A12 eZ re k the washington post.friday, april 3 , 2020
the Georgia medical Association
and a member of the governor’s
task force advising him on the
pandemic. Still, reisman said
information about the virus was
rapidly evolving and that “re-
sponsibility lies above all with
individual people.”
Some of the people affected
have been those involved in
emergency response.
Gracia Szczech, the regional
fEmA administrator based in
Atlanta, alerted staff in an email
monday of an employee’s p ositive
test — the third in the Atlanta
office, according to a person fa-
miliar with the matter who spoke
on the condition of anonymity to
discuss sensitive details.
A fEmA spokesperson said:
“A s staff have reported diagnoses,
fEmA regional offices have im-
plemented CDC approved and
recommended cleaning of the
workspace. They also continue to
advise all staff on mitigation and
safety measures to protect them-
selves and others from the virus.”the coronavirus pandemic
BY LAURIE MCGINLEYYou’ve been cooped up for
weeks and your days are running
together. The end is not in sight.
Here’s what you need to know
about the coronavirus pandemic
right n ow.
Q: Is i t safe for me to go o utside?
a: for most people, absolutely,
experts say. T he o utdoors may
preserve your sanity — and save
social distancing itself.
“If w e don’t e ncourage people
to get outside, we will have a
widespread social insurrection,”
said Jeanne marrazzo, director of
the d ivision o f infectious d iseases
at t he University of Alabama a t
Birmingham.
Experts say if you maintain a
six-foot distance from other
people, you s hould be even safer
outside t han in a closed a rea.
When outdoors, “you don’t
have to stay s ix feet away f rom
your spouse o r child,” s aid maria
raven, chief of emergency
medicine at t he University o f
California a t San francisco. “But i f
you a re meeting a friend for a hike
or going t o the grocery store, keep
your distance.”
If you are a senior o r someone
who i s chronically i ll or h as a
suppressed immune s ystem, you
might want t o see if you can g et
prescriptions a nd groceries
delivered, o r send a younger
relative to pick them up.Q: If I’m older, do I have to stay
inside all the time?
a: It’s h ard t o generalize,
marrazzo said, b ecause “some 7 0-
year-olds run marathons, so you
can’t m ake a blanket s tatement
about people’s r isks.” But
conditions such as chronic
obstructive pulmonary disease,
heart disease a nd diabetes raise
people’s r isks o f becoming
severely ill o r dying of covid-19,
the d isease c aused by the
coronavirus. And e ven h ealthy
seniors, she said, “don’t g et a
complete pass” on increased risk.Q: What about masks? Everyone
seems to be talking about them a ll
of a sudden.
a: President Trump said
Thursday at a c oronavirus t ask
force b riefing that “a
recommendation is coming out”
that would urge A mericans to
begin wearing cloth masks or f acecoverings in public, but “ I don’t
think it will b e mandatory. I f
people want to wear them, they
can.” Vice President Pence, who
heads the t ask force, confirmed
the g uidance would be released in
“coming days.”
However, a White House o fficial
said the g uidance being
considered is “narrowly t argeted
to areas with high c ommunity
transmission” a nd the matter
remains u nder discussion.
New data is showing a high
proportion of infected people may
not s how s ymptoms, even a s they
spread the virus b y emitting
droplets when they talk, s neeze or
even exhale. A mask — or some
kind of cloth face c overing s uch as
a bandanna o r scarf — keeps t hose
people from i nfecting others.
Any such recommendation w ould
make clear p eople should avoid
the k ind o f gear — N 95 respirators
or surgical masks — needed by
health-care workers.
Some experts have already been
urging people to start using
masks or face c overings.
others say not s o fast. raven
says that while there may be
benefits t o universal masking, i t
also may give people a false senseof security a nd result in a
reduction in social d istancing.
To m frieden, former director of
the C DC and president a nd chief
executive of resolve to Save Lives,
a New York-based nonprofit,
agrees there may be unintended
consequences in universal mask
use b y the g eneral public. Wearing
an uncomfortable m ask may
prompt y ou to touch your f ace
more — and accidentally infect
yourself if your finger is
contaminated. Also, he said, t here
are i ndications t hat the moisture
that collects may encourage a
buildup o f viruses a nd bacteria on
a cloth mask.Q: What do I do i f my s pouse gets
sick?
a: It d epends. If you h ave been
with the person day and night for
several days, you m ay a lready be
exposed. S till, you c an’t k now for
sure, and doctors say it’s w ise t o
err on the side of caution and
distance yourself as m uch as
possible.
most c ases o f covid-19 are mild,
and a spouse probably will b e able
to take care of himself or h erself.
If possible, the ill spouse s hould
move into an extra bedroom, use adifferent bathroom a nd wear a
mask to protect o thers in the
household.
If you are living w ith someone
who n eeds help, you should w ear
a mask and gloves w hile
providing care.Q: What are the symptoms of
covid-19?
a: A f ew m onths into t he crisis,
we now know the d isease has a far
wider range of symptoms than
initially thought. In a ddition to
coughing, shortness of breath and
other f lu-like s ymptoms, doctors
are s eeing gastrointestinal
problems — nausea and vomiting,
for example — chest pain a nd a
loss of the sense o f smell. Some
doctors report b rain
inflammation and pinkeye in
patients. It’s n ot c lear, physicians
say, w hether the varied symptoms
are c aused by c ovid- 19 or are j ust
occurring at t he same time.Q: What do I do if I think I’m
infected?
a: Consult with y our primary
care doctor, if you have one. Don’t
go t o the p hysician’s o ffice or the
emergency room w ithout c alling
ahead. T he coronavirus i s highlycontagious, and doctors want to
protect themselves and o ther
patients from infection. You’ll
probably be advised to self-
quarantine and, b ecause there is
no effective treatment f or the
disease, to take o ver-the-counter
medicines s uch a s Ty lenol o r
motrin.
If symptoms g et w orse, and you
have trouble breathing or h ave
underlying medical c onditions,
seek immediate medical c are.Q: Will I be tested?
a: It d epends on where y ou live
and even what hospital or health
system you use. S ome p atients
will have much more access to
testing than others. At the
University of California-San
francisco, f or example, t he testing
has ramped u p sharply in recent
days in the hospital and
outpatient clinics, raven s aid. But
the h ealth system doesn’t test
people who d on’t h ave symptoms
— the so-called worried well.
[email protected]Joel achenbach, ariana eunjung cha,
angela Fr itz, carolyn y. Johnson, lena
H. sun, and William Wan contributed
to this report.Can I go outside? Should I wear a mask? Plus other a nswers about covid-19.
“It’s almost a different
approach, waiting to
know it’s bad. I’m
afraid that by the time
they have reports of
cases, it’s already
too late.”
W. Craig Fugate, a former Fema
administratorInterviews with mayors, busi-
ness leaders and health officials
in states where stay-at-home or-
ders were recently imposed illus-
trated how decisive Tuesday’s
White House briefing was to
their thinking, as Trump struck a
newly solemn tone and his advis-
ers unveiled grim projections
even with best-case mitigation
efforts.
DeSantis acknowledged as
much in remarks Wednesday,
saying of his statewide order, “I
did speak with the president
about it.”
The industries exempted from
his order, including landscaping
and boating in addition to food
service and others, resembled the
catalogue of essential services
requested by the florida Cham-
ber of Commerce, which sent a
letter to DeSantis outlining its
view of an appropriate govern-
ment response on march 22.
While slowing the outbreak was
the “foremost priority,” wrote the
Chamber’s president and chiefproach, waiting to know it’s bad.
I’m afraid that by the time they
have reports of cases, it’s already
too late.”
A federal official involved in
emergency management in a
group of states across the South-
east echoed that assessment.
“We needed to be where we are
now three weeks ago,” said the
official, who spoke on the condi-
tion of anonymity because he was
not authorized to discuss the
response effort. “It’s like Hurri-
cane Katrina is hitting all 50
states at the same time.”
Effective planning has been
thwarted by the multiple models
available to state officials, who
choose to rely on certain numbers
and not others, the official said,
based on a “political decision that
is out of the hands of the respond-
ers.”
The series of new orders an-
nounced this week leave about a
dozen states without sweeping
restrictions limiting travel to es-
sential needs.executive, mark Wilson, “we
must be mindful that the policies
intended to protect human
health and curb the pandemic do
not also cause an even worse
effect on the economy and jobs.”
florida’s neighbor to the north
also changed course Wednesday.
“A t this point, I think it’s the
right thing to do,” said Brian
Kemp, Georgia’s republican gov-
ernor, who had resisted a state-
wide order and whose top aide
had taken to facebook over the
weekend to accuse local officials
of “overreach” f or directing resi-
dents to stay at home.
Kemp said he learned Tuesday
that the virus was “transmitting
before people see signs.”
for weeks, the Centers for
Disease Control and Prevention
and others have been warning
about the disease’s spread in the
absence of symptoms.
That cases could remain unde-
tected was “quite apparent from
what was going on in China,” s aid
Andrew reisman, president ofCody Hall, a spokesman for
Kemp, said updated CDC guid-
ance, in addition to new model-
ing and projections about hospi-
tal capacity, shifted the gover-
nor’s thinking.
To m Wolf, the Democratic gov-
ernor of Pennsylvania, also is-
sued a statewide order W ednes-
day, calling it the “most prudent
option” as the number of cases in
his state surpassed 5,000.
After initially barring local ju-
risdictions from ordering resi-
dents to stay at home, Arizona’s
governor, republican Doug Duc-
ey, this week reversed himself
and issued a statewide order.
But Will Humble, a former
director of the state’s health de-
partment, said it was unenforce-
able.
“It says it’s a stay-at-home or-
der, but try to find something
that’s not exempted that wasn’t
already closed,” he said.
Aides to the governor and
state’s health director didn’t re-
spond to requests for comment.
Governor’s offices in missouri
and oklahoma also didn’t re-
spond to requests for comment.
A spokeswoman for the Ala-
bama Department of Public
Health, Arrol Sheehan, said the
state “continues to review situa-
tions in other states, follow our
plans, update our plans, coordi-
nate with health-care and com-
munity partners and advise our
citizens regarding the measures
we can take to reduce the spread
of this virus.”
Within states that have issued
sweeping directives, there has
also been defiance from busi-
nesses, as well as religious lead-
ers and vacationers.
The decision by Hobby Lobby
to r eopen stores in multiple
states that had ordered nones-
sential businesses closed
prompted state law enforcement
officials to send cease-and-desist
letters to the company, which is
based in oklahoma City. Hobby
Lobby is known for its successful
challenge to a component of the
Affordable Care Act requiring
family-owned corporations to
pay for insurance coverage for
contraception.
Two employees of the chain,
who spoke on the condition of
anonymity because they are still
employed by a store, provided
images of signs in Hobby Lobby
store windows in ohio and mas-
sachusetts contending the busi-
ness was “operating as essential”
because it was offering “PPE
mask supplies” a nd “various com-
ponents for at-home small busi-
nesses.”
Hobby Lobby’s corporate of-
fice did not respond to a request
for comment.
There were other, more recre-
ational r easons for rule-breaking,
including spring-break excur-
sions.
Dan Gelber, the mayor of mi-
ami Beach, said macabre scenes
out of New York helped his con-
stituents understand the need for
strict measures, including the
stay-at-home order issued for his
city more than a week ago.
“It would have made sense to
start substantial social distanc-
ing in early march,” the mayor
said. “But there was no messag-
ing for that. A nd no one saw the
threat it became literally days
later.”
isaac.stanley-becker
@washpost.com
[email protected]sands of lives worldwide. But
government and private-sector
leaders across a large swath of
the country remain defiant that
the devastation unfolding in
New York and other seemingly
faraway cities should not curtail
life in their own communities.
In some cases, skeptics have
been slow to acknowledge the
science behind the spread of the
novel coronavirus. In others,
such as florida, politicians took
heed of demands from the busi-
ness community, which lobbied
DeSantis as recently as d uring a
monday webinar to balance med-
ical imperatives with economic
needs. Elsewhere, adamance
about local autonomy was pro-
nounced. Some, meanwhile,
maintained that it was religious
authority that mattered.
“While we do not know for
certain what the future holds, or
how long this disruption w ill l ast,
we can all rest in knowing that
God is in control,” t he conserva-
tive Christian founder and chief
executive of the craft store chain
Hobby Lobby, which opened
stores in a handful of places
against state orders, wrote in a
letter to his employees.
E xperts are now warning that
a group of governors in the South
and the Great Plains — largely
republican-led states — risk act-
ing too late.
Alabama, for example, has
more than 1,100 cases, with just
five counties untouched by the
virus. New infections have risen
as sharply as in California.
In some cases, the resistance
has led to rising political ten-
sions, with often Democratic
mayors imposing orders of their
own that they acknowledge can
only be so effective when sur-
rounding jurisdictions do not act.
“ As a c ity, w e need to operate as
if we could be anyone else,” said
mayor randall Woodfin of Bir-
mingham, Ala. “I think we’re in
the middle of a storm.”
Lyda Krewson, the mayor of St.
Louis, said her city’s stay-at-
home order was undermined by
the absence of a blanket policy,
warning, “We have a fluid society,
frankly.”
“I feel like the entire country
ought to be under a stay-at-home
order,” Krewson said in an inter-
view.
The pleas have not been from
politicians alone. Joining Krew -
son and others in appealing to
the missouri governor was the
state’s medical association,
which sent a letter to Parson
saying a statewide order was the
“only way to curb the exponential
spread of covid- 19 in missouri.”
In Texas, the state’s hospital and
nurses associations sent a joint
letter to the republican gover-
nor, Greg Abbott, telling him,
“The time has come for Te xas to
issue a statewide stay-at-home
order.” Abbott announced a new
statewide directive T uesday but
refused to call it a stay-at-home
order.
Current and former emergen-
cy management officials said the
delay would cost lives.
“Part of the problem is just
reluctance to wrap your head
around the fact that the numbers
could get that bad that fast,” s aid
W. Craig fugate, a former fEmA
administrator.
He singled out the South, say-
ing, “It’s almost a different ap-
defiance from a
Stay-at-home resistance reveals regional, political divides
Joe raedle/agence France-presse/getty imagesJoe burbank/orlando sentinel/associated pressin florida, where Gov. Ron
deSantis issued a statewide
stay-at-home order this week, a
lone figure walks down a
deserted Miami street and
nurses set up drive-through
coronavirus t esting at the
convention center in Orlando.