npr--2020-04-24--As Fraudsters Exploit Pandemic Fears, Justice Department Looks To Crack Down

As Fraudsters Exploit Pandemic Fears , Justice Department Looks To Crack Down The coronavirus pandemic has brought out the good side of many Americans , but certainly not all Americans .
Officials say that fraud related to COVID-19 — like hoarding equipment , price gouging and hawking fake treatments — are spreading as the country wrestles with the outbreak .
`` It 's a perfect ecosystem for somebody like a fraudster to operate in , '' said Craig Carpenito , the U.S. attorney for New Jersey and the head of the Justice Department 's COVID-19 price gouging and hoarding task @ @ @ @ @ @ @ that there 's a magic pill that they can take or that if they buy a certain kind of mask or a certain kind of protective gear that it 's going to protect them and their families , '' he said .
`` That creates opportunities for the types of people that prey upon scared people .
They prey upon their fear . ''
A month ago , Attorney General William Barr instructed federal prosecutors around the country to aggressively investigate and prosecute scams and other crimes related to the COVID-19 pandemic .
@ @ @ @ @ @ @ hoarding task force and put Carpenito in charge of it .
From that perch , Carpenito has one of the best views of virus-related crime nationwide .
`` Instead of seeing that tremendous support from all aspects of society , we 're still seeing that sliver , that that dark underbelly , that small percentage of folks who instead of putting the interests of the country and support for those medical professionals that are putting themselves at risk in the forefront , they 're finding ways to try and take advantage of this @ @ @ @ @ @ @ '' he said .
`` And it 's despicable . ''
The most prevalent kind of fraud that federal authorities are seeing at this point , he and others say , is tied to personal protective equipment like N95 masks , gloves or face shields .
In one notable case , prosecutors brought charges against a Georgia man , Christopher Parris , for allegedly trying to sell $ 750 million worth of masks and other protective equipment to the Department of Veterans Affairs but with a sizable advance payment .
The problem , @ @ @ @ @ @ @ other items did n't exist , at least not in the quantities Parris was offering .
Steven Merrill , the head of the FBI 's financial crimes section , says the bureau refers to these sorts of operations as advance-fee schemes .
`` We 're getting many complaints that different entities are entering into these agreements , paying money upfront , sometimes hundreds of millions of dollars , and may or may not get any masks or other PPE ordered at all , '' Merrill said .
`` So our guidance to the @ @ @ @ @ @ @ these frauds and solicitations . ''
Other problems , such as hoarding and price gouging , can arise even when the medical gear does exist .
The FBI is trying to identify individuals who are stockpiling protective equipment and trying to sell it at exorbitant markups , sometimes 40 to 70 times the value , Merrill said .
A few weeks ago , the FBI seized nearly 1 million respirator masks , gloves and other medical gear from a Brooklyn man who was allegedly stockpiling them and selling them to nurses and doctors @ @ @ @ @ @ @ 700 % markup .
The man , Baruch Feldheim , has been charged with lying to the FBI about price gouging .
He 's also been charged with allegedly assaulting a federal officer after he coughed on agents and claimed he had COVID-19 .
The confiscated items , meanwhile , have been distributed to medical workers in the New York area .
Carpenito said the Justice Department has more than 100 investigations open into price gouging .
It has hundreds more , he said , into other crimes tied to the pandemic , @ @ @ @ @ @ @ one case out of California , prosecutors charged a man who was allegedly soliciting large investments for what he claimed was a cure for COVID-19 .
`` He was doing so by broadcasting this scheme via , notably , YouTube , where had thousands of hits and views , '' Merrill said .
In a separate case out of Florida last week , the Justice Department got a court order to stop a Florida church from selling on its website an industrial bleach that was being marketed as a miracle treatment for the @ @ @ @ @ @ @ Centers for Disease Control and Prevention says there is no cure at this point for the virus .
More than a month into this crisis , there 's no sense COVID-related crime is going to slow down .
In fact , Carpenito and Merrill say that with the massive $ 2 trillion economic relief package beginning to be doled out , they expect to see even more fraud in the weeks and months ahead .
`` What we 're worried about is that not only do we have these existing conditions , but @ @ @ @ @ @ @ the country — the arrival of $ 2 trillion to hit the streets , '' Merrill said .
`` And anytime there 's that much money out there , you can just multiply the amount of frauds that are going to take place .
So we 're preparing for many more complaints to come in and new schemes to arrive on a daily basis . ''

As Fraudsters Exploit Pandemic Fears, Justice Department Looks To Crack Down
Enlarge this image toggle caption Alex Brandon/AP Alex Brandon/AP
Updated at 3:02 p.m. ET
The coronavirus pandemic has brought out the good side of many Americans but certainly not all Americans. Officials say that fraud related to COVID-19 — such as hoarding equipment, price gouging and hawking fake treatments — are spreading as the country wrestles with the outbreak.
"It's a perfect ecosystem for somebody like a fraudster to operate in," said Craig Carpenito, the U.S. attorney for New Jersey and the head of the Justice Department's COVID-19 price gouging and hoarding task force.
"People want to believe that there's a magic pill that they can take or that if they buy a certain kind of mask or a certain kind of protective gear that it's going to protect them and their families," he said. "That creates opportunities for the types of people that prey upon scared people. They prey upon their fear."
A month ago, Attorney General William Barr instructed federal prosecutors across the country to aggressively investigate and prosecute scams and other crimes related to the COVID-19 pandemic. He also created the price gouging and hoarding task force and put Carpenito in charge of it.
From that perch, Carpenito has one of the best views of virus-related crime nationwide.
"Instead of seeing that tremendous support from all aspects of society, we're still seeing that sliver, that that dark underbelly, that small percentage of folks who instead of putting the interests of the country and support for those medical professionals that are putting themselves at risk in the forefront, they're finding ways to try and take advantage of this situation and illegally profiteer from it," he said. "And it's despicable."
The most prevalent kind of fraud that federal authorities are seeing at this point, he and others say, is tied to personal protective equipment like N95 masks, gloves or face shields.
In one notable case, prosecutors brought charges against a Georgia man, Christopher Parris, saying he sold $750 million worth of masks and other protective equipment to the Department of Veterans Affairs but with a sizable advance payment.
The problem, prosecutors say, is the masks and other items didn't exist, at least not in the quantities Parris was offering.
Steven Merrill, the head of the FBI's financial crimes section, says the bureau refers to these sorts of operations as advance-fee schemes.
"We're getting many complaints that different entities are entering into these agreements, paying money upfront, sometimes hundreds of millions of dollars, and may or may not get any masks or other PPE ordered at all," Merrill said. "So our guidance to the public is to please be wary of these frauds and solicitations."
Other problems, such as hoarding and price gouging, can arise even when the medical gear does exist.
The FBI is trying to identify individuals who are stockpiling protective equipment and trying to sell it at exorbitant markups, sometimes 40 to 70 times the value, Merrill said.
A few weeks ago, the FBI seized nearly 1 million respirator masks, gloves and other medical gear from a Brooklyn man who was allegedly stockpiling them and selling them to nurses and doctors at what officials say was around a 700% markup.
Baruch Feldheim has been charged with lying to the FBI about price gouging. He has also been charged with allegedly assaulting a federal officer after he coughed on agents and claimed he had COVID-19.
The confiscated items, meanwhile, have been distributed to medical workers in the New York area.
On Friday, federal prosecutors in New York brought the first criminal case for alleged price gouging and hoarding under the Defense Production Act, which was invoked by President Trump early this month in response to the pandemic.
The defendant, Amardeep Singh, allegedly had stockpiled more than 5 tons of medical equipment, including masks and gloves, at his retail store and warehouse on Long Island.
The government says Singh was selling some of the gear in a "COVID-19 Essentials" section in his shop at significantly inflated prices. Disposable face masks, for instance, were allegedly selling at a more than 1,000% markup.
Carpenito said the Justice Department has more than 100 open investigations into price gouging. It has hundreds more, he said, into other crimes tied to the pandemic, including fake treatments and cures.
In one case out of California, prosecutors charged a man who was allegedly soliciting large investments for what he claimed was a cure for COVID-19.
"He was doing so by broadcasting this scheme via, notably, YouTube, where had thousands of hits and views," Merrill said.
In a separate case out of Florida last week, the Justice Department got a court order to stop a Florida church from selling on its website an industrial bleach that was being marketed as a miracle treatment for the virus.
To be clear, the Centers for Disease Control and Prevention says there is no cure at this point for the virus.
More than a month into this crisis, there's no sense COVID-related crime is going to slow down.
In fact, Carpenito and Merrill say that with the massive $2 trillion economic relief package beginning to be doled out, they expect to see even more fraud in the weeks and months ahead.
"What we're worried about is that not only do we have these existing conditions, but we are awaiting — like everybody in the country — the arrival of $2 trillion to hit the streets," Merrill said. "And anytime there's that much money out there, you can just multiply the amount of frauds that are going to take place. So we're preparing for many more complaints to come in and new schemes to arrive on a daily basis."


npr--2020-04-24--Why The Warning That Coronavirus Was On The Move In U.S. Cities Came So Late

Why The Warning That Coronavirus Was On The Move In U.S. Cities Came So Late In early February , the Centers for Disease Control and Prevention was looking for ways to stop the novel coronavirus before it got out of control in the United States .
The agency selected six cities for sentinel surveillance — a sort of early warning system to detect if the coronavirus was spreading freely .
The idea was to look for the virus among patients who had mild respiratory symptoms and no known travel-related risk factors — patients who were n't being tested under CDC @ @ @ @ @ @ @ the project along , the CDC 's plan was for cities to piggyback on their well-established flu-tracking programs .
Patient samples were already being tested for influenza strains .
The agency would provide coronavirus tests for a subset of those patients to see if the coronavirus outbreak was spreading undetected .
But that quick start to the project was far from quick in most places .
Fully five weeks later — contrary to statements from top CDC officials — only one of those cities had in hand any results from completed coronavirus tests @ @ @ @ @ @ @ .
Challenges with the CDC 's coronavirus tests , struggles with logistics , clashes between federal and state officials and even hospitals ' fears of being stigmatized as a source of infection — all cost valuable time in controlling the spread of the coronavirus across the U.S. , sources tell NPR .
Once the surveillance project finally got underway , its early warning came too late for some cities .
Others appear to have gotten the alert just in time — or at least soon enough to significantly curb the death toll .
@ @ @ @ @ @ @ was moving far faster than they realized , health authorities in California cities were able to use the information to convince public officials to issue stay-at-home orders for most residents — earlier by a week or more than other places , at a time when unabated community spread of the virus had already begun .
`` It does feel like we lost time , '' says Jennifer Nuzzo , an epidemiologist at Johns Hopkins University 's Bloomberg School of Public Health .
`` As we learned that this disease was spreading — and @ @ @ @ @ @ @ should have stood up sentinel testing in the United States . ''
Virus under the radar : how the surveillance project began On Feb. 13 of this year , Health and Human Services Secretary Alex Azar made an announcement before a Senate committee .
Five cities , he said — Chicago , Los Angeles , New York , San Francisco and Seattle — would begin looking for the coronavirus in some people who did n't meet the CDC 's strict guidelines for getting a test .
Honolulu was added to that list of @ @ @ @ @ @ @ was to find out if the coronavirus was spreading undetected .
At that time in February , the CDC had been running only a few dozen tests per day at its headquarters in Atlanta .
Beyond those , public health labs were not able to process the CDC 's test kits because the kits were faulty .
As a result — outside the new surveillance experiment — the only patients who could get tested had to be symptomatic for COVID-19 and either had traveled to Hubei province in China or had contact with @ @ @ @ @ @ @ the coronavirus .
Hospitalized patients who had recently traveled to any part of China could also be tested .
The six cities were selected because of the high likelihood that coronavirus cases would emerge there and because , in partnership with the CDC , they already had flu-surveillance programs in place .
Every flu season , the cities that have such programs test hundreds of samples from patients showing mild respiratory symptoms for various strains of influenza .
They report their findings to the CDC to help track where flu is spreading and @ @ @ @ @ @ @ that system to the current pandemic , samples from patients who tested negative for flu would be eligible for a coronavirus test .
Since the public health labs could n't run the CDC 's tests , the federal agency offered to do tests for them at its headquarters in Atlanta .
`` We recognize there was a situation where we did n't have as many tests as we wanted to do in the U.S. , '' says Dr. Joseph Bresee , deputy incident manager at the CDC .
`` But any sentinel site @ @ @ @ @ @ @ '' Officials hoped to use the surveillance testing to more accurately gauge how fast the coronavirus had already spread — and to do so quickly .
`` Results from this surveillance would be an early warning signal to trigger a change in our response strategy , '' the CDC 's Dr. Nancy Messonnier announced to the press in a briefing on Feb. 14 .
`` This is just the starting point , and we plan to expand to more sites in the coming weeks until we have national surveillance . ''
A month @ @ @ @ @ @ @ health officials assured Congress that surveillance testing was underway .
`` The CDC has already started that in six sentinel cities and will expand that in many more cities , '' Dr. Anthony Fauci , director of the National Institute of Allergy and Infectious Diseases , told the House Oversight and Reform Committee .
`` We need to know how many people — to the best of our ability — are infected , as we say , 'under the radar screen . '
`` Here 's the thing : Some of those sentinel @ @ @ @ @ @ @ testing programs off the ground .
Chicago was the first in the CDC project to look for the coronavirus in its flu patients , beginning testing on March 2 in five hospitals , along with several other counties in Illinois .
It had an advantage .
The Illinois state public health lab was the first in the U.S. to be able to process the CDC 's test kits , beginning in mid-February — somehow avoiding the faulty test kits that went to other states .
`` Being able to do the testing locally @ @ @ @ @ @ @ that we would be able to do sentinel surveillance , '' says Dr. Jennifer Layden , chief medical officer for the Chicago Department of Public Health .
In the first week of testing , 95 emergency room patients all tested negative for the coronavirus .
But by the second week , 5 % of patients were found to be positive .
`` We were surprised by the number of positives , '' says Layden .
`` Identifying community transmission let us know that was occurring and changed our protocols about who we should @ @ @ @ @ @ @ in the middle of the two-week project , sampling a broader number of mild cases for surveillance became challenging , state officials say , as the chemicals used in running tests began to run low .
`` We do want to expand our sentinel surveillance in order to look for the community spread , '' said Dr. Ngozi Ezike , director of the Illinois Department of Public Health , in a press briefing on March 8 .
`` And so that means you would need more reagents . ''
Ultimately , the city @ @ @ @ @ @ @ surveillance testing findings for a full week ; a statewide shelter-in-place order took effect on March 21 .
The city quickly became a hot spot for viral spread , seeing an early surge in coronavirus cases that is only just starting to flatten .
With a high volume of travelers flying in from China every day , health officials in Los Angeles suspected by late January that a wave of coronavirus cases was headed their way .
The city 's first documented case showed up Jan. 26 — a traveler from Wuhan , @ @ @ @ @ @ @ infection might be falling through the cracks .
`` We were interested in trying to identify people who might have been missed by the CDC testing criteria at that time , '' says Dr. Prabhu Gounder , medical director of the Respiratory Disease Unit at the Los Angeles County Department of Public Health .
Los Angeles County health officials identified five hospitals for the surveillance project that served large Chinese immigrant populations in the area .
After discussions , they began drafting a study protocol with one of those hospitals .
Gounder says @ @ @ @ @ @ @ , but the hospital 's board was not — remember , only one coronavirus case had been confirmed in the county at that point .
`` They had a very different perspective , '' Gounder says of the hospital 's board .
`` They were concerned that if the second case in LA County was linked to this hospital , that there would be a certain stigma that would potentially be bad for the hospital in terms of the anxiety among health care workers about exposure and also the potential for the patients @ @ @ @ @ @ @ may be exposed to COVID by coming to this hospital . ''
Los Angeles health officials declined to identify the specific hospital because they had agreed to keep discussions confidential .
NPR contacted several hospitals and confirmed that discussions with the Los Angeles County Department of Public Health had taken place , but could not verify which hospital 's board had those concerns .
Gounder says efforts to find the coronavirus in the general community stalled for several weeks in the region , until another hospital called — Los Angeles County + USC @ @ @ @ @ @ @ `` This is a leading-edge indicator , '' says Dr. Brad Spellberg , chief medical officer at Los Angeles County + USC Medical Center .
`` If you do n't look at it , you 're missing the canary in the coal mine .
You 're waiting for the coal mine to collapse on you . ''
Spellberg 's hospital had been preparing its own surge plan to be ready for a big , sudden influx of COVID-19 patients .
But not being able to test mild cases for the illness was like @ @ @ @ @ @ @ .
So his hospital partnered with the county to do surveillance testing of patients with mild respiratory symptoms in the hospital and its affiliated urgent care center — though Spellberg says there was contention within his institution about testing mild cases .
`` There was huge resistance , '' Spellberg says .
The hospital had just secured a small number of tests from a private laboratory — Quest Diagnostics — and had intended them for the sickest patients , which was in accordance with the CDC 's general guidelines at the time .
@ @ @ @ @ @ @ , 'You 're wasting our tests .
Do n't do this . '
`` Nonetheless , testing at the county medical center 's hospital and associated clinics began March 12 , and results started coming back a few days later .
Over four days , the researchers learned something that alarmed them : As many as 5 % of patients they tested had the coronavirus .
`` It 's spreading in the community silently , and we did n't even know about it , '' says Spellberg .
`` These were people that @ @ @ @ @ @ @ to social events , wandering around the community for days and days . ''
`` We were all a little bit surprised and alarmed , '' says Gounder .
`` It was the first real firm data point that we had that confirmed our suspicions . ''
The finding marked a key turning point in LA County 's coronavirus response .
Until then , health officers had been trying to contain the virus , using contact tracing to meticulously track down every person who may have been exposed .
But when a virus @ @ @ @ @ @ @ containment strategy alone is insufficient , epidemiologists say .
Three days after the Los Angeles surveillance study wrapped up , Los Angeles Mayor Eric Garcetti added a new strategy , ordering residents to stay at home , with certain exceptions .
So far , the county 's hospitals have not been overwhelmed by COVID-19 patients .
`` It is possible that the 'Safer at Home ' order went into place just in the nick of time to stave off a New York situation , '' says Spellberg .
As health officials in King @ @ @ @ @ @ @ the CDC in early February , state health officials had a suggestion : The Seattle Flu Study , a research project that was already gathering samples from patients with respiratory symptoms , could be tapped to check for the coronavirus .
`` That was a surveillance system that was up and running , '' says Dr. Scott Lindquist , Washington state epidemiologist for communicable diseases .
`` My point was , why do n't we use those samples ?
It was up and running — let 's do it . ''
But as @ @ @ @ @ @ @ Study 's coronavirus test — developed by the study 's researchers — was n't yet authorized by the Food and Drug Administration , and the lab the study used was n't certified to do clinical work for patients .
( The FDA did n't authorize labs outside the CDC to handle coronavirus testing until the end of February . )
`` CDC and FDA would not approve us using those samples , '' says Lindquist .
`` I kept asking , 'Ca n't we just [ get ] an exception ? '
`` @ @ @ @ @ @ @ the flu study tested samples for the coronavirus anyway and discovered on Feb. 28 a Snohomish County teenager with a presumptive COVID-19 diagnosis who had not traveled to a country with a known coronavirus outbreak and who had had no contact with a patient who was positive for the virus .
Meanwhile , King County , Wash. , health officials continued working to find other clinics to partner with for sentinel surveillance testing , as the CDC suggested — clinics that would collect samples to be sent to the CDC labs in Atlanta @ @ @ @ @ @ @ a number of logistical issues to sort out , such as finding the right populations to test , setting up a system to inform patients and arranging collection methods and transportation for samples to a site where they could be evaluated .
That approach never came to fruition .
Eventually , researchers running the Seattle Flu Study got the necessary approvals to begin surveillance testing , so the county chose to partner with them .
The surveillance study officially began on March 23 .
Lindquist says sentinel testing earlier than that would have @ @ @ @ @ @ @ after the state 's first confirmed case , on Jan. 21 .
Researchers have since found that the virus was likely spreading for weeks , undetected , during that time period .
`` It could have let us know that it was here before we had the community outbreaks and transmission in the long-term-care facilities , '' Lindquist says .
`` But we missed that period . ''
The pattern of slow starts or delays that plagued Chicago , Los Angeles and Seattle also plagued the other three cities in the CDC 's @ @ @ @ @ @ @ York City began its surveillance testing , it was far too late to provide an early warning .
NPR was unable to get details of New York 's experience with the project , but city health officials did confirm that in March , New York collected its first samples for this project — from more than 500 patients .
On March 23 , the day New York sent those first samples to the CDC for testing , the city already had more than 12,000 coronavirus cases .
By the time it got preliminary @ @ @ @ @ @ @ showing 6.6 % of patients were positive , the city 's outbreak was out of control — with more than 900 deaths , and climbing .
Hawaii got a relatively early start with surveillance , in relation to its first recorded case , and results so far suggest that this may have paid off .
The state started testing for community spread with the CDC project in mid-March .
That was not long after Hawaii 's first case of COVID-19 was confirmed on March 6 in a passenger returning from the Grand Princess @ @ @ @ @ @ @ of that testing , the state found no cases of community spread ( according to data ultimately released March 27 ) , and it found one case the next week .
Hawaii issued its stay-at-home order to begin March 25 .
Since then , Hawaii has tested more than 1,000 samples through its flu-surveillance network .
As of April 17 , 2.1 % of those cases have come back positive for the coronavirus .
San Francisco , after having early discussions with the CDC , did not begin sentinel surveillance testing .
A @ @ @ @ @ @ @ Public Health told NPR that it was not the city 's decision , but ultimately the project `` did not materialize . ''
The city provided no further detail .
Outside the CDC 's six original cities , some other communities were eager to establish their own surveillance testing .
But they , too , ran into trouble .
For example , about 30 miles south of San Francisco , in the heart of Silicon Valley , Santa Clara County saw its first travel-related case of the coronavirus on Jan. 31 .
The @ @ @ @ @ @ @ original list of six test sites , because it is n't part of the agency 's flu-surveillance network .
Santa Clara County health officials had discussed starting sentinel surveillance testing on their own , but — as was a problem in Seattle and New York — the county health lab initially could n't run CDC test kits .
In late February , the county found its first instance of community spread .
`` We needed to know pretty urgently how much [ community spread ] was happening , '' says Dr. George Han @ @ @ @ @ @ @ Clara County Public Health Department .
On March 5 , with help from a CDC field response team , Santa Clara County tested a sample of patients with mild symptoms at four urgent care centers and found that 11 % were positive for the coronavirus .
Two days after that testing wrapped up , Santa Clara and five other Bay Area counties issued shelter-at-home orders to residents .
`` This data [ from the sentinel testing ] helped inform that decision because it was one of the few relatively unbiased sources of data @ @ @ @ @ @ @ Han says .
`` That was , I think , a key point that we needed to have in order to issue the orders . ''
The action has been widely credited with , so far , preventing an overwhelming surge in COVID-19 cases in the region .
Santa Clara health officials say that if the CDC test kits had been functioning earlier in February , they would have started sentinel surveillance even sooner — and potentially have prevented even more deaths .
The county recently learned that a resident died of COVID-19 @ @ @ @ @ @ @ first deaths previously known and reported .
That discovery suggests the virus already was circulating in Santa Clara County in late January .
What was gained and lost in a crucial few weeks As coronavirus outbreaks have ballooned across the U.S. , epidemiologists say the communities that ordered social distancing and sheltering at home earlier than others may have substantially limited the number of infections and deaths .
`` A week or two can make a big difference , '' says Dr. Arthur Reingold , an epidemiologist at the University of California , @ @ @ @ @ @ @ `` The earlier you do it , the better . ''
The CDC says the long period of time it took to begin sentinel surveillance — up to six weeks in some cities — can be attributed to the logistical challenges of dealing with a new and deadly virus .
`` The rollout at these clinics — both identifying clinics that were interested and ready and willing to do this and also just getting them ready in terms of the sample shipping and collection — even though it was similar to influenza , @ @ @ @ @ @ @ a little more time , '' says the CDC 's Bresee .
Plus , Bresee says it was important that safety protocols were in place before the projects began — health care workers testing patients for the coronavirus needed to receive and wear additional personal protective equipment , for example .
At the time , Bresee says , the CDC was also monitoring other data — such as the number of hospitalizations of people with flu-like symptoms — that suggested that cases of coronavirus infections were still limited in February .
`` It @ @ @ @ @ @ @ three- or four-week delay , or longer , resulted in losing visibility in what was happening , '' says Bresee .
`` But I do n't think so . ''
While it 's hard to know for sure whether earlier surveillance testing would have changed outcomes for tens of thousands of people in hospitals and millions sitting at home , leading epidemiologists say those early weeks of the outbreak were crucial .
`` Three weeks is an enormous amount of time to allow cases to accumulate without knowing about it , '' says @ @ @ @ @ @ @ Public Health .
`` If we had had sentinel surveillance [ activated ] in a number of cities — cities where we expect to see cases first — we possibly could have caught it earlier and possibly intervened before the case numbers exploded . ''
Next steps for communities and the U.S. As many cities look forward to a time when cases of the coronavirus wane , they 're already beginning to plan new surveillance efforts to get ahead of the next wave of new infections .
`` We absolutely want to restart @ @ @ @ @ @ @ that , '' says Layden , the chief medical officer of Chicago .
`` We want to have a good sense of the level and amount of spread that 's occurring in our community . ''
Some cities are planning on setting up surveillance projects that test a sample of patients with flu-like symptoms , while others plan to use antibody tests , which check for prior infection instead of active cases , to get a better estimate of how broadly the outbreak has already spread .
The U.S. government has also identified @ @ @ @ @ @ @ reopening the country .
In this case , the project would look beyond mild cases ; it would test people who seem healthy .
The goal is to get a sense of how many people who do n't show symptoms are actually infected and able to spread the virus .
`` We 'll be doing sentinel surveillance throughout nursing homes , throughout inner-city federal clinics , throughout Indigenous populations — to really be able to find an early alert of asymptomatic individuals in the community , '' Dr. Deborah Birx , of the @ @ @ @ @ @ @ said at a press briefing last week , as the Trump administration laid out its plan .
Some epidemiologists say this sort of national effort could be a chance to get sentinel surveillance right — providing the critical information that health officials will need to avoid a second , bigger surge of severe illness and death .
`` Going forward , we need a national testing strategy , period , '' says Nuzzo .
`` Not just testing people for clinical purposes , but testing strategically so we can understand how much illness @ @ @ @ @ @ @ 's spreading . ''
An effort like that would require widespread availability of coronavirus tests .
While the Trump administration claims that adequate testing capacity already exists , many regions of the country still report shortages of test supplies , signaling that the country is n't yet prepared to gather the crucial surveillance data it will need .

Why The Warning That Coronavirus Was On The Move In U.S. Cities Came So Late
Enlarge this image toggle caption Michael Nagle/Bloomberg via Getty Images Michael Nagle/Bloomberg via Getty Images
In early February, the Centers for Disease Control and Prevention was looking for ways to stop the novel coronavirus before it got out of control in the United States.
The agency selected six cities for sentinel surveillance — a sort of early warning system to detect if the coronavirus was spreading freely. The idea was to look for the virus among patients who had mild respiratory symptoms and no known travel-related risk factors — patients who weren't being tested under CDC guidelines at the time.
To speed the project along, the CDC's plan was for cities to piggyback on their well-established flu-tracking programs. Patient samples were already being tested for influenza strains. The agency would provide coronavirus tests for a subset of those patients to see if the coronavirus outbreak was spreading undetected.
But that quick start to the project was far from quick in most places. Fully five weeks later — contrary to statements from top CDC officials — only one of those cities had in hand any results from completed coronavirus tests, according to an investigation by NPR.
Challenges with the CDC's coronavirus tests, struggles with logistics, clashes between federal and state officials and even hospitals' fears of being stigmatized as a source of infection — all cost valuable time in controlling the spread of the coronavirus across the U.S., sources tell NPR.
Once the surveillance project finally got underway, its early warning came too late for some cities. Others appear to have gotten the alert just in time — or at least soon enough to significantly curb the death toll.
As they got evidence that the virus was moving far faster than they realized, health authorities in California cities were able to use the information to convince public officials to issue stay-at-home orders for most residents — earlier by a week or more than other places, at a time when unabated community spread of the virus had already begun.
"It does feel like we lost time," says Jennifer Nuzzo, an epidemiologist at Johns Hopkins University's Bloomberg School of Public Health. "As we learned that this disease was spreading — and spreading efficiently — between humans, we should have stood up sentinel testing in the United States."
Virus under the radar: how the surveillance project began
On Feb. 13 of this year, Health and Human Services Secretary Alex Azar made an announcement before a Senate committee.
Five cities, he said — Chicago, Los Angeles, New York, San Francisco and Seattle — would begin looking for the coronavirus in some people who didn't meet the CDC's strict guidelines for getting a test. Honolulu was added to that list of cities a week later. The goal was to find out if the coronavirus was spreading undetected.
At that time in February, the CDC had been running only a few dozen tests per day at its headquarters in Atlanta. Beyond those, public health labs were not able to process the CDC's test kits because the kits were faulty.
As a result — outside the new surveillance experiment — the only patients who could get tested had to be symptomatic for COVID-19 and either had traveled to Hubei province in China or had contact with someone confirmed to have been infected with the coronavirus. Hospitalized patients who had recently traveled to any part of China could also be tested.
Enlarge this image toggle caption J. Scott Applewhite/AP J. Scott Applewhite/AP
The six cities were selected because of the high likelihood that coronavirus cases would emerge there and because, in partnership with the CDC, they already had flu-surveillance programs in place. Every flu season, the cities that have such programs test hundreds of samples from patients showing mild respiratory symptoms for various strains of influenza. They report their findings to the CDC to help track where flu is spreading and which strains are prevalent.
To adapt that system to the current pandemic, samples from patients who tested negative for flu would be eligible for a coronavirus test. Since the public health labs couldn't run the CDC's tests, the federal agency offered to do tests for them at its headquarters in Atlanta.
"We recognize there was a situation where we didn't have as many tests as we wanted to do in the U.S.," says Dr. Joseph Bresee, deputy incident manager at the CDC. "But any sentinel site, we had guaranteed testing for."
Officials hoped to use the surveillance testing to more accurately gauge how fast the coronavirus had already spread — and to do so quickly.
"Results from this surveillance would be an early warning signal to trigger a change in our response strategy," the CDC's Dr. Nancy Messonnier announced to the press in a briefing on Feb. 14. "This is just the starting point, and we plan to expand to more sites in the coming weeks until we have national surveillance."
A month later, on March 11, top health officials assured Congress that surveillance testing was underway.
"The CDC has already started that in six sentinel cities and will expand that in many more cities," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the House Oversight and Reform Committee. "We need to know how many people — to the best of our ability — are infected, as we say, 'under the radar screen.' "
Here's the thing: Some of those sentinel cities were still having trouble getting their testing programs off the ground.
Chicago goes first
Chicago was the first in the CDC project to look for the coronavirus in its flu patients, beginning testing on March 2 in five hospitals, along with several other counties in Illinois.
It had an advantage. The Illinois state public health lab was the first in the U.S. to be able to process the CDC's test kits, beginning in mid-February — somehow avoiding the faulty test kits that went to other states.
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"Being able to do the testing locally definitely made it more feasible and realistic that we would be able to do sentinel surveillance," says Dr. Jennifer Layden, chief medical officer for the Chicago Department of Public Health.
In the first week of testing, 95 emergency room patients all tested negative for the coronavirus. But by the second week, 5% of patients were found to be positive.
"We were surprised by the number of positives," says Layden. "Identifying community transmission let us know that was occurring and changed our protocols about who we should consider testing for COVID-19."
But in the middle of the two-week project, sampling a broader number of mild cases for surveillance became challenging, state officials say, as the chemicals used in running tests began to run low.
"We do want to expand our sentinel surveillance in order to look for the community spread," said Dr. Ngozi Ezike, director of the Illinois Department of Public Health, in a press briefing on March 8. "And so that means you would need more reagents."
Ultimately, the city and state waited to act on the surveillance testing findings for a full week; a statewide shelter-in-place order took effect on March 21. The city quickly became a hot spot for viral spread, seeing an early surge in coronavirus cases that is only just starting to flatten.
Success in Los Angeles after a false start
With a high volume of travelers flying in from China every day, health officials in Los Angeles suspected by late January that a wave of coronavirus cases was headed their way. The city's first documented case showed up Jan. 26 — a traveler from Wuhan, China — and officials feared cases of infection might be falling through the cracks.
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"We were interested in trying to identify people who might have been missed by the CDC testing criteria at that time," says Dr. Prabhu Gounder, medical director of the Respiratory Disease Unit at the Los Angeles County Department of Public Health.
Los Angeles County health officials identified five hospitals for the surveillance project that served large Chinese immigrant populations in the area. After discussions, they began drafting a study protocol with one of those hospitals.
Gounder says the hospital's medical staff was supportive, but the hospital's board was not — remember, only one coronavirus case had been confirmed in the county at that point.
"They had a very different perspective," Gounder says of the hospital's board. "They were concerned that if the second case in LA County was linked to this hospital, that there would be a certain stigma that would potentially be bad for the hospital in terms of the anxiety among health care workers about exposure and also the potential for the patients to be anxious and concerned that they may be exposed to COVID by coming to this hospital."
Los Angeles health officials declined to identify the specific hospital because they had agreed to keep discussions confidential. NPR contacted several hospitals and confirmed that discussions with the Los Angeles County Department of Public Health had taken place, but could not verify which hospital's board had those concerns.
Gounder says efforts to find the coronavirus in the general community stalled for several weeks in the region, until another hospital called — Los Angeles County + USC Medical Center, in Los Angeles.
"This is a leading-edge indicator," says Dr. Brad Spellberg, chief medical officer at Los Angeles County + USC Medical Center. "If you don't look at it, you're missing the canary in the coal mine. You're waiting for the coal mine to collapse on you."
Spellberg's hospital had been preparing its own surge plan to be ready for a big, sudden influx of COVID-19 patients. But not being able to test mild cases for the illness was like "flying blind," he says. So his hospital partnered with the county to do surveillance testing of patients with mild respiratory symptoms in the hospital and its affiliated urgent care center — though Spellberg says there was contention within his institution about testing mild cases.
"There was huge resistance," Spellberg says. The hospital had just secured a small number of tests from a private laboratory — Quest Diagnostics — and had intended them for the sickest patients, which was in accordance with the CDC's general guidelines at the time. "The whole system was, like, 'You're wasting our tests. Don't do this.' "
Enlarge this image toggle caption Damian Dovarganes/AP Damian Dovarganes/AP
Nonetheless, testing at the county medical center's hospital and associated clinics began March 12, and results started coming back a few days later. Over four days, the researchers learned something that alarmed them: As many as 5% of patients they tested had the coronavirus.
"It's spreading in the community silently, and we didn't even know about it," says Spellberg. "These were people that had been going to work, going to social events, wandering around the community for days and days."
"We were all a little bit surprised and alarmed," says Gounder. "It was the first real firm data point that we had that confirmed our suspicions."
The finding marked a key turning point in LA County's coronavirus response. Until then, health officers had been trying to contain the virus, using contact tracing to meticulously track down every person who may have been exposed. But when a virus is spreading undetected, that sort of containment strategy alone is insufficient, epidemiologists say.
Three days after the Los Angeles surveillance study wrapped up, Los Angeles Mayor Eric Garcetti added a new strategy, ordering residents to stay at home, with certain exceptions. So far, the county's hospitals have not been overwhelmed by COVID-19 patients.
"It is possible that the 'Safer at Home' order went into place just in the nick of time to stave off a New York situation," says Spellberg.
Seattle and CDC clash over early testing
As health officials in King County, Wash., began discussions with the CDC in early February, state health officials had a suggestion: The Seattle Flu Study, a research project that was already gathering samples from patients with respiratory symptoms, could be tapped to check for the coronavirus.
"That was a surveillance system that was up and running," says Dr. Scott Lindquist, Washington state epidemiologist for communicable diseases. "My point was, why don't we use those samples? It was up and running — let's do it."
But as a research project, the Seattle Flu Study's coronavirus test — developed by the study's researchers — wasn't yet authorized by the Food and Drug Administration, and the lab the study used wasn't certified to do clinical work for patients. (The FDA didn't authorize labs outside the CDC to handle coronavirus testing until the end of February.)
"CDC and FDA would not approve us using those samples," says Lindquist. "I kept asking, 'Can't we just [get] an exception?' "
Sensing a growing urgency, researchers conducting the flu study tested samples for the coronavirus anyway and discovered on Feb. 28 a Snohomish County teenager with a presumptive COVID-19 diagnosis who had not traveled to a country with a known coronavirus outbreak and who had had no contact with a patient who was positive for the virus.
Meanwhile, King County, Wash., health officials continued working to find other clinics to partner with for sentinel surveillance testing, as the CDC suggested — clinics that would collect samples to be sent to the CDC labs in Atlanta for processing. But the county had a number of logistical issues to sort out, such as finding the right populations to test, setting up a system to inform patients and arranging collection methods and transportation for samples to a site where they could be evaluated. That approach never came to fruition.
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Eventually, researchers running the Seattle Flu Study got the necessary approvals to begin surveillance testing, so the county chose to partner with them. The surveillance study officially began on March 23.
Lindquist says sentinel testing earlier than that would have been very helpful in the weeks immediately after the state's first confirmed case, on Jan. 21. Researchers have since found that the virus was likely spreading for weeks, undetected, during that time period.
"It could have let us know that it was here before we had the community outbreaks and transmission in the long-term-care facilities," Lindquist says. "But we missed that period."
Surveillance elsewhere: missteps and successes
The pattern of slow starts or delays that plagued Chicago, Los Angeles and Seattle also plagued the other three cities in the CDC's surveillance project.
By the time New York City began its surveillance testing, it was far too late to provide an early warning. NPR was unable to get details of New York's experience with the project, but city health officials did confirm that in March, New York collected its first samples for this project — from more than 500 patients.
On March 23, the day New York sent those first samples to the CDC for testing, the city already had more than 12,000 coronavirus cases. By the time it got preliminary test results back on March 31, showing 6.6% of patients were positive, the city's outbreak was out of control — with more than 900 deaths, and climbing.
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Hawaii got a relatively early start with surveillance, in relation to its first recorded case, and results so far suggest that this may have paid off. The state started testing for community spread with the CDC project in mid-March. That was not long after Hawaii's first case of COVID-19 was confirmed on March 6 in a passenger returning from the Grand Princess cruise ship.
In the first week of that testing, the state found no cases of community spread (according to data ultimately released March 27), and it found one case the next week. Hawaii issued its stay-at-home order to begin March 25. Since then, Hawaii has tested more than 1,000 samples through its flu-surveillance network. As of April 17, 2.1% of those cases have come back positive for the coronavirus.
San Francisco, after having early discussions with the CDC, did not begin sentinel surveillance testing. A spokesperson for the San Francisco Department of Public Health told NPR that it was not the city's decision, but ultimately the project "did not materialize." The city provided no further detail.
Silicon Valley starts its own surveillance
Outside the CDC's six original cities, some other communities were eager to establish their own surveillance testing. But they, too, ran into trouble.
For example, about 30 miles south of San Francisco, in the heart of Silicon Valley, Santa Clara County saw its first travel-related case of the coronavirus on Jan. 31.
The county wasn't on the CDC's original list of six test sites, because it isn't part of the agency's flu-surveillance network. Santa Clara County health officials had discussed starting sentinel surveillance testing on their own, but — as was a problem in Seattle and New York — the county health lab initially couldn't run CDC test kits.
In late February, the county found its first instance of community spread.
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"We needed to know pretty urgently how much [community spread] was happening," says Dr. George Han, deputy health officer with the Santa Clara County Public Health Department.
On March 5, with help from a CDC field response team, Santa Clara County tested a sample of patients with mild symptoms at four urgent care centers and found that 11% were positive for the coronavirus. Two days after that testing wrapped up, Santa Clara and five other Bay Area counties issued shelter-at-home orders to residents.
"This data [from the sentinel testing] helped inform that decision because it was one of the few relatively unbiased sources of data that we could rely on," Han says. "That was, I think, a key point that we needed to have in order to issue the orders."
The action has been widely credited with, so far, preventing an overwhelming surge in COVID-19 cases in the region.
Santa Clara health officials say that if the CDC test kits had been functioning earlier in February, they would have started sentinel surveillance even sooner — and potentially have prevented even more deaths. The county recently learned that a resident died of COVID-19 on Feb. 6, earlier than the first deaths previously known and reported. That discovery suggests the virus already was circulating in Santa Clara County in late January.
What was gained and lost in a crucial few weeks
As coronavirus outbreaks have ballooned across the U.S., epidemiologists say the communities that ordered social distancing and sheltering at home earlier than others may have substantially limited the number of infections and deaths.
"A week or two can make a big difference," says Dr. Arthur Reingold, an epidemiologist at the University of California, Berkeley's School of Public Health. "The earlier you do it, the better."
The CDC says the long period of time it took to begin sentinel surveillance — up to six weeks in some cities — can be attributed to the logistical challenges of dealing with a new and deadly virus.
"The rollout at these clinics — both identifying clinics that were interested and ready and willing to do this and also just getting them ready in terms of the sample shipping and collection — even though it was similar to influenza, it was different enough that it took a little more time," says the CDC's Bresee.
Plus, Bresee says it was important that safety protocols were in place before the projects began — health care workers testing patients for the coronavirus needed to receive and wear additional personal protective equipment, for example.
At the time, Bresee says, the CDC was also monitoring other data — such as the number of hospitalizations of people with flu-like symptoms — that suggested that cases of coronavirus infections were still limited in February.
"It's a good question about whether this three- or four-week delay, or longer, resulted in losing visibility in what was happening," says Bresee. "But I don't think so."
While it's hard to know for sure whether earlier surveillance testing would have changed outcomes for tens of thousands of people in hospitals and millions sitting at home, leading epidemiologists say those early weeks of the outbreak were crucial.
"Three weeks is an enormous amount of time to allow cases to accumulate without knowing about it," says Nuzzo, of the Bloomberg School of Public Health. "If we had had sentinel surveillance [activated] in a number of cities — cities where we expect to see cases first — we possibly could have caught it earlier and possibly intervened before the case numbers exploded."
Next steps for communities and the U.S.
As many cities look forward to a time when cases of the coronavirus wane, they're already beginning to plan new surveillance efforts to get ahead of the next wave of new infections.
"We absolutely want to restart sentinel surveillance and are preparing to do that," says Layden, the chief medical officer of Chicago. "We want to have a good sense of the level and amount of spread that's occurring in our community."
Some cities are planning on setting up surveillance projects that test a sample of patients with flu-like symptoms, while others plan to use antibody tests, which check for prior infection instead of active cases, to get a better estimate of how broadly the outbreak has already spread.
The U.S. government has also identified sentinel testing in its road map for reopening the country. In this case, the project would look beyond mild cases; it would test people who seem healthy. The goal is to get a sense of how many people who don't show symptoms are actually infected and able to spread the virus.
"We'll be doing sentinel surveillance throughout nursing homes, throughout inner-city federal clinics, throughout Indigenous populations — to really be able to find an early alert of asymptomatic individuals in the community," Dr. Deborah Birx, of the White House's coronavirus task force, said at a press briefing last week, as the Trump administration laid out its plan.
Some epidemiologists say this sort of national effort could be a chance to get sentinel surveillance right — providing the critical information that health officials will need to avoid a second, bigger surge of severe illness and death.
"Going forward, we need a national testing strategy, period," says Nuzzo. "Not just testing people for clinical purposes, but testing strategically so we can understand how much illness is in the community and how it's spreading."
An effort like that would require widespread availability of coronavirus tests. While the Trump administration claims that adequate testing capacity already exists, many regions of the country still report shortages of test supplies, signaling that the country isn't yet prepared to gather the crucial surveillance data it will need.


npr--2020-04-23--First Responders Want Prior Warning About Who Has Coronavirus

First Responders Want Prior Warning About Who Has Coronavirus COVID-19 , like every epidemic before it , is testing the limits of medical privacy rights .
And right now it 's first responders — police and paramedics — who say they have a right to know who has the virus .
The question has popped up around the country .
Just this week , Chicago 's WBEZ reported that the Cook County Board of Commissioners is discussing whether the public health department should give police and fire departments the addresses of people who have COVID-19 .
First responders are at @ @ @ @ @ @ @ and many say it would help them if they knew ahead of time when they 're about to respond to a call from someone with the disease .
They are not asking to have the master list of addresses of people with the virus , but they say they 'd like dispatchers to warn them when a call is on that list .
But many public health experts doubt the usefulness of that information .
Former CDC director Tom Frieden says it might even be counter-productive .
`` There could be a misguided @ @ @ @ @ @ @ he says .
`` You would n't want a policeman or fireman to think , 'Well , since that address is n't on the list , it 's safe . '
With COVID spreading , we have to assume it could be anywhere . ''
Ideally , first responders should handle every call with proper precautions .
But some police and fire agencies say it 's not realistic to expect them to wear complete protective gear during every interaction with the public .
`` Especially for more rural departments , they 're rationing @ @ @ @ @ @ @ , chief of police in Bloomington , Minn. and president of the Minnesota Chiefs of Police Association .
`` They have to pick and choose when to use it , especially when they only have three [ surgical ] gowns in a department .
A little bit more information would be helpful . ''
In Minnesota , pressure from emergency services chiefs led the governor to order the state 's Department of Health to share the addresses of people who 'd tested positive .
The order was issued two weeks ago , but @ @ @ @ @ @ @ them yet .
`` They 're still testing it , '' says Chief Potts , referring to a new process for sending addresses of COVID-19-positive people to first responders through computer-aided dispatch systems .
In parts of the state where dispatch calls go out over an open radio system , the governor 's order requires the addresses to be shared through more private means , such as a direct phone call to police officers or EMT 's .
The extra steps are necessary because medical data privacy laws are especially strict in Minnesota @ @ @ @ @ @ @ laws that determine whether first responders can get these addresses .
`` States can impose their own privacy restrictions , '' says Roger Severino , Director of the Office for Civil Rights of the U.S. Dept .
of Health and Human Services .
He says the primary federal law governing medical data privacy , the Health Insurance Portability and Accountability Act , or HIPAA , sets a national standard , but he calls it a `` floor , '' not a `` ceiling . ''
`` Where state laws require certain disclosures , @ @ @ @ @ @ @ he says .
And HIPAA itself allows for the disclosure of medical information under certain conditions .
`` The safety of first responders and the people they interact with can be taken into account , '' Severino says , `` in a limited fashion , just for that purpose , to make sure people 's safety is protected . ''
But he cautions that the information should be passed on to first responders as they need it , and not in a broad fashion .
Releasing a complete list of all the addresses @ @ @ @ @ @ @ would be going too far .
In practice , some of this is moot .
Even if first responders do n't get prior warning , they 're still free to ask the people they 're helping about whether they 're infected .
Seattle public health officials do n't provide addresses of people who 've tested positive , but that does n't mean the first responders have to work in the dark .
`` We have worked very hard to educate 9-1-1 dispatch and EMS to screen for potential COVID as a means to @ @ @ @ @ @ @ timely and high-quality care , '' the public health department wrote in an email to NPR .
`` Based on these questions — if a patient is risk-positive for COVID — the EMS team will don full PPE as part of patient care . ''

First Responders Want Prior Warning About Who Has Coronavirus
COVID-19, like every epidemic before it, is testing the limits of medical privacy rights. And right now it's first responders — police and paramedics — who say they have a right to know who has the virus.
The question has popped up around the country. Just this week, Chicago's WBEZ reported that the Cook County Board of Commissioners is discussing whether the public health department should give police and fire departments the addresses of people who have COVID-19.
First responders are at great risk of contracting the coronavirus, and many say it would help them if they knew ahead of time when they're about to respond to a call from someone with the disease. They are not asking to have the master list of addresses of people with the virus, but they say they'd like dispatchers to warn them when a call is on that list.
But many public health experts doubt the usefulness of that information. Former CDC director Tom Frieden says it might even be counter-productive.
"There could be a misguided sense of security from that," he says. "You wouldn't want a policeman or fireman to think, 'Well, since that address isn't on the list, it's safe.' With COVID spreading, we have to assume it could be anywhere."
Ideally, first responders should handle every call with proper precautions. But some police and fire agencies say it's not realistic to expect them to wear complete protective gear during every interaction with the public.
"Especially for more rural departments, they're rationing PPE's," says Jeff Potts, chief of police in Bloomington, Minn. and president of the Minnesota Chiefs of Police Association. "They have to pick and choose when to use it, especially when they only have three [surgical] gowns in a department. A little bit more information would be helpful."
In Minnesota, pressure from emergency services chiefs led the governor to order the state's Department of Health to share the addresses of people who'd tested positive. The order was issued two weeks ago, but police say that information isn't reaching them yet.
"They're still testing it," says Chief Potts, referring to a new process for sending addresses of COVID-19-positive people to first responders through computer-aided dispatch systems.
In parts of the state where dispatch calls go out over an open radio system, the governor's order requires the addresses to be shared through more private means, such as a direct phone call to police officers or EMT's.
The extra steps are necessary because medical data privacy laws are especially strict in Minnesota. Generally speaking, it's state laws that determine whether first responders can get these addresses.
"States can impose their own privacy restrictions," says Roger Severino, Director of the Office for Civil Rights of the U.S. Dept. of Health and Human Services. He says the primary federal law governing medical data privacy, the Health Insurance Portability and Accountability Act, or HIPAA, sets a national standard, but he calls it a "floor," not a "ceiling."
"Where state laws require certain disclosures, HIPAA moves to the side," he says. And HIPAA itself allows for the disclosure of medical information under certain conditions.
"The safety of first responders and the people they interact with can be taken into account," Severino says, "in a limited fashion, just for that purpose, to make sure people's safety is protected."
But he cautions that the information should be passed on to first responders as they need it, and not in a broad fashion. Releasing a complete list of all the addresses of COVID-19 patients, for instance, would be going too far.
In practice, some of this is moot. Even if first responders don't get prior warning, they're still free to ask the people they're helping about whether they're infected. Seattle public health officials don't provide addresses of people who've tested positive, but that doesn't mean the first responders have to work in the dark.
"We have worked very hard to educate 9-1-1 dispatch and EMS to screen for potential COVID as a means to assure provider safety while continuing to provide timely and high-quality care," the public health department wrote in an email to NPR. "Based on these questions — if a patient is risk-positive for COVID — the EMS team will don full PPE as part of patient care."


npr--2020-04-23--U.S. Hospitals Hit By Financial 'Triple Whammy' During Coronavirus Pandemic

U.S .
Hospitals Hit By Financial 'Triple Whammy ' During Coronavirus Pandemic The coronavirus outbreak has thrown hospital systems throughout the U.S. into crisis — both medical and financial .
The cost of treating coronavirus patients , combined with the loss of revenue from canceling elective procedures , has left many hospitals in desperate financial straits .
Some estimates suggest hospitals are losing $ 50 billion a month , says Rick Pollack , president and CEO of the American Hospital Association .
Earlier this month , as part of the coronavirus relief package known as the CARES Act , the @ @ @ @ @ @ @ in aid to hospitals across the country .
On Friday , another $ 20 billion is expected to be released .
While that may sound like a large sum , Pollack told NPR on Thursday that hospitals have `` a tremendous need . ''
`` I think it 's fair to say that hospitals are facing perhaps the greatest challenge that they have ever faced in their history , '' said Pollack , whose organization represents the interests of nearly 5,000 hospitals .
Here are excerpts from the interview .
Can you paint @ @ @ @ @ @ @ for hospitals right now ?
We 're being faced with what I would call a triple whammy .
We have the increased expenses that have been incurred in terms of preparing for the surge and caring for the COVID patients .
And then we have the decreased revenues associated with having shut down regular operations in terms of scheduled procedures .
You combine that with the increased number of uninsured as a result of the economic situation , and you 've got a triple whammy there .
Some of the federal bailout money @ @ @ @ @ @ @ them for treating uninsured patients .
Are you getting enough money for that ?
The CARES legislation was really designed to provide emergency relief for uninsured and insured people .
We do n't take a backseat to anyone in advocating for coverage of the uninsured .
But there are other mechanisms to cover those that do n't have insurance .
We think that these funds from the CARES Act really should be focused on maintaining the viability of hospital operations .
Listen to the full interview at the audio link above .

U.S. Hospitals Hit By Financial 'Triple Whammy' During Coronavirus Pandemic
Enlarge this image toggle caption David Sacks / Getty Images David Sacks / Getty Images
The coronavirus outbreak has thrown hospital systems throughout the U.S. into crisis — both medical and financial. The cost of treating coronavirus patients, combined with the loss of revenue from canceling elective procedures, has left many hospitals in desperate financial straits.
Some estimates suggest hospitals are losing $50 billion a month, says Rick Pollack, president and CEO of the American Hospital Association.
Earlier this month, as part of the coronavirus relief package known as the CARES Act, the federal government began disbursing $30 billion in aid to hospitals across the country. On Friday, another $20 billion is expected to be released.
While that may sound like a large sum, Pollack told NPR on Thursday that hospitals have "a tremendous need."
"I think it's fair to say that hospitals are facing perhaps the greatest challenge that they have ever faced in their history," said Pollack, whose organization represents the interests of nearly 5,000 hospitals.
Here are excerpts from the interview.
Can you paint us a picture of the financial situation for hospitals right now?
We're being faced with what I would call a triple whammy. We have the increased expenses that have been incurred in terms of preparing for the surge and caring for the COVID patients. And then we have the decreased revenues associated with having shut down regular operations in terms of scheduled procedures. You combine that with the increased number of uninsured as a result of the economic situation, and you've got a triple whammy there.
Some of the federal bailout money will also go to hospitals to reimburse them for treating uninsured patients. Are you getting enough money for that?
The CARES legislation was really designed to provide emergency relief for uninsured and insured people. We don't take a backseat to anyone in advocating for coverage of the uninsured. But there are other mechanisms to cover those that don't have insurance. We think that these funds from the CARES Act really should be focused on maintaining the viability of hospital operations.
Listen to the full interview at the audio link above.


npr--2020-04-24--Amazon To Change Time-Off Policy During Pandemic, Extend Pay Bump

Amazon warehouse employees had been able to take unlimited unpaid time off during the coronavirus pandemic .
But starting May 1 , Amazon will instead ask workers who want to stay home to use their regular accrued time off or request a leave of absence .
Amazon was one of the few companies to extend unlimited , though unpaid , time off to its workers who are declared essential during the health crisis .
But the retailer announced changes to that policy on Friday , raising alarm among some workers who worry about having less flexibility .
Amazon on Friday @ @ @ @ @ @ @ 16 its pay bump of $ 2 an hour and double overtime , which had previously applied through April .
The company offers up to two weeks of paid leave to staff who have been diagnosed with COVID-19 or are `` presumptively positive . ''
Warehouse workers , some of whom have been staging strikes at several facilities around the country , say they worry the loss of the unlimited unpaid time off would force them to choose between safeguarding their own and their family 's health and potentially losing their jobs .
@ @ @ @ @ @ @ of absence policy will `` cover COVID-19 circumstances , such as high-risk individuals or school closures . ''
In an email to NPR , a company spokeswoman said the policy would apply to workers whose family members are at high risk .
`` We continue to see heavy demand during this difficult time and the team is doing incredible work for our customers and the community , '' Amazon said in its blog post on Friday .
Earlier this month , the company announced it would keep hiring more warehouse and delivery workers @ @ @ @ @ @ @ , to keep up with skyrocketing demand as the nation turns to online shopping during the coronavirus quarantines .
Meanwhile , some Amazon employees have been staging protests , demanding more paid leave options , calling for the closure of warehouses with a growing number of confirmed coronavirus cases , and criticizing the company for its recent firing of several activist workers .
The company says those workers broke rules , that the protests have been small and that accusations of lax safety measures are `` unfounded . ''
`` I 've already @ @ @ @ @ @ @ for weeks about approving a paid leave of absence , '' warehouse worker Billie Jo Ramey from Michigan said in a statement on Friday , through Amazon-worker advocacy coalition Athena .
`` My doctor gave me a note to quarantine because I 'm high risk and I have an autoimmune disease .
Amazon is forcing me to choose between my life and my job . ''
Editor 's note : Amazon is among NPR 's financial supporters .

Amazon To Change Time-Off Policy During Pandemic, Extend Pay Bump
Enlarge this image toggle caption Angela Weiss/AFP/Getty Images Angela Weiss/AFP/Getty Images
Amazon warehouse employees had been able to take unlimited unpaid time off during the coronavirus pandemic. But starting May 1, Amazon will instead ask workers who want to stay home to use their regular accrued time off or request a leave of absence.
Amazon was one of the few companies to extend unlimited, though unpaid, time off to its workers who are declared essential during the health crisis. But the retailer announced changes to that policy on Friday, raising alarm among some workers who worry about having less flexibility.
Amazon on Friday also said it would extend through May 16 its pay bump of $2 an hour and double overtime, which had previously applied through April. The company offers up to two weeks of paid leave to staff who have been diagnosed with COVID-19 or are " presumptively positive."
Warehouse workers, some of whom have been staging strikes at several facilities around the country, say they worry the loss of the unlimited unpaid time off would force them to choose between safeguarding their own and their family's health and potentially losing their jobs.
Amazon on Friday said its unpaid leave of absence policy will "cover COVID-19 circumstances, such as high-risk individuals or school closures." In an email to NPR, a company spokeswoman said the policy would apply to workers whose family members are at high risk.
"We continue to see heavy demand during this difficult time and the team is doing incredible work for our customers and the community," Amazon said in its blog post on Friday.
Earlier this month, the company announced it would keep hiring more warehouse and delivery workers, filling up to 175,000 new jobs, to keep up with skyrocketing demand as the nation turns to online shopping during the coronavirus quarantines.
Meanwhile, some Amazon employees have been staging protests, demanding more paid leave options, calling for the closure of warehouses with a growing number of confirmed coronavirus cases, and criticizing the company for its recent firing of several activist workers.
The company says those workers broke rules, that the protests have been small and that accusations of lax safety measures are "unfounded."
"I've already been going back and forth with Amazon for weeks about approving a paid leave of absence," warehouse worker Billie Jo Ramey from Michigan said in a statement on Friday, through Amazon-worker advocacy coalition Athena. "My doctor gave me a note to quarantine because I'm high risk and I have an autoimmune disease. Amazon is forcing me to choose between my life and my job."
Editor's note: Amazon is among NPR's financial supporters.


npr--2020-04-24--Notre Dame Basketball Coach Muffet McGraw Wants To See More Women Coaching

Notre Dame Basketball Coach Muffet McGraw Wants To See More Women Coaching For 33 years , Muffet McGraw coached the women 's basketball team at Notre Dame , winning two national championships and leading the Fighting Irish to 848 victories .
Last year , she made waves by vowing not to hire male coaches for her staff .
`` We do n't have enough female role models .
We do n't have enough visible women leaders .
We do n't have enough women in power , '' she told reporters in April 2019 .
`` All these millions of girls @ @ @ @ @ @ @ they could come out every day , and we 're teaching them great things about life skills , but would n't it be great if we could teach them to watch how women lead ? ''
McGraw was inducted into the Naismith Memorial Basketball Hall of Fame in 2017 .
She talked with All Things Considered about her decision , being an example for women and what her plans are for retirement .
On why she decided to retire now I think that 's the thing about retiring , everybody wants to know @ @ @ @ @ @ @ how did you know ?
And a few people told me that , you know what , sometimes you wake up one day and you go , `` I 'm done . ''
And it was n't quite that quick .
But I 've been on a one-year plan with myself .
Every season , I look at : We won the championship .
`` Are you going to come back next year ? ''
`` Yeah , I think I have one more year . ''
And then we get to the @ @ @ @ @ @ @ think I have one more year . ''
And then this year , I kind of looked back and thought , you know , I think I have the program where I want it to be and I 'm ready for somebody else to take over .
I 'm ready to do something new .
I really wanted a new challenge .
I 've gotten a little more active in the community and talking about women ... and I 'm really enjoying that role .
And I 'd like to spend more time @ @ @ @ @ @ @ pandemic — with sports on hold — influenced her timing It did in a way .
I think I was decided .
I had made my decision after the season .
You do n't want to make a decision right after the season .
So I was definitely leaning towards retiring .
And then what happened during the pandemic was I had a great opportunity to pretend I was retired for a month with no one knowing it and deciding if I was going to be able to live with it or not @ @ @ @ @ @ @ my decision .
...
Although I will be able to at least leave the house when I 'm retired , which I 'm not doing much of right now .
On changes in women 's basketball over more than three decades coaching I think our game has come a long way .
I think the level that we 're playing at is a very high level of basketball .
The fan attendance has grown .
Unfortunately , the media attention has not .
We still get about 4 % of media attention .
@ @ @ @ @ @ @ early '70s and said men 's and women 's sports should be equal , we had about 90 % of our coaches were female .
And now ... we 're looking at 60 % of our coaches are men .
And of course , all of the coaches in men 's basketball are also men .
So , I would like to see more women in coaching , certainly in head coaching positions , but also as assistant coaches .
I 'd like to see that diversity , because I think this is @ @ @ @ @ @ @ , `` I have a chance to be a head coach . ''
And so you want them to see women on TV .
And unfortunately , you know , we 're on TV , but we do n't get the same attention as the men 's conference tournaments and the NCAA men do .
On the advice she 's given to her successor , Niele Ivey , a former Notre Dame player and assistant coach I think the biggest thing is to be yourself , I think believe in yourself .
Because @ @ @ @ @ @ @ things .
We question ourselves a little bit more than men do .
We do n't exude that confidence that men seem to just have .
We 're team players , we 're very loyal , we 're always asking for input , we 're good listeners .
And sometimes it 's hard for women to stand up and take charge .
And so I 've really helped her to just use her voice , [ to say , ] `` this is the direction I want to go in . ''
To @ @ @ @ @ @ @ people are going to criticize you no matter what you do , so you really are better off doing what you think is best .
And of course , you 're going to get input from your staff and from different people and you 're going to continue to be mentored and to grow and to listen to other people .
But I think , `` your vision , your plan , '' that 's the one that I want her to follow .

Notre Dame Basketball Coach Muffet McGraw Wants To See More Women Coaching
Enlarge this image toggle caption Robert Franklin/AP Robert Franklin/AP
For 33 years, Muffet McGraw coached the women's basketball team at Notre Dame, winning two national championships and leading the Fighting Irish to 848 victories.
She retired this week.
Last year, she made waves by vowing not to hire male coaches for her staff.
"We don't have enough female role models. We don't have enough visible women leaders. We don't have enough women in power," she told reporters in April 2019.
"All these millions of girls that play sports across the country, they could come out every day, and we're teaching them great things about life skills, but wouldn't it be great if we could teach them to watch how women lead?"
McGraw was inducted into the Naismith Memorial Basketball Hall of Fame in 2017.
She talked with All Things Considered about her decision, being an example for women and what her plans are for retirement.
Interview Highlights
On why she decided to retire now
I think that's the thing about retiring, everybody wants to know, what's the magic answer and how did you know? And a few people told me that, you know what, sometimes you wake up one day and you go, "I'm done." And it wasn't quite that quick. But I've been on a one-year plan with myself.
Every season, I look at: We won the championship. "Are you going to come back next year?" "Yeah, I think I have one more year."
And then we get to the championship game. "Yeah, I think I have one more year."
And then this year, I kind of looked back and thought, you know, I think I have the program where I want it to be and I'm ready for somebody else to take over. I'm ready to do something new. I really wanted a new challenge. I've gotten a little more active in the community and talking about women ... and I'm really enjoying that role. And I'd like to spend more time doing it.
On how the coronavirus pandemic — with sports on hold — influenced her timing
It did in a way. I think I was decided. I had made my decision after the season. You don't want to make a decision right after the season. So I was definitely leaning towards retiring. And then what happened during the pandemic was I had a great opportunity to pretend I was retired for a month with no one knowing it and deciding if I was going to be able to live with it or not.
So I would say it reinforced my decision. ... Although I will be able to at least leave the house when I'm retired, which I'm not doing much of right now.
On changes in women's basketball over more than three decades coaching
I think our game has come a long way. I think the level that we're playing at is a very high level of basketball. The fan attendance has grown. Unfortunately, the media attention has not. We still get about 4% of media attention.
When Title IX was passed in the early '70s and said men's and women's sports should be equal, we had about 90% of our coaches were female. And now ... we're looking at 60% of our coaches are men. And of course, all of the coaches in men's basketball are also men.
So, I would like to see more women in coaching, certainly in head coaching positions, but also as assistant coaches. I'd like to see that diversity, because I think this is where kids are looking up and seeing, "I have a chance to be a head coach." And so you want them to see women on TV. And unfortunately, you know, we're on TV, but we don't get the same attention as the men's conference tournaments and the NCAA men do.
On the advice she's given to her successor, Niele Ivey, a former Notre Dame player and assistant coach
I think the biggest thing is to be yourself, I think believe in yourself. Because as women, we tend to overthink things. We question ourselves a little bit more than men do. We don't exude that confidence that men seem to just have. We're team players, we're very loyal, we're always asking for input, we're good listeners. And sometimes it's hard for women to stand up and take charge.
And so I've really helped her to just use her voice, [to say,] "this is the direction I want to go in." To not be afraid and to know that people are going to criticize you no matter what you do, so you really are better off doing what you think is best. And of course, you're going to get input from your staff and from different people and you're going to continue to be mentored and to grow and to listen to other people. But I think, "your vision, your plan," that's the one that I want her to follow.


npr--2020-04-24--Navy Recommends Reinstating Ousted Captain Of USS Roosevelt

In what could amount to a stunning about-face for the Pentagon , congressional sources have confirmed to NPR that top Navy leaders have recommended that Capt .
Brett Crozier be put back in command of the coronavirus-plagued aircraft carrier USS Theodore Roosevelt .
After Crozier 's emotional letter pleading for a more decisive response to his ship 's COVID-19 outbreak leaked to the news media on March 31 , he was removed as the ship 's skipper on April 2 by then-acting Navy Secretary Thomas Modly .
The Navy 's top civilian in turn resigned after denigrating Crozier in widely @ @ @ @ @ @ @ , who had hailed Crozier as a hero when he left the ship .
Adm. Michael Gilday , the Navy 's top officer , is reported by The Associated Press to have met with Joint Chiefs Chairman Gen. Mark Milley on Tuesday and with Defense Secretary Mark Esper on Friday to recommend the fired captain 's reinstatement .
`` This afternoon , Secretary Esper received a verbal update from the acting Secretary of the Navy and the Chief of Naval Operations on the Navy 's preliminary inquiry into the COVID-19 outbreak on the @ @ @ @ @ @ @ Hoffman in a statement emailed from the Pentagon .
`` After the Secretary receives a written copy of the completed inquiry , he intends to thoroughly review the report and will meet again with Navy leadership to discuss next steps .
He remains focused on and committed to restoring the full health of the crew and getting the ship at sea again soon . ''
The AP quotes Hoffman as saying before that meeting that Esper `` is generally inclined to support Navy leadership in their decision '' regarding Crozier .
But Esper @ @ @ @ @ @ @ a delay in any public announcement while he weighs Crozier 's fate .
The Democrat who chairs the House Armed Services Committee reacted sharply on Friday to Esper 's decision to hold back the results of the Navy investigation that concluded with a recommendation to give Crozier his command back .
`` The Secretary of Defense needs to reinstate Captain Brett Crozier as commanding officer of the U.S.S .
Theodore Roosevelt , '' Rep. Adam Smith , D-Wash. , said in a statement emailed to NPR .
`` While Captain Crozier 's actions @ @ @ @ @ @ @ aboard the TR were drastic and imperfect , it is clear he only took such steps to protect his crew . ''
Smith also blasted the former acting navy secretary 's decision to remove Crozier .
`` Modly 's subsequent decision to board the U.S.S .
Roosevelt and deliver a petty , obscenity-laced speech attacking Captain Crozier while the crew of the Roosevelt dealt with the COVID-19 outbreak should seriously call into question Modly 's decision making ability in general , '' Smith wrote , `` and makes it all the more clear @ @ @ @ @ @ @ was completely wrong . ''
The sidelined captain himself tested positive for coronavirus after leaving the Roosevelt and has been kept in isolation in distinguished visitors quarters at a naval base in Guam , where the aircraft carrier is docked , according to The New York Times .
On the day Crozier was relieved of his command , 114 of his crew members had tested positive for the virus .
That number has since risen to 856 , and 4,234 of the ship 's crew have been moved ashore to remain in quarantine @ @ @ @ @ @ @ sailors assigned to the Roosevelt have now been tested for COVID-19 .

Navy Recommends Reinstating Ousted Captain Of USS Roosevelt
Enlarge this image toggle caption Petty Officer 3rd Class Nicholas/U.S. Navy via AP Petty Officer 3rd Class Nicholas/U.S. Navy via AP
In what could amount to a stunning about-face for the Pentagon, congressional sources have confirmed to NPR that top Navy leaders have recommended that Capt. Brett Crozier be put back in command of the coronavirus-plagued aircraft carrier USS Theodore Roosevelt.
After Crozier's emotional letter pleading for a more decisive response to his ship's COVID-19 outbreak leaked to the news media on March 31, he was removed as the ship's skipper on April 2 by then-acting Navy Secretary Thomas Modly.
The Navy's top civilian in turn resigned after denigrating Crozier in widely criticized remarks to sailors aboard the Roosevelt, who had hailed Crozier as a hero when he left the ship.
National Security U.S. Sailor Dies In Guam Of Coronavirus-Related Complications U.S. Sailor Dies In Guam Of Coronavirus-Related Complications Listen · 3:54 3:54
Adm. Michael Gilday, the Navy's top officer, is reported by The Associated Press to have met with Joint Chiefs Chairman Gen. Mark Milley on Tuesday and with Defense Secretary Mark Esper on Friday to recommend the fired captain's reinstatement.
Esper's spokesman confirmed the Friday meeting.
"This afternoon, Secretary Esper received a verbal update from the acting Secretary of the Navy and the Chief of Naval Operations on the Navy's preliminary inquiry into the COVID-19 outbreak on the USS Theodore Roosevelt," writes Jonathan Hoffman in a statement emailed from the Pentagon.
"After the Secretary receives a written copy of the completed inquiry, he intends to thoroughly review the report and will meet again with Navy leadership to discuss next steps. He remains focused on and committed to restoring the full health of the crew and getting the ship at sea again soon."
The AP quotes Hoffman as saying before that meeting that Esper "is generally inclined to support Navy leadership in their decision" regarding Crozier.
But Esper is also reported to have asked for a delay in any public announcement while he weighs Crozier's fate.
The Democrat who chairs the House Armed Services Committee reacted sharply on Friday to Esper's decision to hold back the results of the Navy investigation that concluded with a recommendation to give Crozier his command back.
"The Secretary of Defense needs to reinstate Captain Brett Crozier as commanding officer of the U.S.S. Theodore Roosevelt," Rep. Adam Smith, D-Wash., said in a statement emailed to NPR. "While Captain Crozier's actions at the outset of the health crisis aboard the TR were drastic and imperfect, it is clear he only took such steps to protect his crew."
Smith also blasted the former acting navy secretary's decision to remove Crozier.
"Modly's subsequent decision to board the U.S.S. Roosevelt and deliver a petty, obscenity-laced speech attacking Captain Crozier while the crew of the Roosevelt dealt with the COVID-19 outbreak should seriously call into question Modly's decision making ability in general," Smith wrote, "and makes it all the more clear that his decision to relieve Captain Crozier was completely wrong."
The sidelined captain himself tested positive for coronavirus after leaving the Roosevelt and has been kept in isolation in distinguished visitors quarters at a naval base in Guam, where the aircraft carrier is docked, according to The New York Times.
On the day Crozier was relieved of his command, 114 of his crew members had tested positive for the virus. That number has since risen to 856, and 4,234 of the ship's crew have been moved ashore to remain in quarantine. The Navy reports that all 4,938 sailors assigned to the Roosevelt have now been tested for COVID-19.


npr--2020-04-24--Meet 'Spot:' The Robot That Could Help Doctors Remotely Treat COVID-19 Patients

Meet 'Spot : ' The Robot That Could Help Doctors Remotely Treat COVID-19 Patients Brigham and Women 's Hospital in Boston has been testing a new piece of hardware to help them treat coronavirus cases — a robot called Spot .
Last week , the hospital began using the robot in interviewing patients suspected of having less-serious cases of COVID-19 .
It 's only been deployed a handful of times so far , but according to Peter Chai , an emergency medical physician at Brigham and Women 's , the hope is that using Spot could limit staff exposure to @ @ @ @ @ @ @ , '' said Chai in an interview .
`` Spot does n't need to wear a mask or gown . ''
Spot was developed by robotics firm Boston Dynamics and has been on the market for some time .
The robot 's distinct four-legged design helps it navigate terrain where humans and other robots may have difficulty going , says Michael Perry , vice president for business development .
`` Part of the benefit of legged mobility is going to spaces that wheeled robots and drones can not go , '' Perry told @ @ @ @ @ @ @ specifically for medical purposes , the firm says that once the pandemic hit , hospitals began asking `` if our robots could help minimize their staff 's exposure . ''
`` One of the hospitals that we spoke to shared that , within a week , a sixth of their staff had contracted COVID-19 and that they were looking into using robots to take more of their staff out of range of the novel virus , '' Boston Dynamics said in a statement .
Boston Dynamics than consulted with MIT and Brigham and @ @ @ @ @ @ @ iPad and radio so a medical technician could interface with patients in the triage tent the hospital — and others — use for potential COVID-19 patients .
So far , Spot has been mainly used to interview patients , but Perry adds that the next plan is to have the robot start taking vital signs of new patients , which he says could happen as soon as next week .

Meet 'Spot': The Robot That Could Help Doctors Remotely Treat COVID-19 Patients
Enlarge this image toggle caption Boston Dynamics Boston Dynamics
Brigham and Women's Hospital in Boston has been testing a new piece of hardware to help them treat coronavirus cases — a robot called Spot.
Last week, the hospital began using the robot in interviewing patients suspected of having less-serious cases of COVID-19. It's only been deployed a handful of times so far, but according to Peter Chai, an emergency medical physician at Brigham and Women's, the hope is that using Spot could limit staff exposure to COVID-19.
"It also eliminates PPE," said Chai in an interview. "Spot doesn't need to wear a mask or gown."
Spot was developed by robotics firm Boston Dynamics and has been on the market for some time. The robot's distinct four-legged design helps it navigate terrain where humans and other robots may have difficulty going, says Michael Perry, vice president for business development.
"Part of the benefit of legged mobility is going to spaces that wheeled robots and drones cannot go," Perry told NPR.
Although Spot was not developed specifically for medical purposes, the firm says that once the pandemic hit, hospitals began asking "if our robots could help minimize their staff's exposure."
"One of the hospitals that we spoke to shared that, within a week, a sixth of their staff had contracted COVID-19 and that they were looking into using robots to take more of their staff out of range of the novel virus," Boston Dynamics said in a statement.
Boston Dynamics then consulted with MIT and Brigham and Women's, outfitting Spot with an iPad and radio so a medical technician could interface with patients in the triage tent the hospital — and others — use for potential COVID-19 patients.
So far, Spot has been mainly used to interview patients, but Perry adds that the next plan is to have the robot start taking vital signs of new patients, which he says could happen as soon as next week.