Michigan coronavirus Q & A: Reader questions answered - Bridge Michigan

Michigan coronavirus Q & A: Reader questions answered - Bridge Michigan


Michigan coronavirus Q & A: Reader questions answered - Bridge Michigan

Posted: 17 Mar 2020 03:59 PM PDT

Michigan coronavirus Q & A: Reader questions answered 

Bridge readers are flooding our email help line with the challenges of navigating the coronavirus crisis. Below are answers to reader questions about health, workplace and employment, daily life and civil society. We will update this Q & A as often as possible in the days ahead. 

While we don't have the capacity to reply to every email, we greatly appreciate your personal stories and questions — you help inform and guide the stories Bridge reporters are publishing each day. 

If you send a question to the help line, please provide an email address and cellphone number, in case we need to follow up.

HEALTH-RELATED QUESTIONS

Q: Should I go get my bi-annual mammogram, dental cleaning, heart doctor appointment well visits, etc.?

Answered by Dr. Aron Sousa, internist and dean, Michigan State University College of Human Medicine:

If patients have chronic or acute conditions that they are struggling with, they should go to their doctor. For example, if they have a lump in their breast or their heart failure is not well controlled, they should continue their care as though there was no COVID-19 crisis. 

You should put off your bi-annual mammogram, your cataract surgery, or your knee replacement for a couple of months. The same goes for regular dental cleanings. 

But if you have diabetes and you have been having trouble with your feet, go to the podiatrist. You should continue to get care that clearly will prevent a health problem in the next few weeks. 

Parents should still take their kids to their 1-,2-,4- and 6-month well-baby checks, but you can probably delay the well-child visit of your 12-year-old for a couple of months. I will say, people still need to get their flu shot. There is a lot of flu going around and keeping flu under control will help our health system better deal with COVID-19.

Q: I am five months pregnant. Fevers are already known to cause premature births. This negative impact has already been seen in a few third-term, COVID-19 positive pregnant women. Premature pregnancies can cause all sorts of problems for my baby, if not kill her. However, no one is coming out saying COVID-19 is directly responsible. This is deeply concerning and has left pregnancies out of the topics that are being discussed.  

Answered by Dr. Nigel Paneth, epidemiology and pediatrics professor and pediatrics at Michigan State University College of Human Medicine:

The information we have about effects on pregnancy are sketchy, but the fact that very few deaths from COVID-19 have been in people under 50 suggests (but does not prove) that pregnancy is not an especially severe risk factor for severe illness. Based on small samples from China, the virus does not appear to be transmitted to the baby, nor appear in breast milk. 

Having said that, we generally think that pregnancy makes the woman a bit more susceptible to infections of all kinds. We have not heard of reports from either China or Italy about increases in pre-term birth or miscarriage. The advice now being offered to just about everyone — avoid even small group gatherings, be careful with hand-washing, stay at home as much as possible — applies especially to pregnant women. 

Q: What type of pain relievers are recommended for people with the coronavirus? 

A number of doctors, based on research, advise not using nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, saying they can prolong the illness by "damping down" the patient's immune system and could worsen kidney injuries in an ill person. They recommend acetaminophen, the main ingredient in Tylenol, to relieve pain and reduce fever.

Q: Supposedly the virus has a 14-day incubation period.  Let's say I am tested today and the results are negative.  I'm assuming that I could be tested again in 21 days and the result is now positive. Can people be tested more than once?
If people are not retested, can we have an accurate count of how many people in a certain area have the virus?

Answered by Dr. Daniel Havlichek, infectious disease specialist and chief, Division of Infectious Diseases, Michigan State University College of Human Medicine:

COVID-19 will go on for many weeks/months. People will get re-exposed over time (especially health care workers) and retesting will be appropriate in some settings. Testing negative once is helpful but people always need to be cautious.  

Q: Do you have any confirmation about whether vinegar or isopropyl alcohol solutions are effective for disinfecting home surfaces? We are sensitive to many of the commercial cleaners due to asthma in our household, and I typically use a homemade cleaner with vinegar and essential oils. Looking for recommendations on effective disinfectants that won't exacerbate respiratory conditions.

Vinegar solutions aren't recommended for fighting coronaviruses as they are not effective in killing them. 

Isopropyl alcohol solutions, however, can be effective if the alcohol concentration is around 70 percent. Hand sanitizers often have a concentration of 60 percent alcohol, and Lysol contains approximately 80 percent alcohol. Both are effective against coronaviruses.

Q: My husband and I share custody of our daughter.  My mom just moved in with us, and she is one of those at-risk people. My daughter's father is a police officer who is exposed to everything.  But now she is coming home and should I isolate my mom or my daughter?  How do I do this every weekend? I'm so stressed about this.

Health officials recommend keeping at least 6 feet away from others. In this case, that means your daughter and your mother. In addition, the CDC advises cleaning "high touch" surfaces every day to help kill any virus. While the virus can live on surfaces, at the moment, the CDC states, it has not documented any cases of COVID-19 that involved someone contracting the virus from a surface. The virus is commonly transferred through respiratory droplets that infected people breathe, cough or sneeze out. 

To date, most cases of COVID-19 are in adults. The CDC encourages parents to help stop the spread of COVID-19 by teaching children to do the same things everyone should do to stay healthy.

  • Clean hands often using soap and water or alcohol-based hand sanitizer
  • Avoid people who are sick (coughing and sneezing)
  • Clean and disinfect high-touch surfaces daily in household common areas (e.g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks)
  • Launder items including washable plush toys as appropriate in accordance with the manufacturer's instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from an ill person can be washed with other people's items.

Q: My daughter just returned home from a Caribbean cruise and was denied access at two other ports. She returned home two days ago and her father and her mother are both very sick and elderly. How does she go about getting tested for the coronavirus? 

Q: My husband has a productive (yellow, mild to moderate) cough and a tickly throat seven days after a plane flight. No other symptoms. He is 78 and has a mild underlying heart condition. Do these conditions indicate the Covid virus? What is your advice? 

If you believe you may have the virus, the first step is to call your doctor, as recommended by the Centers for Disease Control and Prevention.

 If you don't have a doctor, the state of Michigan has a hotline for people who suspect they may have coronavirus. That number is 888-535-6136.

Google your county health department or nearest hospitals for additional coronavirus hotlines for help in your area.

The CDC urges those who believe they may have the coronavirus to call ahead before visiting a doctor or emergency room. 

Q: Will wearing "surgical" type rubber gloves while out and about help?

The CDC recommends regularly washing your hands with soap and water for at least 20 seconds. Avoid touching your face, which can help transmit the virus.

As to gloves, the answers are mixed:

One study found that latex gloves provided "less than total" protection due to holes even in the new gloves and lack of durability. Another study suggested "a good and cost-effective way to prevent [a virus'] transmission in the healthcare setting is through barrier precautions, which include the use of gloves."

Q: How many of the people tested positive for the virus are sick and in the hospital? 

This is not data that is being reported by the state, as patient privacy is protected by HIPAA privacy law. However, the state of Michigan is updating the following at 2 p.m. every day on their COVID-19 website:

  • Cases and deaths broken down by county
  • Cases by age range (in 10-year increments)
  • Cases by gender

Each time the state updates the caseload, the Bridge Coronavirus Tracker updates its statewide map of cases.

A research study released this week suggested there are many undetected "stealth cases." Columbia University researcher Jeffrey Shaman said, "these stealth transmissions will continue to present a major challenge to the containment of this outbreak going forward."

One assessment of the situation in Wuhan, China, had a death rate among those infected at as high as 12 percent, possibly because of an overwhelmed health care system. The World Health Organization (WHO) currently has put the overall COVID-19 death rate at about 3.4 percent. The WHO estimates that about one in five of those infected will need hospital care. 

Q: When I shop I use my debit card and place it in the machine. Can the coronavirus get on your card from an infected person's card in the machine prior to yours? Just wondering if the virus can spread from plastic to metal to plastic?

The virus can live on plastic and metal for as long as nine days, according to recent reports. Plastic cards are preferable to using paper money or coins because they can be sanitized.

One plastic credit card provider, Apple, advises users to "gently wipe with a soft, slightly damp, lint-free microfiber cloth" and "moisten a soft, microfiber cloth with isopropyl alcohol and gently wipe the card." But "don't use window or household cleaners, compressed air, aerosol sprays, solvents, ammonia, or abrasives."

The CDC advises cleaning "high touch" surfaces every day and to "clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product."

WORKER, EMPLOYER, AND WORKPLACE SAFETY QUESTIONS

Q. I work for a cleaning company. We clean residential houses throughout Michigan. Is it safe to continue to work in Michigan as a house cleaner?

The National Domestic Workers Alliance has set up a Care Fund to provide emergency assistance for domestic workers to stay home. The organization also has assembled a list of tips for house cleaners: 

  • Find out whether anyone in the home has symptoms and schedule the cleaning after a doctor has cleared the person.
  • Use cleaning products recommended to fight the spread of viruses.
  • Wash your hands before and after cleaning the house.
  • Make sure you have good ventilation. 
  • Spray cleaners into a cloth rather than directly onto a surface, and then wipe with the cloth.
  • Change and wash your clothes after work.

Q. I work at a hospital as a housekeeper. Yesterday, I walked into the room of a a patient who has the virus without a mask. I had gloves on and I didn't get close to her. I didn't know she had the virus. NOBODY told me NOT to go in her room.

The CDC's recommended precautions  include designating space within the facility for COVID-19 patients and using face masks and eye protection within the units. The CDC also recommends that patients with suspected or known cases of the virus be cared for in a single-person room with the door closed.

Q: I have a relative whose unemployment insurance is soon to be exhausted. At this time, employers are not hiring (farthest from their mind). So now his employment search is on a hiatus. Due to the national emergency, will he be able to apply for extended benefits to cover this period? If so, how does that happen?

The U.S. House and the White House have reached a deal on a relief package to assist those affected by the coronavirus outbreak, which includes expanded unemployment benefits as one of its relief measures. The Senate is expected to take a vote on the package this week.  President Trump has indicated that he will sign the bill when it reaches his desk.

Details about what these benefits will entail, as well as how to apply for them, will be clearer when this relief package is signed into law.

Q: Will small businesses, such as privately owned restaurants, be helped financially by the government? Will employees be able to collect unemployment for the amount of time that the restaurant is closed? If the government will be helping, will a restaurant be penalized for not staying open for carryout? Some restaurants cannot afford to stay open only for carryout.  It would cost more to stay open for carryout only, (utilities, payroll, food orders...). 

Gov. Gretchen Whitmer has announced she is working to address small businesses impacted by COVID-19. Earlier this month, Congress passed legislation that makes $1 billion available to the U.S. Small Business Administration (SBA) to provide low-interest loans to small businesses, small agricultural cooperatives, and nonprofits that have suffered substantial economic losses as a result of the COVID-19 pandemic.  

The Michigan Economic Development Corp. (MEDC) is working with small business entrepreneurial support organizations to get help, and the governor is applying this week for an Economic Injury Disaster Loan Declaration. For more information, visit MEDC's website: www.michiganbusiness.org or call 888-522-0103. The Michigan Small Business Development Center can also provide resources for small businesses impacted by COVID-19. Visit their website https://sbdcmichigan.org/small-business-covid19/ for additional information. 

The state also expanded a work share program for qualifying business that could help avoid mass layoffs by splitting the cost of employees. A participating business could scale back worker hours and ask unemployment insurance to make up the difference in lost pay.

Experts say Michigan workers who are laid off because of the coronavirus should qualify for unemployment benefits that will provide them at least a portion of their regular income — up to $362 a week. 

Q:  I have a small dance school in Montcalm Co. Our smallest class is six 3-year-olds and the largest is 25 students ages 9-16. We decided to stay open with extreme restrictions to how many can be in the building at a time, with  extreme cleaning and sanitizing measures in place. Are we OK?

Recommendations for limits on crowd sizes have swung wildly in the last week, from Monday's announcement by President Donald Trump to limit groups to no more than 10, to Gov. Gretchen Whitmer's initial order of crowds no more than 250, changed later to 100. The Centers for Disease Control and Prevention (CDC) recommended no more than 50 people.

In general, though, the CDC suggests that people considering group events consider:

  • The number of people attending, and whether that number can be reduced.
  • How many of those attending are at greater risk of more serious illness if they contract COVID-19.
  • How close together the attendees will be within a confined area. The CDC recommends no closer than 6 feet.
  • The level of transmission in your community and in the areas from which attendees will travel.

As the country works cooperatively to "flatten the curve" of the outbreak, consider every possible means of avoiding further spread of COVID-19.

Q: If I'm not able to collect unemployment and my job was affected by the coronavirus, how do I  get financial help?

Gov. Whitmer signed an order Monday to temporarily extend unemployment benefits for workers for six additional weeks of unemployment insurance, up to a maximum of 26 weeks. Experts say those laid off because of the coronavirus should qualify for up to $362 a week. 

In addition, local solutions include places of worship, the United Way's 2-1-1 helpline and community food bank assistance. 

Some credit card companies are offering assistance  for those with balances. You can contact them directly to find out their guidelines.

The U.S. House of Representatives on Saturday passed an emergency relief package that would fund a response, giving "some workers two weeks of paid sick leave and up to three months of paid family and medical leave, equal to no less than two-thirds of their pay." It would help employees of businesses with between 50 and 500 employees. The bill also adds funding for the Supplemental Nutrition Assistance Program, food banks and food assistance for families of children receiving free or reduced-price school lunch programs. The Senate will likely take up the bill this week.

Congress continues to debate how best to help people, with one proposal from Sen. Mitt Romney (R-Utah) suggesting a $1,000 per adult direct payment.

Q:  I am a substitute teacher and also work at a museum. Both jobs are shut down due to the coronavirus. I am also sick myself and I don't know if it is a flu or the virus. I have a mortgage, other bills and a 1 year old. Will I be able to apply for unemployment or is there any help my family can receive until this is over?

In addition to statewide school closures, as of Monday, March 16 at 3 pm, all Michigan restaurants, cafes, coffee houses, bars, taverns, brewpubs, distilleries, clubs, movie theaters, indoor and outdoor performance venues, gymnasiums, fitness centers, recreation centers, indoor sports facilities, indoor exercise facilities, exercise studios, spas, and casinos were ordered temporarily closed via an executive order signed by Gov. Gretchen Whitmer

Employees who are laid off as a result of these closures are advised to apply for unemployment compensation online at www.michigan.gov/uia. Online application is recommended because of increased call volumes, but those seeking to file a claim for unemployment benefits can also call 866-500-0017 to apply Monday to Friday, or visit your nearest Unemployment Insurance Local Office.  

To file a claim, you will need:

  • Your Social Security Number, your driver's license or state identification number or your MARVIN PIN
  • If you are not a U.S. citizen or national, you will need your alien registration number and the expiration date of your work authorization.
  • Names and addresses of employers you have worked for in the past 18 months including quarterly gross earnings and the last date of employment with each.

Your application for benefits will be evaluated to determine whether you are eligible for benefits and how much you may receive. 

Q: Are there supposed to be children in an office during this crisis?

Because of school closures, and in some cases, day care, many parents are struggling to find ways to supervise their children and still earn a living. The U.S. Department of Labor says employers face the likelihood of increased absenteeism during the outbreak and recommends flexibility for employees struggling with child care issues.

The Centers for Disease Control and Prevention recommendations for workplace safety include practicing good hygiene, adjusting meetings and travel, exercising increased care with food, and having those who are sick or have a sick family member stay home. In addition, the Labor Department advises not sharing phones, desks, offices or other equipment.

Q: I am a college student dependent on my work-study award  to pay my tuition and student loan. Is there anything that the government is doing anything for students in need?

Student loans come from a variety of sources. Some options for addressing student debt include requesting deferment or forbearance or exploring an income-driven repayment option. The president said Friday that interest on federal student loans will be frozen, but details of that action are still to come.

Meanwhile, if you are relying on work-study, contact your supervisor and ask about flexible options. Since universities have closed and many are working from home, there may be a way for you to work remotely. If that is unsuccessful, contact your school's financial aid office.  

DAILY LIVING & CIVIL SOCIETY QUESTIONS

Q: Would it be worthwhile to provide information on organizations (food programs, artist & arts programs, etc.) that are affected by this & how people who can afford to can donate/help them through this?

Bridge is currently working to compile a list of such programs and organizations across the state, which will be published as soon as possible. 

The University of Michigan Medicine Health Blog advises 10 steps to help others. The Center for Disaster Philanthropy has organized a fund to support preparedness, containment, response and recovery activities for those affected and for the responders.

In addition, local responses are coordinated through houses of worship, the United Way and the Red Cross. Community food banks are likely to be in high need of donations for many months as the economic impact of the pandemic begins to hit homes.

Q: I am 64 years old and rely on three AirBnb rentals for income. I do all the cleaning and laundry. Can you advise the best way to protect myself in this situation?

The CDC recommends wearing disposable gloves when handling dirty laundry and discarding them after each use. If possible, do not shake dirty laundry, and launder your clothes and linens at the warmest appropriate temperature for your items and dry them completely. Clean and disinfect clothes hampers after each use.

When cleaning, disposable gloves should also be worn and discarded after each use. Disinfecting can be done using a diluted bleach solution, alcohol solutions comprising at least 70 percent alcohol, or EPA-registered household disinfectants.

Q: My wife's mother is 92 and lives in a senior high rise.  She is well, in good health, and the place appears to be applying appropriate practices regarding the virus.  Should we consider bringing her to our house instead?  She would then be 150 miles away from her doctors and her friends and would probably be bored at our house.  Any recommendations?

Older adults risk developing serious complications from coronavirus if they contract the illness. The best way to prevent illness is to avoid being exposed to the virus. Whether your family chooses to invite your mother-in-law to your home, or she remains in her own home, it is important that she practices social distancing and frequent handwashing, and avoids touching her eyes, nose, and mouth. These are the best ways to avoid contracting COVID-19.

Q: Most advice seems to be "stay home." How about getting outside, not with a group, but to hike, bike, walk, bird watch, etc.?

Getting outside can be a source of stress relief. As long as you are staying at least six feet from others, the great outdoors can be a place to relax and reset. Avoid playground equipment and physical contact, such as group contact sports.

Q: My husband and I are seniors.  Should I allow my grandchild to visit?

Because of the increased risk of severe illness as a result of COVID-19 for seniors, the CDC recommends that older adults and people with severe underlying commitments avoid interaction with others if there is a COVID-19 outbreak in your community. However, phone calls, video chats, letter-writing, and other ways of connecting virtually are great strategies for remaining connected with family and friends throughout this crisis.

Q: We live in Michigan and have a spring break trip planned to Alabama. We are traveling by car and I was wondering if we would still be able to travel. Would we have to quarantine ourselves after we return? 

Q. We are heading home from wintering in Arizona. Will there be any problems when we get to the Michigan state line? Will Michigan be closing its borders? 

There are no domestic travel restrictions in place. 

If you have a compelling reason to believe you may be infected as a result of travel, such as close proximity to someone who now is a confirmed case or you have traveled to areas with a heavy outbreak, you should self-quarantine. In all cases, review the CDC's guidelines for travel with in the United States. The CDC's emphasis is on traveling in crowded airports and on cruise ships and offers guidance when traveling to or from areas with high rates of coronavirus. 

Before traveling, consider the following: Can you risk being off work if you get the virus? Are you putting yourself near high-risk populations? Do you have a plan if something goes wrong?

Q: We have a neighbor who runs a day care in her home. Is there anything she should be doing for safety?

Q: With all the restrictions in place and school cancelled, why are child care centers still allowed to be open? It seems dangerous to the children and their families to remain open.

Read Bridge's full story on why child care centers remain open. Michigan had not closed child care centers, despite ordering the closure of K-12 schools, dine-in restaurants, bars and movie theaters. That's because the state has (so far) made a calculated decision that it is vital to keep as many doctors, nurses, police and first-responders as possible working through the pandemic; officials do not want to risk having medical professionals stay home to take care of toddlers. This increases the risk of young children being infected with coronavirus, but children rarely become seriously ill from the virus, which is much more deadly to senior citizens and adults with serious health issues. 

The CDC recommends the following steps for daycares in communities where there is minimal to moderate community transmission:

  • Coordinate with local officials
  • Implement multiple social distancing strategies, such as:
  • Canceling field trips and large gatherings
  • Avoid mixing students in common areas
  • Stagger arrival and/or dismissal times
  • Limit nonessential visitors
  • Teach staff, students, and their families to maintain distance from each other in the day care
  • Consider ways to accommodate the needs of children and families at risk for serious illness for COVID-19.
  • In communities where there is substantial community transmission, the CDC recommends:
  • Continued coordination with local officials
  • Consider extended daycare dismissal
  • To see the CDC's recommendations, visit https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html

Q: I heard that Governor Whitmer is going to close gas stations. Is this true?

The state of Michigan has not closed gas stations and Bridge has heard no information that would indicate that this is forthcoming.

In dealing with rumors, check for official word from the state of Michigan and avoid potential disinformation campaigns on social media. In states including Pennsylvania and Colorado where nonessential business have been ordered closed, gas stations are in the same group as  grocery stores that remain open.

Q: Do you feel it is safe having cellphone stores open? It is concerning that employees and customers are touching cellphones or tablets for sales or troubleshooting. What about bank lobbies?

Neither cellphone stores nor banks have been ordered to temporarily close by the state, as of March 17. However, some stores and banks are choosing to close their lobbies to help stop the spread of the coronavirus. All Apple retail stores are currently closed, for example. The U.S. Treasury's Office of the Comptroller of the Currency has issued guidance to banks for working with customers while COVID-19 is prevalent. Financial trade groups in Michigan are recommending customers use online banking when possible.

Q: With all K-12 schools closed, will the state provide laptops or tablets to students to attend online classes?

As Bridge reported March 15:

Many schools sent home packets of study materials with students, and many offer online learning opportunities. But not all students have access to high-speed Internet or have computers in their homes."

In rural Michigan, 37 percent of homes do not have broadband Internet, and 14 percent of homes have no Internet at all.

Comcast, one of the state's major Internet providers, announced it is offering 60 days of basic Internet service free to low-income families in response to the coronavirus crisis.

So, while many Michigan teachers are attempting to keep their students engaged academically during the break, classes will pick up where they left off when schools closed.

Q: Are mortgage/rent payments going to be suspended during this time? Will health insurance still be deducted from paychecks ? What utility bills are being waived during this crisis? 

Here is a list of credit card companies taking steps to help consumers.

Some banks also are putting help in place.

Federal Housing Finance Agency Director Mark Calabria said hardship forbearances are an option for borrowers with Fannie Mae and Freddie Mac loans. He urged borrowers to reach out to their mortgage holders.

The United Kingdom today announced that mortgage lenders will offer those struggling with payments because of the pandemic a three-month relief period. 

Some temporary help with utilities is available through the state. Consumers Energy and DTE announced they will not shut off utilities to low-income customers for now. You can find more about companies offering utility relief here.

(March 17, 2020)

HEALTH-RELATED QUESTIONS

Q. I have a cough, which may be from my allergies —  but I take care of my mom 24/7 at home. Should I wear a mask?

There has been some debate about whether masks are effective in controlling the new coronavirus. In general, the World Health Organization says that healthy people don't need to wear masks. Michigan Department of Health and Human Services officials also are not recommending that healthy people wear face masks. Remember, the CDC advises cleaning counters, tablets and other "high-touch" surfaces every day.

But if you're caring for a sick or high-risk person? "Yes, you should wear a mask to protect anyone you are caring for if you have a cough or sneeze," Dr. Marcus Zervos told Bridge Magazine Monday in response to numerous such inquiries from readers. Zervos is an infectious disease specialist with Henry Ford Health System and is advising the City of Detroit in its response to COVID-19.

He added that doctors recommend people with coughs, fever, and shortness of breath should be evaluated by a physician (note: call first before going in) and should maintain a regular schedule of hand-washing for 20 seconds with soap and water.

Q. Does it make a difference if you use antibacterial soap or regular hand soap? 

No. COVID-19 is a virus, and there is no added value to antibacterial soap. Wash hands with soap for at least 20 seconds. If that's not available, use hand sanitizer that contains at least 60 percent alcohol.

There are a lot of myths but garlic, onion, hair dryers, vodka, bleach and saline don't work.

"There's a lot of misinformation on the Internet and it's important to look at reliable sources like the CDC and the Michigan Department of Health and Human Services," Zervos said.

Q. My husband has been coughing and sneezing for four days. I am concerned because he has refused to use hand sanitizer and every time he sneezed or coughed he said he is not changing his life. Today, he spent all day sleeping and he refuses to get tested or checked for coronavirus. How can I make him realize how dangerous this attitude is for us and for the rest of Michigan? I need just to talk with someone. 

Suggest to your husband that even if he does not care about himself, he should care about his loved ones, his neighbors and people who are more vulnerable to the coronavirus and their concerns.

"We need to do a better job of educating the public but also individuals to not only get the help they need themselves but also how they impact others," Zervos said.

Michigan has a hotline specifically for people who suspect they may have coronavirus, they might be able to give you advice or recommend someone who can. That number is 888.535.6136. 

Q. My husband and I are in the high-risk group so we have decided on a self-imposed quarantine.  This is day five of being in the house and we are starting to wonder what is happening 'out there'.  Are grocery store lines still a block long? Should I try to leave the house and shop at midnight? Are grocery stores still offering home delivery or are the delivery people quitting their jobs out of fear?  Sooner or later, even those going the self-imposed quarantine route will need food.

Some grocery stories around the country are opening early just for seniors to allow them to get necessary groceries with a higher degree of safety. Call your local markets to see if they are among them and, if not, push them to consider the move. 

Some grocery stores are limiting hours to allow time to restock, so again check before you go. Some commonly used supplies, including toilet paper, bread, canned goods, and cleaning items, are in scarce supply in many stores as folks stock up. Many stores are limiting the number of a single item shoppers may purchase. 

Gov. Gretchen Whitmer in a Sunday news conference recommended that people go shopping at unusual hours, mostly to limit exposure to others.

Contact your local grocer to determine whether delivery may be available. Amazon is continuing its delivery service, and states:

"As COVID-19 has spread, we've recently seen an increase in people shopping online. In the short term, this is having an impact on how we serve our customers. In particular, you will notice that we are currently out of stock on some popular brands and items, especially in household staples categories. You will also notice that some of our delivery promises are longer than usual. We are working around the clock with our selling partners to ensure availability on all of our products and bring on additional capacity to deliver all of your orders."

Q. I live in Iron Mountain of the Upper Peninsula of Michigan and I'm wondering where the nearest reported case of the coronavirus was to me. My wife has lung diseases and if this were to infect her, she would die.

The State of Michigan has a coronavirus website to share the most current information, including a subscription option for regular updates. The Bridge Coronavirus Tracker updates cases confirmed statewide on a daily basis. Reports on cases are changing quickly. As of this writing Monday evening, no cases had been reported in the Upper Peninsula.

Q. So if you get the virus and it says to drink water. I have read the virus stays on glass plastic and aluminum. So, what are you supposed to drink water out of? Are you re-infecting every time you take a sip?

Dr. Asaf Bitton, a primary care physician and executive director of Ariadne Labs, a joint health system innovation center at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, told CNN there may be evidence the virus can live on plastic and metal for as long as nine days.

If you are buying bottled water, consider sanitizing the container or use a glass from home. If you are the only person drinking from your container and you are not infected, you are not likely to be at risk. If you do have COVID-19, you're already infected. You should have your own glass or cup to drink from, and not share anything with family members, including the same bathroom if possible.  

Q. Should I be concerned? I'm stage 4 COPD and I breathe badly. I'm not on oxygen. I deep clean my house daily and I cleaned my car.

The World Health Organization states that children and young adults infected generally have mild cases. However, seniors and people with underlying health issues are at increased risk if they do come down with the virus, and so health officials recommend taking precautions.

Those in high-risk groups — age 60 and over and/or with underlying health issues — are urged to stay away from situations in which they may come in contact with the virus. Health officials recommend all people maintain a distance of at least 6 feet from others, particularly in public spaces. In some instances, health officials have suggested self-isolating. 

Early symptoms generally include cough, fever, or shortness of breath. Warning signs that you may need emergency medical attention, include:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

Q. How would I be able to tell if I have the virus or if it's just my lupus flaring up since they both mimic the same symptoms. I have had a low-grade fever for three or four days, muscle pain and a headache that just went away. I have not seen any type of question or response to this question and I just need to know.

Lupus is considered an underlying health condition, which puts you at higher risk of infection and makes any COVID-19 infection potentially more serious, according to the Lupus Foundation of America, which states, "The threat the infection poses for people with lupus is higher than the general population."

According to the World Health Organization, common symptoms of the novel coronavirus are:

  • Fever 
  • Tiredness
  • Dry cough (The CDC also mentions shortness of breath) 

Some people may have:

  • Aches
  • Nasal congestion and/or runny nose
  • Sore throat
  • Diarrhea 

Symptoms are usually mild and begin gradually. 

Most people (about 80 percent) recover from the virus without needing special treatment. 

If you believe you may have symptoms of COVID-19, the Centers for Disease Control and Prevention recommend that you first call your doctor. If you don't have a doctor, the State of Michigan has a hotline specifically for people who suspect they may have coronavirus. That number is 888.535.6136. 

Q. Is there a body temperature range the virus operates in?

A healthy person has a body temperature that averages 98.6 degrees Fahrenheit. An adult who has a temperature of 100.4 degrees is considered to have a fever.

Even those who develop mild cases of the COVID-19 typically develop a fever (almost nine in 10 cases) and have some respiratory symptoms such as a dry cough (seven in 10).

It takes between two and 10 days for an infected person to develop symptoms, including a fever, according to the World Health Organization.

Q. My wife is experiencing many symptoms.  Where can she go to get tested? We are in Lapeer County.

The first step is to call your doctor, as recommended by the Centers for Disease Control and Prevention

If you don't have a doctor, the State of Michigan has a hotline specifically for people who suspect they may have coronavirus. That number is 888.535.6136. 

The CDC urges those who believe they may have the coronavirus to call ahead before visiting a doctor or emergency room. If they can see you, they do not want you mixing in waiting rooms with other patients, so it's important to take direction from them on where to go, if anywhere.  

The state of Michigan says it is working to increase its capacity to test cases, and health systems in some areas now are providing drive-through services, though as Bridge revealed this week they have not been without problems. Gov. Gretchen Whitmer said in a Sunday news conference that the state will be creating guidelines in the next few days to prioritize testing. Follow your local health department and the news for updated information.

WORKER, EMPLOYER, AND WORKPLACE SAFETY QUESTIONS

Q. I filed unemployment online and within 24 hours received notice that the weekly unemployment amount is $179. How can the government say they are looking out for employees of closed business when the weekly unemployment income is like a slap in the face?

Q. I work at a locally owned restaurant, if the establishment is forced to close whether by owner's choice or mandated by government, is there relief for lost wages?

Q. I waitress at two different restaurants. What help is there for my family?

Q. I work for a contractor. I now have no income for 3+ weeks but I don't seem to be covered by any relief measures. Is there anything that applies to me getting compensation? We don't get sick time.

In addition to statewide school closures, as of Monday, March 16 at 3 pm, all Michigan restaurants, cafes, coffee houses, bars, taverns, brewpubs, distilleries, clubs, movie theaters, indoor and outdoor performance venues, gymnasiums, fitness centers, recreation centers, indoor sports facilities, indoor exercise facilities, exercise studios, spas, and casinos were ordered temporarily closed via an executive order signed by Gov. Gretchen Whitmer

Employees who are laid off as a result of these closures are advised to apply for unemployment compensation online at www.michigan.gov/uia. Online application is recommended because of increased call volumes, but those seeking to file a claim for unemployment benefits can also call to apply at 1-866-500-0017, Monday – Friday, 8:00 a.m. to 4:30 p.m., or visit your nearest Unemployment Insurance Local Office.  

To file a claim, you will need:

  • Your Social Security Number, your Driver's License Number or State Identification or your MARVIN PIN (if you have one)
  • If you are not a U.S. citizen or national, you will need your Alien Registration Number and the expiration date of your work authorization.
  • Names and addresses of employers you have worked for in the past 18 months including quarterly gross earnings and the last date of employment with each.

Your application for benefits will be evaluated to determine whether you are eligible for benefits and how much money you may receive. 

Q. Will factories and warehouses with more than 250 people shut down? I work in a warehouse where people come to work sick all the time. 

Gatherings of 250+ people doing industrial or manufacturing work were exempted from Gov. Whitmer's executive order cancelling all events and assemblages of this size. For now, factories and warehouses can stay open in Michigan. If this situation changes, it will be reported in the Bridge Coronavirus Tracker 

DAILY LIVING & CIVIL SOCIETY QUESTIONS

Q. Here in Albion, our city council faces a dilemma about the coronavirus and the capacity of persons at our city council meetings. We can find no way at this time to NOT hold the council meeting in open session and still remain compliant with the Open Meetings Act. Whenever we hold a meeting it MUST be open to the public and the public MUST be afforded the right to speak. Though we are cognizant of the virus, our first duty is to uphold the law.

As of Monday night, this was a developing and not-yet-resolved issue.

Robin Luce Herrmann, general counsel for the Michigan Press Association and a specialist on the state's Open Meetings Act, told Bridge Monday:

The governor issued an Executive Order last week regarding meetings of State public bodies in light of the coronavirus issues.  The order mandates:

  1. Deferring what can be deferred and addressing only those items that are absolutely necessary; 
  2. Ensuring that the public has ability to hear all participants and participate themselves; and 
  3. Proper notice. 

"We think local public bodies should follow these steps.  The MPA is working with entities representing local public bodies to adopt similar emergency rules for local public bodies.  In addition to those above, because local public bodies will be addressing only those items that are absolutely necessary, we think it is also critical to make agendas and meeting packets available online in advance of the meeting.  We suggest 48 hours in advance if at all possible. 

"If the local public body does not have an online presence, notices of the meeting and information on how people can participate should be run in local newspapers along with a meeting agenda. And, meeting packets, agendas, and minutes should be made available online either through a local newspaper or the statewide website that MPA has offered to make available to the public so the public knows where it can find the information. MPA will work with its members to promote the site to the public and ensure it is available as quickly as possible."

Monday afternoon, the Michigan Municipal League released a statement saying:

"The U.S. Centers for Disease Control and Gov. Gretchen Whitmer are urging everyone to limit face-to-face gatherings of large numbers of people to help stop the spread of the COVID-19 virus. But the current restrictions of Michigan's Open Meeting Act are hampering the ability of local governments to meet the needs of first responders, health care workers, businesses and constituents in responding to the coronavirus pandemic. 

"We call on state officials to move quickly to allow city and village councils and other local governments to hold meetings via virtual modes of communications, such as teleconferences and Skype, when possible during this critical period. The Michigan Municipal League is strongly supportive of a fully transparent government – but also of one capable of doing its job of protecting the health, safety and welfare of people. Quick, decisive action is needed now, by our state leaders and our local leaders."

Q. Have day cares been told to close ? What is the Governor's stand on day cares staying open or closing? Why are public schools closed yet day cares are not?

Read Bridge's full story on why child care centers remain open. Michigan had not closed child care centers as of mid-afternoon Monday, despite ordering the closure of K-12 schools, dine-in restaurants, bars and movie theaters. That's because the state has (so far) made a calculated decision that it is vital to keep as many doctors, nurses, police and first-responders as possible working through the pandemic; officials do not want to risk having medical professionals stay home to take care of toddlers. This increases the risk of young children being infected with coronavirus, but children rarely become seriously ill from the virus, which is much more deadly to senior citizens and adults with serious health issues. 

Q. Where can we go with or without the kids to prevent boredom?  Is it OK to go to the park if it is not too crowded? How about a bike ride? Small shop stores? Camping?

Social distancing is an important tactic in helping prevent the virus' spread, according to health officials. In addition, some early suggestions are that children may not have symptoms but may carry the infection and spread it to others.

Being outdoors, going for walks or hikes, may be an ideal solution, but avoid playground equipment and physical contact, such as group contact sports.

Q. I've been home with my kids for five days and we haven't left the house. When can we start to relax?

Not yet. Sterilizing surfaces and frequent hand-washing are still imperative, as the incubation period of coronavirus is two to 14 days, according to the Annals of Internal Medicine

A paper in the same periodical found that the average incubation period is five days, similar to the SARS virus.

Henry Ford Health System infectious disease specialist Marcus Zervos told Bridge cases are likely to rise in Michigan even as social-distancing measures take effect and a study in the Lancet medical journal  found the virus can linger long after people feel better. The median length of time it remains in respiratory tracts of a patient after symptoms begin is 20 days.

Short answer: remaining vigilant is imperative. But also see above answer, about going outside and allowing you and your kids to get some exercise and fresh air. 

Q. Is swimming in public pools dangerous? I am wondering if the virus can be transmitted through water. In my water class there is at least 6 feet separating us.

This may be a moot point after Gov. Gretchen Whitmer on Monday ordered the closure of health clubs along with bars and restaurants.

Nonetheless, rest easy.

"There is no risk for coronavirus. There is no association with water. The way it is spread is by coming within 6 feet of someone who is coughing or sneezing," Henry Ford health System infectious disease specialist Marcus Zervos told Bridge.

The virus doesn't survive in water. It spreads when someone with coronavirus sneezes or coughs and spreads droplets on another person who then wipes their eyes or mouth. 

The only way to get it in a pool, theoretically, is if both were alongside each other.

Q. Why do we have to keep our windows closed?

You don't! The Centers for Disease Control and Prevention recommends increasing ventilation to prevent the spread of COVID-19. That includes opening windows.

Q. Is it safe to get the mail from my mailbox? Can the virus be present on the mail? How long can the virus be active while on the mail?

Coronavirus can remain on cardboard for 24 hours and up to two or three days on plastic or stainless steel, but researchers say it is likely far less than that after a sneeze.

"You don't get it from the mail," Henry Ford health System infectious disease specialist Marcus Zervos told Bridge. "Someone would have to be sick, cough directly on it and then you would have to [immediately] touch your face or eyes.

"Getting a package is not a risk. But you should be careful always about washing your hands."

Q. My husband has been incarcerated for less than 60 days. He has about 3 weeks left. Today I received a message stating there would be no visitation. My concern is that every single county jail in the area is over-crowded. Inmates sleeping on the floor, and nowhere to move. I think that the governor should release the inmates with low crime charges and little time left. My husband is 60 years old living in this crowded area! I am worried sick about this virus getting into these overcrowded jails. How about a response on this? 

Michigan Department of Corrections Director Heidi Washington issued a statement directing supervisors questioned about the virus and any employees who test positive to notify human resources. The department also closed prisons to visitors, effective March 13.

Local counties and sheriffs' offices, which have jurisdiction over jails, are making determinations. At least one county jail is working with county judges to decide whether some inmates might be eligible for an early release.

Gov. Gretchen Whitmer currently has not issued guidelines regarding incarcerated people; however, multiple task forces say they are considering appropriate measures to address the quickly evolving circumstances.

Q. We are planning on having a wedding on March 29th of 500 people. Is there any way that you can make that possible please before I postpone? Will the ban be lifted for gatherings of 250 people or less by March 29? 

Not likely. Gov. Gretchen Whitmer issued an executive order March 13 barring gatherings of more than 250 people due to the fast spread of the coronavirus. In addition, the Michigan Department of Health and Human Services on March 11 recommended cancelling large gatherings of more than 100 people. Sunday, the CDC further urged the entire country to avoid gatherings of more than 50 people for the next eight weeks. 

While no one can accurately predict when the government will lift such restrictions, other nations with outbreaks of COVID-19 that began earlier than in the U.S. have found that the virus remains a factor for many weeks if not longer. In China, for example, where the outbreak began Dec. 31, 2019, the number of new cases reported daily have just lessened in the last few days to single digits. 

It's important to remember how easily the virus is spreading, that those not exhibiting symptoms may be carriers, and that our health systems do not have the personnel or equipment to cope with large numbers of patients should the virus infect a lot of people within the same timeframe.

Q. Will school closures be extended beyond April 5th?

As of March 16, Education Week is reporting that 35 states have decided to close public schools, affecting at least 35.9 million students.

On March 12, Gov. Gretchen Whitmer ordered K-12 public schools to close through April 5. Due to the rapidly evolving nature of events, no one can say whether that closure will be extended. It may be prudent to plan for that contingency.

Q. How are funeral visitations and services affected by the virus? 

Gov. Gretchen Whitmer issued an executive order March 13 barring gatherings of more than 250 people due to the fast spread of the coronavirus. In addition, the Michigan Department of Health and Human Services on March 11 recommended cancelling large gatherings of more than 100 people. On Sunday, the CDC further urged the entire country to avoid gatherings of more than 50 people for the next eight weeks. 

Those in high-risk groups—age 60 and over or with underlying health issues—are urged to stay away from situations in which they may come in contact with the virus.

Some religious institutions in Michigan are using their own precautions

Overseas in areas where the virus affected people earlier than in the U.S., some have gone to webcasting funeral services, holding small gatherings, or scheduling later memorial services. 

Q. Is the government going to close borders to the UP, including the Mackinac Bridge?  It would seem like this would reduce our chances of getting it here. This is a very poor area and a virus could devastate so many. 

The Michigan Department of Transportation is monitoring the COVID-19 outbreak and will make decisions about road closures accordingly. As of March 16, there are no plans to close the Mackinac Bridge, MDOT told Bridge on Monday. The bridge provides access to and from the Upper Peninsula for Michigan residents' needs including access to goods and services. For daily updates, please check the Mackinac Bridge Authority website.  

Q. My daughter returned from her Illinois college this weekend and may not be returning in the foreseeable future because of the coronavirus. Census takers were planning a count for later this week at her college, but it is uncertain how it will take place. We will be completing our household census questionnaire soon. Should she be counted in Michigan now as part of Census 2020?

The U.S. Census Bureau indicated Sunday that said college students who live on campus are still expected to be counted at their university, even if students have evacuated for the remainder of the semester due to the COVID-19 outbreak. These students will be counted through the Census Bureau's Group Quarters Operation that is used to count groups of people living in shared spaces, like nursing homes, prisons, and halfway houses. 

The Census Bureau says they will count students at their college and or university even if the student is at home on April 1, since residence criteria mandates individuals be counted where they live and sleep most of the time. Students should expect a reminder from their institution to fill out the census on their own.

Bridge confirmed the same on Monday with Joan Gustafson, external affairs officer of the Michigan Nonprofit Association, who sits on Governor Whitmer's Complete Count Committee. 

Q. What about the homeless?  They are the most vulnerable.

Housing experts on the national, state and local levels are concerned that efforts to address the coronavirus pandemic may neglect homeless populations. People experiencing homelessness often have underlying health conditions that make them more vulnerable and "lack access to bathrooms, areas where they can self-quarantine, and adequate healthcare resources."  

The Capital Area Housing Partnership said: "In any crisis, whether it's a world health epidemic or a natural disaster, housing becomes one of the most immediate issues that affects people." The Lansing Housing Commission and Capital Area Housing Partnership are working to hold off on evictions for many affordable housing units in an attempt to reduce homelessness in light of coronavirus concerns. 

(MARCH 15, 2020)

Q. I believe I have symptoms of the coronavirus. Where should I go to get tested? It's been about four to five days of the symptoms. I do not have a primary doctor and I can't afford to go to the emergency room to determine if it is the coronavirus or the flu. 

The first step is to call your doctor, as recommended by the Centers for Disease Control and Prevention.

 If you don't have a doctor, the state of Michigan has a hotline for people who suspect they may have coronavirus. That number is (888) 535.6136.

Google your county health department or nearest hospitals for additional coronavirus hotlines for help in your area.

The CDC urges those who believe they may have the coronavirus to call ahead before visiting a doctor or emergency room. 

Q. Now that the president has declared a national emergency, does this severely limit even smaller gatherings of under 100? Similarly … I have a band, there are six of us. We use my basement for practice. We are all over 60.  Should we have practice?

The declaration of a national emergency creates novel ways for the government to free up resources to respond to the pandemic. 

Scientists are gathering data as the pandemic unfolds, but the virus appears deadliest for those older than 60. The CDC recommends canceling gatherings of more than 10 people for groups that serve higher-risk populations.

In addition, Michigan Gov. Gretchen Whitmer has banned public gatherings of more than 250 people until April 5, while the state Department of Health and Human Services recommends cancelling gatherings of more than 100 people. The state also recommends:

  • Regular cleaning and frequent disinfection of touched surfaces, like doorknobs, keyboards, and light switches.
  • Washing hands often with soap and water or use hand sanitizer.
  • Avoid touching eyes, nose, or mouth with unwashed hands.
  • Cover your mouth and nose with a tissue when coughing or sneezing.
  • Avoid handshakes.
  • Avoid contact with sick people.
  • Stay home if sick.

Q. My son doesn't have school. Will I receive relief from my job in order to stay home with him? My job has told me I have to come to work, but the governor has said employers need to be empathetic. Similarly, … my granddaughter's boss said if she takes off work to care for her school-aged children, she will be fired. How can this happen under the national emergency? 

The declaration of a national emergency is a federal response intended to streamline how the government gets money to the states to help fund additional resources needed to respond to a crisis, such as state and local emergency staff and supplies.

Government provisions for worker protections – from health to economic wellbeing – are rapidly evolving and not yet entirely clear. 

The U.S. House of Representatives on Saturday passed an emergency relief package that would fund a response, giving "some workers two weeks of paid sick leave and up to three months of paid family and medical leave, equal to no less than two-thirds of their pay." It would help employees of business with between 50 and 500 employees. The bill also adds funding for the Supplemental Nutrition Assistance Program, food banks, and food assistance for families of children receiving free or reduced-price school lunch programs.

The U.S. Senate is likely to take up the bill this week. Congress also may expand unemployment benefits for workers impacted by coronavirus. 

It remains to be seen how relief measures will be enacted and the effects on individual states and workers. Meanwhile, the U.S. Department of Labor has published guidelines on fair labor standards during the coronavirus.

Q. Why are we not pushing to close the malls? Similarly, why are casinos allowed to stay open?

Michigan officials say they are trying to balance public health with economic considerations in setting limits on gatherings and have yet to take extreme measures such as closing all public spaces. 

Malls in New Jersey and Pennsylvania have closed as a precaution, and retailer Apple announced it is temporarily shutting down all of its stores outside of China due to the virus.

Michigan malls, retailers and casinos say they are taking more steps to disinfect public spaces, reducing capacity and complying with Whitmer's ban on gatherings of more than 250 people.

Regulators in Illinois and Indiana have ordered casinos to close temporarily due to the coronavirus. Sunday evening, Whitmer indicated the Michigan Gaming Control Board is working toward a temporary closure of Michigan casinos. When reporters pressed, she did not immediately provide details on when such temporary closure may go into effect.

The CDC has advised that people are more at risk for contracting respiratory illnesses such as COVID-19 in public places, particularly those with little air circulation and where sick people may have been present. 

Those in high-risk groups—age 60 and over or with underlying health issues—are urged to stay away from situations in which they may come in contact with the virus.

Q. Wondering if it is still OK to travel by car to the Upper Peninsula? Similarly, … I drove from Michigan yesterday and was there for one day only, so should I self-isolate myself?

There are no domestic travel restrictions in place. Drivers who want to cross the Mackinac Bridge can do so, although those who want assistance from the program that provides a driver won't be able to get that help for now.

If you have a compelling reason to believe you may be infected—you were in close proximity to someone who now is a confirmed case or you have traveled to an area of China with a heavy outbreak, you should self-quarantine for 14 days.

In all cases, review the CDC's guidelines for travel with in the United States. The CDC's emphasis is on traveling in crowded airports and on cruise ships, and offers guidance when traveling to or from areas with high rates of coronavirus. 

Before traveling, consider the following: Can you risk being off work if you get the virus? Are you putting yourself near high-risk populations? Do you have a plan if something goes wrong?

Q. My family recently returned from a Florida vacation. Our child's daycare facility is requiring that everyone in the family receive COVID-19 testing and that they are negative before our daughter can come back into the building. Otherwise, she must remain away for 14 days and we will still have to pay for those two weeks. Our primary care providers will not test us because the "requirement" does not follow CDC guidelines. I have heard of no such recommended guidance for this. Is this something they can do?

Testing is a huge concern.

As of March 12, Michigan was working to complete 120 tests for the virus, with a capacity to test 1,300. To be tested, your doctor must suspect you have COVID-19 and then must call the local health department, which then contacts the Michigan Department of Health and Human Services. That department will determine whether to do the test, and then the doctor will get nasal and oral swabs to overnight ship to the state lab in Lansing.

While it seems that young children are less likely to get sick from COVID-19, Michigan and other states have shut down schools to prevent the spread of the illness because children without any symptoms may still be able to transmit the virus. The CDC published an extensive and accelerating set of guidelines applying to both schools and child care centers. Those guidelines range from social distancing as a community is preparing for onset of coronavirus to extended facility closures when there is "substantial community transmission." 

Q. I live in Wayne County. I have no fever, coughed once but have been feeling aches. I just wanted to know is it possible to just have aches with the coronavirus? Thank you for your time.

Emergency warning signs of COVID-19, indicating that you need immediate medical attention, are:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • Confusion or inability to arouse
  • Bluish lips or face

The CDC says that this list is not all inclusive; however, even the mild cases of the virus normally start with a fever (almost 9 in 10 cases) and include some respiratory symptoms such as a dry cough (7 in 10).

Nearly all (97.5 percent) of those with COVID-19 showed symptoms within 12 days, according to one study of 181 confirmed cases.

Q. I have an employee that has now been home for seven days. This man (49) who NEVER gets sick is home with horrible fevers, cough and chest congestion. How do I proceed about work? He sounds awful and I do not want him coming to our business. How long does he need to stay home if he cannot get a coronavirus test?

The CDC recommends sick workers should stay home. If sick employees do show up for work, they should be separated.

Congress is considering coronavirus relief measures including various forms of assistance to employers and workers.

The World Health Organization says those who become ill generally have shown symptoms five to six days after they were infected and can carry the virus for up to 12 to 14 days before becoming ill. 

The illness can last for two weeks, and up to six weeks in severe cases. The Harvard Medical School FAQ, updated March 13, says some research has found patients still carry the virus several weeks after they recover and may still be contagious during that time. 

Those who may have COVID-19 should contact their healthcare provider to determine whether to be tested. The CDC recommends that people who are ill stay at home until there is little risk of transmitting the illness to others, often five days since there was any fever. That decision should be made case-by-case, though, in consultation with healthcare providers and state and local health departments.

Q. Where in Michigan can you be tested for the coronavirus, and do we have test kits here in Michigan?

Whitmer on Sunday said the state is working to expand the availability of tests and will prioritize those who are to be tested in coming weeks.

As of March 12, Michigan was working to complete 120 tests for the virus, with a capacity to test 1,300. To be tested, your doctor must suspect you have COVID-19 and then must call the local health department, which then contacts the Michigan Department of Health and Human Services. That department will determine whether to do the test, and then the doctor will get nasal and oral swabs to overnight ship to the state lab in Lansing.

For those without a primary care physician or health insurance, there is a network of free clinics in Michigan. There is also a network of Federally Qualified Health Centers that serve individuals regardless of insurance status.

Private labs are also now doing testing in Michigan, but these tests must be approved by a health care provider as well.

Henry Ford Allegiance Hospital in Jackson and Beaumont Health hospitals in Royal Oak, Dearborn and Troy on Saturday began to offer drive-through testing. Spectrum Health in Grand Rapids also opened a drive-through testing station on Saturday. Others may follow suit in the coming days.

Q. What are tips on how to be healthy and successfully manage your body if you have the virus?

Some cases of COVID-19 are mild, particularly for younger people. If you think you have the illness, call your doctor for advice.

Meanwhile, if you are self-quarantined, follow the same protocols you would for other viral illnesses: Stay home. Monitor your symptoms. Get plenty of rest. Stay hydrated.

Q. How long is an isolated virus particle viable? By isolated I mean deposited on a hard surface by a cough. This is relevant when one is considering visiting a building that has recently been identified as being visited by an infected person.

Because the virus is previously unknown, scientists are collecting the data that will give more fact-based answers to these questions. Much of the data scientists are using now are from cases in China. Preliminary information indicates that the virus may live for several hours up to a few days. Dr. Asaf Bitton, a primary care physician and executive director of Ariadne Labs, a joint health system innovation center at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, told CNN there may be evidence the virus can live on plastic and metal for as long as nine days. Major health organizations recommend an abundance of caution.

The CDC recommends disinfecting commonly touched surfaces daily, including countertops, doorknobs, light switches, cell phones and television remote controls.

Q. Are there potential long-term medical impacts of the coronavirus for those who survive it?

 This novel coronavirus is one of multiple strains of the virus and scientists are working now to develop a vaccine to help prevent it. This strain, COVID-19, has become a health threat because it is previously unknown and humans don't have the antibodies to resist the illness. It is causing more deaths than known illnesses, such as the flu, because scientists still do not know the best treatments. 

Those who are not showing signs of the virus may still be able to spread it, health officials now believe. It also has spread extremely fast (is highly contagious), and it threatens to overwhelm our health systems with more patients than we have hospital beds.

Long term, those who survive likely will have the same health impact as they would had they contracted similar viruses. For example, those who have had pneumonia may be more susceptible to future respiratory infection. This is a new virus, and scientists are continuing to gather data to understand it.

Q. I've haven't heard anyone reminding folks to sanitize credit and debit cards. They are used widely in card readers where germs are easily transferred.

The virus can live on plastic and metal for as long as nine days, according to recent reports. Plastic cards are preferable to using paper money or coins because they can be sanitized.

One plastic credit card provider, Apple, advises users to "gently wipe with a soft, slightly damp, lint-free microfiber cloth" and "moisten a soft, microfiber cloth with isopropyl alcohol and gently wipe the card." But "don't use window or household cleaners, compressed air, aerosol sprays, solvents, ammonia, or abrasives."

The CDC advises cleaning "high touch" surfaces every day and to "clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product."

However, it's important to remember that health officials believe the virus is being spread person-to-person through droplets that can travel up to 6 feet when an infected person coughs or sneezes. People also can breathe in droplets if they are near an infected person who exhales. So it's important to avoid touching your face after touching objects that many others have, such as public door handles and grocery carts, before washing your hands. And clean items you touch every day at home, such as countertops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables.

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