A new study says since the start of the pandemic, 911 calls for emergency medical services in the United States have dropped by 26% compared with the past two years.
RICHMOND, Va. — New coronavirus cases are climbing in states such as Virginia, but concerns persist that people dealing with other health emergencies may be avoiding the hospital out of infection fears. A new awareness campaignaims to ease those concerns, especially for people of color.
An online survey for the American Heart Association found that 55% of Hispanics and 45% of Blacks said they’d be scared to go to a hospital with heart attack or stroke symptoms because of COVID-19 fears.
“These are situations that can actually kill people, like heart attack or stroke, at a much higher rate than COVID itself,” he said.
Health experts have said COVID-19 cases disproportionately have affected certain ethnic groups, which is likely to be creating these concerns.
The Heart Association is launching a public awareness campaign in English and Spanish. Called “Don’t Die of Doubt,” it reminds people that a hospital is the safest place to go if they’re experiencing symptoms of a heart attack or stroke.
Asch, who also is a regional board president for the Heart Association, said that while it’s reasonable to worry about becoming infected with COVID if you go to the hospital, it isn’t likely to happen.
“They have everything possible in place to prevent you from getting infected by COVID,” he said.
If stroke or heart attack symptoms are ignored, health officials have said, the next round of symptoms could be much more severe.
Disclosure: American Heart Association Mid Atlantic Affiliate contributes to our fund for reporting on Health Issues, Hunger/Food/Nutrition, Poverty Issues, Smoking Prevention. If you would like to help support news in the public interest, click here.
According to new research from AT&T, businesses are understandably skittish in regards to remote workers being exposed to more cyberattacks.
AT&T’s survey found that 70% of the large business felt remote working made them more vulnerable to cyberattacks. AT&T’s study of 800 cybersecurity professionals across the U.K., France and Germany found that more than half (55%) now believe remote working is making their companies more vulnerable to cyberattacks.
With “work from anywhere” policies in place for millions of employees due to Covid-19, the security perimeter has moved out of office spaces, which has provided cybercriminals with new vectors of attack.
AT&T Alien Labs Open Threat Exchange (OTX) is one of the largest intelligence-sharing communities in the world, with more than 140,000 security and IT professionals from 140 countries daily contributing and sharing information. In March, as the coronavirus pandemic became more widespread and organizations around the world started implementing wide-scale remote working policies, OTX experienced a 2,000% month-over-month increase in Covid-related incidents of comprise (IOCs).
Along the same lines, Nokia Deepfield saw a significant increase in Distributed Denial of Service (DDOS) attack volumes during March. That trend continued throughout April and May. In June, the aggregate volume of DDoS traffic was 40% to 50% above the pre-pandemic levels from February.
“Cybercriminals are opportunistic, taking advantage of the fear and uncertainty surrounding issues like the current global health and economic situation as well as sudden shifts and exposures in IT environments to launch attack campaigns,” said John Vladimir Slamecka, AT&T region president, EMEA, in a statement. “It can be a challenge for IT organizations to stay on top of emergent threat activity in the wild.”
According to AT&T’s survey, employees were the biggest risk identified by the cyber experts. At 31%, AT&T’s research found there was a lack of awareness, apathy or reluctance to embrace new technologies as the biggest challenges for implementing better cybersecurity practices within businesses.
One in three (35%) of the employees utilize the same devices for both work and personal uses while 24% are sharing or storing sensitive information in unsanctioned cloud applications. With work from home employees, 18% of the employees were sharing their devices with another family member.
Somewhat surprisingly, 25% of the businesses haven’t offered additional cybersecurity training for their employees while 24% haven’t created secure gateways to applications hosted in cloud or data centers.
In addition, 22% hadn’t increased endpoint protection for laptops and mobile while 17% hadn’t installed internet browsing protection for web-base threats.
The Covid-19 pandemic has also created fertile ground for phishing and other fraud-related activities. Among the cybersecurity experts’ responses in the survey, 44% cited ransomware and/or malware as their top security concern. Phishing (39%) and external threats such as nation-state attacks or hacking (39%) rounded out their top three concerns.
The coronavirus pandemic has accelerated businesses’ digital transformations. Cybersecurity experts are gearing up for new innovations as a response to business conditions around Covid-19. Almost half (47%) expect more digital transformation of business processes and cloud implementation in the year to come.
Two in five (40%) believe that their business will adopt new automation and robotic tools. For the largest businesses, those with more than 5,000 employees, nearly half (48%) will be changing their technology partners in the next year.
“While many organizations had already supported some remote workers on a regular basis, the sudden increase has put stress on IT systems, processes, and teams,” said Slamecka. “Others have had to scramble to quickly roll out solutions focused on keeping their entire workforce connected and productive.
“In either case, sudden and unplanned changes in the way workers connect to the corporate network and access corporate data and applications in the data center and cloud can introduce new cyber risks and vulnerabilities.”
Report reflects marked gender inequality in corporate sector, with only 6% of listed companies having female CEOs
Posted on August 4th, 2020 | By Ntando Thukwana
The Covid-19 pandemic, which has prompted companies to place greater emphasis on their social responsibilities, may give companies the impetus to address gender and other inequalities, reports advisory firm PwC.
The report issued on Tuesday came as the country observes women’s month honouring women who marched against the pass laws 64 years ago. It paints a picture of pronounced gender inequality in the corporate sector with only 6% of listed companies having female CEOs.
People receiving the maximum SSI live on $783 a month. The Chicago Disability Activism Collective is proposing an additional $266 per month.
Posted on August 4th, 2020 | By Clare Proctor
With the coronavirus heightening challenges already faced by people with disabilities, activists are calling for an increase monthly Supplemental Security Income.
The SSI Justice Campaign is proposing the state add $266 to people’s monthly SSI, a federal income program designed to help aged and disabled people who have minimal or no income. The current federal monthly maximum is $783.
The Chicago Disability Activism Collective launched the campaign with full support of Cook County Commissioner Alma Anaya, who represents the 7th District on Chicago’s Southwest Side.
Many people with disabilities can’t work and rely solely on SSI to cover rent, food and other basic needs, Anaya said. Coupled with a cost of living in Cook County that’s higher than the national average, Anaya said an increase to Illinois’ SSI is “far overdue.” The increase would also benefit undocumented people with disabilities, Anaya said.
The additional $266 would be funded through a state-level inheritance tax increase, according to the draft resolution. Anaya said the resolution will be introduced in the Illinois General Assembly.
People who rely on SSI have faced challenges long before the coronavirus pandemic, said Monia Taylor, a member of CDAC. When bills roll in and demand payment, Taylor said she can’t wait for another monthly SSI installment to come through.
“The poverty Black people and disabled people face on a daily basis didn’t start with COVID,” Taylor said. “The virus just exacerbated the problem, having to choose between rent and buying food because you don’t have enough money for both.”
Adam Ballard, a housing and transport policy advocate advising the campaign, said high rent forces many people with disabilities to live in congregate settings if they don’t have a housing voucher. Even people who have housing vouchers have to contribute 30% of their SSI to rent, Ballard said, already leaving people “in a pinch.”
Transportation costs can also quickly stack up, even with subsidized taxi rides through the Chicago Taxi Access Program and other services, Ballard said.
The number of Chicago taxi medallions surrendered this year increased from 552 as of March 11 when the pandemic hit the city to 2,501 on June 11, according to data obtained by the Sun-Times through a FOIA request. The decrease leaves 636 licensed taxis in the city.
“We have a system that forces people to make decisions that limit their travel as well,” Ballard said. “Their outcomes limit their freedom.”
People in the Supplemental Nutrition Assistance Program, for example, can’t use the benefits to have groceries delivered. Instead, they must make a trip to the store.
Angela Lacy, president of CDAC, said she’s been living in a “pandemic situation” for a long time, kept from social events and being unable to afford services and goods because of the economic strain of relying on SSI.
“We’re surviving, but we’re not living,” Lacy said. “The lack of income from SSI has caused me to live this way.”
A shortage of chemicals needed to test for the virus is part of what is slowing turnaround times.
Posted on August 4th, 2020 | By Sarah Mervosh and Manny Fernandez
Frustrated by a nationwide testing backlog, the governors of six states took the unusual step of banding together on Tuesday to reduce the turnaround time for coronavirus test results from days to minutes.
The agreement, by three Republican governors and three Democratic governors, was called the first interstate testing compact of its kind. The six states — Louisiana, Maryland, Massachusetts, Michigan, Ohio and Virginia — agreed to work with the Rockefeller Foundation and two U.S. manufacturers of rapid tests to buy three million tests.
The bipartisan plan highlights the depth of the testing problems in the United States more than six months into the pandemic.
The United States is testing about 755,000 people a day, up from about 640,000 per day a month ago, and far more than in April and May, according to the Covid Tracking Project. But numbers alone do not tell the whole story. With testing chemicals and other equipment in short supply, and a surge in coronavirus cases nationwide leading to skyrocketing demands, many Americans are still having to wait many days for results, effectively rendering those tests useless.
Most people who are tested for the virus do not receive results within the 24 to 48 hours recommended by public health experts to effectively stall the virus’s spread and quickly conduct contact tracing, according to a new national survey by researchers from Harvard University, Northeastern University, Northwestern University and Rutgers University.
The survey — representing 19,000 people from 50 states and Washington, D.C., who responded to an online questionnaire last month — found lengthy wait times among those who had been tested for the virus, about 18 percent of all respondents. People who had been tested for the virus in July reported an average wait time of about four days. That is about the same wait time for those who reported taking a test in April. Over all, about 10 percent of people reported waiting 10 days or more.
Respondents in a vast majority of states reported a median turnaround time of at least three days, including residents of California, Florida, Texas and other hot spots.
The survey also found disparities across racial groups, an indication that people who are hit hardest by the pandemic are also having to wait longer for test results. Black people surveyed reported an average wait time for results of five days, and Hispanic respondents reported an average wait time of 4.6 days, compared with 3.9 days for white people.
“Testing is just not quick enough,” said Matthew A. Baum, a professor of public policy at Harvard University and one of the researchers in the group, which found that wait times were “strikingly similar” across the country. “This is an enormously widespread problem.”
The challenge, experts say, is a basic issue of supply and demand. About half of all coronavirus tests are conducted by large-scale commercial laboratory companies like LabCorp and Quest Diagnostics, which are racing to turn around swabs while competing with a global market. There is also a critical shortage of certain equipment and supplies, including reagents, the chemical ingredients needed to detect whether the coronavirus is present in a sample.
Federal officials argue that long wait times are unusual, citing figures that more than 80 percent of tests are completed within three days. With plans to reduce the share of tests done by commercial labs, shifting more responsibility to hospitals and other facilities where tests can be done in as little as 15 minutes, officials say that turnaround times are expected to improve soon. Still, labs around the country have been feeling the pressure for weeks.
In Brunswick, Ga., lab technicians are working around the clock. Machines churn out results in 50 minutes to four and a half hours, but there are so many orders that the labs cannot keep up. Regular shipments of chemicals needed to test for the virus do not last even a week, so pathologists have begun to carefully dole out their supplies.
“We literally ration tests,” said Dr. Patrick Godbey, the president of the College of American Pathologists and the director of two labs in the Brunswick area. He estimated that for every test his labs are able to perform, they have to send three to national commercial laboratory companies.
“Why keep a backlog?” he said. “Tomorrow is going to be just as busy.”
In California, Dr. Amir Jamali, an orthopedic surgeon, had to order swabs from eBay in order to test surgery patients at his practice in the Bay Area. He paid about $50 for a bundle of five, which he said was far above the normal price. But now, Dr. Jamali said, the effort has been largely for naught because turnaround times at local labs are inching longer by the day.
“We used to be able to get it within 24 and 48 hours,” Dr. Jamali said. “Almost every week it’s increasing to three day, five days, seven days, 10 days.” In that time, he fears his patients could have gone to a party or a barbecue, potentially exposing other people, as well as his staff and other patients. Some days, he has had to cancel surgery rather than risk exposure.
“It’s like having no testing,” he said.
The problem spans much of the country. In Alabama, the health department recently put out a warning that the turnaround time for test results has ballooned to an average of seven days.
“A test result that comes back in seven or eight days is worthless for everybody — it shouldn’t even be counted,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security and a physician in Pittsburgh. “It’s not a test in any kind of effective manner because it’s not actionable.”
Despite a shortage of the chemical reagents, Dr. Adalja said he typically has no problem getting a quick test for hospitalized patients, who are given priority. But people who go to a drive-through clinic or walk into a CVS may have to wait much longer for their tests to come through the system.
Based on federal guidance, LabCorp said it was prioritizing hospitalized patients and nursing home tests. “All other testing for patients are performed in the order in which they are received,” a spokeswoman said in a statement. As of July 30, the company reported that its turnaround time for test results was two to three days from when the sample was picked up.
A Georgia schools superintendent defended the district’s reopening plans after a photo went viral showing a packed hallway with no social distancing and few masks.
James Davis, executive vice president of general diagnostics for Quest, said that the company had recently ramped up testing by acquiring its own testing process and ingredients, and that it was already seeing improvements in turnaround times. But he said there was only so much that can be done because a majority of about 150,000 tests that Quest performs each day rely on automated testing machines from two companies that must use reagent kits from those companies, similar to a Honda car that needed a replacement part made by Honda.
“Right now, we live hand to mouth,” he said of the chemicals. “I need a shipment on Monday to make sure all of my labs run through Wednesday, and then on Wednesday, I need another shipment,” he said, adding, “That’s how tight the supply chain is.”
The six-state agreement announced on Tuesday showed how the lack of a federal testing program has left municipalities and states to fend for themselves. The Trump administration has provided new support to hard-hit regions by providing free coronavirus testing in cities through a “surge testing” program announced last month. But the bulk of government-sponsored testing has been provided by cities, counties and states that hire third-party contractors such as Quest and LabCorp. As a result, the length of the delay varies between states, and within them.
In Texas, officials in San Antonio said it was taking 24 to 36 hours to get test results back at a free government-run testing site at Freeman Coliseum. The wait was longer at Legacy Community Health clinics in Houston and the surrounding Gulf Coast region, where test results were on a two-day to five-day turnaround time.
On Tuesday, officials in Harris County, which includes Houston, said they were increasing testing capacity and shortening lab turnaround times as part of federal “surge testing.” The temporary support, which lasts until 30,000 testing samples are reached at two free testing sites, will have test results in three to five business days.
The compact was negotiated by the Rockefeller Foundation and Gov. Larry Hogan of Maryland, a Republican, during the final days of his tenure as chairman of the National Governors Association. Instead of each of the six states separately ordering thousands of tests, the group of states is instead in discussions with the two U.S. manufacturers of antigen tests, the Quidel Corporation and Becton, Dickinson & Company, to buy three million tests, or 500,000 tests per state.
Unlike the more readily available tests that use polymerase chain reaction, or P.C.R., antigen tests can rapidly determine whether a person has been infected by the virus by detecting fragments of virus in a sample. The tests will deliver results in 15 to 20 minutes, the governors said. Still, scientists have said the tests can frequently miss infections. Tests from both Becton Dickinson and Quidel could produce false negative results between 15 and 20 percent of the time.
The Trump administration’s testing czar, Adm. Brett P. Giroir, told Congress last week that “turnaround times are definitely improving.” But Admiral Giroir, a doctor and the assistant secretary for health, testified that getting test results within two to three days “is not a possible benchmark we can achieve today.”
Posted on August 4th, 2020 | By Shoshy Ciment and Amanda Krause
L’Oréal US employees who want to work from home are being required to give the company access to their medical history, two current L’Oreal employees confirmed.
Beauty watchdog Instagram account esteelaundry shared a photo of the form employees must sign that releases “information regarding any physical or mental limitation(s)” that could affect their ability to “safely perform work” during the pandemic.
According to Helen Rella, an employment and labor lawyer at Wilk Auslander, L’Oreal is perfectly within its rights to request medical records or information from its employees who are requesting accommodations.
“We have never seen a situation like this before with anticipated mass applications for disability-based accommodations,” Rella said. “Employers and employees are encouraged to work together in an interactive process to address the situation and keep the workforce functioning.”
A spokesperson for ‘L’Oréal USA said the company “does not ask for any employee’s actual medical records or details of a medical diagnosis.” The request form includes the release of “medical information.”
As the US slowly reopens, employers are grappling with how — if at all — to bring people back into the office.
In the case of L’Oréal USA, a push to return to the office has some employees in an uncomfortable situation. Those employees who wish to remain working from home must provide access to their medical records in order for any accommodations from the company to be considered, according to a post on beauty watchdog Instagram account esteelaundry.
The post, which was published about a week ago, shows the form that L’Oreal employees can sign that would release “information regarding any physical or mental limitation(s)” that may affect their ability to “safely perform work,” during the pandemic, which they must fill out if they wish to remain working from home. Two current L’Oreal employees confirmed the arrangement to Business Insider.
A spokesperson for ‘L’Oréal USA, which employs nearly 11,000 people noted that the company “does not ask for any employee’s actual medical records or details of a medical diagnosis. Any employee seeking a medical exemption from returning to in-office work is required to provide verification from their physician. In most instances, a doctor’s note is a sufficient verification.”
The request form includes the release of “medical information.”
The spokesperson added: “Any confidential information shared by employees is managed by a third-party provider in conjunction with HIPAA-trained HR professionals who determine eligibility for medical exemptions from returning to in-office work.”
The legal implications of requesting medical information
According to Helen Rella, an employment and labor lawyer at Wilk Auslander, L’Oreal is perfectly within its rights to request access to medical information from its employees who are requesting to stay at home.
Rella explained that it is up to an employer to set the terms and conditions of employment, which includes where the job is physically carried out. Since statewide restrictions and stay-at-home orders have been lifted, employees have technically been required to come back into work if their job demands it and could be subject to termination of they refuse.
In the event an employee makes this type of request, the employer has the legal right to ask for pertaining medical certification and records in order to justify any accommodation.
“Employee medical records are considered highly confidential and an employer may only request information related to the stated disability and need for an accommodation, and may not generally request all medical records of the employee,” said Rella.
The practice of releasing medical information to one’s employer during the process of requesting workplace accommodations has been the norm in employment law for some time. But the pandemic is making situations like these a lot more common across a variety of workplaces, Rella said.
“We have never seen a situation like this before with anticipated mass applications for disability-based accommodations,” Rella said. “Employers and employees are encouraged to work together in an interactive process to address the situation and keep the workforce functioning.”
L’Oréal could face lawsuits down the line as a result of these medical-release documents
Jackie Voronov and Jeffrey Daitz, labor and employment attorneys at Hall Booth Smith, P.C., told Insider that while L’Oréal’s documents are not inherently illegal or unethical, they could lead to issues for the company at a later time.
“You could sue somebody based on a perceived disability, and questionnaires like this can put you into a lawsuit on a perception of an Americans with Disabilities Act violation, so it’s a very sensitive and delicate issue,” Daitz told Insider.
Voronov added: “As a rule of thumb in this day and age, in the year 2020, where anybody can say ‘You’re discriminating against me because I’m disabled,’ there’s better ways to get the information you seek.”
Are you an employee in retail working during the pandemic? Email firstname.lastname@example.org to share your story.
Update: This story has been updated to include L’Oréal’s comment and to clarify that the company’s authorization form includes the release of medical information not medical records.
Single parents, parents with young children and parents who can’t work from home are the groups most at risk to stop working entirely because they have no child care, said Goldman Sachs (GS) economists David Choi and Joseph Briggs in a note to clients on Tuesday.
Nearly a third of the pre-pandemic US labor force has kids at home, and about 15% of the work force falls into at least two of those three risk categories above, Choi and Briggs said. That totals about 24 million people.
Since May, some 7 million people per week have not worked because they didn’t have access to childcare, according to data from the Census Household Pulse Survey, a number that accounts for about 14% of virus-related reasons for missing working.
Long story short, it’s bad for the recovery if parents are forced to stop working to care for their kids. America lost more than 20 million jobs in March and April due to the pandemic lockdown, but the labor market has been recovering since hitting that trough. Reopening schools is also about more than childcare.
While the employment of teachers is back to its pre-Covid levels, schools employ plenty of additional staff, such as cafeteria and custodial workers, who can only return to their jobs once schools reopen. And if support staff don’t, that could drag the unemployment rate by some 0.2 percentage points, the Goldman economists said.
For students, learning from home may also have plenty of long-run effects, including lower-quality education, a lack of development in social skills and food insecurity for kids reliant on school lunches. All of that can translate into worsening income and educational inequality later in life.
All that considered, the argument to reopen schools seems strong, especially because preliminary evidence suggests younger children are less likely to transmit Covid-19. That is why some countries have managed to reopen schools without triggering a spike in infections.
But the countries that have succeeded at that so far also had less virus spread to begin with, the Goldman economists cautioned. The lesson seems to be that the reopening of schools has to be done with a lot of caution and discipline.
States across the US are currently experiencing the virus at different rates. While cases the Northeast peaked early, Southern states, for example, are battling very high infection rates now, making it much riskier there to reopen schools.
A Michigan library had to ask patrons to stop microwaving books to kill the coronavirus after noticing returned books with scorched pages. The Cleveland Clinic issued a public warning about the danger of using vodka concoctions as a hand sanitizer when recipes started to circulate.
Fear of covid-19 is exposing a lack of health literacy in this country that is not new. The confusion is amplified during a health emergency, however, by half-truths swirling in social media and misinformed statements by people in the public eye.
One in five people struggle with health information, says Michael S. Wolf, director of the Center for Applied Health Research on Aging at the Feinberg School of Medicine at Northwestern University.
“It’s easy to misunderstand [medical information],” says Wolf, who is also founding director of the medical school’s Health Literacy and Learning Program. Some will be too ashamed to say so while others won’t realize they missed a critical detail.
The people most likely to have low health literacy include those dying in greater numbers from covid-19: older adults, racial and ethnic minorities, nonnative English speakers, and people with low income and education levels.
“Covid has brought to fore the vast inequities in society,” says cardiologist Jared W. Magnani, associate professor of medicine at the University of Pittsburgh School of Medicine. If you don’t understand words such as “immunocompromised” or “comorbidity,” for instance, you miss cautionary information that could save your life.
But low health literacy cuts across all demographics, stresses Alison Caballero, director of the Center for Health Literacy at the University of Arkansas for Medical Sciences. “Given the right headache or stress about a sick child, [gaps in comprehension] can happen to anyone. When you don’t feel well, you don’t think as clearly.”
Health literacy is not about reading skills or having a college degree. It means you know how to ask a doctor the right questions, read a food label, understand what you’re signing on a consent form, and have the numeric ability to analyze relative risks when making treatment decisions.
“None of this is intuitive,” Wolf says.
Magnani has patients who don’t believe they have high blood pressure because their lives aren’t stressful. Or respond with “Great news!” when he tells them a test result was “positive.” He was lead author of a statement from the American Heart Association about overcoming health literacy barriers to improve patient outcomes.
“Most health care doesn’t occur in the exam room,” Magnani says. Misunderstandings over hospital discharge or medication instructions can undo the best medical care. Yet, nearly 1 in 3 of the 17,309 people in a study by researchers from the Agency for Healthcare Research and Quality (AHRQ) responded that instructions from a health provider were “not easy to understand.”
Wolf says he was surprised during a study on reading prescription labels by how many high school graduates could not follow medication instructions. “Being able to read the label doesn’t mean you can interpret it,” he says. “Take two pills, twice daily” was frequently misunderstood. Replacing the awkward wording with “Take two in the morning and two at bedtime” would solve that, Wolf says. Health-care professionals “need to meet people where they’re at.”
Health literacy is the best predictor of someone’s health status, some physicians maintain. Decades of research consistently link low health literacy to poorer medical outcomes, more hospitalizations and emergency room visits, and higher health-care costs. The less literate often experience higher mortality rates for heart disease and more foot amputations if diabetic. And you are less likely to wear sunscreen, maintain an optimal weight and take other health-preventive measures if your health literacy is low.
Anatomy knowledge is another gap.
To avoid misdiagnosis, Philadelphia internist Melissa G. Schiffman says she has to weigh each patient’s comprehension when they discuss symptoms. They may tell her they have kidney pain but the discomfort is lower in their back and more consistent with back strain, she says. Or a patient may be embarrassed to say “testicles” and complains of groin pain, she says.
Explaining medical risk and probability is another challenge.
“ ‘Why did you prescribe this? It says it hurts your kidneys,’ ” Schiffman will hear from a patient. “They may not understand that only a very small percentage of people may get a stated side effect.” Then there are people with heart attack symptoms who don’t go to the ER because they think covid-19 risk is worse, she says.
Over 3,000 studies found that health education materials far exceed the eighth-grade reading level of the average American, too. Beyond not using plain language (“joint pain,” not “arthritis”), texts assume the patient knows more than they do. Telling people to sanitize surfaces to kill the coronavirus means little if you don’t tell them what to use and how to do it, Caballero says. “What does it mean to practice good respiratory hygiene?” she asks. “These are not actionable instructions.”
“People don’t want to look dumb, but patients should never feel embarrassed to ask any question,” Schiffman says. “It’s not in anyone’s interest.”
Poor health literacy is no longer viewed as just the patient’s problem. The AHRQ created the Health Literacy Universal Precautions Toolkit to help physicians communicate more clearly. The American Medical Association and the National Institutes of Health recommend that patient education materials be written at no higher than a sixth-grade level. More instruction materials are using pictures and diagrams that can be easier to follow than text.
Doctors are encouraged to employ the teach-back technique, meaning the doctor asks the patient to repeat what they’ve heard rather than simply asking, “Do you understand?”
Magnani goes a step further to try to identify patients who need help. When teaching, he says, “I tell trainees that when they ask a patient if they have questions and there are none, it may be an indication that the patient doesn’t know how to ask questions.”
In addition, “health care is becoming a harder test,” Wolf says. Health billing and insurance options can be impossible to navigate. We have an aging populationwith more chronic conditions and cognitive decline. And more is being asked of patients such as testing their own blood sugar or blood pressure.
“The health-care system has not done its job for diverse stakeholders,” says Wolf about providing health information within everyone’s grasp. “We can’t put this [burden] in the lap of the patient.”
One Senator said recently that the fact that many federal employees have been doing their jobs successfully during the COVID-19 pandemic via telework is clear evidence that federal agencies do not need to be located in Washington, DC.
Senator Joni Ernst (R-IA) said in a recent hearing, “During the COVID-19 pandemic, many of our federal workers have successfully done their jobs remotely, showing us that they don’t necessarily need to be in Washington to do their jobs. I think this bolsters my argument that we can and should move more jobs out of Washington…”
She was making a pitch for a bill that she introduced last year which would facilitate moving federal agencies out of Washington, DC. The Strategic Withdrawal of Agencies for Meaningful Placement (SWAMP) Act (S. 2269) would create a competitive bidding process that allows states, cities, and towns across the country to compete to be an agency’s new home.
Specifically, the bill would:
Repeal the section of the U.S. Code that requires federal agencies and departments to be located in Washington, D.C.
Prohibit agencies currently headquartered in the Washington, D.C. area from entering into new lease agreements, making significant renovations to their existing locations, or beginning construction on new facilities in the area.
Exempt the Executive Office of the President, the Department of Defense, and all other national security-related agencies that must be in close proximity to Congress and the White House.
Ernst said that the bill would distribute future agency headquarters over geographically diverse areas of the nation to help ensure agencies focus on the stakeholders.
In a statement about the bill, Ernst said, “Instead of housing federal agencies in swampy D.C., let’s move them outside the Beltway and closer to the folks who know the needs of their states, farms, and businesses best. And in the process, we will see more job creation and greater opportunities for communities across the country—not just in D.C.”
Ernst’s bill is not the first to propose moving federal agencies out of Washington. Perhaps the most aggressive legislation introduced recently would move most federal agencies outside of the DC area. Introduced by Senator Josh Hawley (R-MO), the Helping Infrastructure Restore the Economy (HIRE) Act (S. 2672) would move 90% of the positions in 10 executive departments to other states.
“We’re excited to announce ERS and NIFA’s new, permanent home in downtown Kansas City, Missouri and provide clarity on commute times and work-life balance for our employees,” USDA Secretary Sonny Perdue said in a statement last October.
Whether or not any of these other efforts in Congress to relocate agencies will come to fruition remains to be seen.
Posted on August 3rd | By Alexia Fernández Campbell
Lucie Joseph started to feel sick on April 28 as she rang up customers at a Shell gas station in Delray Beach, Florida.
Joseph said her boss wouldn’t give her time off without a doctor’s note. But the owner of the gas station, Sun Gas Marketing and Petroleum, didn’t offer her health insurance, so she didn’t go to the doctor. Joseph, a single mother with a 10-year-old son, kept working — seven more shifts over 10 days.
Joseph’s symptoms worsened, so she decided to get tested for COVID-19. On May 9, Joseph learned she had tested positive, and a nurse told her to quarantine. Over the next six weeks Joseph tested positive twice more and texted the results to a manager. As instructed, she didn’t return to work until she had two consecutive negative tests. On June 15, however, she was fired.
“I was stunned,” said Joseph, who showed the Center for Public Integrity images of the text messages with her employer and a document indicating she’d tested positive for COVID-19.
Joseph, who earned $13 an hour, didn’t realize she had a legal right to job protection. She eventually was paid two weeks’ wages, but even this violated the law: She should have been paid as soon as she went into quarantine.
Two months before Joseph was fired, President Donald Trump signed the Families First Coronavirus Response Act, which requires certain small- and medium-sized businesses to pay a worker’s full salary for two weeks if they become infected with COVID-19 and prohibits businesses from firing employees for taking leave.
But Joseph didn’t know about the law until she consulted a lawyer. Many other workers are equally uninformed.
Meanwhile, hundreds of U.S. businesses have been cited for illegally denying paid leave to workers during the pandemic, according to documents Public Integrity obtained through a Freedom of Information Act request. As of June 12, nearly 700 companies had violated the law’s paid-leave provisions and owed back wages to hundreds of employees, according to Labor Department records. Violators include six McDonald’s franchises and the owners of Comfort Suites, Courtyard by Marriott and Red Roof Inn franchises.
In all, the businesses owe $690,000 in unpaid wages to 527 employees, who are not identified in the documents. Most of the workers are low-wage earners in the construction, hotel and food industries. It’s likely many more companies have broken the law because workers such as Joseph aren’t aware of their rights and therefore haven’t filed complaints. The Trump administration hasn’t made a point of educating them.
“Workers with low wages are most in need of paid leave,” said Tanya Goldman, a former Labor Department policy advisor who’s now an attorney at the Center for Law and Social Policy, a nonprofit focused on advancing anti-poverty policies. “They literally cannot afford to stay home and take a sick day if they get COVID.”
Eileen Arslan, comptroller for the Courtyard by Marriott franchise in Fort Walton Beach, Florida, which was cited for a violation, said hotel staff members were confused at first about who was covered under the new law. But as soon as they heard from the Labor Department, they paid the employee the wages owed. Red Roof Inn’s corporate office said they were trying to track down the employee involved, but didn’t give further comment. The corporate office for Comfort Suites did not respond to request for comment.
Joseph is now receiving unemployment pay while looking for work. She’s preparing to sue Sun Gas, claiming it broke the paid-leave law. “Bosses need to know that we’re human, that we have family too,” Joseph said.
Sun Gas owner Richard Vogel did not respond to requests for comment about why Joseph was fired.
Congress is considering another stimulus bill that would extend paid sick days to workers not covered under the current law, such as health-care workers, first responders and employees at companies with more than 500 workers. Establishments with fewer than 50 workers are exempt if they show paid leave would seriously hurt their businesses.
But the bill is tied up in the Senate as Republicans and Democrats fight about how much aid to give workers.
‘I need to eat’
About a third of U.S. workers don’t receive paid time off from their employers. Most of them work in low-wage jobs. Others, such as Joseph, get only one or two days of paid time off a year. Others get a bit more, such as Angely Rodriguez.
Rodriguez, who works as a cashier at a McDonald’s restaurant in Oakland, California, gets up to five sick days a year under state law. But that wasn’t enough to pay her bills while she recovered from COVID-19.
Rodriguez was one of 11 employees at the McDonald’s in the East Bay neighborhood of Temescal who tested positive for the coronavirus in late May. Forced to quarantine, Rodriguez asked if she could get paid while she recovered at home. Probably not, her boss said, adding that she would check with her supervisor. Rodriguez said she never got a response.
Rodriguez, who earns $14.14 an hour, didn’t realize she had the right to get paid for two weeks during quarantine.
“Imagine living here without any money,” Rodriguez said in Spanish. “I can’t stay in my home if I don’t pay the rent, and I need to eat and send money to my family.”
Click here to download the document obtained by the Center for Public Integrity through a Freedom of Information Act request.
Rodriguez and five co-workers are suing the franchise owner, VES McDonald’s, for allegedly breaking local labor laws, including a temporary Oakland ordinance that requires employers to give workers two paid weeks off if they get sick during the pandemic.
Rodriguez said she eventually was paid for 60 hours but is owed another 20. The company said it eventually paid all workers in mid-June who asked for leave, according to court records.
Rodriguez’s employer, McDonald’s franchise owner Valerie Smith, did not respond to a request for comment. In court documents, her lawyers said the franchise has complied with the law.
A spokesperson for McDonald’s Corp. said the company asks employees who are sick to stay home.
“We’re confident the vast majority of restaurant employees impacted by COVID-19 are getting paid sick leave through existing franchisee and corporate policies, the Families First Coronavirus Response Act, CARES Act and state and local regulations, and McDonald’s USA requires its franchisees to comply with all applicable laws and regulations,” the spokesperson wrote.
Rodriguez and Joseph are the types of workers the Families First law was supposed to help: low-income earners who aren’t paid if they are sick or don’t get enough paid leave to quarantine for at least two weeks.
The law also guarantees working parents 10 weeks off at two-thirds pay if a worker’s child-care provider closes because of the pandemic. Employers get a tax credit to cover the cost.
Data from the Labor Department’s Wage and Hour Division, which enforces the paid-leave law, shows that businesses with a large number of low-wage workers are breaking the law more often than others.
Most of the violators are construction and renovation companies, hotels, restaurants, grocery stores and manufacturers. According to the Labor Department, about a dozen companies are repeat violators, including a McDonald’s restaurant in Salem, New Jersey, and the Broward Children’s Center near Fort Lauderdale, Florida. The owner of the McDonald’s in Salem did not respond to a request for comment. The child-care center said it’s complying with the law and declined to comment further.
The U.S. Postal Service has the most violations — 57. It owes workers nearly $100,000, Labor Department records show.
Workers fight for sick leave
Sandra Capkovic, who delivers mail in the Tampa, Florida, area, told Public Integrity a supervisor denied her request for 10 weeks of paid leave to take care of her 7-year-old son, whose babysitters have been unavailable during the pandemic. Capkovic said her supervisor told her the paid-leave law covers only parents whose children’s schools and day-care facilities are closed, and she would have to use the 10 days of annual leave she had accumulated. The Families First law covers working parents whose “child care provider” is unavailable, but doesn’t specify whether that includes babysitters.
Capkovic said she didn’t file a formal complaint because she didn’t know if her supervisor had violated the law.
A spokesperson for the postal service said the agency began educating employees about their rights as soon as the law was signed by the president.
“Significantly, the number of violations cited (57) is a very small fraction of the Postal Service workforce, which is comprised of more than 630,000 employees,” she wrote.
Two former Labor Department officials said the 692 paid-leave records obtained by Public Integrity likely reflect only a fraction of employers who are breaking the law.
“It’s very challenging for an employee, in a time of increasingly high unemployment and instability in the labor market, to have the courage to make a complaint,” said Michael Hancock, an employment lawyer at the firm Cohen Milstein in Washington, D.C., and an assistant administrator for policy in the Wage and Hour Division during the Obama administration.
The Wage and Hour Division has fielded more than 250,000 calls since the paid-leave law went into effect, and about 25 million people have visited its website. The division did not respond to questions about the number of complaints filed or investigations that remain open.
Violation data obtained by Public Integrity suggests investigators are not conducting companywide audits, Hancock and Goldman said. All but a dozen of the 692 violations involved just one employee at one company. Labor experts say that’s a sign federal investigators are not checking to see if other workers at a company were illegally denied leave.
Hancock called this one-off enforcement strategy “irresponsible.”
Goldman said the division should do more to educate workers and employers about the law because many may not know about the temporary paid-leave benefit.
Congress set aside $15 million for the Labor Department to spend on advertising and program administration. But the agency didn’t launch a major outreach campaign until mid-July — more than three months after the law was signed.
Of the six workers who spoke to Public Integrity, only one was aware of the law at the time it could have been of help.
The Labor Department has defended its enforcement of the paid-leave benefits. Investigating individual complaints — instead of conducting companywide audits — allows staff to quickly resolve cases that could otherwise take months, said Edwin Nieves, a spokesperson for the Wage and Hour Division (WHD).
“[The division’s] response has been swift and comprehensive,” he wrote in a statement to Public Integrity. “WHD has simultaneously addressed the need to provide information to the American workforce about their rights and benefits available under the Families First Coronavirus Response Act (FFCRA) and the need to enforce the new law to ensure workers get the protections they need and deserve.”
Fighting paid-sick leave
The coronavirus aid bill introduced by the House of Representatives in March would have created the nation’s first paid sick-leave program. The bill would have allowed paid time off to anyone who earned income in the previous 30 days before becoming sick with coronavirus or needing to take care of a family member.
Then the lobbying began.
On March 12, a day after the bill was introduced, the U.S. Chamber of Commerce warned lawmakers not to pass a universal paid-leave program.
Later that evening, the National Association of Manufacturers sent Congress a similar message.
By the time the legislation passed the House on March 14, it looked much different than the bill introduced three days earlier. The paid-leave program excluded employees of companies with more than 500 workers, or about half the U.S. workforce. It also excluded health-care workers and emergency responders, and gave the Labor Department authority to exclude businesses with fewer than 50 employees.
After the federal paid-leave program went into effect in April, the Labor Department further narrowed the group of workers eligible for the benefit. It ruled, for example, that hospital janitors and cafeteria workers were also unprotected because of the law’s exclusion of health-care providers.
The interpretation incensed former Obama Labor Department officials, who charged the Trump administration in an op-ed with “undermining the health and welfare of workers and their families.”
It’s unclear if the coronavirus legislation lawmakers are negotiating will restrict, expand or leave the program untouched.
In the meantime, Joseph is looking for work. Her dream of owning a home seems farther away than ever.
“This is a big hit,” she said. “It’s hurting me, not being able to work.”
Peter Newbatt-Smith and Kristine Villanueva contributed to this report.
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