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Current Events

Class During COVID?

The CDC updates its guidance for returning Americans to work & play during the COVID-19 pandemic.

Here are the highlights for kids going back to school.

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Something To Consider

Reminder: CDC is not providing a legal directive – just recommendations.

CDC says its “considerations are meant to supplement—not replace” local laws and guidance.

CDC suggestions include disclaimers such as “when practical” and “if feasible” – we didn’t include these everywhere (redundancy!) but they’re used often.

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Big Picture

“The more people a student or staff member interacts with, and the longer that interaction, the higher the risk of COVID-19 spread.”

CDC's May 19th "Considerations For Schools." This one sentence sums up a guiding principle for all the recommendations issued.
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Basic Recommendations

  • Temperature & symptom checks daily.
  • Hand washing or sanitizing frequently.
  • Masks for everyone as much as possible.*

*CDC acknowledges this is difficult for younger students, and says masks should be worn when social distancing isn’t possible. Question: How does this apply to small groups of young students in a contained classroom? TBD.

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Logistics

  • Seating: Students should face forward – not facing each other – and sit separated if sharing tables.
  • Hallways: “One-way” routes in hallways should be implemented to keep children/staff from passing each other face-to-face.
  • New Design: Physical barriers or “sneeze guards” should be installed between bathroom sinks and in high-traffic areas.
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Learning

Limit sharing – from books to balls to crayons to toys. Students should have their own assigned “gear” and not share.

Cohorts” – this is a key word found in the guidance. The CDC suggests limiting the widespread mixing of students and staff, and emphasizes keeping people in the same small groups (as a way to limit interactions, therefore preventing or slowing transmission of disease).

 

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Playing & Eating

  • “Close communal use shared spaces such as dining halls and playgrounds with shared playground equipment if possible; otherwise, stagger use.”
  • Avoid spirit nights, assemblies, field trips and opt for virtual activities.
  • Eating: Serve meals in classrooms rather than cafeterias.
  • Sports: CDC advises to “minimize risk” with no specific guidance for different sports. More info. on our source page.
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Key Word: Staggered

Staggered seating on buses.

Staggered pick-up and drop-off times.

Staggered schedules or rotating schedules (virtual school some days, in-school classes other days).

Staggered use of shared spaces, like playgrounds.

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During the second week of May, lawmakers during a Senate hearing asked health officials, including CDC Director, for more guidance on getting kids back to school. In addition to the paramount goal of education, schools in America have a dramatic economic impact by providing childcare for working parents.

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Flush It Out

How monitoring your *Number 2* may help protect your Number 1.

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“Wastewater from an entire dorm, or an entire segment of a campus, could be tested to determine whether there is coronavirus in that sewage.”

Adm. Brett Giroir, a commissioned officer in the U.S. Public Health Service, on "experimental approaches, that look interesting, if not promising" for COVID-19 surveillance, answering a Senate hearing question about how children & young adults can safely return to school.
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Wait. What?

  • Scientists track viral shedding: how & when a sick person spreads the virus & level of contagion in different scenarios.
  • Genetic evidence of SARS-CoV-2 (virus that causes COVID-19) is present in stool samples (though we don’t know if it can spread that way).
  • Why It Matters: Monitoring wastewater *may* help early detection of COVID-19 cases in communities (without relying on individual tests).
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What To Know:

  • Precedent: Researchers have looked at city wastewater for presence of opioids, hormones.
  • Vancouver, WA sending daily sewage samples to Arizona State Univ, a leading lab in this field.
  • Bend, Oregon: one of 300+ cities participating in a study with a bio startup aligned w/ Harvard, MIT.
  • CDC to Politico: Gov’t itself considering monitoring sewage but hasn’t yet.
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Something To Consider:

“There is not a lot of evidence of transmission through stools. I know at least one tabloid in the UK got a lot of coverage by someone speculating that COVID-19 could be spread by flatulence or, to quote the headline, by farting. There really is not a lot of science behind that.”

CDC Deputy Dir. for Infectious Diseases, Dr. Jay Butler.
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A lead researcher in wastewater surveillance refers to our sewage systems as “the information superhighway under your feet.” Just how much sewage would be needed to get an accurate read of COVID-19 community outbreaks is TBD.

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What to know about a first-of-its-kind quick test for COVID-19.

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What To Know

FDA approved first “antigen test” for COVID-19.

Test looks for “fragments of proteins found on or within the virus” (FDA).

Uses a nasal swab and machines already available in many doctor’s offices.

Results in 15 minutes.

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“…positive results from antigen tests are highly accurate, but there is a higher chance of false negatives, so negative results do not rule out infection.”

The FDA advises using an additional test (PCR test) follow negative results. PCR tests read the genetic material of the virus. While rapid PCR tests exist, they can be more expensive, complex and take longer to get results. Bottom Line: Antigen tests can quickly confirm positive cases - negative results need subsequent testing.
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Context & Concerns

  • The World Health Organization advised against antigen tests in early April.
  • WHO: Significant chance for false negatives: “half or more of COVID-19 infected patients might be missed by such tests, depending on the group of patients tested.”
  • WHO: Antigen tests *could be* important “triage tests” to rapidly identify patients likely to have COVID.
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Can You Get Tested?

The FDA says this is hopefully the first of many antigen tests.

Antigen tests are widely used for flu and strep.

However, some doctors may still want to send you to test site. Not all offices will be able to follow protocols required for administering a COVID-19 test (ex: full protective gear for each & every test).

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COVID-19 Test: Cheat Sheet

3 main types of COVID-19 tests.

  • Antigen: nasal swab test measures for proteins attached to the virus during an active infection (someone sick).
  • PCR (polymerase chain reaction): often a nasal swab test for genetic fingerprint of COVID-19 during an active infection.
  • Antibody: blood tests looking for the presence of an immune response to COVID-19 (AFTER exposure to COVID).
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Fmr. FDA commissioner Scott Gottlieb told the Washington Post: “We need these kinds of tests...This is a nice complement to the overall testing platform in this country.” In the past, as testing availability increases, infection numbers *do* rise but mortality rates go down. It's TBD if this will happen with COVID-19.

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America’s New Unemployment Rate

14.7%

Better than expected and yet “the most heartbreaking day in the history of the job market.”

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The Basics

Highest unemployment rate in the history of the survey dating back to 1948; also highest month-to-month increase ever.

20.5M jobs lost. Job losses seen in every category; gains in none.

Hardest hit: leisure and hospitality with more than 7M+ unemployed – nearly half the entire workforce in that category.

 

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Something To Consider

In order to be counted as “unemployed” in a jobs report, an American has to be able to work, want to work and actively looking for work.

An estimated 9M+ Americans were laid-off but NOT actively looking for work (as their lay-off may be viewed as temporary). The government says *If* they were counted, the unemployment rate would be closer to 20%.

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“The sharp increases in these measures reflect the effects of the coronavirus pandemic and efforts to contain it.”

The Bureau of Labor Statistics, which produces this monthly jobs report, notes women have a higher unemployment rate (15.5%) than men (13%). The Wall Street Journal suggests this is because large job losses occurred in industries where women are "represented in high numbers," such as education and health services.
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“This has got to be the most heartbreaking day in the history of the job market.”

Austan Goolsbee, former White House economic advisor to Pres. Obama, says "we have to hope that this is not a normal business cycle" and that it doesn't take many years to repair the damage. He says the government (federal and local) should provide more support to taxpayers to make sure they aren't evicted or have to"liquidate" if the job market doesn't improve soon.
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“We’re going to rebuild it back as fast as we can.”

Pres. Trump on America's economy. While predicting to see a transition back over the next several months he says the stakes are high: "We have to come back otherwise you have a broken country." Over the last several weeks, lawmakers approved $3T+ of stimulus money during what the President referred to as an "artificial" or government-imposed shutdown of the economy. Additional stimulus is TBD as lawmakers have voiced concern about gov't debt.
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Early estimates for this month's unemployment rate topped 16%, so this report was actually viewed by some as better than expected. For context: The national unemployment rate in March was 4.4%. Lingering questions: Is this report a one-off? How long does a job recovery take?

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The FDA approves the the first COVID-19
at-home test.

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Why It Matters:

  • More Data: More tests = more information to guide our next steps.
  • Saves Gear: At-home tests will save time and equipment, both on short supply. Healthcare workers have to administer COVID-19 tests in full protective gear (even though the majority of people tested nationwide test negative for COVID-19).
  • Transmission: If you are sick, this test keeps you away from other people.
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What To Know:

  • First at-home test approved for COVID-19 in America.
  • LabCorp developed it. It costs $119.
  • You can’t just go buy it: A doctor must approve it for you.
  • Not available everywhere: Not all states allow at-home testing, including the hardest hit states of NY & NJ.
  • Not available for everyone: Healthcare workers, first responders will receive priority.
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How It Works:

  • After a physician places an order, a kit will arrive in the mail at your home.
  • The kit comes with everything you need, the most important component? A specific nasal swab.
  • You collect your own sample by swabbing the inside of your nose and mail it back to LabCorp with the box provided.
  • FDA says it’s as “safe & accurate” as testing at hospitals, doctors offices, etc.
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To date, the FDA has authorized more than 50 COVID-19 diagnostic tests and 4 antibody (aka serological) tests. Pres. Trump is using the Defense Production Act to manufacture 20M swabs a month for tests. Interesting to note: the FDA says it's investigating using q-tip style swabs for testing.

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STAYING HOME?

You shared your favorite stay-at-home books, movies, recipes and games!

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White House COVID-19 Task Force

WHAT WE LEARNED TODAY

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“You don’t need results of testing to tell you what you should do.”

Vice Pres. Mike Pence emphasized what every American can do to change the course of COVID-19. The message from the White House today: Everyone, including the young and healthy, needs to follow the guidelines of practicing social distancing, as well as avoiding crowds, discretionary travel, and dining out.
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“…we can change the way respiratory viruses — not only for this, but the future — affect Americans.”

Dr. Deborah Birx on the current stakes of public health measures. She applauded grocery stores that have implemented specific shopping times for senior citizens, adding that she hopes the practice expands and continues during flu seasons.
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“We will win.”

Pres. Trump, who says our economy will come "roaring back" despite the impact of COVID-19 and that he wants to "go big" on economic stimulus. The IRS will defer tax payments for affected individuals and businesses. One stimulus idea includes directly sending money - reportedly up to $1,000 - to Americans within a certain income bracket, though the exact figure is unknown.
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“This is worse than 9/11.”

Treasury Sec. Steve Mnuchin on the current state of the airline industry. Sec. Mnuchin said programs for airlines and businesses of 500 or less are in the works. After 9/11, the stock market temporarily closed. When asked about that, Sec. Mnuchin said the markets will remain open despite the current volatility, though shortening trading hours may be an option if needed. He added, "Americans need to know they have access to their money."
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"Everything else is going to come back. A life is never going to come back." President Trump on why saving American lives is the number one priority right now, and why all Americans must join together in order to do so. What do you think of the new guidelines?

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PATIENT ZERO

What exactly happened to the first case of COVID-19 in America?

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What We Know

  • January 19, 2020: A 35-year-old man arrived at a clinic in Snohomish County, north of Seattle, Washington.
  • He recently returned from Wuhan, China where he visited family; he did not knowingly make contact with anyone ill OR visit the open-market in question as the source of a mysterious outbreak.
  • By the time he arrived at the doctor’s, he hadn’t felt well for several days.
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Timeline of Illness

  • Jan 15: Patient travels home from China.
  • Jan. 16 or Day 1 of illness: Cough starts.
  • Days 4-5: Nausea/vomiting; goes to clinic, admitted to hospital.
  • Days 6-11: Fever of 102-103F.
  • Day 9: Evidence of pneumonia, depleted oxygen levels.
  • Day 10: Given oxygen, antivirals.
  • Day 12: Taken off oxygen, cough continues; remains hospitalized at least through Jan. 30th + home isolation.
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“Our report of the first confirmed case of 2019-nCoV in the United States illustrates several aspects of this emerging outbreak that are not yet fully understood, including transmission dynamics and the full spectrum of clinical illness.”

Analysis by Washington State 2019-nCoV Case Investigation Team who says one of the challenges of COVID-19 is that it presents like other respiratory illnesses during flu season. They noted the similar, rapid evolution from no signs of pneumonia to a diagnosis in 5 days.
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“Everyone should know these red-flag symptoms. COVID can turn serious in any age adult. If you’re a healthy adult under 60, the signs and symptoms to seek care are much the same that I would say for the flu – prolonged high fever (104 or higher), chest pain, shortness of breath, lethargy, or inability to drink fluids or urinate.”

Dr. Darria Long Gillespie, ER room physician and author of “Mom Hacks.”
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“We’re at a critical junction right now, but we can still mitigate this substantially.”

Trevor Bedford, Bedford Labs, wrote this on March 2. The prominent researcher believes Patient Zero may have led to upwards of 1,500 cases in the Seattle area that he expects will mimic Wuhan, China with a spike in illnesses. The CDC calls his work tracing the illness an "interesting hypothesis" but says others may have contributed to the spread.
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It reportedly took Patient Zero nearly a month to be deemed "fully recovered" and no one in close contact with him is known to have tested positive for the illness. The Seattle area remains one of the hardest hit in the nation.

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White House COVID-19 Task Force

WHAT WE LEARNED TODAY

 

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“We have not reached our peak… We will see more cases and we will see more suffering and death.”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, reiterating that the U.S. has YET to see the height of COVID-19, noting that the most vulnerable are the elderly and those with underlying conditions. Nonetheless, as pointed out by U.S. Surgeon General Dr. Jerome Adams, "almost all people will recover - 98, 99% of people will recover."
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“If you don’t have to travel, I wouldn’t do it.”

Pres. Trump's advice to the American people. The ban against entry into the U.S. from 26 European countries went into effect on Friday. On Monday, the United Kingdom and Ireland will be added to the list. U.S. citizens and green card holders are exempt from the ban. Pres. Trump said the U.S. is *ALSO* considering domestic travel restrictions.
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“We don’t want to say the risk is low when we don’t know how low the numbers are for people who are asymptotic.”

Dr. Deborah Birx, White House COVID-19 coordinator, explaining that although we know a lot about the high risk of serious illness to older Americans, we don't know enough yet about transmission, specifically, how many are carrying COVID-19 that show no symptoms, but are spreading it. BIG unknown: Are people under 20 asymptomatic and spreading the virus?
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“If you are sick, stay home. You’re not going to miss a paycheck.”

Vice President Pence on the stimulus deal that passed the House and is on its way to the Senate on Monday, which has several provisions, including free coronavirus testing, two weeks of emergency paid sick leave for displaced workers, increased Medicaid funding, as well as boosts to nutrition programs for students and low-income persons.
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“We need your help. Social distancing and mitigation – they’re not to protect the 30-year-old or the 20-year-old from getting coronavirus. They’re to protect your nana.”

U.S. Surgeon General Dr. Jerome Adams on why people of ALL ages need to contribute to the efforts to overcome COVID-19. Dr. Adams' prescription: "know your risk, understand your circumstances, and get the facts to protect yourself at coronavirus.gov."
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What's Next? Treasury secretary Steve Munchkin suggested that other stimulus ideas are on the table, such as a payroll tax cut, refundable tax credits, suspending interest on student loans, and using the strategic oil reserves. WHAT DO YOU THINK OF THE U.S. RESPONSE TO COVID-19?

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LESSONS FROM THE PAST

Why were certain American cities hit brutally hard by the 1918 flu pandemic while others were spared?

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“Schools, theaters, churches and dance halls in cities across the country were closed. Kansas City banned weddings and funerals if more than 20 people were to be in attendance. New York mandated staggered shifts at factories to reduce rush hour commuter traffic. Seattle’s mayor ordered his constituents to wear face masks.”

National Institute of Health describing the scene in America during the flu outbreak of 1918.
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WHAT TO KNOW:

What They Researched: In 2007, the National Institute of Health funded two studies examining the government response to the flu pandemic of 1918.

What They Found: Government intervention (containment/restrictions) worked to help slow the spread of the flu, but the real life-saving factor: how quickly the measures were put in place.

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One Example

Both St. Louis and Philadelphia put similar measures in place, such as banning large gatherings.

St. Louis put the ban in place 48 hours after first cases emerged.

Philadelphia put the ban in place two weeks after first cases emerged.

“Peak mortality” rates in St. Louis were 1/8 that of Philadelphia.

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WORTH NOTING

“… had San Francisco left its controls in place continuously from September 1918 through May 1919, the analysis suggests, the city might have reduced deaths by more than 90 percent.

Researchers concluded this about public measures: the earlier the better, and the longer imposed, the more effective. Many cities removed measures too early allowing re-transmission to occur.
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ONE LESSON?

“… in the event of a severe pandemic, cities will likely need to maintain (non-pharmaceutical interventions) for longer than the 2–8 weeks that was the norm in 1918.”

Both studies note the challenges of comparing the past and present. However, both came to the conclusion that during a pandemic with no vaccine, public measures may need to be in place longer than previously believed.
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Something To Consider

Researchers said finding precise public measures, their timing and how effective (how many people REALLY followed the guidance) is challenging.

Some cities, like Philadelphia, handled a large influx of soldiers from WWI where others did not. This is one reason for the disease spread – but also a factor for concentrated mortality rates.

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"...nonpharmaceutical interventions may buy valuable time at the beginning of a pandemic while a targeted vaccine is being produced.” Dr. Anthony Fauci in 2007 reacting to this study. Dr. Fauci remains the director of NIH’s National Institute of Allergy and Infectious Diseases, helping to lead the national response to COVID-19.

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While Americans hunker down at home, four soldiers died abroad in service to the nation.

The swift retaliation and why it matters.

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Backstory

Sunday: Two Marines killed in action during a raid of an ISIS complex in Northern Iraq.

Wednesday: Two U.S. servicemembers + 1 U.K. soldier died during a rocket attack outside of Baghdad. 14 others injured. The U.S. blamed Iranian-backed militias.

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“The United States will not tolerate attacks against our people, our interests, or our allies.”

Sec. of Defense Mark Esper on an airstrike targeting five weapons storage facilities the U.S. says belong to the militia that attacked U.S. and coalition forces Wednesday. Sec. Esper says the same Iranian-backed group is responsible for a series of other attacks.
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Important Context

  • Despite the U.S. targeting and killing an Iranian military leader after the death of an American contractor in December by an Iranian-backed militia, a similar attack targeted Americans Wednesday.
  • Despite the U.S. declaring the “defeat” of ISIS in Iraq and Syria, the group reportedly is attempting to regroup in Northern Iraq.
  • Bottom Line: The threats from both ISIS and Iran continue; tensions simmer.
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A message from the Defense Dept after the airstrikes Friday morning in Iraq: "These terror groups must cease their attacks on U.S. and coalition forces or face consequences at a time and place of our choosing." Meanwhile, Iran confronts one of the deadliest outbreaks of COVID-19 on the planet.

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A closer look at the “emergency powers” invoked by state and local governments in response to COVID-19 as New York enacts a first-of-its-kind “containment zone.”

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Why Declare A State Of Emergency?

“The main purpose of declaring a state of emergency is increased flexibility to respond and prevent, as well as to allocate funds where needed.”

North Carolina Governor Roy Cooper on the benefits of declaring an emergency. At least 18 other states have declared emergencies to combat the coronavirus.
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PREPAREDNESS

Emergency orders allow states & localities to up their preparation efforts

  • Deploying the National Guard troops to provide assistance to local authorities.
  • Gaining access to federal & state funds to assist affected communities (ex: emergency & medical supplies).
  • Fast-tracking coordination btwn local, state, & federal agencies to speed up delivery of goods and services.
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PREVENTION

Emergency orders allow state and localities to take preventative measures

  • Setting up satellite healthcare facilities and waiving copays and deductibles for coronavirus testing.
  • Enacting laws to prohibit price gouging of key items (ex: hand sanitizer).
  • Prevent community spread by closing schools or houses of worship and canceling large events (ex: SXSW).
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NY Gov Cuomo said this about his use of new emergency measures, calling in the National Guard to help with cleaning, food delivery and containment in a suburb of New York City: "It is a dramatic action, but it is the largest cluster in the country."

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