state, walks an uncertain path. The mayors of its densely packed and polyglot cities speak of rising rates of infection. Last week, health officials announced that workers at Taylor Farms New England, which packs salads and produce for supermarkets in North Kingstown, had tested positive for the virus. By Sunday, 133 cases had been reported in connection with the facility.
Statewide, hospitalizations appear to have peaked a week ago at 277, and have dropped slightly.	Statewide, hospitalizations appear to have peaked a week ago at 277, and have dropped slightly.
Deaths from the virus reached a daily peak of 19 in Rhode Island earlier this month, according to a New York Times tally, and fell to as low as five on one day last week. By Monday, 7,708 people in Rhode Island were reported to have tested positive for the virus and 233 people had died.	Deaths from the virus reached a daily peak of 19 in Rhode Island earlier this month, according to a New York Times tally, and fell to as low as five on one day last week. By Monday, 7,708 people in Rhode Island were reported to have tested positive for the virus and 233 people had died.
In its accomplishments and struggles, Rhode Island represents much that is confounding about confronting this virus. Like most of the governors in the Northeast, Ms. Raimondo was reluctant to issue a shelter-in-place order in mid-March, hoping that social distancing and the careful tracking of routes of infection might forestall a crushing shutdown of the economy.	In its accomplishments and struggles, Rhode Island represents much that is confounding about confronting this virus. Like most of the governors in the Northeast, Ms. Raimondo was reluctant to issue a shelter-in-place order in mid-March, hoping that social distancing and the careful tracking of routes of infection might forestall a crushing shutdown of the economy.
She soon reversed herself, closing parks and tartly advising people crowding beaches and backyards to “knock it off.” On March 28, she ordered all but essential businesses and employees to shelter in place, saying: “This is going to get very real very fast for all of us.”	She soon reversed herself, closing parks and tartly advising people crowding beaches and backyards to “knock it off.” On March 28, she ordered all but essential businesses and employees to shelter in place, saying: “This is going to get very real very fast for all of us.”
A week later, Ms. Raimondo and Nicole Alexander-Scott, her health commissioner, made a concerted effort to ramp up testing after Rhode Island had trailed some other New England states on that front. State officials across the nation have struggled to acquire and administer large numbers of tests, two steps considered essential in stopping the spread of the virus and reopening economies. Rhode Island officials said they were uncertain about what the testing regimen would cost, as they were pulling it together quickly from private-sector donations, including CVS Pharmacy, and federal stimulus dollars.	A week later, Ms. Raimondo and Nicole Alexander-Scott, her health commissioner, made a concerted effort to ramp up testing after Rhode Island had trailed some other New England states on that front. State officials across the nation have struggled to acquire and administer large numbers of tests, two steps considered essential in stopping the spread of the virus and reopening economies. Rhode Island officials said they were uncertain about what the testing regimen would cost, as they were pulling it together quickly from private-sector donations, including CVS Pharmacy, and federal stimulus dollars.
In recent weeks, Ms. Raimondo, who has a background as a data-driven venture capitalist, has regularly urged residents to keep a journal of all people they encounter each day, in case they test positive for the virus and health workers need to track down their contacts. Amid the crisis, Ms. Raimondo’s approval rating has risen to 80 percent, in one survey, from scraping by last fall with 36 percent.	In recent weeks, Ms. Raimondo, who has a background as a data-driven venture capitalist, has regularly urged residents to keep a journal of all people they encounter each day, in case they test positive for the virus and health workers need to track down their contacts. Amid the crisis, Ms. Raimondo’s approval rating has risen to 80 percent, in one survey, from scraping by last fall with 36 percent.
“She’s a no-baloney technocrat,” said Ross Cheit, a professor in Brown University’s public policy program. “She’s not charming but she’s really smart, and that’s made her really popular now.”	“She’s a no-baloney technocrat,” said Ross Cheit, a professor in Brown University’s public policy program. “She’s not charming but she’s really smart, and that’s made her really popular now.”
Of late, state and local officials have turned their focus on testing to Pawtucket and Central Falls — dense, working-class cities nestled along the Seekonk River. These cities have multigenerational immigrant families, from Central America, Cape Verde and a dozen African nations, and many live tightly packed.	Of late, state and local officials have turned their focus on testing to Pawtucket and Central Falls — dense, working-class cities nestled along the Seekonk River. These cities have multigenerational immigrant families, from Central America, Cape Verde and a dozen African nations, and many live tightly packed.
In Pawtucket, a city of 70,000 people, 570 residents have tested positive, second only to Providence, the state’s largest city.	In Pawtucket, a city of 70,000 people, 570 residents have tested positive, second only to Providence, the state’s largest city.
“We have police going old-school, cruising around with their microphones going, telling them to distance, to wash hands and that free testing is available,” Mayor Donald R. Grebien of Pawtucket said.	“We have police going old-school, cruising around with their microphones going, telling them to distance, to wash hands and that free testing is available,” Mayor Donald R. Grebien of Pawtucket said.
The two cities now have platoons of workers trying to contact all residents, and in their native languages. The object is to persuade those who are symptomatic to get tested. To this end, they have placed a testing site in the middle of both cities, an approach that is critical because nearly one-fifth of residents do not have cars. Testing is free with a referral, and anyone who needs a lift to the site can get one. Providence also added a walk-up testing center last week.	The two cities now have platoons of workers trying to contact all residents, and in their native languages. The object is to persuade those who are symptomatic to get tested. To this end, they have placed a testing site in the middle of both cities, an approach that is critical because nearly one-fifth of residents do not have cars. Testing is free with a referral, and anyone who needs a lift to the site can get one. Providence also added a walk-up testing center last week.
	Updated June 24, 2020
	Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
	A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
	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.
	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.
	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.
	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 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.
Once a resident has tested positive, officials begin the painstaking task of trying to trace whom the person came in contact with. “It’s been a herculean effort,” Ms. Raimondo said in a briefing. “It’s very labor intensive.”	Once a resident has tested positive, officials begin the painstaking task of trying to trace whom the person came in contact with. “It’s been a herculean effort,” Ms. Raimondo said in a briefing. “It’s very labor intensive.”
Rhode Island is one of the few states to attempt such widespread testing and tracing. New York City until recently confined most of its testing to those who showed up at hospitals, the sickest of the sick. Perhaps as a result, Rhode Island’s test results show infections near evenly distributed by age, without a tilt toward the oldest and sickest that is seen in most cities.	Rhode Island is one of the few states to attempt such widespread testing and tracing. New York City until recently confined most of its testing to those who showed up at hospitals, the sickest of the sick. Perhaps as a result, Rhode Island’s test results show infections near evenly distributed by age, without a tilt toward the oldest and sickest that is seen in most cities.
Ahead for the state is figuring out how to merge its elaborate testing program with a plan to reopen.	Ahead for the state is figuring out how to merge its elaborate testing program with a plan to reopen.
Ms. Raimondo and other officials have taken pains to make clear that the first months back will not resemble anything like pre-virus life. Retail stores could open for pickup of preordered items; restaurants with outdoor seating might soon be allowed to experiment. Each decision will entail a speculative, precarious calculus as the state tries to avoid new outbreaks. “We’re about to enter a whole new era of work,” she said.	Ms. Raimondo and other officials have taken pains to make clear that the first months back will not resemble anything like pre-virus life. Retail stores could open for pickup of preordered items; restaurants with outdoor seating might soon be allowed to experiment. Each decision will entail a speculative, precarious calculus as the state tries to avoid new outbreaks. “We’re about to enter a whole new era of work,” she said.
To some extent, the many unionized city employees who have worked through the shutdown, in offices and on bridges and roads, have pioneered this new way of work life: They wear masks and gloves and have their temperature taken every day. Working hours are staggered, and meals are solitary affairs.	To some extent, the many unionized city employees who have worked through the shutdown, in offices and on bridges and roads, have pioneered this new way of work life: They wear masks and gloves and have their temperature taken every day. Working hours are staggered, and meals are solitary affairs.
“We police it pretty tight,” said Michael Sabitoni, president of the Rhode Island Building & Construction Trades Council, which represents 16 unions. “This is not the old life.”	“We police it pretty tight,” said Michael Sabitoni, president of the Rhode Island Building & Construction Trades Council, which represents 16 unions. “This is not the old life.”