The Role of the Board & Management
· The Board of Directors and Management (representing the Association) do not presume to be medical authorities on COVID-19 or any other health related matters.
· The Association cannot protect or guarantee the physical health of residents.
· The Association is authorized to enact precautionary measures, such as closing or limiting facilities, implementing additional cleaning protocols, offering sanitizing solutions in common areas, and increasing awareness for the good of all residents.
· Communications from the Association regarding COVID-19 are intended to provide useful information to residents and offer insight into decisions made by the Board of Directors and Management. Residents are encouraged to stay informed and to seek updates from reputable sources.
· Any questions or concerns regarding healthcare, information, or advice should be directed to your personal healthcare provider, the Shelby County Health Department, or the CDC (Centers for Disease Control).
· Should there be contradictory information, the Association and residents should defer to healthcare professionals and/or authorities.
Face mask ordinance (July 6, 2020)
Below you will find common area mask requirements pursuant to City of Memphis Ordinance No. 5751, which requires masks to be worn while in public. You will also find modified rules regarding guests.
* Interior common areas such as hallways, elevators, stairwells, and entrance lobbies are public space. Therefore, masks must be worn in those areas.
* A mask is not required while walking to and from your vehicle, but be prepared to put one on before entering the building.
* Appropriate social distancing should be observed at all times.
* Avoid sharing an elevator if at all possible, but certainly no more than 2 passengers from different households. The exception would be family members.
* Residents should avoid bringing guests into the building, if possible.
* Close family members and significant others are permitted to visit.
* Residents should inform guests of the mask requirement before their arrival.
* Residents should inform service personnel of the mask requirement before their arrival.
Thank you for your anticipated cooperation.
pool rules during covid-19 pandemic (may 22, 2020)
The Centers for Disease Control and Prevention have determined that there is no evidence that the virus that causes COVID-19 can be spread to people through the water in swimming pools. Notwithstanding the COVID-19 outbreak, state and local governments have ruled that swimming pools may be opened.
In consultation with its property managers, counsel, and other advisors, the River Tower at South Bluffs Homeowners Association has adopted the following Rules and Regulations for the use of the pool during the outbreak. These Rules and Regulations will be in effect until further notice from the Association.
1. Only residents of River Tower may use the pool. No guests are permitted.
2. The maximum number of residents that may use the pool or the pool area at any time is 30.
3. All residents must sign in with the guard before going to the pool area. This will help to ensure compliance with occupancy limits.
4. Residents may not reserve a seat if they are not present at the pool area.
5. All residents using the pool must be in groups of fewer than ten (10) people, whether in or out of the pool. All such groups of fewer than ten (10) residents must maintain at least six (6) feet of separation from other groups, whether in or out of the pool.
6. So that all residents have an opportunity to use the pool, residents may use the pool for a maximum of forty-five (45) minutes per day.
7. When out of the water, all residents inside the pool area must wear a face mask or other face covering, unless they are under the age of two (2), have trouble breathing, or are unable to remove a face covering without assistance.
8. Pool users should wash their hands frequently, cover coughs and sneezes, and properly dispose of tissues.
9. Residents should avoid the pool area if they have a cough, fever, or other symptoms of COVID-19, or if they have been exposed to someone who has COVID-19.
10. Between the hours of 6:00 A.M. until 9:00 A.M., the pool is reserved for residents over the age of 55, pregnant women, and residents with chronic medical conditions or compromised immune systems. No others may use the pool at those times.
11. Sharing equipment among non-family members is not permitted (this includes, for example, fins, snorkels, kickboards, goggles, water weights, pool noodles, floats, and pull buoys).
12. Any personal items left overnight will be disposed of daily.
13. Swimming lessons and other classes are not permitted.
14. Pool furniture within the pool area may have been removed or relocated to provide for social distancing. Residents are not permitted to move such furniture.
15. Residents are responsible for cleaning all chairs, tables, lounges, and other pool furniture after each use.
16. All other pool rules as detailed on page 21 of the River Tower Resident Handbook that are not specifically addressed in this document, will remain in full force and effect.
Residents should be advised that the River Tower at South Bluffs Homeowners Association is unable to provide cleaning, sanitation, or lifeguard services for the pool and pool area. All residents must make an informed decision whether or not to use the pool.
Residents use the pool at their own risk.
The River Tower at South Bluffs Homeowners Association relies on all residents of River Tower to follow these rules and regulations so that all residents can use the pool safely. If the Association becomes aware that residents are not following these rules and regulations, it will be forced to close the pool.
Thank you for your anticipated cooperation.
back to business framework & Guidelines (May 4, 2020)
Please understand that these guidelines are temporary and should be seen as a ‘mild’ re-opening. We need to be ready to resume a more stringent physical distancing program if COVID-19 infections spike in Shelby County. After six weeks of closures and extreme distancing measures, being cautionary for a couple more weeks can’t hurt too much.
· Guests or visitors are not permitted during phase one of re-opening.
· Guests or pet sitters are not permitted to reside in units during the absence of the unit owner.
· Again, this policy is temporary. We can possibly resume a more normal visitor policy in phase two.
Swimming Pool & Sundeck
· The Shelby County Health Department has not cleared public pools to be opened during Phase One.
· The fitness center will be open regular hours. (24/7)
· Residents should safely distance themselves, at least six (6) feet, from other residents working out.
· As per Phase 1 of the Mayor’s Plan, there is a 45-minute time limit on workouts daily.
· The number of residents in the fitness center at any given time must not exceed three (3).
· Each individual should consider cleaning/disinfecting the equipment before using it.
· Each individual must clean/disinfect all equipment that they have used before leaving, including benches, seats, and hand-weights.
· You will need to bring your own floor mat, if desired. Please take it with you when you leave.
· Residents are advised to use face masks and gloves while in the fitness center, but it is not required.
· Please be aware that others may be waiting to use the fitness center.
· The fitness room will be cleaned twice daily in the morning and afternoon by staff. Please wait outside while the room is being cleaned.
Maintenance, Repairs, & Renovations
· Preventive maintenance and repairs may be scheduled.
· No renovations will be permitted at all during this time.
· Food deliveries should be picked up by the resident in the lobby.
· All move-ins and move-outs must be scheduled with management and will only be allowed Monday through Friday, between 8 and 5. Unscheduled movers will be denied access.
· Open-house is not permitted at this time. Showings should be arranged with management.
· No more than two in an elevator at any time except for families. Do not enter elevator if two individuals are already in the elevator.
· No more than one in the locked mail room at a time, and no more than two in the unlocked portion of the mailroom. Stay back, be patient, and wait for it to clear out. Do not enter mailroom when the postal workers are there.
· No more than two residents with dogs inside the dog park at one time.
· Business meetings or gatherings of any kind in the building are not permitted.
The Association’s decisions must always be subordinated to life safety and not to convenience. Therefore, the same steps used by the Association to evaluate when and how to close at the start of the pandemic to combat the spread of COVID-19 in our community will be employed to determine our reopening.
The Association has followed cues from state, local, and federal governments and heeded the advice of medical and management professionals and the Association’s counsel when crafting and enforcing our pandemic guidelines.
The Association has tried to be reasonable in its decisions and tried its best to discharge its duties in good faith and in the best interests of everyone. As the Association has a fair number of “60 and Over” residents and those with underlying medical conditions, the Association will not rush to re-open certain aspects of the common area before it is safe to do so. That is the reason the Association will evaluate after two weeks how well the Association and how well the surrounding community is doing before expanding or terminating some of the above rules.
**Please continue to practice social distancing and good hand hygiene.
**These guidelines will be reviewed May 18 after the Association evaluates how well Memphis, Shelby County, and the surrounding metropolitan area has done during the first two weeks of reopening.
PLan for Re-opening (May 1, 2020)
PLAN FOR RE-OPENING
The Association is aware that the past weeks have been difficult for every one of us. We are aware that members of our community have made serious sacrifices. We have residents who have put their livelihoods and their ability to take care of their families on the line. We have healthcare employees and other frontline workers who have continued to serve through a very tough period of hardship.
Our mission from the beginning of this pandemic was to safeguard our community, and try to do our best to see that no one came down with the Coronavirus during these unprecedented times. So far, we have succeeded, and that only happened because of you. Without your patience, cooperation, understanding, assistance and determination, the Association could not have accomplished its mission so far. You are to be congratulated and we give thanks to everyone for your cooperation in helping to limit the spread of the virus not only in our building, but also throughout Memphis and Shelby County.
With that being said, phase one of the 3-phase Back-to-Business plan with the City of Memphis and Shelby County will begin May 4. For a review, visit: Framework – Back to Business. This website will give you a rundown of different business requirements for them to be able to operate under in the different phases.
Note that as we advance through different phases, reversal of phase advancement could occur based on negative trends in the data, metrics, and different parameters. There will be at least two weeks between each phase. City leadership will be monitoring the situation and, if deemed necessary, can delay the next phase or reverse the phase.
We are grateful for your thoughtful diligence in following the guidelines for staying home and practicing social distancing. While these practices have gotten us to the point where we are comfortable with a phased reopening of our economy, it’s not the time to forget those good habits that we have established. For the Association, continue to stay home when you can, wash your hands frequently, wear a mask in public and continue to practice social distancing. By Monday afternoon, the Association will be updating its recommendation for our residents. Until then, continue to remain in Level Three, which is how we have been operating for the past five weeks. We must work together to ensure that this reopening is successful.
*Updated Community Guidelines will be announced by email on Monday, May 4, 2020.*
Soap vs. sanitizer: Which is better? (April 8, 2020)
All Coronaviruses (COVID-19 included) and Influenza viruses are killed by all forms of soap and alcohol fairly readily. However, washing with soap and water is better than alcohol based hand sanitizers although they both kill COVID-19. The difference between the two is that alcohol takes a little longer to kill viruses on the skin than soap, because soap performs two functions. The first is that soap disrupts the virus’ outer membrane and in effect kills the virus similar to how alcohol kills the virus, but soap also emulsifies viruses on your skin and lifts them off your skin, which allows running water to flush it down the drain.
So soap and water is the preferred method of washing your hands. Any brand of soap, liquid, solid or scented, will suffice. They all do the same thing and it doesn’t really matter the formulation of soap, either. You don’t need “antibacterial soap”—which the Food and Drug Administration advises to skip altogether due to a lack of evidence of its usefulness. The only trick to killing the virus with alcohol or soap is that this all takes a little time to happen, and that’s why you need to take at least 20 seconds to wash your hands.
Why? First off, your skin is wrinkly, and it takes some time for soap to penetrate into all the tiny folds and demolish the viruses that lurk within. Then the soap needs a few moments to do its chemical work. You do need a bit of time for all the soap to interact back and forth with the virus particle. Twenty seconds does the trick just fine. Alcohol does the same thing; however, you need a very high concentration of alcohol, 60% or higher, to achieve the same effect of killing the virus. The problem with alcohol-based sanitizers is if your hands are wet or sweaty or dirty when you use the sanitizer that can dilute it and diminish its effectiveness. Also, sanitizers do not clean your hands of sticky grease to which viruses can also adhere.
The best method for avoiding germs and viruses on your hands is washing your hands thoroughly with soap and water. The physical act of hand-washing and running water really does remove a very, very large percentage of bacteria, viruses, dirt and grime, something that hand sanitizer does not do. The benefit of hand sanitizer is the ability to combat germs when water and soap are not immediately available.
You often hear that the water you wash with should be warm, but why? After all, even hot water does not kill bacteria or viruses until you get to a temperature that would scald your skin. Cold water will work, but you have to make sure you work really vigorously to get lather and get everything soapy and bubbly.
HOMEMADE CLOTH FACE MASK (April 6, 2020)
Scientists now know that people who are infected with the new coronavirus can spread it even when they don’t have symptoms. (This was not known in the early days of the current pandemic.) Up to 25% of infected people may not show symptoms, said CDC director Dr. Robert Redfield. They’ve also learned that people who are symptomatic shed the virus up to two days before showing symptoms. “This helps explain how rapidly this virus continues to spread across the country.”This silent spread also bolsters the case for people in the general population to wear masks when in public, since anyone could be sick.
With the realization there are individuals who are asymptomatic and can spread infection, it’s hard to make the recommendation that only ill individuals wear masks in the community setting for protection, because it’s not clear who is ill and who is not.
However, there are two sides of the issue regarding the wearing of a mask. One side believes that if everyone wears a mask when they leave their house, then people who have the virus but who don’t have symptoms will be wearing a physical barrier that can catch infected droplets that escape their mouth or nose. That helps protect everyone.
People in the second camp believe that the available scientific evidence does not show that masks are effective enough in public settings to warrant a mass recommendation, and that wearing one may give people a false sense of protection and embolden them to ignore recommendations that are actually effective, like staying away from other people. They also believe that wearing a mask can inadvertently encourage people to touch their face more. (See the very end of this write up for a second camp view.)
Nonetheless, the general thinking is that there is some data that would demonstrate some potential benefit of masks. It’s hard to be dogmatic and overly dismissive of the data. With that in mind, the CDC on Friday recommended wearing cloth face masks in public settings where other social distancing measures are difficult to maintain, (e.g., grocery stores, convenience stores, pharmacies, etc.), especially in areas of significant community-based transmission.
When you hear face masks for COVID-19 prevention, there are generally two types recommended for healthcare providers: surgical masks or N95 respirators.
The CDC is not recommending surgical masks or N95 respirators for the general public. It is an option that everyone can decide for themselves whether to wear a cloth face mask or not to wear one; it is not mandatory; it is optional. The CDC is advising the use of simple cloth face masks to help slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. Cloth face masks fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure to be used with social distancing, hand washing, etc.
There have been several studies that tested whether homemade cloth face masks helped tamp down on the spread of respiratory viruses and protect healthy people from getting sick. Across these studies, it’s quite consistent that there’s some small effect and there’s no risk associated with wearing masks, if appropriate precautions are taken. The CDC felt like it would be prudent to recommend some kind of face mask at this point to protect individuals.
When to use a cloth face mask
· If you are healthy, you should consider wearing a cloth face mask in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores, convenience stores, pharmacies, etc.), especially in areas of significant community-based transmission.
· Wear one if you are coughing or sneezing.
· It is effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water and social distancing.
· If you wear one, then you must know how to use it and dispose of it properly.
· Make sure it fits snugly over your face.
No matter how well it seals to the face no cloth face mask will eliminate exposures entirely.
How to put on, use, take off and dispose of
· The user should visually inspect the product prior to use and, if there are concerns (such as degraded materials or visible tears), discard the product.
· Before putting on, clean hands with alcohol-based hand rub or soap and water.
· Cover mouth and nose first and make sure there are no gaps between your face and the mask. Then fasten tightly.
· Avoid touching the mask; if you do, clean your hands with alcohol-based hand rub or soap and water.
· Replace with a new one as soon as it is damp or soiled.
· After removing it and in so doing do not touch the front of the mask; discard immediately in a closed bin; clean hands with alcohol-based hand rub or soap and water.
· Wash it before using again to be safe.
Common mistakes include not being pressed or tightened against the contours of the user's face and not fitting tightly over the face and nose. For safety, the mask cannot leave gaps between the skin. Some use tape on the sides of the mask to close up gaps. Replace it if it becomes damaged or damp. Whatever you do, don't get a false sense of security.
Wearing a mask will probably help—as long as you wear it properly, clean it often, wash your hands, continue to not touch your face, and physically distance yourself from other people. And just know that there’s limited evidence that wearing a homemade mask will protect you from getting sick. If you decide to wear a homemade mask, just be mindful of what the possible benefits are and what the possible limitations are. And be realistic.
There have been several studies which offer some insight into the usefulness of each fabric, should you choose to make a mask. As you look at these four studies, remember there are variations in reported efficiency and such, but by looking at these and other studies, which you can research yourself, one can get an idea of a fabric’ usefulness against the coronavirus.
(1) English researchers evaluated several household materials to determine which one offered the most protection during a pandemic. Here is what English researchers found in 2013 regarding the mean % filtration efficiency of various materials using both a single and a double layer of each material for the MS2 virus (a commonly used surrogate for Coronavirus). Filtration efficiency tests measured how well each mask material filtered out the tested organism:
Tea Towel [Dish cloth]: 72.4%; Cotton Mix: 70.2%; Antimicrobial pillowcase: 68.9%; Linen: 61.6%; Pillowcase: 57%; Silk: 54.3%; 100% cotton T-shirt: 50.8%; Scarf: 48.8%
From this test, it was found to be harder to breathe through more layers and through different materials. (https://www.designworldonline.com/cdc-weighs-diy-facemasks-for-the-general-public-heres-the-science-behind-mask-materials/).
(2) Then there is a document summarizing the current evidence from the Stanford Medicine Anesthesia Informatics and Media Lab, which is assisting front line anesthesiology providers in their efforts against the current COVID-19 pandemic. The document includes a table showing the comparative effectiveness of various mask materials in filtering viral-sized particles, in this case the bacteriophage MS2 virus. Surgical masks rated 90% effective; vacuum cleaner bags 86%, tea towels 72%, antimicrobial pillow cases 69%, cotton T-shirts 51% and scarves 49%. Their findings suggested that “a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection.
The authors also noted that there were tradeoffs to be made in terms of difficulty breathing through items like vacuum cleaner bags, which was probably due to less secure mask fitting. It is also clear that home-made masks such as tea towels may still confer a significant degree of protection, albeit less strong than surgical masks or N95 masks. (https://smartairfilters.com/en/blog/diy-homemade-mask-protect-virus-coronavirus/).
(3) A Wake Forest Institute for Regenerative Medicine tested a variety of cloth materials to see which ones not only allowed for breathability, but also filtered small particles—such as viruses. To test various masks and fabrics, the team pumped air through both types of face coverings. Their instruments could read down to 0.3 microns, which is about the size of a big virus. Regular surgical masks filtered out 62 percent to 65 percent of particles. For comparison, N95 masks filtered 95 percent of those particles. But the fabrics led to a variety of results. One piece of cloth filtered just 1 percent of particles, rendering it virtually useless, while others were found to perform even better than the surgical masks. They had some that performed at 79 percent. The best masks were constructed of two layers of heavyweight "quilter’s cotton" with a thread count of at least 180, and had thicker and tighter weave. Lesser quality fabrics also worked well, as long as they had an internal layer of flannel. If you can, use a woven fabric, like batik, but don't use a knit fabric, because the holes between the knit stitches are bigger. In other words, if the fabric allows for a substantial amount of light to shine through, it's probably going to allow tiny viral particles through, as well. (The research from Wake Forest has not been submitted for publication and has not yet been peer-reviewed.)
(4) A 2010 study by the National Institute for Occupational Safety and Health (NIOSH) tested how well tiny particles could penetrate different materials such as sweatshirts, cotton T-shirts, scarves, and towels. Sweatshirts were found to offer slightly better protection than tees against the particles—blocking about 20-30% of particles compared to fewer than 14% from the T-shirt. Cotton towels were also found to be more protective than scarves, blocking about 34-40% of particles compared to 11-27% with scarves.
Other hospitals, such as Vanderbilt University Medical Center in Nashville, have also suggested using tightly woven fabrics for do-it-yourself facial coverings. Kaiser Permanente published instructions on making DIY masks, calling for two layers of cotton fabrics with a tight weave.
Other suggestions: You can use the same fabric for the outer and inner linings if you want, or use different ones to help you remember which side is clean and which is dirty or use different colors for the inner and outer linings so you know which side to expose to the outside environment, i.e., you should always have the same side facing outward (the contaminated side). Wash all fabrics before sewing to pre-shrink, and to assure you are working with the most sanitary materials possible. Don't use stretchy, sequined or velvet material. The mask should reach above the bridge of the nose and below the chin and extend across the cheeks to beyond the corners of the mouth, so no gaps, if possible, occur when talking or moving. The fit is important. A mask should be snug. A fabric tie might work better than an elastic band. Layers add additional protection, so three-ply is good, as is including a small pocket or pouch, into which an additional filter can be inserted, such as an industrial air filter with a high rating for filtration, for additional protection. Vacuum bags are highly effective filters, according to the document put out above by the Stanford Anesthetics Informatics and Media Lab, but may not be a good choice because of the effort required to breathe through them. Paper towels and wet wipes are too porous and are of little use. Masks with a silky outer layer (if possible), middle layer of a thick, tightly woven material like cotton, and then comfortable cotton on the inside are ideal. Skip the wool or other fabrics that can cause allergies or irritate your skin. Or another way: an outer layer of tea cloth, inner layer of a micro-fleece to wick away moisture, and an inner tea cloth layer. When selecting material, a trade-off must be made between filtration efficiency and breathability.
More information about homemade face masks
While homemade face masks of scarves and antimicrobial pillowcases and others made from various materials may offer some degree of protection, they offer a lot less protection than surgical masks or N95. Nevertheless, anything that can even be 10% effective, 50% effective, is something one should consider. Many in the U.S. are reluctant to wear a face mask because doing so is still “a symbol that you’re sick in some way,” But the best way to look at this is that you are not only protecting yourself, but more importantly that you are protecting your family and other people.
Cloth face masks should be routinely washed depending on the frequency of use. A washing machine should suffice in properly washing a face covering. Avoid using bleach or other harsh chemicals until it is known the effect on the fabric's effectiveness. Additional studies will be needed to determine whether masks retain their filtering ability after multiple cycles through the washing machine. Wash it every day and hang it outside to dry, if possible. Sunlight is very germicidal. It is advised that two or more sets of such face covers be made so that one can be washed and dried while the other is used. There should not be a sharing of face covers and a face cover must be used by only one individual. So, in a family of several members, each member should have a separate face cover and a backup.
Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.
The internet has many examples on DIY cloth face masks. The following are two from the CDC:
In deciding to use a cloth face mask, remember that face masks must be worn correctly, must remove them carefully to avoid their hands becoming contaminated, and used in combination with good universal hygiene behavior in order for them to be effective.
Furthermore, please do your own research and not rely on this write-up to be definitive or thorough. This write up does not endorse any one homemade mask pattern or fabric because there’s no evidence pointing towards one type or fabric to use. Furthermore, this write up should not influence your decision on whether to wear a mask or not, nor should it replace your knowledge gained from your own research. Your decision rests on your own judgment, and other sources should be relied upon. The sources cited herein should be checked.
Remember, your mask can potentially keep someone else safe while their mask can potentially keep you safe. It prevents at least some of your respiratory droplets from spreading to others while in public. That could be enough to make a difference, and just to have even a small effect is useful.
Here is one of many counter arguments to wearing a homemade mask under the heading: “The biggest problem with DIY masks: Unlike surgical masks, household fabrics can absorb viral particles.” https://www.businessinsider.com/does-homemade-diy-cloth-mask-work-protect-against-coronavirus-2020-4?op=1.
COVID-19 “SHELTER-IN-PLACE ORDER” (April 3, 2020)
Tennessee Governor Bill Lee took his earlier “Stay-at-Home” order a step further Thursday by issuing an executive order: “Shelter-in-Place,” which clearly requires that Tennesseans stay at home unless they are carrying out essential activities or business.
From Alisa Haushalter, DNP, RN, PHNA-BC, Director of Shelby County Health Dept:
“Confirmed coronavirus cases hit 638 in Shelby County as of Thursday afternoon, up 28% from 497 Wednesday, with seven deaths. Statewide, there are 2,683 people with the virus as of Thursday morning and 24 have died from it. Statewide, 32,452 have been tested with a positive rate of 8.27%.The positivity rate of those tested in Shelby County is 9.1%. Health officials expect the surge of patients in hospitals to occur the third week of April to the first of May.
“People who are tested, and testing is increasing, should isolate themselves until test results are known. That means staying at home, not going in or out. Family members should stay in a different part of house during isolation.
If you are a contact of someone who tested positive, you should isolate yourself for 14 days, again not going in or out of your house, and should separate yourself from family members.
“If you are caring for a sick person at home, wear gloves and a mask if you have them.”
Haushalter said it is recommended that swimming pools not open.
“The need for more beds is being worked on,” she said, including a site for a new 1,000-bed hospital that will be announced soon.
“One of the two new deaths is under age 40. Another victim was over age 80. It’s a once-in-a-lifetime epidemic and should be treated as such.”
Tennessee is expecting the demand for hospital resources to reach its zenith on April 19. The city’s COVID-19 website shows 200 people across the state are hospitalized as of Thursday morning. As more people get sick, the U.S. Army Corps of Engineers is evaluating sites in the Memphis area to convert to medical care facilities to ease the burden on hospitals. At this time, it appears as though Gateway Shopping Center on Jackson Avenue will be used as an alternative care site for COVID-19 patients.
The search for more medical sites comes as hospitals, anticipating a patient surge, seek out more supplies, including masks, ventilators, and beds. Residents are urged to follow social distancing rules and stay home as much as possible as infections rise. Still, officials worry the need for key supplies and medical staff will exceed capacity.
Data from both state and local health departments shows people 21 to 30 years old account for the highest percentage of cases.
COVID-19 TESTING update (April 1, 2020)
The University of Tennessee has developed a digital triage tool to help evaluate your symptoms and determine if you need to be tested for COVID-19 at this time. Go to this website: https://www.mycareplan.net/covid-19/ and click “LAUNCH QUESTIONNAIRE.” Depending on how you answer the questionnaire, it will tell you whether you need to be tested or not. The following is from their website.
Where can I get tested?
The testing site is located at Liberty Bowl Stadium. The physical address is 335 S Hollywood St. The testing tents are stationed in Tiger Line. You will enter at the intersection of Central and Early Maxwell. Look for signs. Mobile drive-thru site operations are daily from 8 am - 4 pm (except for inclement weather). Appointments REQUIRED for testing.
You are required to remain in your vehicle at all times unless instructed to vacate by a member of our health care personnel. All testing will take place in your car. The line may be long, so please arrive at least 5-10 minutes prior to your scheduled appointment. Please bring a valid form of ID that you can share through the window of your vehicle. At this time, you are the only person who will be tested. Even if you bring other people in the vehicle they WILL NOT BE TESTED.
Results are delivered by health care personnel 3-5 days from the date of testing. They will notify you with the contact information you provided. Additional printed information will be acquired at the testing site. Should your symptoms worsen prior to receiving your test results, contact your primary care provider or report to the emergency department with severe symptoms.
Christ Community clinic also offers testing—but text first!
If you would like to be tested at a Christ Community clinic, start by sending a text message with the code "Test2020" to the phone number 91999. You will then be prompted to fill out a brief form online. A nurse will call you back and ask you questions about your symptoms and contacts. You will then be given an appointment. The primary testing location is now the Christ Community Health Services Third Street Health Center: 3362 S. 3rd St, Memphis, TN 38109. All testing is by appointment. It is drive-through and testing takes place from 3 p.m. to 4 p.m. Monday through Friday, with limited hours on Saturday and no testing on Sunday. As of Tuesday, Christ Community had run about 200 tests. The tests are free and the samples are processed with commercial labs, including LabCorp and others.
Baptist Memorial Health Care is offering testing
Baptist Memorial Health Care operates numerous hospitals and other health care facilities in west Tennessee, Arkansas and Mississippi. Various Baptist clinics, minor medical centers and emergency rooms are conducting coronavirus tests. Anyone seeking testing at a Baptist facility should start by calling the coronavirus resource center at 866-941-4785. The number is staffed by nurses 24 hours a day, seven days a week. They will hear about your symptoms and let you know if you should get a test per Centers for Disease Control criteria or if not, what the next steps are. The nurses can also advise you on the best place to get the test. The cost of the test varies based on where you get the test. Baptist sends its samples to the commercial lab, AEL, for processing. As of Tuesday, March 31, the health care system had conducted 7,211 tests across its regional system.
COVID-19: UPDATE (MARCH 27, 2020)
The best resource for COVID-19 information is the CDC. Below are a few helpful links.
How to prepare (Topics: How it spreads, Protect Yourself, Protect Your Family, and more.)
Symptoms & Testing (Topics: Symptoms, Should You Get Tested, Reducing Stigma)
If You Are Sick (Topics: What to Do If You Are Sick, Caring for Someone)
COVID-19 Information and Updates by Locale
Shelby County (via Shelby County Health Department)
State of Tennessee (via Tennessee Department of Health)
United States (via Centers for Disease Control and Prevention)
World (via World Health Organization)
Important Miscellaneous Information
The severity of the novel coronavirus can differ from person to person.
What is so critical for people to know is that if they get mild, cold-like symptoms, they should assume until proven otherwise by testing or a primary healthcare provider or clinic that they have COVID-19, and self-quarantine themselves until you can contact your primary healthcare provider, clinic, or the Shelby County Health Department.
There are varying levels/stages of severity. There are mild cases, which look and act like the common cold, with no fever, while others will have some respiratory symptoms, sore throat, runny nose, fever, headache and others will have shortness of breath, fever, cough, pneumonia and/or respiratory failure. And there can be varying levels of severity of shortness of breath and pneumonia all the way to assisted breathing by a ventilator to multi-organ failure and death. And there can be unusual symptoms as a few studies state that patients with some early mild symptoms reported that they couldn’t smell or taste anything. A temporary lack of smell or taste also affected some SARS patients in 2002. This symptom may indicate that the virus may infect nerve cells responsible for identifying odors.
It’s important to remember that no matter how healthy and active you are, your risk for getting pneumonia increases with age. This is because our immune system naturally weakens with age, making it harder for our bodies to fight off infections and diseases. Also, remember that the two groups most at risk of experiencing severe illness due to this coronavirus infection are older adults, defined as “over 60 years old,” and individuals who have other health conditions that compromise their immune system.
Why is self-quarantining so important early on when you develop even mild symptoms? People who contract the novel coronavirus emit high amounts of the virus very early on in their infection, which explains why we’re seeing so much transmission within our communities, according to a new study from Germany, which helps to explain the rapid and efficient way in which the virus has spread around the world. Shedding from the upper airways (nose, throat or larynx) early in infection makes for a virus that is much harder to contain. Very high levels of the virus are emitted from the nose and throat of patients from the earliest point in their illness—when people are generally still going about their daily routines. Just one sneeze can spread the disease to someone close by.
The scientists said at peak shedding, people with COVID-19 are emitting more than 1,000 times more viruses than was emitted during peak shedding of SARS infection in 2002, a fact that likely explains the rapid spread of the virus. The SARS outbreak was contained after about 8,000 cases; the global count of confirmed COVID-19 cases has already topped 462,684; confirmed in the United States: 85,356; confirmed in Tennessee: 957; confirmed in Shelby County: 223, as of March 27, 2020. (TN Department of Health, CDC, and WHO websites report up to date numbers each afternoon.)
Present data confirm what the spread of the disease has been signaling—early and potentially highly efficient transmission of the virus occurs before clinical symptoms or in conjunction with mild symptoms at the very first of the infection. The study also noted that people develop antibodies to the virus quickly, typically within six to 12 days after the symptoms started. The rapid rise of antibodies may explain why about 80% of people infected with the virus do not develop severe disease. When/if the infection progresses, the virus moves deeper into the lungs.
The early contagiousness of the virus tells us that gatherings of people and limiting visitors should be avoided as the virus shows very effective person-to-person transmission. The virus does a great job of replicating in the upper respiratory tract, even when people don’t have any symptoms or just begin to feel sick. Researchers currently believe one infected person generally infects two to more than three others, which would make the new coronavirus more contagious than seasonal flu, SARS and MERS.
Grocery Shopping Safety & Meal Delivery Tips (March 26, 2020)
Here are some precautions to take:
The above site has some good advice and recommendations. For the “Avoid a direct hand-off” advice/suggestion from the website, the Homeowner’s Association is only allowing deliveries of meals and groceries to the front lobby. Please try to pay and tip online/app and try not to pay with cash. Do not approach the delivery person closer than six feet. If the delivery is groceries, get a cart and ask the delivery person to place the groceries in the cart. If the delivery is food, ask the delivery person to place the box(es) on the coffee table in the lobby. It has been reported that the virus can stay on cardboard boxes for 24 hours (plastic also), so you might want to pick up the cardboard box(es)and/or plastic with gloved hands and certainly wash your hands after you get back to your unit. If no-contact delivery option is offered, use it.
If you shop at the store―take sanitizing wipes and hand sanitizers with you so you can clean any shopping carts or baskets you use. If you use gloves remember that if your gloves touch a contaminated product, they will just contaminate the next thing that is touched. Just shop with caution, and avoid touching your face, eyes, and nose as you walk about the store. Use hand sanitizer after going through the checkout. Also, don’t take the whole family along and limit your time in the store as much as possible. If you can, use a credit card in lieu of cash.
The riskiest areas will be those with items people touch the most, like salad bars (which should be avoided these days) and the produce section. Make these your last stops in the store to avoid transferring the virus, if present, to other areas. Typically, picking produce involves touching and poking around for desired ripeness, but these days it's best to avoid touching anything you don't have to and use your eyes to dictate what's fresh. For example, avoid fresh foods with obvious bruises or brown spots. If the food comes in plastic packaging, be mindful to touch just the one you want to select.
Grab a plastic produce bag and put your hand inside and use that to pick up something like a head of lettuce or tomatoes. Then drop it into another bag and seal it up. This way you’re not touching everyone else’s produce and if everyone followed this practice, it could go a long way in helping to curb the spread of germs.
Many think they are saving the environment by forgoing the paper bags issued at checkout, but during a viral outbreak, disposable might be better. How many people do you know that bring their own bags clean out those bags or spray them with disinfectants or sanitizer afterward? Not many. These bags, if not properly sanitized after use, have high levels of bacteria and potentially viral particles inside and if reused too quickly―and without proper sanitation―could potentially infect you. If you’re going to reuse them, wash them out or sanitize them afterward.
You should also order earlier than you normally do since delivery times are filling up faster than usual and availability may be limited.
The U.S. Department of Agriculture does not currently have any reports of human illnesses that suggest COVID-19 can be transmitted via food or food packaging. Furthermore, the CDC reports, COVID-19 isn’t known to be transmitted through food. However, it is always important to follow good hygiene practices—i.e., wash hands and surfaces often, separate raw meat from other foods, cook to the right temperature, and refrigerate foods promptly―when handling or preparing foods. We still need to be cautious because all of these viruses can mutate. And what we say today may be different tomorrow.
And since we’re still learning more about the virus daily, it’s a good idea to take any extra precautions you can.
If you’re immunocompromised, consider buying pre-packaged produce that likely has undergone strict sanitation standards at the packing site.
For the elderly and those with a chronic medical condition―have someone shop for you; if that is not possible, then it is a good idea to shop at grocery stores that have dedicated hours that are for more vulnerable populations to shop―ones in which there will be fewer people, and where cleaning can take place beforehand.
The greatest risk at grocery stores is contracting the virus from person-to-person transmission and less of a risk when touching produce, cans, or other items at the grocery store, and don’t take the receipt if you don’t specifically need it. Moreover, when you can, use your own pen to sign receipts.
If you’re ordering takeout, stick with restaurants you know and trust
Now is not the time to take a chance on a new spot. In times like these, it’s important to have a sense of familiarity with a restaurant and to feel safe about its sanitation practices. Is this a place you’ve gone to before and you know what you’re getting yourself into, as opposed to ordering from a facility that you know nothing about? For the time being, it is best to order from your typical go-to places.
If you drop in, take a visual inventory when you pop in to pick up your takeout. Watch how people are working and that they’re wearing gloves and they’re taking the gloves off and sanitizing and keeping their work areas clean/organized. Is the place clean, etc.?
Temporary social distancing measures (march 23, 2020)
BEGINNING TUESDAY, MARCH 24, 2020, AT 6:00 P.M.
· Guests or visitors are not permitted per the mayor’s declaration.
· Guests or pet sitters are not permitted to reside in units during the absence of the unit owner.
· Housekeeping and dog walking services should be suspended.
Maintenance, Repairs, & Renovations
· All preventive repairs must be postponed or cancelled. If repairmen arrive to the property, they will not be allowed to enter the building. Emergency repairs will be allowed.
· No renovations will be permitted at all during this time.
· Food deliveries should be picked up by the resident in the lobby.
· Orders for furniture, appliances, etc. should be postponed. Exceptions could be made for inoperable appliances.
· All move-ins and move-outs must be scheduled with management and will only be allowed Monday through Friday, between 8 and 5. Unscheduled movers will be denied access.
· Open-houses are not permitted at this time. Showings should be arranged with management.
· The fitness center will be closed indefinitely after 6:00 p.m., Tuesday, March 24, 2020.
· No more than two in an elevator at any time except for families. Do not enter elevator if two individuals are already in the elevator.
· No more than one in the locked mail room at a time, and no more than two in the unlocked portion of the mail room. Stay back, be patient, and wait for it to clear out. Do not enter mail room when the postal workers are there.
· No business meetings or gatherings of any kind in the building.
· No more than two residents with dogs inside the dog park at one time.
Part-Time Residents or Second Homeowners
· If River Tower IS NOT your primary residence, please follow the mayor’s declaration to remain at home.
MEMPHIS MAYOR’S DECLARATION OF “SAFER AT HOME” (March 23, 2020)
BEGINNING TUESDAY, MARCH 24, 2020, AT 6:00 P.M.
HERE’S WHAT YOU CAN DO ACCORDING TO MAYOR’S DECLARATION:
· Go to the grocery, convenience or warehouse store
· Go to the pharmacy to pick up medications and other healthcare necessities
· Go to medical appointments (check with your doctor or provider first)
· Go to a restaurant for take-out, delivery or drive-thru
· Care for or support a friend or family member
· Take a walk, ride your bike, hike, jog and be in nature for exercise-just keep at least six feet between you and others.
· Walk your pets and take them to the veterinarian if necessary
· Help someone to get necessary supplies
· Receive deliveries from any business which delivers
HERE’S WHAT YOU CANNOT DO ACCORDING TO MAYOR’S DECLARATION:
· Go to work unless you are providing essential services as defined by this Order
· Visit friends and family if there is no urgent need
· Maintain less than 6 feet of distance from others when you go out
· Visit loved ones in the hospital, nursing home, skilled nursing facility or other residential care facility, except for limited exceptions as provided on the facility websites.
testing centers for covid-19 (mARCH 20, 2020)
Locations for COVID-19 testing will be added daily. Tennesseans should first call their usual source of care. If an assessment cannot be done in that location, individuals should call the assessment sites prior to going onsite. Most locations do a phone assessment to determine if an in-person assessment or test is needed. Most individuals, particularly those with mild or no symptoms do NOT need a test.
Remote assessment sites, or “drive-through testing" sites for the coronavirus/COVID-19, are quickly becoming available for Tennesseans to safely pursue COVID-19 testing without taking unnecessary risks.
Visit https://www.tn.gov/health/cedep/ncov/remote-assessment-sites.html and select Shelby County. Below is the current list as of March 20, 2020.
DO NOT SIMPLY SHOW UP AT ONE OF THESE SITES! CALL OR TEXT FIRST!
Christ Community Health Services Women's Center 2400 Poplar Ave #501 Memphis, TN 38112 901-842-3168 or Text “Test2020” to 91999
Christ Community Health Services Broad Avenue Health Center 2861 Broad Ave Memphis, IN 38112 901-842-3161 or Text “Test2020” to 91999
Christ Community Health Services Frayser Health Center 969 Frayser Blvd Memphis, TN 38127 901-842-3162 or Text “Test2020” to 91999
Christ Community Health Services Orange Mound Health Center 2569 Douglass Ave Memphis, TN 38114 901-842-3164 or Text “Test2020” to 91999
Christ Community Health Services Third Street Health Center 3362 S 3rd St Memphis, TN 38109 901-842-3166 or Text “Test2020” to 91999
Christ Community Health Services Raleigh Health Center 3481 Austin Peay Hwy Memphis, TN 38128 901-842-3165 or Text “Test2020” to 91999
Christ Community Health Services Hickory Hill Health Center 5366 Mendenhall Mall Memphis, TN 38115 901-842-3163 or Text “Test2020” to 91999
Care Memphis Clinic (drive thru) 493 Dr. M L King Jr Avenue Memphis, TN 38126 901-526-0802 Prioritizing current patients; Please call ahead for phone or telemedicine triage before scheduling drive up testing
COVID-19 Drive-Thru Assessment Center 3360 S. Third Street Memphis, TN 38109 901-842-3160 or Text “Test2020” to 91999 Please call or text to schedule an appointment
VACCINES FOR COVID-19 (March 20, 2020)
Human trials began this week—but even if they go well, there are many barriers before global immunization is feasible.
All eyes have turned to the prospect of a vaccine, because only a vaccine can prevent people from getting sick. About 35 companies and academic institutions are racing to create such a vaccine, at least four of which already have candidates they have been testing in animals.
Vaccines expose the body to an antigen, which is a small dose of virus parts. The antigens trigger an immune response: The body’s immune cells produce antibodies, which combat the invader and protect against further infection. There are several ways to create a vaccine. The first of these–produced by Boston-based biotech firm Moderna–entered human trials this week. Until the potential vaccine is tested in humans vaccinologists have absolutely no idea what the immune response will be.
This unprecedented speed is due to Chinese efforts to sequence the genetic material of COVID-19 (also called Sars-CoV-2). China shared that sequence in early January, allowing research groups around the world to grow the live virus and study how it invades human cells and makes people sick.
But there is another reason for the head start. Though nobody could have predicted that the next infectious disease to threaten the globe would be caused by a coronavirus–flu is generally considered to pose the greatest pandemic risk–vaccinologists had hedged their bets by working on “prototype” pathogens. The speed with which the vaccinologists have produced these candidates builds very much on the investment in understanding how to develop vaccines for other coronaviruses.
Coronaviruses have caused two other recent epidemics–severe acute respiratory syndrome (SARS) in China in 2002-04, and Middle East respiratory syndrome (MERS), which started in Saudi Arabia in 2012. In both cases, work began on vaccines that were later shelved when the outbreaks were contained. One company, Maryland-based Novavax, has now repurposed those vaccines for Sars-CoV-2 (COVID-19), and says it has several candidates ready to enter human trials this spring. Moderna, meanwhile, built on earlier work on the MERS virus conducted at the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland.
Sars-CoV-2 (COVID-19) shares between 80 and 90 percent of its genetic material with the virus that caused SARS–hence its name. Both consist of a strip of ribonucleic acid (RNA) inside a spherical protein capsule that is covered in spikes. The spikes lock on to receptors on the surface of cells lining the human lung–the same type of receptor in both cases–allowing the virus to break into the cell. Once inside, it hijacks the cell’s reproductive machinery to produce more copies of itself, before breaking out of the cell again and killing it in the process.
All vaccines work according to the same basic principle. They present part or all of the pathogen to the human immune system, usually in the form of an injection and at a low dose, to prompt the system to produce antibodies to the pathogen. Antibodies are a kind of immune memory which, having been elicited once, can be quickly mobilized again if the person is exposed to the virus in its natural form.
Traditionally, immunization has been achieved using live, weakened forms of the virus, or part or whole of the virus once it has been inactivated by heat or chemicals. These methods have drawbacks. The live form can continue to evolve in the host, for example, potentially recapturing some of its virulence and making the recipient sick, while higher or repeat doses of the inactivated virus are required to achieve the necessary degree of protection. Some of the COVID-19 vaccine projects are using these tried-and-tested approaches, but others are using newer technology.
Clinical trials, an essential precursor to regulatory approval, usually take place in three phases. The first, involving a few dozen healthy volunteers, tests the vaccine for safety, monitoring for adverse effects. The second, involving several hundred people, usually in a part of the world affected by the disease, looks at how effective the vaccine is, and the third does the same in several thousand people. But there’s a high level of attrition as experimental vaccines pass through these phases. Not all horses that leave the starting gate will finish the race.
There are good reasons for that. Either the vaccine candidates are unsafe, or they’re ineffective, or both. Screening out duds is essential, which is why clinical trials can’t be skipped or hurried. Approval can be accelerated if regulators have approved similar products before. The annual flu vaccine, for example, is the product of a well-honed assembly line in which only one or a few modules have to be updated each year. In contrast, Sars-CoV-2 is a novel pathogen in humans, and many of the technologies being used to build vaccines are relatively untested too. No vaccine made from genetic material–RNA or DNA–has been approved to date, for example. So the COVID-19 vaccine candidates have to be treated as brand new vaccines. While there is a push to do things as fast as possible, it’s really important not to take shortcuts.
We must urgently develop measures to tackle the new coronavirus—but safety always comes first. Make no mistake, it’s essential that we work as hard and fast as possible to develop drugs and vaccines that are widely available across the world. But it is important not to cut corners. Governments are understandably desperate for anything that would forestall the deaths, closures and quarantines resulting from COVID-19. But combating this disease demands a vaccine that is safe and potent.
An illustration of that is a vaccine that was produced in the 1960s against respiratory syncytial virus, a common virus that causes cold-like symptoms in children. In clinical trials, this vaccine was found to aggravate those symptoms in infants who went on to catch the virus. A similar effect was observed in animals given an early experimental SARS vaccine. It was later modified to eliminate that problem but, now that it has been repurposed for Sars-CoV-2 (COVID-19), it will need to be put through especially stringent safety testing to rule out the risk of enhanced disease.
It’s for these reasons that taking a vaccine candidate all the way to regulatory approval typically takes a decade or more. Most vaccinologists do not think a vaccine will be ready before 18 months, while some say maybe 12 months. That’s already extremely fast, and it assumes there will be no hiccups.
In the meantime, there is another potential problem. As soon as a vaccine is approved, it’s going to be needed in vast quantities–and many of the organizations in the COVID-19 vaccine race simply don’t have the necessary production capacity. Vaccine development is already a risky affair, in business terms, because so few candidates get anywhere near the clinic. Production facilities tend to be tailored to specific vaccines, and scaling these up when you don’t yet know if your product will succeed is not commercially feasible.
Once a COVID-19 vaccine has been approved, a further set of challenges will present itself. Getting a vaccine that’s proven to be safe and effective in humans takes one at best about a third of the way to what’s needed for a global immunization program. Virus biology and vaccines technology could be the limiting factors, but politics and economics are far more likely to be the barrier to immunization.
The problem is making sure the vaccine gets to all those who need it. This is a challenge even within countries, and some have worked out guidelines. In the scenario of this pandemic, for example, the U.S. will most probably prioritize vaccinating healthcare and social care workers, along with those considered at highest medical risk, with the overall goal of keeping sickness and death rates as low as possible. But in a pandemic, countries also have to compete with each other for medicines and vaccines.
Consider the U.S., 120 billion dollars of pharmaceuticals come from the rest of the world. Of the 20 largest ones, which account for fully 90%, ten of these have already imposed export restrictions on PPE (Personal Protective Equipment). China is the biggest of the ten but there are, as mentioned, 20 countries that supply us with pharmaceuticals. This is why America has to be self-sufficient.
Because pandemics tend to hit hardest those countries that have the most fragile and underfunded healthcare systems, there is an inherent imbalance between need and purchasing power when it comes to vaccines. During the 2009 H1N1(swine) flu pandemic, for example, vaccine supplies were snapped up by nations that could afford them, leaving poorer ones short. But you could also imagine a scenario where, say, India–a major supplier of vaccines to the developing world–not unreasonably decides to use its vaccine production to protect its own 1.3 billion-strong population first, before exporting any.
Outside of pandemics, the WHO (World Health Organization) brings governments, charitable foundations and vaccine-makers together to agree on an equitable global distribution strategy, while organizations come up with innovative funding mechanisms to raise money on the markets for ensuring supply to poorer countries. Each pandemic is different and no country is bound by any arrangement the WHO proposes–leaving many unknowns. The question is, what will happen in a situation where you’ve got national emergencies going on?
This is being debated, but it will be a while before we see how it plays out. The pandemic will probably have peaked and declined before a vaccine is available. A vaccine could still save many lives, especially if the virus becomes endemic or perennially circulating–like flu–and there are further, possibly seasonal, outbreaks. But until then, our best hope is to contain the disease as far as possible.
We must urgently develop measures to tackle the new coronavirus—but safety always comes first. Make no mistake, it’s essential that we work as hard and fast as possible to develop drugs and vaccines that are widely available across the world. But it is important not to cut corners. Governments are understandably desperate for anything that would forestall the deaths, closures and quarantines resulting from COVID-19. But combating this disease demands a vaccine that is safe and potent. The worry of many is that this could mean a vaccine is administered before its efficacy and safety have been fully evaluated in animal models or clinical trials.
Testing vaccines and medicines without taking the time to fully understand safety risks could bring unwarranted setbacks during the current pandemic, and into the future. The public’s willingness to back quarantines and other public-health measures to slow spread tends to correlate with how much people trust the government’s health advice. A rush into potentially risky vaccines and therapies will betray that trust and discourage work to develop better assessments.
Science often appears to move at a frustratingly slow rate, especially when something as serious as the coronavirus is spreading so quickly. But science like this needs to move slowly in order to make the proper drugs to save live, while being safe so that the vaccine doesn’t create—rather than solve—a public health crisis. Developing vaccines that are safe and effective takes time, investment, and good science. Developing a vaccine for a coronavirus like the one that causes COVID-19 comes with even more challenges. Such as a vaccine manufacturers can go through all of the testing and approval processes and the outbreak too often is waning by the time the vaccine candidate is ready for widespread testing. SARS disappeared just four months after it caused a global panic. The companies that had begun developing a vaccine against it had to abandon their trials because there just weren’t enough patients. In addition, government funding and pharmaceutical industry interest tend to evaporate once the sense of emergency fades away. No one wants to make a product that’s not going to be used.
National Institute of Allergy and Infectious Diseases director Anthony Fauci told U.S. senators, “It will take at least a year and a half to have a vaccine we can use.” That might seem like an eternity for public health officials staring down a probable pandemic. But if true, it would actually set a record. Most vaccines take between five and 15 years to come to market.
For the Shelby County Health Department COVID-19 Call Center, Dial: 833-943-1658
Available to take calls 8:00am-4:30pm, Monday-Sunday
COVID-19 INFORMATIONAL UPDATE (March 18, 2020)
Tuesday Shelby County Health Department officials said a third patient tested positive for COVID-19, who arrived in the county feeling ill, sought medical care and the treating physician had a test performed by a private lab. That person is now isolated in a home setting and is not hospitalized. The patient is from out of the country with a lengthy travel history. The unidentified person is an individual that absolutely from out of the U.S. that has been in the U.S. for many months and has been traveling extensively over the U.S. and throughout the U.S. The health department said the person did not contact the virus here but while traveling.
Over the past few weeks, it has become clear that the world is facing an unprecedented challenge from COVID-19, commonly known as coronavirus. This is a highly volatile time with many changes happening daily. Like you, the board wants to do what we can to help keep our communities and our families safe and healthy.
On behalf of River Tower, we want to let you know how the Board is responding to the situation. We take our responsibility to our residents and our management employees very seriously.
From the onset of this situation, we have been listening and responding to the appropriate sources for accurate and up-to-date information, and our action and preparedness plan reflects those inputs. As things evolve, we are actively monitoring the situation, assessing risks, and are ready to implement immediate changes to ensure a high level of safety for you, your family, friends and community. We will continue to communicate in a timely and transparent way so you can feel comfortable and confident that we are offering assistance and important information to you so that you can make rational decisions and that you can have confidence in what we are providing is truthful and reliable information.
We ask you to visit River Tower’s webpage daily and click on the coronavirus button for postings. We will post twice a week and more frequently when and if the occasion requires it. Know that what we post one day may have changed overnight or the next day, or the next day, so that is the reason to monitor this site daily. The Board hopes the website will equip you to make thoughtful, informed decisions that promote the health and safety of your family, friends, and community and stop the spread of the coronavirus and disinformation.
What We Are Doing:
- Introducing rigorous additional cleaning procedures;
- Increasing the number of wipes, hand sanitizers, and other cleaning materials available at different places on the first floor for everyone to use;
- Posting signage on the first floor regarding the measures everyone should take to protect our community from this virus;
- Encouraging frequent hand washing, and discontinuing the practice of handshaking; encouraging social distancing at all times;
- Taking sensible steps to help protect our community. This means no annual meeting; no face-to-face Board meetings; allowing no business meetings in the building including the conference room which will be locked; limiting travel.
- Monitoring new developments so that we can quickly adapt and continue to provide the services you need and the best possible experience at our condominium despite the added safety and precautions measures being taken.
We recognize this is a challenging time for all, and we remain deeply committed to the safety and welfare of our community. Each resident and each management employee are the heart of our condominium and we will do everything we can to assist and help you wherever, whenever and however we can. If you can help your elderly or disabled neighbor, please do so please take care of yourselves and each other.
We know that hand washing, social distancing, and no handshaking sound too simplistic to do any good, but they do actually work and we ask that you do your part.
What You Can Do:
- Obsessively wash hands;
- Practice social distancing;
- Stay home if you are sick;
- Limit the number of guests that you have, and try not have any guest at all during this time;
- Delay having repairs or remodeling done in/on your unit until this pandemic is over, and limit your repairs to emergency repairs only;
- Do not travel by bus, train or air in the U.S. unless it is absolutely essential or is an emergency;
- Monitor our website for information and updates on the coronavirus daily;
- Wipe down all equipment that you use when in the gym;
- Use your knuckle to push elevator buttons;
- Use your side, backside or forearm to open doors when you can;
- Do fist bump or forearm bump instead of handshake;
- Cough into your elbow or shoulder;
- Don’t touch your nose, mouth, eyes or ears;
- Assist and help your neighbor;
- Stay aware of the latest information on the COVID-19 outbreak, available on the CDC and WHO websites and the Shelby County Health Department and the Tennessee Health Departments websites.
America is responding. Take Amazon, for example. On 3/16, 2020, they notified all sellers and vendors that it was suspending shipments of all nonessential products to its warehouses to deal with the increased workloads following the coronavirus outbreak. It would accept only shipments of "household staples, medical supplies, and other high-demand products" to its warehouse until April 5 to deal with the high demand of those products amid the coronavirus crisis. Amazon is now prioritizing medical supplies, household staples, and other high-demand products to its warehouses until April 5.
The Board wants to thank Joey who is devoting countless hours to combating this virus and to Janet, who cleans the building for us, wiping and cleaning all touchable surfaces three times a day. When you see them, give them a big “thanks.”
Most importantly, we want to share our best wishes, thoughts and prayers for all of you to remain healthy and safe.
COVID-19 Testing (March 16, 2020)
Soon there will be testing on a broader scale in the U.S. South Korea has done a very good job of managing the COVID-19/coronavirus. Their model consists of massive free testing and treatment, which, so far, has corralled the disease and kept new infection rates low. Mortality rates are even lower at just under 1%.China took the path of lockdowns and forced quarantining, coupled with massive stimulus. Both approaches have worked so far. The U.S.’s approach will be a hybrid of the two: lockdown clusters of the virus and free testing. The U.S. just can’t impose a China style quarantine, but work from home policy, travel bans, canceling sporting events, school closings, etc. will help tremendously.
In South Korea, people with respiratory symptoms who were tested had a 96% negativity rate. Testing has been done on 250,000 people, in a nation of 51 million. It is done for the most part in a McDonald-style fashion: drive-through with the test taking 10 minutes at most. Results are texted to you, usually the next day. There the public and private sectors cooperated and came together in voluntary collaboration to combat the disease. This is what is happening now in the U.S.
U.S. testing so far has been for surveillance purposes, for patients with respiratory symptoms requiring hospitalization, or for patients with such symptoms who have traveled to endemic areas or had contact with confirmed coronavirus cases.
The government has restricted testing to central health agencies or a few accredited laboratories, limiting the ability to rapidly diagnose new cases. For the most part, Lab Corp and Quest Diagnostics have been the testing companies. The tests they have run up to today have shown a 98-99% negativity rate.
But that will be changing beginning this week as more than 2,000 testing labs will be coming on line beginning Monday, which will be able to test of up to 4,000 people a day. Over time, the U.S. will be able to test many tens of thousands to hundreds of thousands of individuals per week and maybe even more, according to what the government said Sunday. Nearly two million tests will be available this week.
When these test sites open, triaging or prioritizing will be in place to take care of the most vulnerable as the supply of testing kits will be low until the supply chain can catch up with demand. The first to receive testing will be the First Responders and Healthcare Workers. The second to receive testing will be those 65 or older, who are showing symptoms of the virus. For the elderly, the temperature will be set at a lower level than those younger than 65. It will be 99.6 or higher.
In addition to the 2,000 labs which will be coming on board. Ten states, with some having developed their own test for COVID-19, are not waiting for the government to establish drive-through or walk-through testing site. For example, Mercy Clinics, which operates in four states, opened their first drive-through site Saturday, 3/14. Its testing is exclusively for patients who have a fever of at least 100.4 degrees and respiratory symptoms including cough or shortness of breath and either traveled to a high risk area or had contact with a known patient. This will be similar to what other drive-through sites offer or will offer. Remember, not everybody in the United States needs or should take a test. The Memphis area does not at this time have a drive-or walk-through site.
Meanwhile, the government has hastened the manufacturing of testing kits and is working with Google. One will be able to go to Google’s Verily website*, which, after one fills in the question blocks, will determine if you need to be tested. The website, if you need to be tested, will direct you to a nearby drive-through test sites set up in public areas, like Walmart parking lots, etc. According to the government, it will have by Monday (3/16/2020) more information on the website, when and where parking lot sites will be available for people to be tested. (For (*) explanation, see the end of this write-up.)
As testing ramps up, the number of reported coronavirus cases will rise sharply. There will be a marked upward spike in the curve as more and more people have access to the testing and more and more positive tests show up. So don’t panic and fear because this is all to be expected.
Be aware that fake testing kits are being offered for sale. Do not buy any testing kit as there are no testing kits for sale in this country. The only testing kits are to be found with public and private medical institutions and none of their kits are for sale.
The sensitivity and specificity of the test are very high, which means if your test is positive, you do have the virus. To find the probability of the test being a false negative has been difficult. Also, the test is able to detect viruses very early, perhaps not in the first day, but a couple of days into an infection when the virus is replicating strongly. Remember, the incubation period is from 2 to 14 days.
Once tested, if you get a negative result that means you are negative at that time. It doesn’t mean you can’t get the virus spreading about overnight or the next day or so because it replicates in your nose and nasal secretions and you would test positive then. A negative test doesn’t mean you should discontinue precautions. It doesn’t mean you can start taking risks because you are negative. So if you have symptoms, you are contagious, just not with the coronavirus. Therefore, treat and consider yourself as being contagious. If you have a negative test make sure also that you are still protecting others from whatever you have.
To emphasize the previous paragraph, if you test comes back negative that will be reassuring to you, but the best thing you can do then is to not stop practicing the critical precautionary measures that are there to protect yourself and others. Don’t stop doing everything possible to protect yourself and others. Furthermore, you must know that a negative result does not rule out COVID-19 nor exclude the possibility of COVID-19.
If the test is negative but the person actually has COVID-19, it’s called a false negative. There are several possible explanations for a false negative:
· The sample might not have been adequate.
· The test might have been faulty, which can happen in a small percentage of the time.
· The person might be too early in their course and aren’t shedding enough viral particles to be detected by the test. Therefore, the test is very likely to give a false negative result if performed before symptoms such as cough, fever and breathing difficulties have occurred.
· The person might have recovered and are no longer shedding particles.
These reasons are why in high-risk cases, the tests might be repeated if the first test comes back negative. At this time, it is hard to know the percentage of false negatives.
Testing positive means that you have the virus, but it does not mean that you will develop symptoms. Some people who have the virus don't have any symptoms at all.
You might have heard that someone’s test results were called “presumptive positive.” That is because a positive test that was done anywhere in the U.S. have to be sent to the CDC so they could confirm the results. In those cases, the final confirmatory, official result took 3-4 days. Not a single test done by any public health lab in the U.S. has been ruled negative by the CDC in its confirmatory testing.
Some spread of the disease is possible before people show symptoms, according to the CDC. However, people are most contagious when they are most symptomatic.
Remember that those who have a chronic medical condition, an autoimmune disease, elderly, and especially elderly with a chronic medical condition are particularly vulnerable.
We all need to know our risks and get the facts on this disease not only to protect one’s self but your family and others.
Everyone should practice social distancing. That means curtailing most social interaction, canceling organized gatherings, working remotely, switching elbow bumps for handshakes, and keeping a distance of at least six feet from others whenever possible. Everyone should also practice obsessive hand hygiene. That means washing your hands with soap and water for 20 seconds on a regular basis, and every time you come into contact with high-traffic areas, like a doorknob or elevator button. Avoid touching your face for any reason—use a tissue to scratch an itch.
The coronavirus is transmitted via fluids in the respiratory system such as mucus and saliva. When coronavirus-infected patients cough or sneeze without covering the mouth, they disperse droplets of mucus and saliva into the air. These droplets stay in the air and fall onto any surface up to six feet away. But droplets can stay on surfaces like doorknobs or handrails and survive for 5-6 days, so people can also be infected by making contact with a surface or object that has the virus before touching their own nose, eyes or mouth. Therefore, regular hand-washing is essential.
Medical conditions that may increase the risk of serious COVID-19 for individuals of any age:
• Blood disorders (e.g., sickle cell disease or on blood thinners)
• Chronic kidney disease as defined by your doctor. Patient has been told to avoid or reduce the dose of medications because kidney disease, or is under treatment for kidney disease, including receiving dialysis
• Chronic liver disease as defined by your doctor. (e.g., cirrhosis, chronic hepatitis) Patient has been told to avoid or reduce the dose of medications because liver disease or is under treatment for liver disease.
• Compromised immune system (suppressed) (e.g., seeing a doctor for cancer and treatment such as chemotherapy or radiation, received an organ or bone marrow transplant, taking high doses of corticosteroids or other immunosuppressant medications, HIV or AIDS)
• Current or recent pregnancy in the last two weeks
• Endocrine disorders (e.g., diabetes mellitus)
• Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
• Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
• Lung disease including asthma or chronic obstructive pulmonary disease (chronic bronchitis or emphysema) or other chronic conditions associated with impaired lung function or that require home oxygen
• Neurological and neurologic and neurodevelopment conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury.
*When more test become available, initially the test will be restricted to those who meet certain criteria. Google, through its life sciences arm, Verily, will work to support the COVID-19 testing effort in the U.S. by partnering with government officials to direct potential patients to Verily's Project Baseline website (https://www.projectbaseline.com/). The website will be made available to everyone. It will help triage individuals for COVID-19 that should be tested from those who don’t need testing at that particular moment. It is in the early stages of development so Verily is planning to roll testing out first in the San Francisco Bay Area. Initially, the tool will direct people to "pilot sites" for testing in the Bay Area only. Verily plans to extend the tool outside of California over time, as more testing kits become available and the kinks have been worked out. Many healthcare facilities and clinics may have their own set of rules as to who can be given the test and where to go for the test. You will need to check with that clinic or company to see if you are eligible for the test. Some, as reported here, are already offering testing.
Keep in mind that things are changing very fast and what is reported one day may change overnight or in a few days and be completely different tomorrow or the next, or the next day. The Board will try its best to give truthful, reliable, and up-to-date information. However, it is your responsibility to keep up with the coronavirus news, changes and recommendations.
Please, to the young people who have elderly parents, living here or elsewhere, consider helping your parents through this difficulty. And to our community here at River Tower, if you know of an elderly or disabled resident living here, offer to help them with their needs.
We realize this health situation has already been, and will continue to be disruptive to many businesses. Now is the time to support the small business owners in the Memphis area and those who live in our building by buying from them, if you can, to help them maintain their business during these difficult and complex times.
This is going to end; when? No one knows. However, we are going to overcome it. We overcame the Bird Flu, SARS, MERS, and the Swine Flu. To get through this, however, we need the cooperation of everyone residing here. We will need the support and help of everyone, so pitch in. It’s how we respond to this challenge that will determine what the ultimate endpoint is going to be. America has always responded and this won’t be any different.
CORONAVIRUS/COVID-19 HODGEPODGE (March 13, 2020)
The coronavirus is in 47 states; none reported in West Virginia, Alaska, or Idaho. There are 1,700 confirmed cases with 41 deaths. Worldwide, it has spread to 85 countries, with more than 3,000 recorded deaths and 90,000 confirmed infections, and the numbers are still rising.
Europe is now the "epicenter" of the global coronavirus pandemic, the head of the World Health Organization says.There were 250 deaths recorded over the past 24 hours, taking the total to 1,266, with 17,660 infections overall.Europe has more reported cases and deaths than the rest of the world combined, apart from China.More cases are now being reported every day than were reported in China at the height of its epidemic.As well as the increases in Spain and Italy, France has now confirmed 2,876 cases and 79 deaths, up from a total of 61 deaths on Thursday.Germany has seen 3,062 cases and five deaths.Spain, the worst-affected European country after Italy, reported a 50% jump in fatalities to 120 on Friday. Infections increased to 4,231. This is the reason a travel ban has been imposed on Europe. Because of its reported results, there have been 798 confirmed infections in the UK and 11 deaths, the reason it has not been banned.
Meanwhile, at least 10 countries in Europe are enforcing border closures, including:
- Denmark: Closes borders to non-citizens from Saturday
- Czech Republic: Bans all foreigners from entering the country, except those with residence permits. Bans most of its own nationals from leaving
- Slovakia: Closes borders to all foreigners except those with a residence permit
- Austria: Closes three land border crossings with Italy to all foreigners, except those with a medical certificate issued within four days. No restriction on Austrian nationals
- Ukraine: Closes border crossings to foreigners (except diplomats) for two weeks
- Hungary: Closes land borders with Austria and Slovenia
- Poland: From Sunday will close borders to foreign visitors
Belgium, France, Switzerland and parts of Germany are among the latest countries to close schools.
The number of cases of coronavirus reported every day in Europe has surpassed China at its peak. But Europe is in a worse position. The overwhelming majority of China's cases were in one place, Hubei province, and those were largely concentrated in one city, Wuhan. It was dealt with by an authoritarian government that imposed the biggest quarantine in human history. While there are hotspots in Europe, this is an outbreak across a continent and different countries are adopting very different strategies for dealing with coronavirus.All these figures are based on cases that have been detected, but scientists fear there could be large outbreaks going on unnoticed in countries that don't have the tools to spot them.
· It takes a median of five days for COVID-19 symptoms to show after contracting the virus.
· The vast majority, 97.5%, of those infected will develop symptoms within 12 days.
Traveling domestically—be proportionate in what you do, in making your decision on whether you travel or not domestically. Where are you going? Seattle, certain areas of California, or New York? If so, then you probably should not go unless it is an emergency or absolutely necessary. Check this website for more: https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-in-the-us.html
· Once again, where are you going?
· Who are we talking about? If a healthy young person and you have a trip that is necessary then consider it. If an elderly person or anyone with a chronic medical condition (diabetes, heart disease, kidney disease or an autoimmune disease), stay away from unnecessary travel and probably travel only in an emergency situation.
Cruise—Not a wise decision at all to travel on a cruise ship at this time.
Visiting Parents, elderly, compromised individuals or nursing home—act as though you are infected—practice social distancing, washing hands while with the person(s). Think not only of yourself but of other people.
How long does this last? No one knows. If past outbreaks are a guide, we are only in the foothills of a new disease that could continue to spread for many more months. It could last anywhere from 4-5 weeks to maybe 8 weeks, but as just stated no one knows as this is a novel virus. What we do know, in this time when there is not yet a vaccine or an antiviral medication and testing is limited, is that we can contain and mitigate its effect and length of time it is around and reduce its destructiveness.
When will a vaccine be available? The development of a vaccine to treat the coronavirus will take time, probably a year away. However, one company is working with the National Institutes of Health on a healthy-volunteer study expected to begin next month, but even with that if the study is successful, we are months away from having a vaccine. Other vaccines are being tested in other countries but are not available at this time.
When will anti-viral medication be available? Several drug companies are in the clinical testing stage for an anti-viral for the coronavirus. One drug, remdesivir, has quite high efficacy across all different coronaviruses and therefore it is one of the prime candidates to be tested The World Health Organization considers remdesivir the most promising candidate to treat COVID-19, on the basis of its broad-spectrum activity, but for the general public we are not there yet.
What is the correct answer to how often does one wash his/her hands? “Too numerous to count.”
ALLERY SEASON: We are entering the allergy season so how does one know if their symptoms are from allergies or from the coronavirus? The answer is that it is not definite, but when we look at experiences the coronavirus that people are getting is usually characterized by fever, cough and shortness of breath, the main three symptoms, which is representative of the lower pulmonary (lung) system, along with sometimes the ones listed in the Board’s information letter dated, 3/13/2020, which was sent out 3/12/2020.
Runny nose, itchy red eyes, and sneezing are not characteristic of the coronavirus and highly unlikely it is the coronavirus. These symptoms are characteristic of an allergy or URI (upper airway infection) and not a lower pulmonary system problem.
If you have the symptoms of the coronavirus, since it is difficult to get the test done as the situation exists now, self-isolate yourself and call your primary care provider before going into the office or emergency department.
Don’t Panic. When there is an unknown like this, then the level of anxiety is out of proportion to what turns out to be reality. But we have to understand why people are concerned because it will get worse before it gets better. We can handle this if we and the government all pull together and do the kind of things that will blunt the coronavirus’ effects. Some virus outbreaks are inconsequential, while others are really consequential, which is what we have now. We have to deal with it by reason and actions and not by fear.
The Board’s goals are to contain and mitigate to protect our community and to do our part in this battle. What’s making the shift from containment to control especially difficult is COVID-19’s unknowns: its contagiousness, incubation period, deadliness. Etc. It could be like an average flu year, or way worse, or not as bad—we just don’t know. We do know that in China and Korea that it appears the illnesses are declining and people are going back to work. They have done it without a vaccine or antiviral medication; they have done it through containment, mitigation, and especially social distancing and washing hands, etc. Italy was very late in implementing containment and mitigation and we can see what is happening there. It is up to us and the government, whether we can do the same as China or Korea.
This is why the Board is responding the way we are and will continue to respond. While some will critique the Board as over reacting or fear mongering, the Board’s philosophy is to do more than less. We will do what is right for our community and consider that everything is on the table as we go forward in making our decisions on how to response to this novel coronavirus in order to protect the health of our community. The Board is trying to do the things that we know (and the experts tell us) helps to contain and mitigate, such as social distancing, washing our hands, avoiding unnecessary travel and following suggestions the Board made in our informational letter dated 3/13/2020, but was sent out 3/12/2020.
COVID-19 Prevention @ River Tower (March 12, 2020)
Help Prevent the Spread of COVID-19 in Our Community
· Residents should limit the number of visitors to the property, if possible.
· Any non-essential repairs or renovations should be postponed to further reduce the number of visitors to the property.
· Party or business meeting reservations are cancelled until further notice.
· Housekeeping and maintenance staff will be especially vigilant in cleaning common surfaces, such as elevator buttons, common door handles, exercise equipment, appliances, countertops, and other common surfaces multiple times daily.
· GET TREATMENT IF YOU ARE SICK; AFTERWARD, STAY AT HOME!
Tips to Help Prevent Exposure to COVID-19 and Flu in General
· Wash your hands with soap for at least 20 seconds after using the restroom, before eating, and after blowing your nose, coughing or sneezing.
· Keep your distance from others (6 feet or more) and avoid handshaking.
· Use alcohol based hand sanitizers containing at least 60% alcohol.
· Avoid touching your face, but especially your eyes nose and mouth.
· Cover your cough or sneeze (1) with a tissue and throw it away or (2) into the bend of your arm if you have no tissue.
· Use your knuckle to push elevator buttons and vending machine buttons.
· Use your hip or forearm to push doors open rather than your bare hand.
· Postpone trips abroad, if possible.
· Older residents are particularly vulnerable and should avoid unnecessary outings. Should the need arise, arrange for groceries to be delivered or ask a neighbor to pick up your prescriptions. Contact the management office if you need assistance with making arrangements.
General Information (March 12, 2020)
The Board is closely monitoring and responding to the evolving public health situation of an outbreak of a respiratory disease caused by a novel* (new) coronavirus (COVID-19) that was first detected in China and which has now been detected in almost 70 locations internationally, including the United States with cases in Tennessee at this time. There is a lot that is still being learned about this virus and we will continue (AND YOU SHOULD ALSO) to monitor the situation to ensure the health and well-being of our community. You are strongly encouraged to review the latest prevention guidelines and travel information of the CDC. (*A "novel coronavirus" is a strain that has not been previously found in humans.)
It is the Board’s responsibility to provide credible information that you can trust. It is your responsibility to do the same, and to comply with disease-avoidance recommendations.
The infection known as COVID-19 can be spread from person to person. There are no specific vaccines or treatments available for this novel coronavirus at this time, or any other coronavirus. However, medication and vaccine research is underway. At this time, one case of COVID-19 has been reported in a pet dog in Hong Kong contracted from a coronavirus infected owner. (Handling your pets website:www.cdc.gov/coronavirus/2019-ncov/php/interim-guidance-managing-people-in-home-care-and-isolation-who-have-pets.html)
At this time, most people in the U.S. will have little immediate risk of exposure to this virus. This virus is NOT currently spreading widely in the U.S. However, this is a rapidly evolving situation and everyone should keep themselves prepared for and updated on this evolving situation.
Illness from this virus has ranged from mild to severe. Signs and symptoms of infection include fever, dry cough, and difficulty breathing. These symptoms may appear 2-14 days after exposure (the incubation period), mainly around five or six days. It has caused severe disease and death in patients who developed pneumonia. Risk factors for severe illness are not yet clear, although older adults (65 or greater) and those with autoimmune or chronic medical conditions may be at higher risk for a severe illness. For levels of Risk see visit website: www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html
· The most common symptoms of COVID-19 are fever and dry cough.
· Less common symptoms are fatigue (38.1 percent), coughing up phlegm (33.4 percent), shortness of breath (18.6 percent), sore throat (13.9 percent), headache (13.6 percent), joint pain (14.8 percent), chills (11.4 percent), nausea or vomiting (5 percent), nasal congestion (4.8 percent), diarrhea (3.7 percent).
· Only very few cases have prominent upper-respiratory tract signs and symptoms (e.g., runny nose or sneezing).
The virus is thought to spread:
· Mainly from person-to-person.
· Between people who are in close contact* with one another (within about 6 feet).
· Through respiratory droplets* produced when an infected person coughs or sneezes. It is not spread through the air.
*Close contact is defined as:
a) being within approximately 6 feet of a COVID-19 case for a prolonged period of time (15 minutes or greater); close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case
b) Having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed or sneezed on)
*Droplets: the virus is not spread by air but by respiratory droplets produced when an infected person coughs or sneezes, and probably by touching an object or surface where it has recently landed and then rubbing your mouth, nose or eyes. Not much is known about the new coronavirus' ability to survive on surfaces or objects.
Can someone spread the virus without being sick?
· People are thought to be most contagious when they are most symptomatic (the sickest).
· Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus.
Our community should remain alert for fever, cough, or difficulty breathing. If you have a fever or develop cough or difficulty breathing, you should limit contact with others, and seek advice by telephone from a healthcare provider or their local health department to determine whether medical evaluation is needed. If you feel feverish, you should take your temperature.
What can you do to protect yourself and your family?
- Prepare for what to do if COVID-19 appears in our community.
- Protect yourself and your family from COVID-19 and other respiratory diseases.
- PLAN for the possibility of school closures, cancelled events, activities, etc.
TAKE THESE STEPS TO PROTECT YOURSELF, FAMILY, AND OTHERS FROM COVID-19 AND EVEN THE FLU
· Avoid close contact and large crowds or gatherings.
· Stay home when sick
· Cough into your bent crotched elbow area, or at least cover your mouth and nose with a tissue.
· Wash your hands for at least 20 seconds with soap and water, or hand sanitizer with 60% or greater alcohol.
· Avoid touching your mouth, nose, and eyes.
· Avoid handshakes; instead do fist bumps.
· Clean and disinfect frequently touched surfaces in your unit, at work or school, on door knobs, workout equipment, light switches, countertops, key boards, remotes, cell phone, water fixtures handles, etc., especially when someone is ill.
· Get a flu vaccine shot.
· Call your doctor if you have been in close contact with someone known to have COVID-19.
· Be cautious of the surfaces you touch.
· Wear gloves when cleaning surfaces, etc.
· Don't share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home.
· Dispose of tissues, gloves, paper towels, etc. properly.
For light switches, elevator buttons, and similar use your knuckle instead of your fingers.
For opening doors, use your forearm, the side of your body, or you back side when possible.
· Find out about your employer’s plans for COVID-19.
· Routinely clean frequently touched objects and surfaces, including doorknobs, keyboards, phones, etc.
· Make sure you have an adequate supply of tissues, soap, paper towels, alcohol-based hand rubs, disposable wipes, etc.
· Train others on how to do your job so they can cover for you in case you or a family member gets sick and you have to stay home.
· If you begin to feel sick while at work, notify management and leave.
· Stay home if you are sick; review the company’s sick leave policy.
· Ask your employer if you can work from home if the virus is in the community.
· Be cautious of the surfaces you touch.
Unit owners should be prepared, if the situation get worse in the U.S. and Shelby County and surrounding area, that schools may close for a period of time. The schools may change their education from four walls to the cloud so be prepared for this also, along with daycare if you have a child attending daycare.
STOCK UP ON HOME SUPPLIES
· Experts suggest stocking at least a 30-day supply of any needed prescriptions, and you should consider doing the same for household items like food staples, laundry detergent, cleaning materials, etc. and diapers, if you have small children.
· Several thermometers.
· Hand sanitizers and soaps.
· Face mask.*
· Disinfecting products—Lysol and Clorox.
· Paper towels and tissues.
(*Although news stories and broadcast media contain reports and images of people wearing surgical masks to ward off the virus, that's not recommended according to top officials of the U.S. Public Health Service.)
FOR FREQUENTLY ASKED QUESTIONS: www.cdc.gov/coronavirus/2019-ncov/faq.html
Per the CDC’s recommendations posted on Wednesday, March 4, 2020, all travelers returning from affected countries (currently China, Iran, Italy, Japan and South Korea) identified by the CDC should stay home for 14 days from the time they left the affected country, monitor their health, and avoid contact with others. If returning travelers from affected countries develop fever, cough, or trouble breathing, they should call their medical provider or the health department and tell them about their symptoms and recent travel. As this situation will change, it will be necessary for you to monitorwww.cdc.gov/coronavirus/2019-ncov/travelers/after-travel-precautions.html for updates on affected countries and recommendation from the CDC.
· That travelers avoid all nonessential travel, especially to China and other countries demonstrating a high rate of infection. There is limited access to adequate medical care, medicines, and supplies in affected areas.
· Travelers should avoid contact with sick people and clean their hands often by washing with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer with 60% or more alcohol.
· Avoid traveling anywhere if you are sick.
· Travelers should stay home for 14 days after returning to the United States and practice social distancing.*
· Travelers that are sick with fever, cough, or have trouble breathing en route or on their return to the U.S. should call their primary care physician or a walk-in clinic before seeking medical care, or if seriously ill you should go to the emergency department at your choice of hospitals.
(*Social distancing means remaining out of congregate settings, avoiding local public transportation (e.g., bus, subway, taxi, ride share), and maintaining distance (approximately 6 feet) from others. If social distancing is recommended, presence in congregate settings or use of local public transportation should only occur with approval of local or state health authorities.)
Experts recommend travelers to consider the risk of the destination they’re heading to and follow the advice of authoritative bodies, like the World Health Organization, the US State Department, or the Centers for Disease Control and Prevention, before making a decision.
If you have already bought travel insurance, be aware that some insurance policies in their disclosure statement do not cover infectious diseases; some have ruled the coronavirus as a pandemic, thus ruling it out for coverage. Most insurers will probably not cover it, if they haven’t already. When it comes to events like the coronavirus outbreak, insurance companies set their own cut-off dates. Customers who purchase a policy after the cut-off date will probably not be covered. For this outbreak, those cut-off dates generally fall around January 23, when the World Health Organization confirmed almost 600 cases of the virus across several countries. Other policies exclude pandemics and infectious diseases completely, regardless of when the policies are bought. The best things you can do are to read the fine print and call the insurance company to figure out what’s covered under your policy. Every provider offers different insurance options that can vary depending on what you’ve selected, and it might not be too late to upgrade to a more comprehensive plan.
While traveling, customers should take their travel insurance information with them, including plan number/details and the toll-free travel assistance phone number. This information also can be accessed usually by a mobile app or by email.
But if you are determined to carry on with your vacation, remember: consider the risk and check travel advisories frequently and do not travel if sick.
CONTACT FOR UP-TO-DATE INFORMATION ON COVID-19:
Shelby County Health Department
Tennessee Department of Health
National Institutes of Health