Trump Administration Sets Demographic Requirements for Coronavirus Reports

WASHINGTON — The Trump administration on Thursday released new requirements for states to report coronavirus data based on race, ethnicity, age and sex of individuals tested for the virus, responding to demands from lawmakers for a clearer picture of the pandemic and its racial discrepancies.All laboratories — as well as nonlaboratory facilities offering on-site testing and in-home testing — will be required to send demographic data to state or local public health departments based on the individual’s residence, according to details released by the Department of Health and Human Services.The new guidelines came as Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, faced a barrage of questions from House lawmakers at a health subcommittee hearing about his agency’s often-halting response to the pandemic, and what some members of Congress said was its failure to anticipate and explain the pandemic’s effect on black and Hispanic communities.“We didn’t have the data we needed to be able to answer that in a responsive way,” Dr. Redfield conceded.The health department announced the new requirements as large protests continued across the nation over the death of George Floyd after a white police officer knelt on his neck for nearly nine minutes. The virus continues to infect and kill black people in the United States at disproportionately high rates, according to data from some cities and states. And epidemiologists fear the mass protests could set off a new wave of infection.Fine-grained data on the race and ethnicity of Covid-19 patients may help the government begin to address health inequities by marshaling resources to particularly hard-hit regions of the country. In its announcement, the department said the data would assist with epidemiologic investigations and contact tracing, and help states anticipate supply chain problems.The data will be stripped of identifying information for privacy reasons but will be publicly available, said Adm. Brett P. Giroir, an assistant health secretary and the federal government’s lead on coronavirus testing efforts.The deadline for states to start sending such data to the health department is Aug. 1, but Admiral Giroir said he expected many states to begin earlier. “We definitely recognize the importance of doing this quickly,” he said.As part of the Paycheck Protection Program and Health Care Enhancement Act, signed into law in April, the Trump administration was required to include demography in its Covid-19 analyses. But the results have been slim. In May, the Department of Health and Human Services sent a brief report signed by Dr. Redfield that mostly included links to coronavirus data on the C.D.C.’s website.Senator Elizabeth Warren, Democrat of Massachusetts, wrote on Twitter at the time that the department should “be embarrassed by the lazy, incomplete, 2.5-page copy-and-paste job it calls a ‘report’ on the racial disparities of Covid-19 cases.”Racial disparities in the pandemic were the subject of a separate virtual briefing held on Thursday by the House’s select subcommittee on the coronavirus. The data the administration has provided is “grossly inadequate,” said Representative James E. Clyburn of South Carolina, the No. 3 House Democrat and chairman of the committee.Testing and death rates during the pandemic have put a spotlight on longstanding racial disparities in access to quality health care. In Washington’s predominantly black neighborhoods, for example, the number of deaths is the highest in the city even though the rate of infection is the highest in one of the city’s more mixed-race and income wards.Dr. Uché Blackstock, an African-American physician and founder of Advancing Health Equity, a health care advocacy group, told the committee that many of her black patients do not have access to testing and, because their disease goes undetected, they do not get the treatment they need.“I have never been as scared for my patients as I have been the last few months,” she said.In his opening statement and in several answers to questions from committee members, Dr. Redfield acknowledged the ravages of the virus on what he called “vulnerable” parts of the population.“I personally want to apologize for the inadequacy of our response,” he told Representative Barbara Lee, a California Democrat who asked about the scanty May report.In one especially sharp exchange at Thursday’s hearing, Representative Katherine M. Clark, Democrat of Massachusetts, noted that the C.D.C.’s website already contained pages of material on what she called “disparate health outcomes” for people of color.“Wasn’t it eminently predictable that Covid-19 would disproportionately impact black, Latinx, and Indigenous communities?” she said.Dr. Redfield responded that it became clear, but only after the agency “stepped back and understood certain social factors in living conditions would be critical.”He framed the scarcity of demographic information as a consequence of antiquated technology in public health systems, something health experts say contributed to the C.D.C.’s slow grasp of the virus’s spread. “We have a long way to go,” he said.

Updated June 2, 2020

Will protests set off a second viral wave of coronavirus?
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.

How do we start exercising again without hurting ourselves after months of lockdown?
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.

My state is reopening. Is it safe to go out?
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.

What’s the risk of catching coronavirus from a surface?
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.

What are the symptoms of coronavirus?
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.

How can I protect myself while flying?
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.)

How many people have lost their jobs due to coronavirus in the U.S.?
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.

Should I wear a mask?
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.

What should I do if I feel sick?
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.

He also said state governments should sharply increase the number of contact tracers, who can identify anyone who comes into contact with an infected person, to 100,000 by September — well beyond the 600 C.D.C. employees and thousands of state-hired workers currently deployed. He said the C.D.C. would help each state understand the number of tracers it needed.“It is fundamental that we have a fully operational contact-tracing work force,” he said, “so that we can stay in containment mode as we get into the fall and winter.”Dr. Redfield also faced testy questions about the inconsistent use of face masks in many states, and he urged Americans to continue physical distancing. At one point, Representative Rosa DeLauro, Democrat of Connecticut and the chairwoman of the subcommittee, displayed a photo of a large crowd at the Lake of the Ozarks over Memorial Day weekend, prompting Dr. Redfield to shake his head.But mask use is sporadic at the police brutality protests as well, and Democrats have been less critical of the demonstrators. Dr. Redfield said that protests in several cities had the potential to become “seeding events” for the virus, and that attendees should consider getting tested within a week.Dr. Redfield admitted that the C.D.C. was struggling in its campaign to persuade Americans to wear cloth masks in public, which began in early April, well after the virus had spread to every pocket of the country.“We’re very concerned that our public health message isn’t resonating,” he said.President Trump has regularly declined to wear a mask in public appearances, saying that he did not “see it for myself.” Some Republicans have followed the president’s lead, characterizing face masks as tools in a culture war. Representative Andy Harris of Maryland, a physician, claimed at the Thursday hearing that there was now a “cult of masks.”“I’m afraid to get a picture taken and be without a mask somewhere because someone will say, well, ‘How can you possibly — you’re a doctor — how can you not wear a mask?’” he said.Dr. Redfield returned to the idea of mask-wearing when asked about the risks of the virus spreading at large protests, where the police’s use of tear gas may cause people to cough virus-laden droplets.“These social-distancing strategies that we learned are something we need to perfect,” he said. “We’re going to need them to be our major defense again in October, November and December.”Sheryl Gay Stolberg contributed reporting.

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