These Coronavirus Immunity Jokes Are Love Letters to Home

Jeremi Barnes wants to be upfront: He’s got to give credit to his girlfriend for the joke that’s doing numbers on Twitter.

“BREAKING NEWS: If you’ve ever had the water in Warrensburg, MO you’re immune to the Coronavirus,” he tweeted. The joke is resonating with folks in the small city of Warrensburg, where Barnes is a senior at the University of Central Missouri. Nearly a thousand people mashed the like button over the last week.

I don’t get the joke, but I get the joke. There’s gotta be something so gross about the water in Warrensburg that not even the dread coronavirus could contest its status as a test of the immune system.

“If you go to any restaurant and ask for a water you will instantly notice it after your first sip,” Barnes tells me via DM. The taste is horrendous, he says, ripe with chlorine. And it just does something to your skin and hair. In a word, Warrensburg’s water is nasty. “Anyone will confirm this.”

Like so many others, Barnes is trying to prepare for the arrival of Covid-19 where he lives. (Missouri confirmed its second case of coronavirus on March 12.) At UCM, he competes on the men’s track and field team — his event is the triple jump — and he learned on Thursday that the team isn’t scheduling any more practices or meets for the foreseeable future. Barnes is taking this in stride; at least, he was gracious enough to explain a joke to a stranger online as the crisis was starting to feel real.

We all get this joke. In fact, we’re all making this joke. Barnes’s take is one of many popping up every minute on Twitter. If you’ve ever eaten at Papaya King on New York’s Upper East Side, you’re immune to coronavirus. If you’ve ever done Fiesta in Old San Antonio, you’re immune to coronavirus. The meme is catching on, maybe (hopefully!) faster than the coronavirus is spreading.

As the U.S. braces for the pandemic — and as local track coaches lap national leaders in making responsible decisions about public safety — social media has pivoted hard to gallows humor. We’re making Tom Hanks fan art and “Corona Time” TikToks and endless hand-washing instruction jokes.

Still others are registering their growing alarm by boasting about surviving frat bathrooms, Riot Fest, and pee-laden water parks (ew). These “if you’ve ever” immunity memes are a nervous laugh in that way, but they’re something else, too. A gesture of defiance against nature, maybe. People are making the point that the places we come from and the things that make them special make us strong. We have faced down gnarly before, and we will do it again.

“If you’ve ever been to Tonic in Reno, you’re immune from Coronavirus,” writes Gabrielle Lucas. She tells me (via DM) that she spent her college days there in Reno. The Tonic Bar and Lounge is one of those establishments at the world’s end, a bar of last resort. No one goes before 2 a.m., Lucas says, and they leave reeking of whiskey and cigarettes. “I think this tweet came from my bones somehow,” replied Andrea Rogers, another Reno person summoning the indomitable spirit of the morning after.

From scanning the timeline, dive bars, municipal water systems, and hometown fast food outlets are the most popular targets of this meme. Most joke about cleanliness: A tweet about the bathroom at the legendary East Village punk venue CBGB resonated with me. If cleanliness is next to godliness, then I’ve been to hell and back — so what do I have to fear from another flu?

All of them — all the resonant jokes anyway, there are plenty that are racist or otherwise awful — display a tenderness about home. It’s as if people are raising a flag, identifying the experiences that distinguish us in the face of a pandemic that threatens to reduce human populations to numbers: the infected, the recovered, the deceased. I, too, know how bad the water tastes in San Angelo, Texas. If sulphur water were a tonic against Covid-19, the CDC would be bottling and selling the Concho River. Still, I find myself idly wishing I was bunkering back at home instead of where I live now. I’m from here, this meme says. You can’t kill me.

These if-you’ve-ever jokes about immunity are tinged with another, darker meaning. Each bit is a piece of disinformation, an illustration of the heedless power of fake news in a global health crisis. They use the same puffed-up tone of idiotic overconfidence employed by regime propagandists, professionally wrong pundits, and that “peak performance” meme guy. That’s part of what makes these jokes land on Twitter: The medium is so infused with malintent and sheer wrongness that the authors of critically mistaken health tips could conceivably be trying to pull one over on hapless readers. Only people in the know will know what’s up.

Of course, the virus bearing down on the nation doesn’t care if we’ve tried the best carne asada fries ever or consume malört as if it were the law. Knowing that the country is not prepared — not in terms of antibodies or vaccines or preventative measures or public health resources or political leadership — what else can anyone say? We screw up our faces, summon deep wells of pride, and tell this asshole germ to jump off the nearest bridge.

Barnes, the Missouri track senior, tells me that if it comes down to it, he may redshirt in order to race again next year. He’s not ready to leave just yet. “Aside from the water and the noise from the train that comes through from time to time, the town is great,” he says. “Pine Street is the place to be! I love Warrensburg.” Why would he quarantine anywhere else?

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Will Coronavirus Stop the French From Voting?

This week, French President Emmanuel Macron delivered a televised address to the nation on efforts to contain the coronavirus pandemic. Following the lead of neighboring Italy — as well as Greece, Poland, the Czech Republic, Ukraine and Denmark — universities, day care facilities and schools will close on March 16.

But on March 15, the first round of local elections will go ahead as planned in 34,968 cities and towns across the country. The government was advised by the scientific community that nothing is standing in the way of French people voting, Macron said.

His comments echoed those of French Prime Minister Edouard Philippe, who on March 7 sent out a letter to all mayors, saying: “Elections are, in the life of our country, an essential moment, where democracy can catch its breath. Postponing them is out of the question.”

But fears of the virus — now classified as a global pandemic — threaten to erode voter turnout that had already been waning in recent election cycles.

A recent survey conducted for online health platform Charles.co by the research and polling firm IFOP (Institut Francais d’Opinion Public) found that, among the 1,008 people surveyed, 28% said they were likely to reconsider going out to vote because of the coronavirus spreading in France.

”They should definitely be worried,” Megan Murray, professor of epidemiology at the Harvard T.H. Chan School of Public Health told CityLab. “It’s insane, really. If you don’t need to put a lot of people in the same place and have them touch things, then you really shouldn’t.”

Up until Macron’s TV appearance, France had been slower than many other countries to take a drastic containment approach to the virus. According to some experts, France is just a few days behind Italy in the spread of the virus, and its health-care system could face similar capacity challenges from a spike in patients. Even before the virus, the country’s hospitals were already strained: Health-care workers took to the streets to protest insufficient funding and resources as recently as last November.

This year’s elections are taking place in a tense political climate, after months of social unrest that culminated in lengthy strikes by rail workers, health-care workers, teachers, and virtually any corporate association targeted by President Emmanuel Macron’s government pension reform. His approval rating rose to 32% in February, from an all-time low of 23% during the “Yellow Vest” movement, creating an uphill battle for mayoral candidates in his party.

More than 47.7 million people are registered to vote in the local council elections, which determine a city’s mayor, but individual polling stations rarely receive more than 800 to 1,000 people throughout the course of the day.  On March 13, the government prohibited gatherings of more than 100 people. So far, there have been no official measures announced to have a staggered vote.

Postponing the vote is no longer feasible, according to Agnes Le Brun, mayor of the city of Morlaix and spokesperson of the Association des Maires de France (Association of Mayors of France), told CityLab. To reschedule an entire election, a bill needs to be drafted and passed by the National Assembly and the Senate. This has been done before: In 2007, municipal elections were pushed back to 2008 because there were too many elections that year.

But the cost and time needed to reschedule an election may be far more than people appreciate, Le Brun said. “Elections require a lot of organization, even though when you look at it from the outside, it seems like there is only something happening on the day when people vote.”

And France isn’t the first country voting under the cloud of the coronavirus. Earlier this month, Israel set up a separate tent for quarantined voters, and the U.S. presidential primaries have thus far gone ahead as planned. The British government, however, announced that it would postpone English local elections scheduled for May. And the U.S. is starting to cancel future presidential primary contests.

New safety precautions

Voting stations will look a bit different on Sunday, and precautions will involve more than hand sanitizer and protective gloves. France uses very few voting machines — only 70 out of the 34,968 towns voting on Sunday will use them, according to newspaper Le Parisien — which means that every voter has to sign a register with shared pens. In Morlaix, officials will be disinfecting reusable pens. There will be: “two boxes,” she explained. “Voters will grab a pen in one of the boxes, and dispose of it in the other one. They will be disinfected regularly.” But this year, voters can also bring their own pen — it just has to have black or blue ink for the vote to be valid. Voters are also encouraged to lift the curtain of the voting booth with “their forearm,” Le Brun said. They will be required to stay at least one meter — a little more than 3 feet — away from one another, and the booths will be disinfected regularly.

A polling station in Bordeaux, France, ready for voters. (Georges Gobet/AFP via Getty Images)

”In principle it is not hard to kill the virus with disinfectant,” Murray said, “but in that context, you’re relying entirely on humans, and the possibility for human error is huge. It’s not a thing that is going to be error-free.”

The administration has made it easier for those isolated, sick or at risk to vote by “procuration” — the equivalent of an absentee ballot.

In the IFOP survey, the respondents who seemed to be the most worried about contracting the coronavirus while voting were the ones who were the least likely to be very negatively impacted: “young people, mostly urban, who get informed via social media or online tools, and are more exposed than the average to rumors spreading online,” Francois Kraus of the IFOP told CityLab. They are the ones who also tend to vote for the Macron government the least, he said.

The elderly are, according to the survey, the least worried about the ongoing pandemic. “They trust public authorities more,” Kraus said, and thus are more likely to believe that risks are under control.

Other countries will be looking at France this weekend for any lessons learned as they head into their own elections.

”The elderly are the highest -risk group with regards to this coronavirus — they need to understand the risk,” Dan Hanfling, former special advisor to the U.S. Department of Health told CityLab in an email. “If this becomes an issue for us later in the year, I would hope that we will have the opportunity to send in ballots by mail.”

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Are Suburbs Safer From Coronavirus? Probably Not.

Alexis Kaiser always planned on renting out the house that came with the 250-acre Oklahoma farm that she and her husband bought in 2015. Her sister thought the idea would never work — 65 miles from the nearest airport, the three-bedroom split-level house seemed too remote.

But the listing fared well on Airbnb. Now Kaiser is tapping into a new strain of social anxiety in order to hit it bigger. As cases of a respiratory illness caused by a novel coronavirus spread throughout the U.S., Kaiser is advertising her abode as a “Covid-19 Safe House” on Craigslist in cities with large infection clusters.

“Don’t just hunker down to get through the pandemic, turn this frightening time into a family get-away in the country,” urges the ad she about the urban frontiers where new infectious diseases flourish. Measles, whooping cough, tuberculosis and other viruses were particularly rampant in early 19th century cities, before better sanitation, vaccination and wider access to healthcare cleaned them up.

And in the pre-globalized era, the countryside did indeed confer some degree of defense. Eva Kassens-Noor, a professor of urban planning at Michigan State University, has studied the 1918 influenza pandemic to better understand the role that population density and other geographic variables play in pandemics. For a 2013 paper in the International Journal of Health Geographics, she and her colleagues found that a population density of 175 people per square mile served as a threshold between higher and lower mortality rates for influenza in India. People living in places with a population density above this threshold were better off getting out of Dodge.

For millennia, urbanites with means did just that. Back in the 14th century, writer Giovanni Boccaccio’s book The Decameron focused on a troupe of wealthy Florentines — the pandemic preppers of their era — escaping the Black Death that festered in the city by holing up in a country home on the city’s hilly outskirts.

But things have changed. Modern transportation networks have made the population shield that rural areas once provided much more porous. Now that humans and freight can travel from, say, Hong Kong to Los Angeles in less than 13 hours — and arrive by vehicle to somewhere sparsely populated hours after that — outbreaks can happen just about anywhere. New pathogens tend to arrive sooner in global hubs, but that doesn’t mean they can’t quickly reach rural locales and proliferate from there, says Benjamin Dalziel, a professor of mathematics at Oregon State University who studies population dynamics.

“Cities with big airports are definitely importing more cases than cities without,” he says. “But it’s not like all the epidemiological sparks would stay there.”

Or, in Keil’s words: “The idea that we can go to countryside to protect ourselves is a bit of a myth, because it doesn’t exist like it used to.”

Meanwhile, rural and exurban areas have their own unique health challenges. For one, new zoonotic pathogens frequently emerge in pastoral places where humans come into contact with animals. And in the U.S. (and many other countries), rural populations are relatively older, making them more at risk for falling seriously ill from Covid-19. More than one in five older Americans lives in rural places. Those living outside cities also have more limited access to health care generally: Rural residents live much further from hospitals than their urban or suburban counterparts, and more of them list access to good doctors as a major community problem. While a disciplined city can overcome its population density disadvantage by canceling mass gatherings, small towns cannot so easily tweak their spatial health disparities. San Francisco can live without Warriors games; a rural hospital can’t be built overnight.

“Rural populations have less means to contract it [coronavirus], but rural populations have less means to treat it,” Kassens-Noor says.

When it comes to other, more familiar infectious diseases, cities benefit from higher vaccination rates and the accompanying phenomenon known as “herd immunity.” If a large enough percentage of a population has received vaccination to an infectious disease, the community can effectively stop its transmission to vulnerable people or those who didn’t get the shot. In a 2015 paper for Infection Ecology and Epidemiology, epidemiologist Carl-Johan Neiderud showed how coverage rates differ across city and county lines. In Indonesia, for example, more people have the measles vaccination in urban areas (80%) than in rural areas (67%).

This isn’t a universal trend, and socioeconomic factors play an important role in both attitudes about and access to vaccines. (Famously, many high-income parts of California contain large numbers of unvaccinated households.) In Chandigarh, India, herd immunity tracks closely with residency and status: 74% of children in urban areas had full immunization by age 2, compared to 63% in rural areas and just 30% in slums. Herd immunity depends on everyone playing along, which is why anti-vaccination adherents are such a threat to vulnerable people in big populations. (There is no vaccine against Covid-19 yet, but herd immunity will likely matter a lot if and when this coronavirus resurfaces.)

Smaller cities can also suffer more acutely from infectious disease than big ones, at least when it comes to the flu. A 2018 paper published in Science, co-authored by Dalziel and Viboud, found that mid-sized metropolitan areas such as Nashville tend to experience shorter and more intense outbreaks of influenza relative to big cities such as New York or Miami. Larger urban populations, the researchers found, provide a greater degree of herd immunity, slowing the spread of the disease through the community and counteracting the role that humidity plays in the spread of flu. Larger urban hospitals also tend to be more capable of handling an influx of sick people.

Of course, Covid-19 is a different bug than the one that killed between 17 and 50 million people worldwide from 1918 to 1920, or the modern variants that resurface during flu seasons. The 1918 influenza outbreak was particularly brutal because it happened in 1918: Social support structures were limited, treatments were relatively primitive, global war fostered illness, and the germ theory of disease was still not well understood. The population-density threshold for influenza mortality in early 20th century India that Kassens-Noor identified doesn’t tell us much about what to do with Covid-19. After all, the population density of, say, Oklahoma City is much, much higher than 175 people per square mile. (The census gives the population density for broader Oklahoma County as 1,013 people per square mile — so OKC is far too urban to dodge an epidemic.)

Dalziel and Viboud both stressed that health researchers are just beginning to understand the transmission dynamics of Covid-19. But it looks like the first cases detected in Italy, Germany, and the U.S. were all on the urban periphery. Some U.S. hot spots — Kirkland, Washington, and New Rochelle, New York — are suburbs of major cities. While it’s too early to detect any consistent pattern in the spread of the novel coronavirus, “what those data underscore is the the fact that you’re not necessarily safe in the suburbs,” Dalziel says. “Those are counter-examples to the idea that it’s just happening in cities.”

Kaiser, the Oklahoma Airbnb host, acknowledges that no one place can guarantee invulnerability to this new pandemic. Still, her listing sounds like an idyllic locale for a destination quarantine — there’s a 14-acre fishing pond and a horse arena. “It seemed like a good way to market the house,” she says. “For someone who has the financial capacity to get away and work from home, here’s your chance to spend a month out on a farm, and avoid some of the trauma we’re seeing in other countries.”

But while the CDC recommends decreasing social contact to limit the spread of the virus, that’s just as doable in a downtown apartment as a countryside manor. Says Viboud: “If you’re staying at home and limiting outside contact, you’d achieve the same purpose.”

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An Emerging Coronavirus Concern: Eviction

Updated: 2020-03-11

Neil Hutchinson, a 52-year-old stagehand based in Oakland, usually has a busy spring: The Game Developer’s Conference comes to San Francisco in March, Google’s Cloud Next conference comes in April, and Facebook’s big F8 conference comes to San Jose in May. In between, he gets calls to come help with smaller shows and events. As the conferences got canceled or postponed one by one on account of coronavirus concerns, Hutchinson got increasingly worried about paying rent on his apartment. In-person concerts dried up, too. By the end of the season, he expects to lose $10,000 in income.

“If this goes on longer than June, the outlook is pretty bleak,” he said.

For many people like Hutchinson, the low-grade fear of getting the Covid-19 virus has been compounded with an urgent sense of economic anxiety. Under the states of emergency being declared in an increasing number of localities, large events have been canceled, public transit has been less crowded, bar and restaurant workers are losing out on tips and entertainers have had shows closed. In expensive coastal cities, where people can pay more than 30% of their income on housing, missing even one paycheck can mean falling behind on rent. And falling behind can mean getting evicted.

To protect low-wage workers from these ripple effects, two California cities, San Francisco and San Jose, are advancing legislation that would put a moratorium on evictions for people whose wages have been affected by coronavirus-related closures and work stoppages. Other city measures are geared at providing housing for those who are already homeless in the event of a virus outbreak. Already, Singapore and Italy instituted policies to prevent new homelessness during their coronavirus outbreaks.

“There are people who are going to lose income they may have otherwise earned,” said San Francisco Supervisor Dean Preston, who introduced an eviction moratorium bill on Tuesday. “We want to make sure that if they’re losing income in that situation, they’re not losing housing as well.”

At a time when many West Coast cities are already experiencing a homelessness crisis, the Covid-19 outbreak has put the significance of home into stark relief. People are being advised to stay inside their apartments and houses to prevent the spread of the virus. But for people who don’t have their own shelter — or who may lose it soon — that won’t be an option. Homelessness has already created a public health disaster in some American cities. The worry is that Covid-19 could only compound it.

“In this moment, there’s no reason to believe that homeless people are any more likely to get the coronavirus,” said Quiver Watts, the editor of Street Sheet, a publication on homelessness published by San Francisco’s Coalition on Homelessness. “But obviously, if it were to outbreak at a city level, folks we work with are susceptible.”

Covid-19 is more deadly for people over 60 years old, who have underlying health conditions or who are immuno-compromised already. Nationwide, about half of the unhoused people are older than 50, many of them falling into homelessness for the first time after that point. In tent encampments, people live far closer together than the six-foot radius researchers say Covid-19 can be transmitted over; in shelters, people sleep on the floor head-to-foot. People experiencing homelessness are less likely to have access to medical care, and more likely to have weakened immune systems.

San Jose mayor Sam Liccardo, whose city is home to more than 6,000 unhoused people, said in a press conference that his city’s legislation to keep people from being evicted was a move motivated in part to preserve “public health and public safety.”

On Tuesday, San Jose’s city council approved the measure, and San Francisco’s mayor committed to approving San Francisco’s, too. After the new eviction moratorium rules take effect in both cities, any renter who provides documentation — in the form of pay stubs, for example — that coronavirus-related issues have affected their ability to earn income will have the right to fight an eviction proceeding. The ordinance does not waive rent payments entirely; it just defers them, and prevents landlords from moving forward with unfair oustings. Under Preston’s plan, rent doesn’t need to be paid back until after the mayor-mandated state of the emergency has been lifted. Under Liccardo’s, the moratorium would last 30 days, with the option to extend it each month.

“The reality is a lot of landlords, especially folks who own rent-controlled units in San Francisco, are looking for ways in the law that they can evict long-term tenants who are low-rent,” said Preston. “And those are the folks who are most at risk here. We want to make it clear for these landlords that they can’t use this as an excuse [to evict.]”

California law is especially unforgiving when it comes to non-payment of rent, Preston said, allowing landlords to serve a three-day “pay or quit” notice. After the notice is posted, “if the tenant doesn’t pay in 3 days, the landlord can evict them, even if they come up with the money later,” Preston said.

In San Jose, the mayor’s decisive action was praised by tenants’ rights advocates. “Many of our clients are a minor emergency away from missing their next rent payment,” said Michael Trujillo, a housing-focused staff attorney for the Law Foundation of Silicon Valley. Those at risk are disproportionately gig, contract and hourly workers, who are unable to work remotely or take sick leave, and for whom a canceled shift or contract can spell disaster.

Trujillo says there are ways the eviction moratoriums could be made even stronger, however. Under Liccardo’s current proposal, tenants would have to let their landlords know they’ll have trouble paying rent on or before the day it’s due, and provide full documentation of the virus-related work outage or closure. “In our experience, it can be really difficult for certain tenants — especially folks that are working in the gig economy and have informal sources of income — to secure some of that documentation,” Trujillo said. “The ideal solution would be an unconditional moratorium: disallowing any eviction for nonpayment of rent during the emergency.”

Councilmember Johnny Khamis told The Mercury News that San Jose’s fix could have negative ripple effects to other city workers: landlords. “I understand the mayor’s concerns, but we also don’t want people to lose their businesses, especially those mom-and-pop landlords, because their obligations to the banks aren’t going away,” Khamis told the paper.

In San Francisco, other resolutions that could protect landlords and renters alike — one preventing foreclosures and another deferring utilities payments — are being drafted, the San Francisco Chronicle reported.

Globally, similar efforts to protect renters are underway. In Singapore, government agencies took steps to stop the unfair expulsions of people who took state-ordered leaves of absence from work, underwent self-quarantine, or were being discriminated against based on race during the earlier days of the coronavirus outbreak.

“Landlords found to have irresponsibly evicted their residents may face restrictions and even be barred from renting out their flats to foreign work pass-holders in future,” read a joint press release by the ministries of National Development, Education, and Manpower.

And in Italy, where the entire country is under quarantine, the deputy economic minister said all mortgage payments will be suspended.

In Oregon, where governor Kate Brown declared a state of emergency due to Covid-19 this week, Portland Tenants United (PTU) has started circulating a petition to ask officials to institute its own eviction pause. It’s been signed by 1,800 people, including Portland Commissioner Chloe Eudaly.

The group’s demands go further than the legislation proposed in San Francisco and San Jose, arguing that the state should bar all evictions for the duration of the crisis. Even if an eviction isn’t precipitated by coronavirus-related income loss, they write, landlords could put more families at risk of contracting it by leaving them out on the street.

“Filling eviction court full of poor, sick people is in no one’s best interest,” said Margot Black, PTU’s co-founder.

To protect those who are already homeless, Liccardo has suspended all homeless encampment sweeps in San Jose, a move the Coalition on Homelessness suggested San Francisco take, too. When people are woken up in the middle of the night and moved forcibly from their makeshift shelters, they can be separated from important medical equipment and lose sleep, which weakens their immune system more.

Officials in King County, Washington, where 22 coronavirus deaths have been reported, bought a motel and plan to house individuals who are sick or potentially infected and who can’t otherwise self-quarantine. And in addition to a $5 million cleaning and staffing effort, which is meant to keep homeless shelters and navigation centers regularly disinfected and running 24/7, San Francisco will make 30 RVs available as “isolation housing” specifically for any unhoused people who come down with the virus.

“The more people are sleeping outside, the greater risk they’ll be at for negative health incomes,” said the Coalition on Homelessness’s Watts. “Not only in moments of crisis but in general, everybody deserves a place they can stay.”

In places where such protections have not been proposed, anxieties remain high. In Buffalo, New York, Richard McGilvray has no sick leave or paid time off, and is about to move into a new apartment with his girlfriend, who’s pregnant with her first child. Coronavirus cases haven’t yet been documented in Buffalo, but fear is spreading faster. “I work in residential property management, and if I were to come down with the sickness, I’d be looking at 14 days with no paid time off,” he said in an email. “A two-week stint without pay could potentially ruin our financial stability — as both myself and my girlfriend are in positions where we cannot work from home.”

Because cities in New York are preempted from legislating on evictions, any moratorium would have to come from the state.

Three years ago, Hutchinson, the stage-hand, says he was evicted from his San Francisco home after a rent increase of more than 300 percent, and has been moving from lease to lease ever since. Since he lives in Oakland, this eviction moratorium won’t cover him.

“The income inequality in this area, that’s a disaster in itself,” he said. “We could have used this a long time ago.”

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Why Aren’t Cities Testing for Coronavirus?

On March 1, on a return flight to her home in Washington, D.C., after a five-day work trip in Bangkok, Maggie McDow came down with something.

The symptoms — aches and fatigue, tightness in her chest — come and go. “One minute I think I’m getting better and the next I’m having trouble breathing and can barely lift my head off the pillow,” McDow wrote in an email on Saturday from her home in D.C.’s Forest Hills neighborhood, where she has been on self-imposed quarantine since her return. “I don’t know if this is Covid-19, but it [is] definitely different [than] anything I’ve had before.”

Because she traveled through an airport in South Korea — where some 7,400 people have been diagnosed with Covid-19 as of Monday — McDow was concerned. A colleague who traveled with her came down with the same symptoms, she says, but in that colleague’s home in rural Indonesia, tests for the coronavirus were not yet available. To McDow’s surprise, getting tested in D.C. would be difficult, too.

Last week, McDow bounced around between her doctor, George Washington University Hospital, and the D.C. Department of Health. On Friday afternoon, she checked in at the hospital’s emergency room. No luck: Even after she tested negative for the flu, she said that the city’s health department declined to run her test for coronavirus. The reason? Since she never left the airport in Seoul, she was deemed at low risk for infection. (The Department of Health did not return requests for comment; George Washington University Hospital referred CityLab to the city.)

McDow described her Kafkaesque journey through the medical system in a Facebook post that was quickly shared more than 20,000 times. On Monday night, she finally got tested for Covid-19: negative. It’s a relief in more ways than one, since she can now see her doctors, who couldn’t treat her before, for whatever is ailing her. She can see her daughters again, too.

McDow’s story has parallels with that of Robin Shulman, who wrote in The New York Times about making three trips to the emergency room before she was given a coronavirus test. (It was also negative.) Chris Hayes, the MSNBC host, reports the same trend in San Diego. “In order to get a test the patient has to have had close contact [with] someone [with] a confirmed infection or travelled to an infected area,” he writes. “But that’s totally insufficient!”

As President Donald Trump has repeatedly stated, coronavirus cases in the U.S. are still fewer than those being reported in France, Germany, or Spain, to say nothing of the many thousands more cases in hot spots like Italy or Iran. Yet the reported number of cases in the U.S. may simply reflect the fact that so few tests are being administered. Given the experience of other nations, it’s almost certainly the case that test results in the U.S. fail to convey the true severity of the problem.

“The numbers of ‘new’ cases reported daily in the U.S. are not new,” writes Marc Lipsitch, director of the Center for Communicable Disease Dynamics at Harvard University, in a post on Twitter. “They are newly discovered as we start to test more. Testing is still completely inadequate, and actual case numbers are much larger than the numbers we’re hearing because most cases never get tested.”

This coronavirus map Europe and North America from Johns Hopkins University’s now even has a graphic feature showing how each of Singapore’s 166 confirmed cases are linked; the rate of new cases has flattened and is now declining. China and South Korea have also seen their rates of new infections dip. Their interventions came early: Guangzho implemented strict social distancing protocols when the region had just seven confirmed cases (and zero deaths), according to Lipsitch. Wuhan went on lockdown when they had 495 confirmed cases (and 23 deaths). The U.S. is now further along than those places were — but with far fewer tests in the field to guide public decisions.

Health experts such as Lipsitch say that efforts to trace the contacts of infected individuals in order to contain the virus are now overwhelming health departments in the U.S.; mass testing only works in the early stages of a contagion outbreak. Now, it’s critical to lower the demand for medical attention before the nation’s healthcare system is overwhelmed (a real possibility). The way to flatten that demand curve is to make the painful decisions associated with social distancing. For the New York suburb of New Rochelle, that means a one-mile “containment” zone that will be administered by the National Guard. Soon, for a host of North American cities, that may mean mass closures of schools, workplaces, public gatherings, and other high-risk sites and events.

As local authorities begin to make those hard calls, questions about testing are starting to look more like woulda, coulda, shoulda. As of Tuesday afternoon, the Covid Tracking Project’s findings show 4,449 total tests nationwide, with 566 positive results and 409 cases pending. That looks like a reassuringly tiny percentage of people in a nation of 329 million are walking around with this bug. Keeping it that way, though, likely looks less like testing centers and more like proclamations. The federal government failed to do more to get tests to the public in time, notwithstanding Trump’s repeated claims that everyone with symptoms “gets a test.” Bottlenecks at the state and local levels proceeded from there — perhaps thwarting the containment stage entirely.

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A City Dweller’s Guide to Coronavirus Avoidance

At a time of growing fear around the spread of the Covid-19 coronavirus, it’s not hard to tumble into a spiral of catastrophizing. Even the most mundane interactions of urban life suddenly feel like a high-stakes gamble: Gripping a subway strap, a doorknob at the co-working space, an e-scooter handlebar, or a jug of half-and-half at the coffee shop means swapping germs with who-knows-how-many other people. Suddenly, the epidemiological dimensions to the “sharing economy” have become obvious. Even if you’re young, healthy and not as susceptible to a fatal dose of the disease, the risk of carrying the infection it to more vulnerable populations is frightening, too.

Along with the virus itself, there’s a ton of viral misinformation circulating. To learn more about the highest-risk urban places and practices, and how to protect yourself and others, CityLab spoke with Martin J. Blaser, director of the Center for Advanced Biotechnology and Medicine at Rutgers University’s Biomedical and Health Sciences department, and Jason Farley, a nurse practitioner at the Johns Hopkins School of Medicine’s infectious diseases division.

The CDC now recommends that all high-risk individuals — those with cardiovascular problems or other conditions that weaken their immune response, or who are over the age of 60 — limit their contact with the outside world, and that everyone else engage in “social distancing” to protect their communities. But city living in the age of coronavirus anxiety doesn’t have to mean complete self-quarantine, as long as you understand the highest-risk places, people and activities. (Also: Bring disinfecting wipes everywhere and wash your hands like crazy.)

Touching stuff

The coronavirus spreads via “viral droplets,” meaning the mucus sprayed into the air when someone infected coughs or sneezes. You can get it by breathing those droplets in, ingesting them, or touching a surface that’s been contaminated. This means all “high-touch” surfaces — like doorknobs, trashcan lids, subway poles — pose some risk. The bad news is that being a busy urbanite means touching everything. The good news is, says Farley, any kind of alcohol-based gel or hand-washing product can mitigate the potential of exposure. Scrub surfaces down before you touch them, and/or sanitize yourself after.

“We should be practicing these techniques regardless of coronavirus,” he said. “High-touch surfaces can transmit myriad viruses: The coronavirus is an emerging disease which has got our attention at this point, but influenza can also live on environmental surfaces for some time, too.”

Studies have not yet been conclusive in showing how long the novel coronavirus can survive on surfaces — depending on the strain, a coronavirus can last from 3 hours to 9 days; for comparison, the flu lasts about 24 hours. A recently released peer-reviewed study out of China found that the virus that leads to the disease Covid-19 could “linger in the air for at least 30 minutes” and live for days on surfaces, depending on the material and the temperature, and up to five days in feces or other bodily fluids.

The virus lasts longer on hard surfaces than on soft ones, according to an FAQ out of Harvard Medical School, meaning browsing through shirts at the mall is probably a bit safer than mashing elevator or pedestrian walk-sign buttons. Coming into contact with still-wet mucus is worse than droplets that have since dried in the afternoon sun, says Farley.

Should you avoid doorknobs and railings entirely? Wear protective gear? Try to open doors with your foot? Cower in your bedroom? The short answer is always some variation of, “Do what you need to do; just wash your hands afterwards.” Because the aggression of the virus depends on the dose, exposure from a railing will likely be milder than from a direct contact with fluids, says Blaser: “If you had your choice off getting it from touching a railing or someone coughing on you, you’d choose the railing.”

Wearing a face mask can help catch your fluids before they land on someone, but their broader benefits are hotly disputed: It definitely slows your transmission of the infection, if you already have it, but doesn’t do much to stop you from contracting it. Stop hoarding N95 respirator masks, says Farley — they’re not one-size-fits all, and without proper training or fitting, they could be permeated by disease. “If it’s used ineffectively, you’re taking a resource that could be used at a hospital or clinic,” he said.

Getting around

The CDC says that your odds for picking up the virus go up if you are anywhere within a six-foot radius of an infected person “for a prolonged period of time.” But new research from China estimates that the distance could be up to 4.5 meters, or more than 14 feet.

You might think that would make crowded public transportation vehicles like subways and buses ground zero for the spread of disease. Rush-hour commuters are smushed together in far closer proximity than six feet, much less 14, and they’re all pawing the same poles and overhead straps. To ease the congregation of large groups of people on the subway, New York City mayor Bill de Blasio issued guidance to skip trains that look too packed, and take the next one.

But, as Wired pointed out, in denser cities “riders tend to hop on and off transit more quickly, which means they have less time to share viral nasties.” Based on a 2011 simulation of how a 1950s influenza epidemic would have spread through New York City, researchers found that only 4 percent of cases would have been been contracted while riding the subway. And Motherboard transportation reporter Aaron W. Gordon tweeted that, if people are waiting on the track for less-full trains, platforms themselves will then become more crowded, and “dwell times” will increase, slowing service.

“The most effective policy choice that could be made here, in my estimation, would be to maximize peak hour service to reduce crowding AND incentivize off-peak commuting,” he wrote. “Run as many damn trains as possible (no, they are not currently doing that on most lines).”

In San Francisco, virus fears may already be driving down transit ridership. Cities are taking precautions by increasing the frequency of their regular disinfectant routines. New York’s MTA has been running low on cleaning supplies, but the state has come up with a resourceful fix: Making its own New York-branded hand sanitizer. (In a typically dystopian 2020 twist, the product is being manufactured by prisoners who may not be able to take advantage of it themselves; Mother Jones reported that typically, hand sanitizer is banned in state prisons because of its alcohol content.)

Despite the fact that the majority of Americans are at low risk of experiencing a fatal case, Farley urges caution. “Public transportation does one of the major things that we recommend not doing: gathering in large crowded spaces,” he said. “It works against social distancing. That being said, we have to be practical.” For high-risk individuals — those who are older, and more immuno-compromised — “avoiding these spaces is optimal”; everyone else should use best hand-washing and Clorox wipe-down practices.

What if you’re using a different kind of shared mobility to get around? The Global Times, a Chinese newspaper, reported that bike-share use has grown under the coronavirus threat.  “The epidemic has highlighted the advantages of bike-sharing — open air and no crowd gathering — which are helpful to curb the spread of the coronavirus,” Liu Ju, an industry analyst, told the paper.

Of course sharing bikes also means sharing germs, though. When you hop on a bike-share cycle or electric scooter, a huge amount of bacteria collects on the handlebars, and sometimes on the seat, says Blaser. Importantly, Covid-19 is a viral disease, not a bacterial one — but if a surface transfers bacteria, it can transfer viruses, too. Avoid soft handlebar grips in a shady space and choose bikes with harder ones that have been out in sunlight. If you’re able, walking or using your own bike are probably the safest bets; otherwise, sanitize the handlebars, wear gloves, or again, just wash your hands once you hop off.

Going to school

Though younger children have been getting the most mild infections from the coronavirus, 300 million schoolchildren around the world have been asked to stay home; some of them are logging into lessons remotely. “The reason to close schools is because children are the big amplifiers,” said Blaser. “The kids have very mild infections, but then they bring them home, then their parents get them, or worse still their grandparents get them.”

But keeping these little germ-monsters home brings a whole cascade of new problems, especially for low-income families. Research from past epidemic-related school closures shows that such households struggle when schools are closed, StatNews reported, because kids don’t get free or discounted lunches, and childcare gaps cause parents to miss work. And the infections often continue to spread, because kids can always find other places to congregate.

As Federal Communications Commission commissioner Jessica Rosenworcel noted on Twitter, remote learning is only a partial — and short-term — solution. And it’s one that is not be available to many people. “The #coronavirus is going to expose some hard truths about the digital divide,” she wrote. “If schools close can learning continue online? Only if students have internet access at home. Millions do not.”

Work and play

Here’s a good rule of thumb to apply to every room you’re thinking of entering, whether it’s a grocery store, restaurant, pharmacy, bar, library, or coffee shop: “It’s not about the space per se, but the types of interaction you have in that space,” said Farley. Those interactions start with turning the door handle (a high-touch surface!), and end with turning the door handle again.

Though there have been no known transmissions in restaurants, says Farley, employees have some control over public health. “I’ve seen a lot of food-service workers using gloves: that’s a good way of protecting themselves,” said Farley. “But those gloves can take the virus from money or a credit card, put it back on your food, and give it back to you. They don’t do anything to protect the consumer.” Having a healthy workforce helps the consumer and the broader community, but what he’s noting is that the outside of a glove can become as dirty as a hand very quickly.

Open-plan offices are the scourge of many, and the rise of the coronavirus offers another reason to hate them. “Open office spaces are among the worst for Covid-19, particularly if they are sealed office spaces without open ventilation and the air is just recirculated within the building,” E Hanh Le, M.D., senior director of medical affairs at Healthline, told the public relations firm Bospar, which did a survey on coronavirus fears. “To reduce the risk of spreading infection, concerned companies should enforce work-from-home policies to keep contagion down.” Dozens of companies have already taken that advice.

For those remote workers looking for a safe space place to plug-in laptops: Look for quiet rooms, not loud ones, recommends Blaser. A coffee shop or library where everyone’s silently reading or typing away will get a lot less spray than a noisier coffee shop or bar where everyone’s yelling over the music to be heard. (Note: At Starbucks, they’ve started turning away your reusable cup.) Places of worship provide no sanctuary from the coronavirus: Faith practices like sharing sacramental wine and communion wafers are coming in for increasing scrutiny, especially after a prominent D.C. pastor revealed he had tested positive for the disease.

For gym-goers freaked out by the prospect of sharing sweaty fitness equipment and yoga mats, remember that the gym has its own built-in protection system: Those alcohol-based hand sanitizer and gym cloths you’re supposed to be using to wipe down equipment before and after using. “A good sanitary practice in general that you clean when you’re done,” said Farley. If you don’t, it’s time to start.

Friends, furry or otherwise

The most important site of transmission may not be outside in the world at all. “You’re more likely to get it from a family member than a stranger,” Blaser said.

Of course, as Farley notes, even if you get it from a family member, they must have originally got it from someone else. But once the virus does enter a household, it’s hard to avoid getting it. “The microbiome of a house is similar amongst its inhabitants, because you share that space all the time,” he said.

Still, transmission isn’t guaranteed, says Farley, as evidenced by a man on the Grand Princess cruise ship who avoided transferring the disease to his wife, even as they lived and slept in close quarters.

As for pets, the risk of dog-kiss transmission is apparently low-to-nil, and there has been no evidence of human to animal transmission or vice-versa. Still, Farley says that if you’re quarantining yourself from other people due to the virus, that should include your cat.

The good news

This might be a novel coronavirus, but the best countermeasures are tried-and-true. “All the disinfectants that we can use against standard viruses work very very well against this Covid-19 virus,” said Andrew Stanley Pekosz, a professor at the Johns Hopkins Bloomberg School of Public Health, in a press conference on March 6. “Almost irrespective of how long a virus can survive on a surface, if you do a good job of trying to clean these common areas — areas that people are touching on a regular basis — you will be reducing your risk [of] getting infected.”

Besides, drastically changing your lifestyle in an effort to evade infection might not make much of a difference. “Right now, everybody’s concentrating on how can I avoid that exposure, but this virus is coming our way,” said Blaser. Up to 100 million people in the U.S. could be infected within the year, he says, if efforts to slow its spread do not work and if its trajectory resembles that of other influenza strains. “It’s going to be amongst us: It is good to try to protect ourselves, but we don’t have to go crazy about it, because chances are we’re going to get it anyhow.”

Besides washing your hands frequently, Blaser says what’s most important is having a healthy life: getting enough sleep, not drinking too much, not smoking, and exercising. And if you’re lucky enough to be considered low-risk during this outbreak, it’s a good time to think about neighbors who aren’t.

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How Coronavirus Took Down SXSW

On Friday, Austin Mayor Steve Adler announced the cancellation of South by Southwest, a two-week film and music festival that brings thousands of visitors to the city — and hundreds of millions of dollars in revenue.

As global alarm over the coronavirus outbreak grew, Adler’s decision went from “largely unthinkable to increasingly inescapable,” as Texas Monthly wrote. Adler and Travis County Judge Sarah Eckhardt declared a “local state of disaster” on Friday, giving public health officials the authority to review mass public events and decide whether they should proceed. Under these powers, officials announced that SXSW wouldn’t go forward. Residents of Austin were unnerved by the news, since the festival pumps millions into local venues, restaurants, and service industry workers’ pockets.

The jet-setter’s spring calendar is starting to look pinched. Austin’s signature mega-event joins a growing list of festivals, conferences, and municipal happenings that aren’t happening, both in cities that are currently struggling with COVID-19 cases and those that are simply bracing for the disease. Scientific organizations planning events in San Diego have canceled three conferences there so far, for example. Facebook, Google and Microsoft all scrapped their annual conferences for developers. The year’s biggest events for smartphone makers and videogame developers are off.

Meanwhile, other cities are proceeding with their plans: While Tokyo curtailed its marathon and Paris postponed its race, for now the Boston Marathon is still a go. How do cities weigh the risks of keeping conference centers and expo halls open as the virus charts its uncertain course? CityLab talked with Adler about how the city arrived at this costly decision — and what happens next.

Who made the decision to cancel SXSW?

Ultimately, the declaration of disaster that I signed [with Eckhardt] was based on the advice and concurrence of public health officials, the public health director, and city manager.

What was the festival’s response?

South-by, throughout the process — and this has been a continuing conversation here for the last two or three weeks — South-by’s position all along was they would honor and accommodate the position of the city, based on health concerns.

When did this conversation first start happening in Austin? As you and other city officials were monitoring this outbreak, when did it start to occur to you and others in conversation that this [coronavirus] was a looming threat for the city, and this festival?

In earnest, a couple weeks ago it became a greater possibility. That changed over time as more and more information was obtained. This is a discussion that is ongoing and it’s a conversation that is happening every day. Medical officers formed the advisory panel a week before the decision was made. That’s a panel made up of representatives from the three major health systems in Central Texas, the top infectious disease physicians at the Dell Medical School, and public health professionals in Central Texas. It was constantly being reevaluated.

How many cases have been detected in Austin at this time?

We don’t have any cases detected in Austin at this time.

How many tests is Austin performing at this time?

That number hasn’t been released, because we’re not releasing negative results. There’s been one or two confirmed cases of testing, but with negative results. We’re not going to keep identifying the number of negative tests that were given.

Live entertainment and big events are part of the lifeblood of Austin. Is the city looking at canceling any future events on the calendar?

No, and understand, this wasn’t just because it was a big event. This [SXSW] was ultimately canceled because it was a big event with multiple contained and closed venues, with large numbers of people coming from cities with person-to-person spread of the virus. Quite frankly, there was no time to properly mitigate.

At the same time this was canceled, the University of Texas basketball games are not being canceled. The rodeo, which draws primarily from Texas and has a lot of outdoor venues, is not being canceled. It’s a mix of factors that led to the canceling of South-by.

People are projecting a lot of lost sales because of the SXSW cancelation. For vendors, restaurant owners, restaurant staff, bartenders, hotel staff, and other workers in the service industry, this will be a big shock. What is the city telling people who are looking at a personal economic blow from this?

It is a shock. It’s horrible. There are people really hurting from this. The city has to mitigate this as best as we can and be as resilient as we can. There are a lot of funds that have been creating and started. There’s one with the Austin Community Foundation.

It’s certainly not going to make people whole. We’re not going to raise $350 million. The city is looking to see what we can do, as are philanthropists and social service organizations and others in the city. We’re lucky and fortunate in Austin that our economy is not dependent on one event. But the canceling of this one event is going to hurt.

Is that the projected cost or shortfall from canceling SXSW?

$350 million is what the estimated economic impact was last year. We were anticipating a similar impact this year. The ultimate impact, we’re not sure what it’s going to be. The city is not shutting down. There are still going to be people going to clubs and restaurants. Certainly there’s going to be real economic injury.

Are people still going to clubs and restaurants right now? Have you noticed or has there been reported any change in behavior?

My hope is that people who are more susceptible — older people, people with compromised immune systems — are staying away from crowds. That would seem to be the prudent thing to do. We don’t have a reported person-to-person spread yet. We’re still encouraging people to go out to eat and go to clubs. People are still doing that. We’re asking people to take extra precautions. Wash their hands more. Don’t go out if they’re not feeling well. We’re urging people to elbow bump rather than shake hands. These are the things that the data indicate slows the spread of the disease.

As this is playing out, your city has been in a protracted battle with the governor’s office over people experiencing homelessness in Austin. What can the city do to help protect vulnerable populations in the event of an outbreak? Is that conversation between your office and the governor’s office changing at all because of this disaster declaration?

The city is looking to see what it can do right now to help harden and support the locations that have folks who are most vulnerable. That’d be senior centers and nursing homes as well as encampments and other places where people who are experiencing homelessness are gathering. You can control better the environment in a closed facility like a nursing home. It’s more difficult where people experiencing homelessness are gathering. But we are looking to see what we can do there in terms of helping to provide additional facilities for people to wash their hands. Better monitoring from a medical standpoint so we can catch people who might become ill. This concern about the most vulnerable is something that Austin shares with cities across the world.

There are changes imminent to the Supplemental Nutrition Assistance Program. As of April 1, it’s going to change the eligibility for some people who are using food stamps through SNAP. Is this change to SNAP going to exacerbate the coronavirus crisis?

I’m concerned about the virus at lots of different levels and the interplay with a lot of federal programs — federal programs that have been cut and might be cut in the future. All of these things are concerns. The degree to which they [the federal government] are compromising the safety net for people, for anybody who lives in the city, makes the entire city more at risk.

Do you feel that Austin is getting the support it needs from the federal government or state government in terms of health supplies, tests and whatever it needs to try to contain the spread of this virus?

There wasn’t a lot of guidance coming from the federal government, from the U.S. Centers of Disease Control and Prevention, with respect to what we should do or not do about big events like South-by. The governor has increased the amount of testing equipment that’s available, in Austin and around the state, and that’s a good element. I can’t think of anything in particular that we wish we had that we’re not getting — other than better direction. That would be great. At this point we don’t have a run on supplies, and we don’t have a reported case yet.

How is monitoring the response affecting your job?

Everyone is concerned about the virus. We’re all looking at it, knowing that it’s a question of time. It’s not whether or not it’s going to spread to our city — it’s when it spreads to our city.

Everybody’s trying to take steps to help ensure that we’re doing everything that we can do to slow its spread and be a city that is ready for its arrival. The hope is that we can slow its spread as best as we can. Hopefully get into the summer months when viruses like the flu traditionally ebb a little bit, and hope for a vaccination or better treatments. It’s coming for all cities.

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Airlines Are Flying Empty ‘Ghost Flights’ Amid Coronavirus Fears

As coronavirus infections rise around the globe, demand for air travel is projected to hits its lowest point since the last financial crisis. Airlines around the world could lose up to $113 billion in revenue this year if COVID-19 continues to spread, the International Air Transport Association forecast on Thursday.

With travelers scarce, some carriers are turning to a troubling practice, the Times of London reports: flying planes with no passengers, in order to hang on to take-off and landing slots. On Thursday, the U.K.’s Secretary of State for Transport, Grant Shapps, posted a letter he sent to air travel regulators after learning of airlines operating “ghost flights” during the global outbreak. “Bad news for the environment, airlines & passengers,” he tweeted.

The custom stems from the way airports manage their limited runway capacity. More than 200 of the world’s busiest airports allocate specific time slots to airlines, which often pay top dollar for them. To manage demand, airlines are required to use their slots at least 80 percent of the time, or risk losing them to a competitor.

In order to maintain that 80/20 ratio, flying empty jets around is not an entirely uncommon industry practice, nor is it illegal. But given the growing scrutiny of air travel’s climate toll, it is frowned upon, especially by U.K. regulators. Several British carriers that have since gone extinct, including British Mediterranean Airways, BMI, and Flybe (which declared bankruptcy this week amid plummeting demand for air travel), have all been reported to fly empty or mostly empty planes from London Heathrow in the past.

Shapps’ letter to British air regulators asked them to suspend the 80/20 rule during the coronavirus crisis. The IATA has also requested that global air regulators suspend the rule until the fall, so that “airlines can respond to market conditions with appropriate capacity levels, avoiding any need to run empty services in order to maintain slots.”

For reference, the average round-trip flight for a single passenger from Heathrow to Hong Kong produces about 1.82 metric tons of CO2, according to a flight emission calculator by The Guardian. That is more carbon pollution than the average person would emit in an entire year in 81 countries around the world.

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The Census Bureau Wasn’t Counting on the Coronavirus

Up on the 18th floor of a federal building in San Francisco’s Tenderloin neighborhood, the census takers are getting ready. On the phone, a receptionist recites a job description to what could be a potential new recruit in Spanish and English. Administrators prepare the postcards that will soon be mailed to every household in the city, asking people to respond to the 2020 census questionnaire online or by mail.

For now, much of the work is happening behind closed doors. But starting on March 30, enumerators will fan out to count the city’s homeless population. And after the nationwide census kickoff in April, these enumerators will start knocking on the doors of households that didn’t respond to their postcards, beginning in May.

Census takers play a critical role in maintaining the health of American democracy. Door-to-door census count operations, however, could run afoul of a different imperative: keeping away from the novel coronavirus.

As more cases of COVID-19 are reported in the United States, the Centers for Disease Control and Protection has recommended that people who may have been exposed to the virus think hard about limiting their interactions with other people, by staying home from work, canceling travel plans and steering clear of public transit. But when the job is counting people — or galvanizing them to fill out forms — avoiding contact with the public isn’t always an option.

The Census Bureau has issued an assurance that they’re working with health authorities at the federal, state and local level to prepare for the spread of disease. “Operations for the 2020 Census and our ongoing household surveys have procedures built in that specifically anticipate epidemics and pandemics, and we will continue to work with the relevant authorities to keep those up to date,” said Steven Dillingham, the bureau’s director, in a statement.

On the West Coast, there is reason to act urgently. In Washington state, nine people have died so far due to the virus. There are more than 40 reported cases in California, including eleven in Santa Clara county and one in Alameda County. San Francisco Mayor London Breed declared a state of emergency on February 25, saying “we need to allocate more resources to make sure we are prepared.”

Seattle, which was home to the first U.S. death from the coronavirus, hasn’t been given official instructions from the Census Bureau related to the coronavirus, says Kelsey Nyland, a communications associate for the mayor’s office. “Since we haven’t received any guidance from the bureau or CDC on how COVID could — if at all — affect census outreach, we’re just going to continue to do the work we’re doing,” she said.

In the San Francisco census office, workers were taking their own precautions. A census employee (who asked not to be named because they were not authorized to speak to the media) gestured at some hand sanitizer when asked about whether the bureau had provided information or instructions about how the coronavirus could affect canvassing efforts. In an email seen by CityLab, Los Angeles Regional Census Center deputy regional director Thomas Szabla sent California census officers two CDC pamphlets with details on COVID-19 and how to stem the spread of infection. The same fliers are posted in the elevators of the federal building where the San Francisco census office is located.

“We are beginning to provide some basic information on the Coronavirus and other related health information,” Szabla wrote in the email. “I know a lot of people are starting to get nervous about this, but we need everyone to stay levelheaded about this and do our best to practice good sanitary habits.” The Census Bureau did not respond to follow-up questions from CityLab about virus preparation efforts.

Could pandemic anxiety disrupt the 2020 census, which decides the apportionment of seats in Congress and guides the distribution of more than $675 billion in federal funds? In the short term, it could certainly complicate the U.S. Census Bureau’s recruitment efforts, says William Frey, a senior fellow at the Brookings Institution’s Metropolitan Policy Program. Already, the low unemployment rate has made hiring enumerators harder. “They might have to take some extra measures to make sure that the census takers feel they’re safe,” he said.

The risk that the virus represents to the 2020 survey extends beyond these door-to-door follow-up counts, however. A successful census relies on the efforts of community associations, faith-based organizations, and other groups to muster a complete count. In Seattle, for example, this work involves extensive community outreach at parks and libraries as well as partnerships with local ethnic newspapers and other organizations. “We’ve already done the groundwork to make sure people have the info that they need,” Nyland said.

Thousands of complete-count committees across the country are already at work to bolster the count. Some of these committees serve very specific, localized, hard-to-count communities, whom the census might not otherwise reach. A pandemic might elevate that risk of being missed. In New York, where authorities announced a second confirmed coronavirus case on Tuesday morning, a group called LatinoJustice canceled a census rollout event scheduled for this week, according to The City.

States with large proportions of hard-to-count populations — racial and ethnic minorities, low-income families, respondents with low education levels, and other sociodemographic groups — are already facing an almost-certain undercount. According to projections from the Urban Institute, California, New York, and Texas face significant undercounts even in a best-case scenario. In the highest-risk scenario, every state would suffer an undercount except Maine, New Hampshire, and Vermont. And that Urban Institute projection didn’t take into account a global pandemic the likes of which the world hasn’t seen in a century.

That last pandemic was the Spanish flu outbreak of 1918 to 1920, which managed to wreak havoc on the 1920 census. A post-hoc report conducted by the director of the census noted that the full count was delayed by about five months, and some areas had to be canvassed again. The war in Europe and Spanish flu at home contributed to a series of nationalist laws restricting immigration; the 1920 census report casts these factors as responsible for the lowest rate of population growth in the nation’s history.

A lot has changed in the past 100 years, and the census has evolved accordingly: 2020 marks the first year that the Census Bureau is enabling people to respond to the questionnaire online. While the internet could be a liability when it comes to access or trust in the census (especially among hard-to-count communities), a digital census is nevertheless something people can complete even if the coronavirus outbreak grows much worse.

“It’s fortunate this time in that the census is counting on a lot of people to give their responses on the internet, which of course doesn’t involve a face-to-face interaction with a census taker,” said Frey. “They’ve tried very hard to make sure the internet system is pervasive, and that it works.”

For example, starting March 12, Seattle-area libraries will have computers available to all to fill out their census forms, regardless of whether they have a library card, says Nyland.

“If a public health crisis alters the bureau’s plans for the census, it could make it even harder to count some communities,” said Beth Lynk, the campaign director of Census Counts, a group housed under the Leadership Conference Education Fund that is working with organizations to help conduct a fair and accurate census. “We are already working with our partners to fight against xenophobia affecting hard-to-reach communities and, in the event of a public health crisis, are poised to strategically redirect resources and alter our outreach plans.”

A pandemic is just one of multiple menaces that census-watchers are tracking. The U.S. Supreme Court decided last summer that the census won’t include the question about citizenship that the Trump Administration was determined to insert, but experts fear that the damage to the count’s reputation with mixed-status or undocumented households was already done.

Already, scammers and other opportunists — including the GOP — are using fake mailers and phishing attacks to try to pry sensitive data or campaign contributions from unwary respondents. Misinformation about the coronavirus could also hurt the census, even if the outbreak is less severe than anticipated. With both the census and the pandemic response, the time to prepare for the worst-case scenario is before the crisis begins.

Local leaders who have the most to lose from a bungled census have been planning for the upcoming count for years. The 2020 census faces especially difficult odds. In addition to the usual funding shortfalls, this survey has weathered an unprecedented attempt to weaponize the count politically, and it still remains to be seen how the mostly untested technology will fare. Some census takers are already reporting frustrations using the Census Bureau’s new smartphone app in the field.

“Obviously, the operational phase of the census is a time when you want everything to go right, and this wild card is going to threaten that,” said Margo Anderson, professor emerita at the University of Wisconsin-Milwaukee and author of The American Census: A Social History. But the census always has to contend with plagues and perils, both natural and manmade: Just this week, tornadoes ripped through Tennessee, destroying dozens of homes that will need to be accounted for somehow this spring. They’ll adjust, she trusts — they always do.

“If you look at any news story in any decade, there are always stories of census offices that burn down. I think the 1850 census schedules from California were lost at sea,” she said. “The Census Bureau right now is likely working on this as we speak. They always have fallback positions.”

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