We took a deeper look at how difficult it might be for people to navigate their way through the U.S.‘s patchwork of social safety net measures as they try to stay afloat during the pandemic and economic downturn. Here are four gaps that we found:
1. Delays, exemptions to financial aid
Congress passed stimulus measures that are providing some Americans with a one-time check of up to $1,200 per adult and $500 per dependent child along with a temporary boost in unemployment benefits. Many received their stimulus through direct deposit, but millions of low-income Americans experienced problems and delays receiving payment. As many as 20 million may have had stimulus deposits go to tax preparers who take a fee out of refunds because clients are too poor to pay for tax prep up front. There are a variety of other reasons for delays: if individuals haven’t filed their 2019 tax returns yet, if their address has changed recently or if they don’t have a bank account.
Workers in more than half of states will receive, on average, more in unemployment benefits than their normal salaries. But there are challenges to receiving unemployment benefits too, as the rules vary from state to state and labor agencies are struggling to keep up with unemployment filings. There are also thresholds for minimum earnings to qualify and limits on how long a person can collect unemployment.
2. Free testing but costly treatment?
Congress mandated that private insurance cover testing at no cost, but not treatment. Infected? Get your deductible ready. Many will count on Medicaid, which typically covers medical bills retroactively for three months prior to application if you were eligible, but people in states that have broad restrictions on retroactive coverage could be left holding the bag. And anyone in the process of getting their Medicaid coverage renewed might be concerned, to say nothing of the nearly 30 million Americans uninsured before the crisis.
And none of this funding even addresses those who develop long-term complications that require ongoing care.
3. Unemployed and uninsured
Losing employment and health insurance coverage counts as a qualifying event to sign up for health insurance through HealthCare.gov or a state-based marketplace, but that assumes people know that they can. The Trump administration has avoided any broad reopening of enrollment, but several states have done so. Laid-off employees may have the option of extending their former employer’s health insurance through COBRA, but this tends to be more expensive and unsustainable.
Two recent studies project that nearly 20 million Americans may face disruptions in employer-based health insurance, with as many as 11 million becoming uninsured. For those newly uninsured, living in a Medicaid expansion state like New York or California might mean you are OK. But even before the pandemic, there were already an estimated 2.3 million people living in nonexpansion states like Texas or Florida who fell into the coverage gap – making too much money to qualify for Medicaid and yet not enough to afford coverage.
4. Safe from eviction, but for how long?
Stay-at-home orders have been seen as key in slowing the spread, but rely on the false assumption that everyone has access to safe and stable housing. Some people looking for affordable housing placements in March and April found themselves in limbo, with progress on paperwork suddenly stalled. For those with housing, unpaid rent was up 50% in April over March. Many large cities and states have temporarily halted evictions and a federal eviction ban covers about a quarter of rental housing. But this is only for nonpayment, leaving a loophole for landlords to continue pursuing eviction for other reasons. And that one-time stimulus check won’t even cover the median monthly rent in a number of states, especially in parts of California and the New York City metro area. So what happens when the check has been spent and the eviction ban is lifted?
A solution
What if these safety net programs were better integrated? Imagine if filing for unemployment triggered a next step – either presenting a series of subsidized health plan options through HealthCare.gov or auto-enrolling those eligible in Medicaid. It would potentially alleviate administrative burden and address gaps in information. States could use a mechanism like Express Lane Eligibility, which allows officials to use information provided from one state agency to make eligibility determinations for Medicaid, though there are good reasons – mostly solvable – why many states haven’t yet.
The U.S.’s social safety net is more a loose patchwork unprepared to handle a crisis like the pandemic, relying on disconnected public programs and old technology. The federal government is relying on short-term measures directed to those affected by the crisis, but we believe it does little to address the plight of those who were already economically vulnerable and those who will be long after this pandemic.
Disaster preparedness isn’t just the National Guard, personal protective equipment and bottled water anymore. This pandemic has shown that it is now also the ability to keep people economically afloat through a potentially prolonged and sudden financial crisis.
Cecille Joan Avila, a policy analyst at Boston University School of Public Health, contributed to this article. Her research for this piece was supported by the Laura and John Arnold Foundation.
President Donald Trump for months has been touting the benefits of taking hydroxychloroquine as a treatment for COVID-19.
However, a massive new study published in the medical journal Lancet has found that treating COVID-19 patients with hydroxychloroquine results in a "significantly higher risk of death."
As the Washington Post reports, the study is based on examining health outcomes from 96,000 COVID-infected patients across the world.
And the study's findings didn't show just minor differences between patients who took hydroxychloroquine and those who didn't.
"For those given hydroxychloroquine, there was a 34 percent increase in risk of mortality and a 137 percent increased risk of a serious heart arrhythmias," the Post writes. "For those receiving hydroxychloroquine and an antibiotic — the cocktail endorsed by Trump — there was a 45 percent increased risk of death and a 411 percent increased risk of serious heart arrhythmias."
Although it is not a controlled study, its sample size is so large that many scientists say it should nonetheless be taken seriously.
“It’s one thing not to have benefit, but this shows distinct harm,” Eric Topol, a cardiologist and director of the Scripps Research Translational Institute, tells the Post. “If there was ever was hope for this drug, this is the death of it.”
And David Maron, director of preventive cardiology at the Stanford University School of Medicine, tells the Post that the study provides "absolutely no reason for optimism that these drugs might be useful in the prevention or treatment of COVID-19."
Economist Nouriel Roubini, who became famous after correctly predicting that a bursting housing bubble would cause a global financial crisis, has issued a dire warning about what will happen to the economy in the wake of the COVID-19 pandemic.
As New York Magazine's Eric Levitz reports, Roubini is predicting that the current recession will morph into a full-scale economic depression that will devastate societies across the globe.
"He foresees a slow, lackluster (i.e., 'U-shaped') economic rebound in the pandemic’s immediate aftermath," Levitz writes. "But he insists that this recovery will quickly collapse beneath the weight of the global economy’s accumulated debts. Specifically, Roubini argues that the massive private debts accrued during both the 2008 crash and COVID-19 crisis will durably depress consumption and weaken the short-lived recovery."
Economic conditions will worsen even more, he argues, when higher inflation kicks in and trade arrangements between the United States and China break down entirely.
And on top of all that, Roubini tells Levitz that disasters brought on by climate change may hammer the economy even further in the coming years.
"The science says these extreme events are becoming more frequent, are coming farther inland, and are doing more damage," he says. "And they are doing this now, not 30 years from now."
A GOP official in Michigan told Politico's Tim Alberta this week that the coronavirus is a "domestic political terrorism" plot aimed at stealing the 2020 election from President Donald Trump.
In an interview, Washtenaw County Republican Party board member Deborah Fuqua-Frey told Alberta that she was suspicious about the way the virus emerged just as the president's impeachment trial was wrapping up earlier this year.
"Isn’t it kind of convenient that as soon as impeachment failed, we’ve suddenly got this virus?" she asked. "This was domestic political terrorism from the Democratic Party."
She then went on to question whether 95,000 Americans had really died from the disease.
"They’ve got all these numbers inflated, especially the deaths," she said. "Nobody can explain why nobody’s dying from other causes anymore. Most of these people who are ‘dying from coronavirus’ aren’t actually dying from coronavirus. It’s domestic political terrorism."
She predicted, however, that the president's voters would be smart enough to see through the ruse of tens of thousands of dead Americans and continue to support the president.
"Trump will be fine," she said. "His voters know better. We aren’t falling for it."
According to a report from the Daily Beast, one of Donald Trump's former wives is talking with friends and associates about the coronavirus pandemic and passing along her findings to the White House.
The report notes that the White House set up a COVID-19 tip line and former Trump wife Marla Maples has been taking advantage of it.
"During the pandemic, Marla Maples, an actress and the president’s second wife, has stayed in touch with a coterie of friends and informal advisers, with whom she has traded tidbits and medical advice on how to combat the virus. In recent weeks, she has quietly transmitted some of those ideas to the Trump White House, in an effort to get them in front of the president—her ex-husband—and senior staffers, two Trump administration officials familiar with the outreach," the Beast reports.
According to the report, it is not known if anything that Maples has shared has reached the President's desk and, if so, whether he has acted upon her tips.
"One of the officials said they first became aware of Maples’s leads after realizing her name had popped up on the 'Covid Mail' tipline, an internal White House email account that is regularly accessed by a small group of Trump officials," the reports states.
"The White House set up 'Covid Mail' to field suggestions and questions from 'friends and family,' as well as from American health professionals and private sector envoys, who are trying to get information on supplies and treatments to the West Wing and federal agencies," the Beast reports. "According to The Washington Post, which first reported on the system last month, 'some officials have privately worried that these [Covid Mail] missives receive priority and distract from more crucial scientific pursuits' regarding the coronavirus."
"A quick browse of Maples’s public social media accounts, including Twitter and Instagram, offers a glimpse into her clique of friendly doctors and health and spirituality consultants. Like many during the coronavirus crisis, she has regularly posted about her and her friends’ perspectives on the illness and has emphasized her own concerns, including the compounding effects that Lyme disease may have on those infected with the virus," the report added.
In an email to the Beast, the former actress simply stated, "PPE is not an area I’m focused on, but the health and well-being of all people is of the highest importance to me. Thank you.”
President Donald Trump pressed for a further reopening of the United States as job losses mount from coronavirus shutdowns, while China's premier warned of "immense" economic challenges even as the Asian giant emerges from the worst of the pandemic.
Calls to kickstart the world's two largest economies came as large parts of Europe continued to resume normal life as the crisis there abates, with more shops opening and beaches welcoming tourists.
But the lifting of restrictions in some places comes despite virus cases passing five million globally, with the disease continuing its march in Latin America and Russia.
Trump, with an eye on his re-election prospects in November, made it clear he hoped more US state governors would move towards a loosening of anti-virus restrictions.
"We did the right thing but we now want to get going... you'll break the country if you don't," he told African-American leaders in Michigan.
AFP / ERNESTO BENAVIDES A worker sweeps the floor next to coffins for Covid-19 victims at El Angel cemetery, in Lima, Peru
Another 2.43 million Americans were put out of work last week, the Labor Department said Thursday, bringing the total of newly jobless to 38.6 million since lockdowns were put in place.
The Republican incumbent also talked about reopening places of worship, something he had initially hoped would be done by Easter Sunday, saying it was important to the nation's healing.
"People want to be in their churches," Trump said. "They're so important in terms of the psyche of our country."
AFP / Brendan Smialowski US President Donald Trump speaks during a tour of the Ford Rawsonville Plant, that has been converted to making personal protection and medical equipment, in Ypsilanti, Michigan
The president has adopted the theme of "Transitioning Back to Greatness" as states reopen at different speeds.
Deaths are still mounting in the US, with the total surpassing 94,000, and Trump ordered flags at federal buildings be flown at half-staff for three days for the victims.
- Return to normal -
Across the Atlantic, much of Europe pressed on with work to get life rolling again, with Cyprus lifting curfews and allowing outdoor restaurants, barber shops and beaches to reopen.
AFP / Philip FONG A visitor wearing a face mask points at masked statues at Yasaka Shrine in Kyoto, Japan
But the Mediterranean island's airports and hotels remain closed.
"I want my work back and my life back," said Sakis Siakopoulos, a restaurant owner in the capital Nicosia.
In Denmark, the exit from lockdown also picked up pace as museums and zoos began reopening and health officials said the spread of the virus was slowing.
AFP / Iakovos Hatzistavrou A man drinks coffee outside a hairdresser's salon in the Cypriot capital Nicosia
France, one of the countries hit hardest by the outbreak, saw its daily death toll dip to 83, providing a cause for optimism.
A closely watched survey by IHS Markit indicated the eurozone economy has now "likely bottomed out", sparking hope that a recovery is to follow.
- 'It doesn't stop' -
But while many European countries have significantly curbed the contagion, Latin America is becoming a new hotspot with cases on the rise.
AFP / Mohammed HUWAIS Yemeni children cheer as a worker wearing a protective gear sprays disinfectant on a car in the capital Sanaa
Brazil -- now home to the third-highest number of cases in the world after the US and Russia -- has recorded more than 20,000 deaths and hit a record 24-hour toll of 1,188.
Grave diggers at a cemetery outside Sao Paulo are scrambling to keep up.
"We've been working 12-hour days, burying them one after the other. It doesn't stop," said one worker at Vila Formosa, wearing a white protective suit, mask and face shield.
AFP / TAUSEEF MUSTAFA Relatives wearing protective gear carry the coffin of a woman who died from COVID-19 into a graveyard in Srinagar
Peru, Mexico and Chile have also seen steady increases in infections.
"It's like a horror film," Miguel Armas, a nurse at the Hipolito Unanue hospital in the Peruvian capital, told AFP.
The death toll worldwide has now surpassed 330,000, according to an AFP tally based on official sources.
- War of words -
Recriminations over the pandemic have continued to fly between the United States and China -- where the outbreak first erupted last year -- with Trump blaming Beijing's "incompetence" for the extent of the global crisis.
AFP / THOMAS COEX Police ask to people to follow physical distancing rules in front of the Hotel des Invalides in Paris
China has rejected that criticism, insisting it has been forthright with the world about the origins of the virus and its work to tackle its spread.
"It is neither responsible nor moral to cover up one's own problems by blaming others," said Zhang Yesui, a spokesman for China's legislature.
On Friday Chinese Premier Li Keqiang took the rare step of not setting an annual economic growth target for the country in light of the "great uncertainty" created by the pandemic.
AFP / Paul ELLIS Medical staff signal from behind a door as they participate in a national "clap for carers" to show thanks for the work of Britain's NHS at Aintree University Hospital in Liverpool, northwest England
At the opening of the National People's Congress he only said Beijing will "give priority to stabilizing employment and ensuring living standards".
"At present, the epidemic has not yet come to an end, while the tasks we face in promoting development are immense," he said.
Virus cases in the Asian giant are now down to a trickle, and Beijing insists its efforts to curb the spread have been a success, but questions remain about whether it underreported the numbers affected by the contagion.
- Second surge -
Governments around the world are testing ways to live long- term with the threat of the virus amid fears of a second wave of infections.
Already a common sight in Spain, masks were officially made mandatory Thursday for anyone over the age of six in public places where social distancing is not possible.
"The more tools we use, the better," said Miguel Domingo, a 49-year-old architect taking his two dogs for a walk in Madrid, which is emerging from one of the toughest lockdowns.
Job losses in the United States are slowing but totaled an unheard-of 38.6 million since the coronavirus pandemic lockdowns began, while officials debate what additional steps will be needed to rescue the beleaguered economy.
Another 2.43 million Americans were put out of work last week, fewer than the previous week but still among the highest figures on record, according to the latest Labor Department data released Thursday.
Meanwhile, other reports showed US housing sales collapsed last month, while manufacturing continues to decline.
Initial claims for unemployment benefits appeared to have passed the peak hit in late March, but economists say joblessness is likely worse than the figures indicate since many people do not qualify for traditional aid.
AFP/File / VALERIE MACON Layoffs caused by the coronavirus in the United States have slowed after hitting their peak in late March, but are still devastating
"The dramatic spike in unemployment claims is trending down, but it still completely overshadows any precedent," Kate Bahn, director of Labor Market Policy at the Center for Equitable Growth, said on Twitter, noting that the latest number was three times higher than the record prior to the pandemic.
Democrats in Congress are calling for the Republican-controlled Senate to pass a $3.3 trillion spending measure approved by the House of Representatives last week to revitalize the economy, but President Donald Trump's administration has rejected the bill as he encourages more state government to loosen the lockdowns.
"We did the right thing, but we now want to get going... you'll break the country if you don't," he told African American leaders in a visit to Michigan, a key election battleground state.
The coronavirus pandemic has killed 93,406 people in the US and infected nearly 1.6 million others, according to John Hopkins University, despite widespread business shutdowns from mid-March to stop the virus's spread.
- Partisan split -
Weekly jobless claims declined but they remain well above any week during the 2008 global financial crisis and are more in line with job losses in the Great Depression last century.
AFP / Jonathan WALTER Unemployment in the US
"Forget the idea that they are coming down. If anyone thinks that 2.5 million new claims is anything but disastrous, they are deluding themselves," economist Joel Naroff said, warning that the economy is in the midst of a second round of layoffs.
The latest weekly number also does not include the 2.22 million people who applied for a federal program aimed at contractors and self-employed workers who would not normally qualify for traditional benefits.
House Speaker Nancy Pelosi pushed to approve the Heroes Act that includes $1 trillion for state and local governments, funds for hospitals, hazard pay for health workers, relief for devastated small businesses and another round of cash disbursements to hard-hit US families -- measures many economists have been calling for.
But Treasury Secretary Steven Mnuchin, though acknowledging a "strong likelihood" additional aid will be needed, rejected Pelosi's effort as "obviously" partisan, and said officials will need to take some time to consider the next steps.
Pelosi fired back at Republicans, including Senate Majority Leader Mitch McConnell, for dragging their feet.
"Instead of telling laid-off workers to pause, Leader McConnell and the Senate GOP need to come to the negotiating table to help deliver the relief to protect lives and livelihoods."
- Home sales plunge -
The Federal Reserve has rolled out trillions in new liquidity to ensure markets continued to function through the downturn, but the central bank's Chair Jerome Powell said additional government spending is necessary to spur a recovery.
AFP/File / Frederic J. BROWN The National Association of Realtors said existing home sales -- a key sector in the world's largest economy -- plummeted in April, the first full month the US lockdowns were in effect
During a video conference with community leaders across the country, Powell repeated earlier warnings of unprecedented economic uncertainty, saying "questions only the virus can answer complicate the outlook."
Adding to the building picture of the damage, the National Association of Realtors (NAR) said existing home sales -- a key sector in the world's largest economy -- plummeted in April, the first full month the lockdowns were in effect.
But realtors and economists are optimistic they will pick up quickly as the economy reopens due to very low borrowing rates.
Sales plunged 17.8 percent last month, dropping in all parts of the country, with sales in western states hit hardest, falling 25 percent compared to March.
NAR's Chief Economist Lawrence Yun said home sales have been "temporarily disrupted" by the pandemic but pointed to a year-on-year price increase of 7.4 percent as evidence that "listings that are on the market are still attracting buyers."
A Philadelphia Federal Reserve Bank monthly report released Thursday showed a slight improvement in manufacturing activity in the region the bank covers, though it was rebounding from a 40-year low in April.
A senior Olympics official has warned that holding the postponed Tokyo Games next year faces "real problems", with even a vaccine unlikely to stave off the threat of the coronavirus.
John Coates, the International Olympic Committee's pointman for Tokyo 2020, indicated that officials would start deciding in October if and how the pandemic-hit Games could go ahead in July 2021.
He told a roundtable organised by Australian media giant News Corp that Japanese Prime Minister Shinzo Abe has been clear the Tokyo Olympics could not be delayed a second time.
"We can't postpone it again and we have to assume that there won't be a vaccine or, if there is a vaccine, it won't be sufficient to share around the world," he said.
Without the safety net of a widely available vaccine, there could be enormous challenges in screening tens of thousands of people from all corners of the world, he said.
"We've got real problems because we've got athletes having to come from 206 different nations," said Coates.
"We've got 11,000 athletes coming, 5,000 technical officials and coaches, 20,000 media, we've got 4,000 working on the organising committee there at the moment, there will be 60,000 volunteers coming," he said.
"There's a lot of people."
Coates said if there are signs the pandemic is contained, even if not eradicated, by October, officials will start preparing "the different scenarios by which the sport could take place".
"Do we quarantine the Olympic village? Do all athletes when they get there go into quarantine? Do we restrict having spectators at the venues? Do we separate the athletes from the mixed zone where the media are?"
With Fox News reporting national numbers also looking bad for the sitting president, Tomasky focused in Ohio where the president appears to be faltering as Republicans appear to be fleeing Trump.
"Wednesday on Morning Joe, the namesake host was running through the states where Joe Biden was currently ahead of Donald Trump or was close. Pennsylvania, Scarborough said, was all but in the bag for Biden. Michigan was looking good, Wisconsin leaning that way. Then he proceeded to name-check (if I’m remembering them all) Florida, North Carolina, Nevada, Colorado, Arizona, Georgia, and even Texas as possibly competitive," Tomasky wrote before adding, "That’s 10 states, fully one-fifth of the whole tattered union. But what state did he not mention? The ur-swing state. The state about which it has often been said, 'As ____ goes, so goes America.'"
Ohio, he suggested.
Noting that Trump won the state in 2016 by 8.1 percentage points, or nearly 450,000 votes, Tomasky claimed recent trends show a sea change against the president this go-around.
"Some numbers from this year’s primary suggest—I don’t want to go too hard here; suggest—that something very interesting might be happening in the Buckeye State, and it’s not good news for Team Orange," he wrote.
Based upon the recent primary that showed an upsurge in Democrats requesting mail-in ballots and numbers from the "open_primary" that saw Republicans crossing over to vote for a Democratic candidate, the columnists suggested that the president is facing a rebellion among GOP voters -- women in particular.
"What’s it mean? Again, I’ll be cautious here. The obvious inference is that this imbalance is explained by suburban women’s disgust with Trump. We’ve seen this register in a lot of polls. Can there be other explanations? Maybe. But there just aren’t that many options," he wrote. " The most likely other explanation is that there was a more competitive presidential race on the Democratic side, spurring Republicans to vote on that side of the fence."
According to Hannah Riddle, the campaign manager for Alaina Shearer, a Democratic congressional candidate running in a traditional GOP district, a report that 8,800 GOP voters switched to voting for a Democrat is a key number.
“A vastly larger number than we’ve seen before. Anecdotally, you go around and talk to people, and they’re pretty disgusted,” Riddle explained.
"Is this 12th District some kind of anomaly?" Tomasky asked. "Well, let’s saunter down to the also very Republican southwest corner of the state, and the 1st congressional district, the suburbs north and west of Cincinnati. Here, GOP incumbent Steve Chabot is being challenged by Democrat Kate Schroder (her career is in public health—a pretty good year for someone with that on her résumé to be running). In the 1st, says Schroder’s campaign manager Allie Banwell, about 6,200 Republicans took a Democratic ballot, while just 543 Democrats requested a GOP ballot. It’s worth noting here that when people request a ballot, they’re becoming a member of that party until the next primary. So it’s a bit of a commitment for people to make."
“There are two big things happening in Ohio,” explained state Democratic Party chairman David Pepper. “The first is this suburban shift from red to blue. And number two, the great economy that Trump brags about? That wasn’t really true here even before COVID,” before adding that Trump is now unable to use his “greatest economy ever” line in light of the economic collapse due to the coronavirus pandemic.
"Look, it may still be a tough state. Biden and Trump are essentially tied there right now, which is a bit of a discouraging sign, because in Pennsylvania, Michigan, Arizona, Florida, and more narrowly in Wisconsin, Biden is ahead. And even though Democratic turnout in Ohio was larger than Republican, the overall turnout figure was a low 23 percent," Tomasky wrote before concluding, "But still, the above numbers are real. They’re actual votes. By 5- or 7- or 12-to-1, Republicans voted Democratic in Ohio more than the other way around, and independents opted to take the Democratic ballot by large margins. It has to mean something."
In Illinois, at least 355 people who live in state-run homes for adults with disabilities have tested positive for the coronavirus. “They don’t know why their family has stopped coming to visit,” a relative said.
While much of the attention related to COVID-19’s impact on vulnerable populations has focused on deaths at nursing homes, infection rates are remarkably high in another kind of residential setting: state-operated centers for adults with cognitive or behavioral disabilities.
As of Thursday, more than 1 in 5 people living in these developmental centers had tested positive for the novel coronavirus, state data shows. That’s more than double the infection rate seen in nursing homes and other long-term care facilities, where confirmed cases account for about 7% of residents, according to the Illinois Department of Public Health.
Of about 1,650 people who live in the seven developmental centers, which are scattered throughout the state, at least 355 have tested positive, or 21.5%. Eight residents have died, as have four workers.
These facilities share some characteristics with other congregate-care settings, such as shared living quarters and the need for workers to bathe residents, change diapers and perform other intimate tasks. But the developmental centers face specific challenges in fighting the virus. Many residents can’t wash their hands on their own or wear masks. They may not understand why their families aren’t coming to visit or why they can’t leave the home for their usual activities.
So when COVID-19 arrived in the facilities, it spread quickly.
At Elisabeth Ludeman Developmental Center in Park Forest, 59% of about 340 residents and about 13% of the 900 workers had tested positive for COVID-19 as of Thursday. More than 37% of residents have tested positive at the Jack Mabley Developmental Center in Dixon, in the western part of the state, which has about 112 residents. So have 13% of the roughly 215 workers.
Only the William Fox Developmental Center in Dwight, the smallest of the seven centers with 80 residents, has reported no cases to date.
COVID-19 has been difficult to fight in the state’s long-term care facilities, where 7,291 of roughly 100,000 nursing home residents have tested positive for the coronavirus and 2,034 have died from it, according to figures provided by state health officials Thursday.
But “if you were working in a nursing home, probably most of the residents would be able to remember to keep their masks on,” said Anne Irving, regional director for AFSCME Council 31, which represents workers in residential facilities that serve people with disabilities.
The precautions taken to protect residents in the centers have also changed their lives dramatically. With all of the facilities closed to visitors since March 12, the adults living there have been cut off from loved ones who normally visit.
“It’s hard on residents that have very different cognitive levels,” said John Haley, whose 63-year-old sister, Jeanne, lives at Ludeman. Haley is also vice president of Parents and Friends of Ludeman Center.
“Much like a child not understanding fully what’s going on around them, they don’t either,” Haley said. “They don’t know why their family has stopped coming to visit.”
Many residents are used to routine, and those who are able also are used to going to jobs or programs during the day. That has stopped. Instead of group activities, residents may be isolated in their rooms or cottages. Familiar caretakers are wearing protective gear that makes them look different too.
“Our residents are not used to seeing us wearing gowns, goggles, face shields, gloves. That personal touch is now through a glove. We aren’t just in crisis — our residents are in crisis,” said Tawny Proulx, who works with residents at Mabley. She is also the local union president.
The Illinois Department of Human Services, which operates the centers, convened an infection control team on March 16 that initiated changes to cleaning and hygiene measures, according to spokeswoman Meghan Powers. Employees are taking residents’ vital signs, including temperatures, twice a day.
At Ludeman, where the outbreak was detected in late March, all residents have now been tested and all staff are being tested as well, with the help of the state, Powers said.
The Illinois National Guard was embedded at Ludeman and at the Shapiro Developmental Center in Kankakee for a week in April to help with health monitoring and temperature checks, Powers said. Additional health care workers are there now, deployed by the State Emergency Operations Center, she added.
At Shapiro, 71 residents had tested positive for the coronavirus as of Thursday— about 15% of the resident population. And at the Murray Developmental Center in Centralia, about 11% of residents had tested positive. Many were asymptomatic; many already have recovered, workers and family members said.
“It’s an incredibly silent and insidious virus,” said Allison Stark, director of Human Services’ Division of Developmental Disabilities. Broader testing at some centers revealed high rates of infection, she said, even if residents had no symptoms.
“That is the reality of this pandemic — despite having the best-laid plans, despite having PPE, despite taking precautions, that it still will spread,” Stark said.
Many Illinois adults with developmental disabilities live not in the state-run centers but in privately operated facilities as well as hundreds of group homes. The state recently began tracking cases in many of the midsize private facilities that often serve people with more significant medical needs and have suffered some severe outbreaks. For example, at Golfview Developmental Center in suburban Cook County, a privately operated 135-bed facility, there have been 94 confirmed coronavirus cases and 10 deaths, according to the state.
Golfview did not respond to a reporter’s request for comment.
But the state says it isn’t tracking cases in smaller group homes, citing privacy issues. Some operators of these facilities, however, have spoken publicly about their efforts to contain the spread of the disease.
Joe Mengoni, vice president of residential and clinical services at United Cerebral Palsy Seguin of Greater Chicago, said his organization has seen two or three UCP group homes where all residents have been infected.
“It’s really tricky to keep them isolated in place when they don’t really understand what’s going on to begin with,” Mengoni said, “and keeping them isolated to their bedrooms is really tricky to manage.”
“I Sure Miss You”
Family members of residents of the state-run developmental centers said in interviews that they felt their loved ones are well cared for, given the unsettling circumstances.
But they said they have had to work creatively with center employees to try to stay in touch.
All the centers have “house phones” that parents and guardians can call to speak with employees and check in on loved ones. But to catch a glimpse, families sometimes resort to peering through the windows of homes.
Some are going back to basics, like writing cards.
Rita Winkeler, of Bartelso, used to visit her son Mark, who does not write or speak, at Murray in Centralia at least twice a week.
Now, she said, she’s been using FaceTime to sing to him and see his smile.
And other residents, who are used to seeing her around in person, are reaching out to her.
“I get about three calls, minimum, a day from different (residents),” Winkeler said. “That’s been a real lifeline.”
Winkeler also has some new pen pals.
“Dear Rita,” one handwritten letter began. “I sure miss you so much. I can’t wait (until) this is over.”
The resident had affixed stickers — a panda, a unicorn and a cheeseburger — to the notebook paper. “I miss my workshop. Family. You.”
Early on in the pandemic, the centers had to scramble to obtain adequate protective gear for employees — masks, shoe covers, face shields and gowns. There’s a better supply now than there had been, workers and family members said, but gowns, in particular, have been difficult to keep stocked.
At Ludeman, Haley and the Ludeman parents group made an appeal for as close a substitution for gowns as they could get: rain ponchos. The Chicago White Sox came through with 1,200 and the Chicago Cubs donated 1,000 to use as backup supplies.
Some workers at Murray have been sewing masks for themselves and others.
With the shortages of protective gear easing, employees say they can now focus more on keeping residents busy and cared for.
Dorothy Clare Tessman, a psychiatric mental health nurse practitioner who treats adults with disabilities, said it’s been extremely challenging to explain to the residents why they can’t participate in their daily activities outside their homes or see their friends.
“People are just really struggling to explain that the person hasn’t done anything wrong. A lot of them are like, why can’t I keep going to my day program?” Tessman said. “The families have struggled to explain that this is related to trying to keep you safe.”
Routine weekly outings have stopped, and workers are trying to offer alternatives as they can. Instead of taking residents to a dollar store or Dairy Queen to spend money they earn at their jobs, employees at Mabley are taking orders from residents, shopping on their behalf and delivering everything from a Coke to McDonald’s french fries, Proulx said.
At the same time, many workers’ home lives are upside-down, as they try to avoid bringing the virus home.
Proulx gets home from Mabley in the afternoon, goes straight to her garage, strips out of her clothes and bags them up. Then she goes inside the house, avoids her husband and heads straight to the basement, where she’s made an apartment for herself for the last few weeks. She has an exercise room, a bathroom, a bedroom.
Tawny Proulx has been living in her basement in Lyndon, Illinois, to mitigate the risk of exposure for her and her husband, who is also an essential worker. (John J. Kim/Chicago Tribune)
Her husband makes her dinner every day. When it’s ready, he rings her phone, leaves the food on paper plates on the stoop and makes himself scarce again.
Proulx puts on her mask, brings her dinner back to the basement and eats it with plastic utensils, alone. She heads back to Mabley at 6:30 a.m. the next day.
So Vulnerable, So Loved
Those supporting a shift away from larger centers to smaller, community-based homes point to the pandemic as another reason to do so.
At a news conference and rally last week, officials from The Arc of Illinois, which advocates for people with intellectual and developmental disabilities, argued that the developmental centers are inherently more dangerous for residents.
“There are more or less set times — this is the time that I can bathe; this is the time that I can go to the common area. Normally what happens is there’s multiple people in a room,” said Nafia Lee, manager for the Going Home Coalition, a group pushing to close developmental centers in favor of community living. “If you have a bathroom with multiple stalls, there’s very little privacy.”
The Arc of Illinois called on the state to increase funding for small community settings and move residents out of the centers once the pandemic has eased.
But community-based group homes have been susceptible to COVID-19 outbreaks too as living quarters typically are shared by several clients.
United Cerebral Palsy Seguin of Greater Chicago, based in Cicero, operates 35 shift-staffed homes that house about 170 adults with disabilities. As of Monday, 14 residents had tested positive for COVID-19, according to Sammy Gutierrez, assistant vice president of residential and clinical services.
Those who test positive are moved temporarily to a home that wasn’t in use; it’s become a quarantine house. One worker has died.
Employees at many Seguin homes are working overtime and taking extra shifts, even staying overnight on air mattresses, as some employees have contracted COVID-19 or can’t work because of underlying medical conditions, according to Gutierrez.
The residents, meanwhile, are having a hard time adjusting to the new routines, like their counterparts in the larger centers.
“They’re depressed. They want to go places. It’s sad that our folks are going through this,” Gutierrez said. “People are coming to work because they know that our individuals need them now more than ever.”
Because state data about COVID-19 outbreaks has been made public only for larger facilities that agreed to release the tallies, it’s difficult to know how widespread cases are in other residential settings for people with developmental disabilities.
Sabrina Chapadjiev, whose 53-year-old brother Sammy lives at a facility in Rolling Meadows run by a company called Clearbrook, worries about the outbreak there.
In letters to parents of special education students, some Illinois school districts are asking them to accept scaled-back remote learning plans or waive their rights to “free appropriate public education.”
“I found out via my family member that there were two confirmed cases in The Commons, where he lives. I immediately had a panic attack,” she said. President and CEO Tony Di Vittoria said in an email that there have been 16 positive cases and four deaths among residents at The Commons.
Chapadjiev, who grew up in Elk Grove Village and now lives in Brooklyn, has been working to organize donations of protective supplies for Clearbrook employees and created a Facebook group for family members of people with developmental disabilities in Illinois so they can advocate together for emergency help.
The residents are so vulnerable and so deeply loved, she said.
“Just because they’re in there doesn’t mean they’re forgotten by their loved ones. In usual times he’s literally home every weekend, and my mom right now is missing him terribly.”
Staying in contact with loved ones is particularly difficult for people who aren’t able to communicate verbally.
Craig Pedersen is 48 and his mom, Peg, is used to visiting him at least once a week at his small, privately operated group home in Villa Park. She usually brings him food and eats with him, reads the logbook that details his care for the week, and organizes his clothes in his room. Craig has cognitive, vision and hearing impairments; he uses a wheelchair.
“He cannot speak to me, so it’s been especially difficult. Other people have done Zoom, or I can talk to his caregivers, but it’s not like being with him and seeing him,” Pedersen said. Craig’s birthday was in April; it was his first birthday spent without his mother.
“For all of his life, it’s been difficult that he can’t tell us what he feels. But it’s worse once he isn’t with you.”
Recently she dropped a meal off for Craig, his housemates and their caregivers. When she left it on the porch, she could see him from a distance through the doorway, but he was too far away to realize she was there. Then, on a particularly warm, sunny day, workers at the home wheeled Craig into the backyard so Pedersen could see him for a moment.
“I just need to see him,” Pedersen recalled she told the workers.
Pedersen came, stood at a distance in her mask — he couldn’t wear one because he wouldn’t understand — and shouted his name.
“Big smile on his face! He could see me and hear my voice,” she said.
The U.S. could have prevented tens of thousands of deaths by imposing social distancing measures between one and two weeks earlier, according to a study by researchers at Columbia University.This article first appeared in Salon.The analysis estimated that 54,000 fewer people would have died by the beginning of May had social distancing restrictions been imposed on March 1 — two weeks before most Americans stopped leaving their homes. The delays resulted in 83% more deaths.
The study also found that about 36,000 deaths could have been prevented if the restrictions were put in place only one week earlier.
"It's a big, big difference," lead researcher Jeffrey Shaman, an epidemiologist at Columbia, told The New York Times. "That small moment in time — catching it in that growth phase — is incredibly critical in reducing the number of deaths."
The new findings highlight the damage caused by attempts to downplay the severity of the virus by politicians like President Donald Trump, who claimed March 9 on Twitter that there were only "546 confirmed cases" and declared that "nothing is shut down" and "life & the economy go on." Researchers estimated that tens of thousands of people had already been infected in the U.S. at that point.
But it was not only Trump. As leaders in California and Washington state imposed strict restrictions early and kept the virus contained, New York Gov. Andrew Cuomo and New York Mayor Bill de Blasio ignored advice from top health officials and delayed strict restrictions. In de Blasio's case, the mayor even urged people to go out to bars and restaurants when the city was already deep into its outbreak, according to recent investigative reports by The New Yorker and ProPublica.
De Blasio did not close the city's schools until March 15, nearly one week after New York began to lead the country in positive cases. The president did not recommend avoiding travel and large groups until March 16. Cuomo's stay-at-home order did not take effect until March 22.
The analysis "makes a compelling case that even slightly earlier action in New York could have been game-changing," Dr. Lauren Ancel Meyers, an epidemiologist at the University of Texas at Austin, told The Times. "This implies that if interventions had occurred two weeks earlier, many COVID-19 deaths and cases would have been prevented by early May not just in New York City but throughout the U.S."
Social distancing has been highly effective in containing the spread, according to a recent study published in the journal Health Affairs.
"Adoption of government-imposed social distancing measures reduced the daily growth rate by 5.4 percentage points after 1–5 days, 6.8 after 6–10 days, 8.2 after 11–15 days and 9.1 after 16–20 days," the study, which was conducted by researchers from the Georgia University, the University of Kentucky and the University of Louisville, found. "Holding the amount of voluntary social distancing constant, these results imply 10 times greater spread by April 27 without [shelter-in-place orders] (10 million cases) and more than 35 times greater spread without" bans on large gatherings, school closings, stay-at-home orders and the shuttering of service and entertainment businesses.
The coronavirus offers important lessons on the need to reduce the threat of climate change.For starters, we’ve learned there is a heavy price to be paid for ignoring repeated warnings from scientists with expertise in their field of study.Researchers at the Global Carbon Project on Tuesday published a report revealing that the Earth can expect a drop of 7% in carbon dioxide emissions this year as a result of the pandemic. It’s the largest decrease in at least 75 years. That’s the good news. But the plunge in carbon emissions shouldn’t be perceived as a silver lining. The decline is temporary....
Paris (AFP) - After COVID-19 first appeared in China late last year, doctors quickly realised what made some patients more vulnerable to the virus than others: age, gender and underlying health problems all played a part.Now, as the pandemic kills hundreds across the world each day, experts say evidence is mounting that other socioeconomic factors -- specifically connected to race and income -- influence who become sick and who dies.Officials in Europe and the US have insisted that COVID-19 doesn't discriminate. But the figures suggest otherwise.A slew of recent studies have highlighted how pe...
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