Rising unemployment rates, continued deliberations on another federal relief package, and schools implementing remote learning after on-campus spikes in case rates marked an eventful week in the COVID-19 pandemic response. Researchers also made significant findings on the efficacy of protective face masks and the disparate impacts COVID-19 has on Black and White communities.
Unemployment Claims Rise
Earlier this month President Trump released an executive order to address the economic downturn that has driven millions to file for unemployment. Per the Department of Labor (DOL), for the first time in several weeks, the number of unemployment applications has increased and jumped to 1.1 million claims last week. Currently, more than 28 million individuals are receiving unemployment benefits. President Trump’s executive order required states who wanted $300 from the federal government of the $400 unemployment benefit to pick up the $100 difference. DOL estimates it will take states up to three weeks to make appropriate adjustments to accommodate for this new expense. This week seven states have been approved to receive these funds from the federal government: Iowa, Arizona, New Mexico, Louisiana, Utah, Colorado, and Missouri
Schools Going Remote After Rise in Cases
As back-to-school season began this month, schools planned to take extra precautions to safeguard their students; however, it has proven to be insufficient. Children are getting infected at a greater percentage, and major outbreaks and infection clusters are being seen in school districts. A similar trend is being seen in universities who are welcoming thousands of students to start their fall semester. Many colleges are partnering with their state health departments to implement a contact-tracing app for students to use. What was thought to be a mechanism that will be easily adopted by the very tech-savvy college student has presented more challenges than expected. Between college students’ reluctance to disclose their weekend plans in fear of getting in trouble and the specter of potential privacy law issues, compliance and uptake has been lower than expected.
Senate COVID-19 Response Bill
Senate Republicans are circulating a slimmed-down COVID-19 stimulus package to serve as their response to the House Democrat’s $25 billion Postal Service funding bill the House will consider on Saturday. This “skinny” plan, which has not yet been formally released by Republicans, doesn’t include the $1,200 checks included in a roughly $1 trillion Republican proposal known as the HEALS Act. The package will most likely fail to reach consensus amongst congressional leaders within the House and the Senate but could potentially be attached to a September stopgap spending bill needed to keep the government open after September 30. Congress is currently in recess as members campaign leading up to November elections. It is unlikely that the “skinny” package will have enough momentum to force members of Congress to fly back to D.C. to vote on passage, but rather, the “skinny” plan will be used to progress discussions in September.
Higher Rate of COVID-19 Infection and Death in Black Americans Linked to Medical Care Access
An extensive study across states and hospitals found that there is no significant difference in in-hospital all-cause mortality rates between Black and White COVID-19 patients. The study took into account co-morbidities, age, and other factors. As overall numbers of cases and deaths is highest among Black patients, the study suggests the importance of access to hospitals and medical care.
Sterilized or Expired N95 Masks Still Effective Protecting Against COVID-19
A recent study of several fitted face masks “alternatives” has demonstrated that expired N95 respirators with elastic bands and ethylene oxide or hydrogen peroxide sterilized N95 masks exhibit similar efficacy in filtering particles and aerosols as new N95 masks, and could thus be considered for use in situations where, for example, PPE rationing is needed. Other face masks studied included imported non-NIOSH-approved masks and surgical masks with head ties and ear loops, all of which demonstrated much less effective filtration. Data showed that appropriate size and fit to the face was also important to filtration efficiency. This study adds to other studies that have investigated fitted face mask re-use after gamma irradiation and chlorine dioxide treatment, the latter also looking at aerosol size.
FDA Releases Guidance on the Manufacturing, Distribution and Selection of Masks for Health Care Use
Related, this week the Food and Drug Administration (FDA) issued some respirator-related decision trees. One decision tree is designed to assist respirator manufacturers in understanding the need for NIOSH approval and FDA authorization based on type of respirator and domestic versus foreign manufacture. A second decision tree provides a process flow to assist health care facilities in respirator understanding, identification and selection. It poses a hierarchy of respirator types and information on emergency use authorizations (EUAs) regarding respirator types.
Yes, It’s Safe to See Your Doctor in Person
During the pandemic, fear of infection has led many people to cancel or avoid scheduling medical appointments, be it for regular health maintenance (e.g., annual checkups, dental cleanings) or medical treatments unrelated to COVID-19, including for serious conditions such as cardiac disease and even in cases of medical emergency. And while some areas have reported a slight rebound in the number of outpatient visits, the numbers still remain well below pre-COVID-19 times. Some caution is justified, as there have been documented COVID-19 infection clusters associated with hospitals, especially when protective measures were not strictly followed. Even before the COVID-19 pandemic, hospital-acquired infections were a serious concern, which led to the development of a series of countermeasures and infection-preventing practices. As we learn more about COVID-19, those guidelines will have to be updated, and in fact such work is already underway.
Some hospitals and health care facilities have developed “quick checklists,” published “lessons learned” and established “best practices” for isolating COVID-19 patients and associated equipment as well as establishing distancing and PPE protocols for all staff and visitors.
Government agencies have issued guidelines, which are being regularly updated as more information is gathered about the course of the disease, routes of transmission, and most effective protective measures. See, for example, Centers for Disease Prevention and Control and Department of Defense guidelines.
Analyzing data from January-April 2020 and focusing specifically on SARS-CoV-2, researchers from Massachusetts have examined records of women accessing health care systems for labor and delivery, comparing infection rates between those who had been visiting their healthcare provider regularly and those who had stayed away. This study found no difference in COVID-19 rates between the two groups, meaning that seeing a healthcare provider in person does not, in itself, increase the rate of SARS-CoV-2 transmission.
