The Washington Post - 18.03.2020

WEDNESDAy, MARCH 18 , 2020. THE WASHINGTON POST eZ re A

The coronavirus outbreak

woke up Thursday morning with symptoms consistent with covid- 19, including shortness of breath and a low-grade fever. His flu test came back n egative, and a coronavirus test is still pending. He is now is quarantined at home in Te aneck, N.J., until at l east Friday. Venegas saw two patients with confirmed covid-19 infections a nd more than a dozen others whom he suspected had the virus. Many were under 50 and had negative tests for the flu. Venegas said he wanted to test at least 20 people for coronavirus but didn’t bother because he knew they would not fit the tight eligibility criteria. He said he’d called in sick only twice before in eight years on the job. “Being sick is daunting,” he said. “I’m n ever s ick.” During Monday’s briefing on the pandemic, Vice President Pence stressed that health-care workers and people older than 65 would receive priority as the government increases the number of testing s ites. “We’re putting a real priority on our extraordinary health-care workers,” Pence said. But the r isks of caring f or infec- tious, seriously ill people under

the pressure of a pandemic are almost impossible to avoid. In hard-hit Italy, for e xample, 20 percent of health-care professionals in the Lombardy region have be- come infected with the virus, according to an update Friday in the Lancet medical journal. In China, 3,387 health-care workers were infected by Feb. 24, almost all in Hubei province, the center of the outbreak, according to Chinese health a uthorities. In the 2003 SARS outbreak in To ronto, most cases w ere acquired in hospitals. Of the 44 people who died, two were nurses and o ne was a doctor. During the Ebola outbreak of 2014-2016, more than 8 percent of Liberian health-care workers died. “If there are large numbers of health-care w orkers exposed, how do we manage that and keep them out of health-care facilities?” asked former CDC director To m Frieden. “... You eliminate your ability t o respond.” [email protected] s [email protected] [email protected] e [email protected]

Lena H. sun contributed to this report.

sTeVeN seNNe/AssoCIATed Press Medical personnel await patients at a drive-through coronavirus testing site at Cape Cod Community College in Barnstable, Mass.

BY TONY ROMM, ELIZABETH DWOSKIN AND CRAIG TIMBERG

The U.S. g overnment is in active
talks with Facebook, Google and a
wide array of tech companies and
health experts about how they can
use location data gleaned from
Americans’ phones to combat the
novel coronavirus, including
tracking whether people are keep-
ing one another at safe distances
to s tem t he outbreak.
Public-health experts are inter-
ested in the possibility that pri-
vate-sector companies could com-
pile the d ata in anonymous, aggre-
gated f orm, which they could then
use t o map the spread of the infec-
tion, according to three people
familiar with the effort, who spoke
on the condition of anonymity be-
cause the project is in its early
stages.
Analyzing trends in smart-
phone owners’ whereabouts could
prove to be a powerful tool for
health authorities looking to track
the coronavirus, which has infect-
ed more than 1 80,000 people glob-
ally. But it’s also an approach that
could leave some Americans un-
comfortable, depending on how
it’s implemented, given the sensi-
tivity when it comes to details of
their daily whereabouts. Multiple
sources stressed that — if they
proceed — they are not building a
government database.
In recent interviews, Facebook
executives said the U.S. govern-
ment is particularly interested in
understanding patterns of peo-
ple’s movements, which can be
derived through data the compa-
ny c ollects from users who allow it.
The tech giant in the past has
provided this information to re-
searchers in the form of statistics.
In the case of coronavirus, this
could help officials predict the
next hot spot or decide where to
allocate overstretched health re-
sources.
“We’re encouraged by Ameri-
can technology companies look-
ing to leverage a ggregated, anony-
mized data to glean key insights
for c ovid-19 modeling efforts,” s aid
an official with the White House’s
Office of Science and Te chnology
Policy, w ho spoke on the condition
of anonymity.
The official said those insights
might “help public health offi-
cials, researchers, and scientists
improve their understanding of
the spread of covid-19 and trans-
mission of the d isease.”
A task force created by tech

executives, entrepreneurs and investors presented a range of ideas around disease mapping and telehealth to the White House during a private meeting Sunday. T he discussions included representatives from tech giants; investors led by the New York-based firm Hangar and well-known Silicon Valley venture capitalist Ron Conway; public-health leaders from Har- vard University; and smaller telehealth start-ups like Ro, two people s aid. “We are still in the process of collecting ideas, recommenda- tions, and proposed actions from task-force members, which we in- tend to present to the White House in the coming days,” said Josh Mendelsohn, the managing partner at Hangar, who helped organize the e ffort. Many of those involved either did not respond or declined to comment. T he Centers for Disease Control and Prevention did not respond t o a request for comment. The early, unprecedented col- laboration between Washington and Silicon Valley reflects the urgent, nationwide scramble to stop a deadly malady that has shut- tered businesses, skewered the

stock market, sent students home from school and now threatens to overwhelm the U.S. medical system with patients in need of critical c are. Over the past week, White House officials led by Michael Kratsios, the country’s chief technology officer, have convened meetings to leverage the tech ex- pertise of Amazon, Apple, Face- book, Google, IBM and o ther t ech- nology leaders. The government has e ncouraged social-media sites to take a more aggressive approach to thwart coronavirus con- spiracy theories, The Washington Post has reported, responding to concerns that foreign misinfor- mation might be stoking panic about the outbreak. And the Trump administration has ex- plored partnering with the tech industry to improve telework and telehealth o fferings for millions of Americans. The relationship hasn’t been without its hiccups: On Friday, President Trump announced Google would be developing a website so Americans could learn how to get tested for coronavirus, which causes the disease covid-19. That differed from the initial

statements from Google’s parent company, Alphabet, which had in- dicated it planned a more limited offering targeting residents of Cal- ifornia. Ultimately, though, Google said soon after it would unveil a website to provide information for U. S. patients nationwide. On Monday, White House leaders, tech experts and health officials struck a more unified note, unveiling a portal for roughly 29,000 r esearch papers o n coronavirus. The portal allows the tech industry’s artificial-intelligence tools — which can scan and ana- lyze data en masse — to process the p apers rapidly to uncover new insights about t he global m alady. “Decisive action f rom America’s science and technology e nterprise is critical to prevent, detect, treat, and develop solutions to COVID- 19,” Kratsios said in a statement. The new efforts by Washington and Silicon Valley arrived the same week that dozens of engineers, executives and epidemiolo- gists issued an open letter, calling on companies to take a greater stand against the coronavirus. Specifically, they encouraged Ap- ple and Google to adopt “privacy

preserving” features that might enable authorities to help doctors determine people who were in contact with a patient that later tested p ositive f or coronavirus. “Technology companies have taken important steps already, such as closing offices in affected areas or showing custom search results in place of user generated content. But we believe there is a lot more that Silicon Valley can do to assist with large scale mitiga- tion,” t hey wrote. Smartphones regularly trans- mit their locations to wireless car- riers and often to major tech companies as well, including Google and Facebook, to make some of their services work. The makers o f apps that deliver weather reports, hail rides or help people find a coffee shop also frequently collect location information, and some sell it to firms that mine the data for b usiness insights and opportu- nities. Privacy advocates typically look skeptically on such commercial uses of location data, calling for stricter laws governing its use. R e- cent news about Israel’s plans to use location data to help track the coronavirus similarly sparked in-

tense discussions about the legal and ethical implications of de- ploying such data to thwart the spread of disease and get medical help to infected p eople. “The balance between privacy and pandemic policy is a delicate one,” Al Gidari, director of privacy at Stanford Law School’s Center for Internet and Society, tweeted last week. “The problem here is that this is not a law school exam. Te chnology can save lives, but if the implementation unreason- ably threatens privacy, more lives may be a t risk.” The issues are all the more sen- sitive for Silicon Valley because the companies faced a severe backlash in 2013, following disclo- sures a bout the r ole of t ech c ompa- ny data in surveillance by the Na- tional Security Agency, m ade public by agency contractor Edward Snowden. Relations between tech companies and government officials were severely strained for years after and have improved only gradually. “Privacy is the first to go when there are national security issues,” said Ashkan Soltani, a former Fed- eral Trade Commission chief tech- nologist who covered the Snowden revelations as a journal- ist. Facebook is already working with health researchers and non- profits in several countries to provide anonymized and aggregated statistics about people’s movements through a project called disease-prevention maps. Facebook populates its maps with the aid of its users, who have given the company permission to collect their location — harnessed via their smartphones — while its app runs in the background. Those l ocations are t hen a ggregated and anonymized by Facebook engineers, who can calculate the likelihood people in one city or town are likely to visit another area, potentially spreading the outbreak t here. “You’re trying to predict the probability that a group of people in Prince George’s County might interact with a group of people from D.C.,” s aid L aura M cGorman, who leads the project. Such a pre- diction could offer clues for how infections might travel. McGorman said government officials, including those in Cali- fornia, are also interested in see- ing whether people are practicing social distancing and whether i t is an effective s trategy. S he s aid engineers had labored over t he past 48 hours to help authorities with their r equests. [email protected] [email protected] [email protected]

drew Harwell contributed to this report.

Government urges fi rms to harness smartphone locations

JeeNNAH MooN for THe WAsHINgToN PosT People walk in Manhattan’s Times Square last week. In recent interviews, Facebook executives said the U.S. government is particularly interested in understanding patterns of people’s movements, which can be derived through data the company collects from users.

Public-heath experts turn to private sector’s data on social distancing

BY LENNY BERNSTEIN, SHAWN BOBURG, MARIA SACCHETTI AND EMMA BROWN

Dozens of health-care workers
have fallen ill with covid-19, and
more are quarantined after expo-
sure to the virus, an expected but
worrisome development as the
U.S. health system girds for an
anticipated surge in infections.
From hotspots such a s the K irk-
land, Wash., nursing home where
nearly four dozen staffers tested
positive for the coronavirus, to
outbreaks in Massachusetts,
Pennsylvania, California and else-
where, t he v irus is p icking off doc-
tors, nurses and others needed in
the r apidly expanding crisis.
“We all suspect it’s t he tip o f the
iceberg,” said Liam Yore, a board
member of the American College
of Emergency Physicians.
“ The risk to our health-care
workers i s one of t he g reat vulner-
abilities of our health-care system
in an epidemic like this,” he said.
“Most ERs and health-care sys-
tems are running at capacity in
normal times.”
Gauging how badly providers
have been hit is difficult because
no nationwide data has been re-
leased by the Centers for Disease
Control and Prevention, medical
associations or health-care work-
er unions. A federal official who
was not a uthorized to talk with the
media, and so spoke on the condi-
tion of anonymity, s aid the g overn-
ment has received reports of more
than 60 infections among health-
care workers. More than a dozen
are related to travel. Authorities

are investigating how the others happened. In previous outbreaks of infec- tious disease, and in other countries where the current pandemic arrived earlier, health-care workers have experienced a dispropor- tionate share of infections. They have been put at r isk i n the United States not only by the nature of their jobs, but by s hortages of protective equipment such as N face masks and government bun- gling of the testing program, which was delayed for weeks while the virus spread around the country u ndetected. At the EvergreenHealth hospital i n Kirkland, Wash. — j ust a few miles from the nursing home at the center of the U.S. outbreak — and in Paterson, N.J., two emergency physicians are hospitalized in critical condition with c ovid-19, according to their p rofessional as- sociation. It is unclear whether the doctors, in their 40s and 70s respectively, were infected at t heir hospitals o r in t heir communities, the A merican C ollege of Emergen- cy P hysicians said. “A s emergency physicians, we know the risks of our calling,” the group’s p resident, William Jaquis, said in t he statement. In P ittsfield, Mass., 160 employ- ees of Berkshire Medical Center have been quarantined at home after exposure to patients who tested positive, forcing the medical center to hire 54 temporary nurses, who began arriving F riday, according to news reports. A provider has tested p ositive a t Johns Hopkins Hospital in Balti- more. In another case, a former employee of NYU Winthrop Hos- pital in Mineola, N.Y., flew from New York to Florida last week while awaiting results of a coronavirus test that ultimately showed he was infected, a spokeswoman told The Washington Post. In P hil- adelphia, St. Christopher’s Hospi-

tal for Children shut its intensive- care unit to new patients and closed a trauma u nit after a physi- cian tested positive, the Philadel- phia Inquirer reported. Bonnie Castillo, head of the 150,000-member National Nurses United, the largest nurses union, said the shortage of protective equipment is the most critical is- sue for those workers. “Nurses take risks every day because they’re willing to do that, they’re called to do that, and they want to do that,” she said. “When you’re being sent out there with one of the most highly contagious viruses without your tools and your weapons and without a coor- dinated plan, it’s f rightening.” Caregivers outside hospitals and nursing homes may be even more vulnerable. A 36-year-old firefighter and emergency medical technician in Santa Cruz, Calif., was denied a test early this month because he didn’t meet the strict government criteria then in force. He tested positive for the virus late last week. “This, to me, was the failure of the public health system,” said his wife, who also has tested positive and spoke on the condition of anonymity because she fears that her family will be unfairly blamed for exposing others. “This was a decision made because there weren’t enough tests to prioritize my h usband.” On March 9 the couple learned that one of the EMT’s co-workers had tested positive after being hospitalized. At that point, based on their contact with someone with a confirmed infection, they both were tested. “A s EMTs, they are going into these vulnerable communities, going into convalescent homes, literally responding to and inter- acting with the most vulnerable people,” s he said.

Eight firefighters in n earby San Jose also have tested positive for the v irus i n recent days, according to news accounts. In Kirkland, 42 of 100 members of the fire depart- ment and a few police officers were quarantined, some after responding t o 911 calls from the L ife Care Center nursing home. Others caught the virus as it spread through the community, said a spokeswoman for the city. Five firefighters remained in quarantine Monday, and one has tested positive for t he virus. A Life Care health worker in h er 40s was one of the first known people to test positive in Seattle’s King County, as public health officials a nnounced Feb. 29. A third of the 180-member staff remained out Friday with covid-19 symptoms, said Timothy Killian, a Life Care spokesman. King County o fficials said Tues- day that a county public health staffer involved i n the c oronavirus response h as tested positive. Because testing has lagged, health-care w orkers often have no way to know whether p eople w alk- ing through the d oor with respira- tory symptoms are suffering from the flu or covid-19, providers said. Even when precautions are taken, the virus has found its way into health-care f acilities. At a Veterans Affairs hospital i n Tucson, 23 people with respirato- ry symptoms were brought to an outpatient clinic with no protec- tions for staffers except masks, said a doctor who works at the facility. She spoke on the condition of anonymity because she is not authorized to discuss care with the n ews media. “They’re not doing the testing,” she said. “They marched them through the hospital to my clinic. They p ut masks o n them but noth- ing else.” Marcelo Venegas, a doctor at a n urgent-care center in Queens,

Health-care workers at risk as epidemic expands

Providers say lack of protective gear, testing makes them vulnerable

The Washington Post - 18.03.2020

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