POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….

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The virus seems to spread the most when people yell (such as to chant a slogan), sneeze (to expel pepper spray), or cough (after inhaling tear gas). It is transmitted most efficiently in crowds and large gatherings, and research has found that just a few contagious people can infect hundreds of susceptible people around them. The virus can spread especially easily in small, cramped places, such as police vans and jails.

As such, for the past several days, the virus has found new environments in which to spread across the United States. At least 75 cities have seen widespread demonstrations and social unrest as Americans have gathered to protest systemic racism and the killing of George Floyd, the black man who died last week under the knee of a Minneapolis police officer…

The pandemic and unrest together have trapped the country in a bind. The demonstrations oppose police brutality. But peaceful, masked protesters—and the journalists covering them—have sometimes been met with an overly aggressive police response.

“I don’t think there’s a question of whether there will be spikes in cases in 10 to 14 days,” Mark Shrime, a public-health researcher at Harvard, told me. “With so many protests happening, that are getting so much bigger, I don’t think it’s a question of if, but when and where.”

Maimuna Majumder, a computational epidemiologist at Boston Children’s Hospital and Harvard Medical School, agrees. “All things considered, there’s little doubt that these protests will translate into increased risk of transmission for COVID-19,” she told me by email.” (A)

“As nationwide protests sparked by the death of a black man in police custody stretched into their sixth day, current and former government officials warned Sunday that the mass demonstrations could lead to new waves of coronavirus infections.

“There’s going to be a lot of issues coming out of what’s happened in the last week, but one of them is going to be that chains of transmission will have become lit from these gatherings,” former Food and Drug Administration commissioner Scott Gottlieb said in an interview on CBS News’s “Face the Nation.”” (B)

“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…

In Los Angeles, where demonstrations led to the closing of virus testing sites on Saturday, Mayor Eric Garcetti warned that the protests could become “super-spreader events,” referring to the types of gatherings, usually held in indoor settings, that can lead to an explosion of secondary infections.

Gov. Larry Hogan of Maryland, a Republican, expressed concern that his state would see a spike in cases in about two weeks, which is about how long it takes for symptoms to emerge after someone is infected, while Atlanta’s mayor, Keisha Lance Bottoms, advised people who were out protesting “to go get a Covid test this week.”…

…Dr. Howard Markel, a medical historian who studies pandemics, likened the protest crowds to the bond parades held in American cities like Philadelphia and Detroit in the midst of the 1918 influenza pandemic, which were often followed by spikes in influenza cases.

“Yes, the protests are outside, but they are all really close to each other, and in those cases, being outside doesn’t protect you nearly as much,” Dr. Markel said. “Public gatherings are public gatherings — it doesn’t matter what you’re protesting or cheering. That’s one reason we’re not having large baseball games and may not have college football this fall.”

Though many protesters were wearing masks, others were not. SARS-CoV-2, the virus that causes the Covid-19 disease, is mainly transmitted through respiratory droplets spread when people talk, cough or sneeze; screaming and shouting slogans during a protest can accelerate the spread, Dr. Markel said.

Tear gas and pepper spray, which police have used to disperse crowds, cause people to tear up and cough, and increase respiratory secretions from the eyes, nose and mouth, further enhancing the possibility of transmission. Police efforts to move crowds through tight urban areas can result in corralling people closer together, or end up penning people into tight spaces.

And emotions have been running high, Dr. Markel said. “People get lost in the moment, and they lose awareness of who is close to them, who’s not, who’s wearing a mask, who’s not,” he said.

The biggest concern is the one that has bedeviled infectious disease experts since the pandemic began, and it’s the coronavirus’s secret weapon: that it can be transmitted by people who don’t display any symptoms and feel healthy enough to participate in protests.” (C)

“Because of delays between exposure to the virus and symptoms, the effects of the protests on the spread of the virus will not be known for several weeks. But epidemiologists said the protests would almost certainly lead to more cases.

Health experts know that the virus is far less likely to be spread outdoors than indoors. And masks reduce the chance of transmitting respiratory droplets that contain the virus. But yelling, shouting and singing can increase how far those droplets are projected. Crowds also increase the risk of transmission. Police tactics such as spraying tear gas — which causes people to cough — herding protesters into smaller areas for crowd control and placing arrested individuals in buses, vans and holding cells also increase the risk of infection.

Tay Anderson, a protest leader and city school board member in Denver, said he had been worried about the disparate effects of the virus on black Colorado residents as thousands marched through the city and rested shoulder to shoulder on the lawn of the State Capitol in silent demonstrations to decry Mr. Floyd’s death.

He put out a call on social media for all protesters to join him in getting tested for the virus on Saturday morning at the Pepsi Center, a concert arena where Denver has been running free, large-scale testing.

“WE ARE STILL IN A PANDEMIC,” he wrote on Twitter.” (D)

““We are still in the middle of a pandemic,” Minnesota Gov. Tim Walz (D) reminded demonstrators in a news conference where he announced the full mobilization of the state National Guard to control the violent unrest.

Warning that hospitals were “on the verge of being overrun,” Walz said “demonstrators should wear masks and try to practice social distancing.”..Two to four weeks after many states began lifting restrictions on restaurants, bars and larger gatherings, cases are rising in areas that had previously dodged the worst of the virus’s impact. Arizona, Mississippi, South Carolina, Utah and Wisconsin all set record highs for new cases reported Friday. Restaurants, gyms, and other businesses have been allowed open for at least two weeks in all of the states.

The five are among 18 states that continue to see increases in their rolling seven-day case averages as of Friday, according to Washington Post data, as has Puerto Rico. Some of the places, such as Washington state, California and parts of Virginia, had imposed stringent stay-at-home measures and had been cautious in their reopening procedures. Other states experiencing case increases, such as Alabama, Missouri and Tennessee, have been more aggressive in their push to reopen.” (E)

“Several health systems in Chicago canceled elective procedures June 1 after a weekend packed with public transit disruptions and protests following the death of George Floyd, according to The Chicago Tribune.

For example, University of Chicago Medicine closed its outpatient centers June 1 in six Chicago neighborhoods, including Orland Park, South Loop, River North, River East, South Shore and Hyde Park.

It also closed its COVID-19 testing sites and canceled elective surgeries at some facilities, according to the report.” (F)

Mass protests that have erupted over police brutality toward black people in America are raising concerns about the risk of spreading the coronavirus. But some health experts, even as they urge caution, said they support the demonstrations — because racism also poses a dire health threat…

Health experts urged protesters not to sing and shout to reduce the threat of person-to-person transmission. And they cautioned that police tactics such as tear gas and pepper spray could exacerbate the situation by prompting people to cough and gasp for air.

The New York City Department of Health and Mental Hygiene issued a list of tips for demonstrators to lower their risk of contracting COVID-19, such as covering their faces and staying in small groups.

“Don’t yell; use signs & noise makers instead,” the department advised…

But the risks of congregating during a global pandemic shouldn’t keep people from protesting racism, according to dozens of public health and disease experts who signed an open letter in support of the protests.

“White supremacy is a lethal public health issue that predates and contributes to COVID-19,” the letter said…

Local governments should not break up crowded demonstrations “under the guise of maintaining public health,” the experts said in their open letter. They urged law enforcement agencies not to use tear gas, smoke and other irritants, saying they could make people more susceptible to infection and worsen existing health conditions.

The medical professionals also acknowledged the potential for COVID-19 cases to rise in the days to come, and they called for public health agencies to boost access to care and testing in affected communities.” (G)

“Mass protests over police brutality have shuttered coronavirus testing sites, complicated efforts to track people who have been exposed and set off fears among local officials that the unrest could spark fresh waves of virus infection.

Testing sites in Pennsylvania, Florida, California and Illinois closed after violence broke out over the weekend, limiting cities’ ability to track the virus just as thousands of people participate in crowded demonstrations across the country.

It comes at a risky time. Public health officials are already worried about caseloads rising and hospitals filling as states reopen and people venture out — sometimes in defiance of ongoing social distancing guidelines. And many of the neighborhoods affected by the violence are already bearing a disproportionate burden of the epidemic, as black Americans are getting sick and dying at far higher rates than white Americans…

Those concerns were palpable in hard-hit New York, where a few private testing sites closed or reduced hours amid the protests. Gov. Andrew Cuomo and Mayor Bill de Blasio imposed an 11 p.m. curfew in New York City, one week before it was finally set to start reopening.

“We spent all this time closing down, locked down, masks, social distancing and then we turn on the television and you see mass gatherings that could potentially be infecting hundreds and hundreds of people after everything we’ve done,” Cuomo said Monday. “We have to take a minute and ask ourselves what are we doing here?”…

“We don’t have a vaccine. We don’t have medication,” said Dr. Umair Shah, who heads the Harris County Health Department in Texas. “We’re relying on people to socially distance and wear facial coverings and avoiding large crowds. When you put those elements straight into protests — it’s completely antithetical to each other.”…

“If people have been protesting, they might not want to share with the health department where they were, especially if there were incidents in that area,” Dr. Jeffrey Klausner, a professor at UCLA’s public health school and a former health official for San Francisco, said. “There’s a brick wall [preventing information sharing] between health departments and any criminal justice efforts, but people don’t know that, so they may be reluctant to answer their phone and be completely forthcoming about their behaviors and movements.”

Those fears could be exacerbated, other health leaders fear, by Minnesota Public Safety Commissioner John Harrington using the term “contact tracing” in a weekend press conference to describe his efforts to find people who took part in looting and rioting over the weekend.

“To weaponize contact tracing — which is critical to help safely reopen our economy and ensure those most impacted by Covid-19 such as low-income communities and communities of color are safe — is unconscionable and undercuts any efforts to end this pandemic,” said David Harvey, who heads the National Coalition of STD Directors. He called it a “gross and dangerous mischaracterization of an essential public health function.”” (H)

“Republicans said Tuesday night that they were moving President Trump’s convention speech out of Charlotte, N.C., and to another city, after coming to a stalemate with Democratic officials in the state about safety and crowd size restrictions because of the coronavirus.” (I)

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