[Ohio-Talk] FW: Daily Clips 4-16-20

[Smith, JW]

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Dr. jw Smith
School of Communication Studies
Scripps College of Communication
Ohio University
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20 E. Union St,
Athens, OH 45701
smithj at ohio.edu<mailto:smithj at ohio.edu>
T: 740-593-4838

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From: shirley.marchi at ood.ohio.gov <shirley.marchi at ood.ohio.gov>
Sent: Thursday, April 16, 2020 11:26 AM
To: Carolyn Peters <dr.carolyn.peters at gmail.com>; Matt Sauer <matthew.sauer at uc.edu>; David.Baker at education.ohio.gov; shauna.dowdy at ood.ohio.gov; jegerhardt9 at gmail.com; margie.hegg at gmail.com; Lisa Hickman <lisah at ocecd.org>; carlo at loparopr.com; Alison McKay <amckay at disabilityrightsohio.org>; kevin.miller at ood.ohio.gov; johnmoore at dsc.org; Peter Moore <PMoore at opra.org>; Jeremy Morris <jmorris at ohiosilc.org>; Smith, JW <smithj at ohio.edu>; Karis Spence <Karis.Spence at huntington.com>
Cc: Kim.Jump at ood.ohio.gov
Subject: Daily Clips 4-16-20

Hello Council Members,

Please see below Daily Clips.
Thank you.

Shirley Marchi



Daily Clips, 4-16-20:


  *   Office of the Governor: Release: 4-16-20, 4:08 p.m.: COVID Update: Deferred Elective Procedures, CARES Act Payments, 1099 Unemployment Claims, First Responder PPE, Testing Partnership, Prison Update, Census 2020



  *   Bullet Point News from 4-15-20



  *   Statehouse News Bureau: 700 Ohio COVID-19 Cases are Nursing home residents; Deaths Include Residents and Staff



  *   The Blade: 107 positive coronavirus cases identified at 30 long-term care facilities in Lucas County


  *   Cleveland.com Cloth masks in public might be here to stay. Here's what you need to know.



  *   NPR: People with Disabilities Fear Pandemic Will Worsen Medical Biases


  *   USA Today 'We are dead': People with Disabilities fear they will be on losing end of doctors' life - or- death choices amid coronavirus crisis



  *   CNBC: Receiving SSI benefits? You will get your coronavirus stimulus payment automatically, government says



  *   WKBN 27: Local Developmental Disabilities Board Seeks Help from Soup Kitchen to Feed Clients


Office of the Governor: Release: 4-16-20, 4:08 p.m.: COVID Update: Deferred Elective Procedures, CARES Act Payments, 1099 Unemployment Claims, First Responder PPE, Testing Partnership, Prison Update, Census 2020

FOR IMMEDIATE RELEASE:
April 15, 2020

MEDIA CONTACTS:
Dan Tierney: 614-644-0957
Breann Almos: 614-799-6480

COVID-19 Update: Deferred Elective Procedures, CARES Act Payments, 1099 Unemployment Claims, First Responder PPE, Testing Partnership, Prison Update, Census 2020

(COLUMBUS, Ohio)-Ohio Governor Mike DeWine, Lt. Governor Jon Husted, and Dr. Amy Acton, MD, MPH, provided the following updates on Ohio's response to the COVID-19 pandemic.

DEFERRED ELECTIVE PROCEDURES:

Governor DeWine announced today that he has asked the Ohio Hospital Association to begin developing a plan to begin treating patients whose non-COVID-19 elective procedures were delayed or deferred due to the ongoing pandemic.

The Ohio Department of Health previously ordered that elective surgeries be postponed to expand hospital capacity for COVID-19 patients and to conserve the personal protective equipment (PPE) that is in short supply.

"We have seen in the last week that Ohio has appeared to flatten the curve, and we feel much better about the capacity of hospitals today. However, there are still serious concerns about the lack of PPE," said Governor DeWine. "As we begin looking at doing procedures that have been delayed, I've asked the Ohio Hospital Association to look at this issue with the shortage of PPE in mind."

Governor DeWine requested that the plan be completed within one week.

CARES ACT/SELF-EMPLOYED WORKERS:

Lt. Governor Husted announced that by the end of next week, the Ohio Department of Job and Family Services (ODJFS) will be able to begin processing the additional $600-a-week payments authorized by the federal CARES Act.

ODJFS also plans to launch an online tool that will allow self-employed, 1099 workers to get in line early, so that as soon as they have the technological ability to process their claims, they will already have their paperwork in and be in line for review. The department expects to be able to begin processing those claims by May 15, 2020.

FIRST RESPONDER PPE:

Ohio Governor Mike DeWine today announced the expansion of Ohio's partnership with Battelle to extend their sterilization services to law enforcement agencies and EMS providers.

The Ohio Department of Public Safety and Battelle have now partnered to sterilize N-95 masks for all of Ohio's first responders. Battelle is providing this service for free.

The Ohio State Highway Patrol developed a statewide collection and distribution system to make this process as simple as possible for local first responders.

Beginning this Friday, local law enforcement agencies and EMS agencies can bring their packaged N-95 masks to any Ohio State Highway Patrol post in the state, and troopers will then bring the masks to Battelle in Columbus where they will be sterilized. The patrol will then bring the masks back to each post where law enforcement and EMS agencies can pick them up.

"This will contribute greatly to our efforts to protect Ohio's protectors," said Governor DeWine. "This process was developed by our Public Safety Strike Force and is a good example of our first responder members identifying a problem and working with their state partners on a solution."

OSU/TOLEDO TESTING PARTNERSHIP:

Health systems worldwide have struggled due to a critical shortage of test kit components, including the swabs used to collect samples and the sterile solution needed to transport the swabs, called viral transport media (VTM).

Governor DeWine announced that a team of Ohio State University researchers created an in-house "recipe" to make the crucial VTM.

In addition, the Ohio State Wexner Medical Center and Ohio State's colleges of Medicine, Engineering, and Dentistry, along with the Center for Design and Manufacturing Excellence, Infectious Diseases Institute, and Institute for Materials Research, collaborated with a national consortium that rapidly deployed a design and testing program for 3D printed testing swabs.

Ohio State is part of the academic-industry-government consortium led by Harvard, the U.S. Army, and the University of South Florida that designed the swabs.  Ohio State teams are working with 3D Manufacturing companies, including FormLabs, Inc. in Toledo, and academic institutes across the State of Ohio to manufacture these swabs and swab kits en-masse for the citizens of Ohio.

"Very soon, the first order of 15,000 3D printed swabs for COVID-19 test kits will be delivered to Ohio State, with a target of 200,000 swabs and swab kits to be shared in partnership with our Ohio Department of Health and hospital systems across Ohio, allowing more people to be tested by the end of April," said Governor DeWine. "We are extremely appreciative of the partnerships between our Ohio academic teams and business partners to create innovative solutions during this time."

The Ohio Department of Health and Ohio State will continue to work on eliminating swab manufacturing and design constraints through a rapid product development cycle, including clinical testing.

PRISON EARLY RELEASE:

Governor DeWine announced today that he is approving the early release of 105 prison inmates in Ohio who had been scheduled to be released in the next 90 days.

Last week, Ohio Department of Rehabilitation and Correction (ODRC) Director Annette Chambers-Smith recommended to the Correctional Institution Inspection Committee (CIIC) that certain inmates be released pursuant to Ohio's overcrowding emergency statute (ORC 2967.18) to allow for increased social distancing between prison staff and inmates. Yesterday, the CIIC agreed with the determination that a limited overcrowding emergency exists in Ohio's prisons and recommended that Governor DeWine move forward with approving the early release of specific inmates.

Strict criteria were used to determine which inmates with an upcoming release date could qualify for early release. Anyone convicted of serious charges such as sex offenses, homicide-related offenses, kidnapping, abduction, ethnic intimidation, making terroristic threats, or domestic violence were excluded. Those who had been denied judicial release in the past had prior incarcerations in Ohio, are inter-state offenders, have warrants or detainers, or have serious prison rule violations in the last five years were also removed from early-release consideration.

Governor DeWine also authorized ODRC to continue to use these criteria to identify other inmates who could qualify for early release under the limited overcrowding statute as more inmates become eligible for release within 90 days.

In addition, Ohio dropped its overall prison population by 311 inmates last week due to efforts of local courts to reduce their jail populations and to hold only critical hearings to allow more room for social and physical distancing.

2020 CENSUS:

Governor DeWine reminded Ohioans to complete the 2020 Census.

The U.S. Constitution mandates a census is held every 10 years to help determine how federal funds will be divided among the states. This funding pays for expenses such as road repairs and food assistance programs; it also determines Ohio's number of representatives in the U.S House of Representatives.

Right now, Ohio's response rate of 52.2% is higher than the national average and higher than all neighboring states, except Michigan, which has a response rate of 55%.

Governor DeWine challenged Ohioans to complete the census and help Ohio surpass the response rate of the state up north.

For more information, visit 2020Census.gov or call 844-330-2020.

CURRENT OHIO DATA:

There are 7,791 confirmed, and probable cases of COVID-19 in Ohio, and 361 confirmed and probable COVID-19 deaths. A total of 2,237 people have been hospitalized, including 677 admissions to intensive care units. In-depth data can be accessed by visiting coronavirus.ohio.gov.

Video of today's full update, including versions with foreign language closed captioning, can be viewed on the Ohio Channel's YouTube page.

For more information on Ohio's response to COVID-19, visit coronavirus.ohio.gov or call 1-833-4-ASK-ODH.

-30-


Bullet Point News from 4-15-20:

*          Ohio's COVID-19 case data is below:
o          7,628 confirmed cases
o          163 probable cases
o          7,791 total cases
o          2,237 hospitalizations
o          346 confirmed deaths
o          15 probable deaths
o          361 total deaths
o          677 ICU admissions
o          More data is available on the COVID-19 Dashboard HERE.

*          Governor DeWine announced an expansion of Ohio's partnership with Battelle and the Ohio Department of Public Safety (DPS) to extend their sanitization services to law enforcement agencies and EMS providers.  Beginning this Friday, local law enforcement and EMS agencies can bring their packaged N-95 masks to any Ohio State Highway Patrol Post in the state. The patrol will then bring those masks to Battelle for sanitization. Battelle is providing this service for free.

*          Pursuant to an overcrowding statute in Ohio law (ORC 2967.18) and agreement from the Correctional Institution Inspection Committee (CIIC), Governor DeWine approved the release of 105 inmates in Ohio. Each inmate will be tested to determine if they have COVID-19 before they are released. The Department of Rehabilitation and Corrections (DRC) has been authorized to continue using the criteria previously set forth to identify other inmates that may qualify for release under the limited overcrowding statute. Additionally, we are sad to announce that there were two more COVID-19 inmate deaths at the Pickaway Correctional Facility.

*          Health systems worldwide have struggled due to a critical shortage of test kit components, including the swabs used to collect samples and the sterile solution needed to transport the swabs, called viral transport media (VTM). Governor DeWine announced that a team of Ohio State University researchers created an in-house "recipe" to make the crucial VTM. The Ohio Department of Health and Ohio State will continue to work on eliminating swab manufacturing and design constraints through a rapid product development cycle, including clinical testing.

*          Governor DeWine asked the Ohio Hospital Association to begin developing a plan to resume treating patients whose non-COVID-19 elective procedures were delayed or deferred due to the ongoing pandemic. Governor DeWine requested that the plan be completed within one week.

*          Lt. Governor Husted announced that by the end of next week, the Ohio Department of Job and Family Services (ODJFS) will be able to begin processing the additional $600-a-week payments authorized by the federal CARES Act. ODJFS also plans to launch an online tool that will allow self-employed, 1099 workers to get in line early, so that as soon as they have the technological ability to process their claims, they will already have their paperwork in and be in line for review. The department expects to be able to begin processing those claims by May 15, 2020.

*          Governor DeWine reminded Ohioans to complete the 2020 Census. Right now, Ohio's response rate of 52.2% is higher than the national average and higher than all neighboring states, except Michigan which has a response rate of 55%. For more information, visit 2020Census.gov or call 844-330-2020.

*          Attached is the Executive Order for nursing home and residential care facilities to notify residents, guardians, and sponsors, of positive or probable cases of COVID-19.

*          Ohioans can apply for unemployment benefits online 24 hours a day, seven days a week, at unemployment.ohio.gov. It is also possible to file by phone at 877-644-6562 or TTY at 888- 642-8203, Monday through Friday 7AM to 7PM, Saturday 9AM to 5PM, and Sunday 9AM to 1PM. Employers with questions should email UCTech at jfs.ohio.gov<mailto:UCTech at jfs.ohio.gov>.

As always, Coronavirus.Ohio.Gov and the Department of Health hotline, 1-833-4-ASK-ODH are great resources for those who have questions.


Statehouse News Bureau: 700 Ohio COVID-19 Cases are Nursing Home Residents; Deaths Include Residents and Staff

4-16-20 Karen Kasler

[https://www.statenews.org/post/700-ohio-covid-19-cases-are-nursing-home-residents-deaths-include-residents-and-staff<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.statenews.org%2Fpost%2F700-ohio-covid-19-cases-are-nursing-home-residents-deaths-include-residents-and-staff&data=02%7C01%7Csmithj%40ohio.edu%7C0c622e7d5ca44f44c0c608d7e21a82f0%7Cf3308007477c4a70888934611817c55a%7C0%7C0%7C637226475838700474&sdata=P7wlHvmYI4SVmnpOwDjtJfMJXiBN54rXa6tLX3tzZb4%3D&reserved=0>]

UPDATE: The state is now listing 836 cases of COVID-19 at 107 nursing homes in 31 counties.

Nine percent of the confirmed cases of COVID-19 in Ohio are in long-term care facilities such as nursing homes and assisted living communities - and some residents and staff are among the dead. The state says it will shed light on more information about that, but some data will stay hidden.

Steele said he's gotten regular calls about testing and was notified when the first case of COVID-19 was found - but the calls have slowed down since.

"They said, 'we're going to pause on letting you know every time we get a positive test because we know that there are going to be more,'" Steele said. "'And we'll share with you what we're doing. And if your loved one is exhibiting symptoms, we will call you right away and let you know', but that we wouldn't be getting regular updates every time they got a positive test."

A nursing home near Seattle was one of the first fatal hotspots of coronavirus early in the pandemic in the US. So those who have family members living in long term care facilities, and those who are working in them have been on high alert for a while.

Pete Van Runkle is with the Ohio Health Care Association, representing more than 2,000 nursing homes, assisted living facilities, and other similar residences.

"Our members want to make sure that everybody is aware and that rumors and innuendo doesn't start flowing around. They need to hear the true situation and what the facility is doing to safeguard everybody else when there has been a positive case," Van Runkle said.

While Van Runkle said most facilities in his organization have been communicating with family members, soon those notifications will be required, because of an order from Gov. Mike DeWine - because DeWine said these cases may not be public records.

"What I made was a policy decision," DeWine said. "It wasn't a legal decision. It was a policy decision that came from my heart, and that is that people have a right to know what's going on in a nursing home."

The state is also requiring nursing homes to notify the Ohio Department of Health of positive coronavirus tests.

Van Runkle said most nursing homes have tried to be transparent about what's happening because they have lost staff members to COVID-19.

"I know that there have been some cases where they have passed away, yes," Van Runkle said.

And he confirmed there have been deaths among residents, too: "Yes - we've had hundreds of deaths in Ohio, and some of those have been folks living in facilities."

Van Runkle said nursing homes want to be a higher priority for testing, saying congregate settings where people tend to have worse outcomes should be top of the list.

Ohio Department of Health Director Dr. Amy Acton said 700 of the more than 7600 confirmed coronavirus cases have been residents at nursing homes and long term care and residential facilities.

But Acton said with such limited testing available, she says they're trying to test judiciously - prioritizing health care workers and the sickest patients.

"We are doing testing in nursing homes, but sometimes based on the history that is being taken there. They might do one or two or three cases, know they have it, and say 'we know we have it.' So it's a very individual nursing home situation."

Steele said he has confidence that the state is concerned about the safety of nursing home residents and staff, and he's pleased with the actions of the facility where his father lives.

"Now, does that mean that I have supreme confidence in our ability to keep them all protected? I'm not sure that I can say that just based on what I see and the availability of resources," Steele said. "We can't just create tests so that we can just test every resident in every one of these facilities, which is what I wish that we could do."

The state's COVID-19 website will now include names of nursing home, assisted living, and long term care facilities where positive coronavirus cases have been found, just as the Ohio Department of Rehabilitation lists the prisons where the virus has been discovered. But the state won't list the total of deaths of residents or staff from nursing homes and long term care facilities.


The Blade: 107 positive coronavirus cases identified at 30 long-term care facilities in Lucas County

4-15-20 Kate Snyder

[https://www.toledoblade.com/local/Coronavirus/2020/04/15/107-positive-coronavirus-cases-identified-at-30-long-term-care-facilities-in-Lucas-County/stories/20200415116<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.toledoblade.com%2Flocal%2FCoronavirus%2F2020%2F04%2F15%2F107-positive-coronavirus-cases-identified-at-30-long-term-care-facilities-in-Lucas-County%2Fstories%2F20200415116&data=02%7C01%7Csmithj%40ohio.edu%7C0c622e7d5ca44f44c0c608d7e21a82f0%7Cf3308007477c4a70888934611817c55a%7C0%7C0%7C637226475838700474&sdata=%2F5rITf1EJjlZIlQQg5B7pFzF%2BU5amn%2BpyvwVeabg%2BYI%3D&reserved=0>]

For the first time, the Toledo-Lucas County Health Department released information revealing that more than 100 cases of the coronavirus have been identified at several care facilities in Lucas County, including a handful of nursing homes.

According to local health officials, 107 positive coronavirus cases have been attributed to 30 facilities. The cases, according to health officials, could be a staff person or a resident.

Thirty-eight positive cases were confirmed as of Wednesday at the Northwest Ohio Developmental Center, according to data from the Ohio Department of Developmental Disabilities. Of those, 32 were confirmed in staff members, and six were confirmed in residents.

Ohio's developmental centers are for adults with developmental disabilities who "are receiving services through their county board, are in crisis, and temporarily cannot be served in the community," according to the department of developmental disabilities.

There are 250 staff members and 71 residents at the developmental center, according to state data. The Ohio agency had one other developmental center with confirmed coronavirus cases thus far - Warrensville Developmental Center, located east of Cleveland, with three cases among the staff.

One resident died suddenly at the Northwest Ohio Developmental Center without showing coronavirus symptoms, according to state data. The result of a post-mortem test conducted on March 31 was positive for the coronavirus, but the official cause of death is still pending.

A representative with the Lucas County Emergency Operations Center did not respond to a request for comment. A representative with the health department said officials would address The Blade's questions about care facilities and the developmental center on Thursday. A representative of the Ohio agency initially said they would try to answer questions and then never returned responses.

During an 11:30 a.m. briefing on Wednesday, local health officials did not specifically discuss the coronavirus situation in care facilities until asked about it.

Health Commissioner Eric Zgodzinski did not provide data at that time but did acknowledge concerns about the virus's spread in nursing homes and care facilities.

"We're seeing a definite, I don't want to say issue, but a definite concern in our nursing homes," he said. "This is a nasty virus, and it spreads quickly in those settings."

Mr. Zgodzinski said the community needs to respond to the issues inside nursing homes, and it would take a team effort to identify what's going on and the best way to help the facilities, which he said are doing the best they can.

"We're seeing this across the nation, unfortunately, in these nursing homes," he said.

Earlier this month, Shannon Lands, spokesman for the health department, told The Blade that coronavirus cases popping up in long-term care facilities is ultimately inevitable.

She also said at that time several cases had surfaced at the developmental center, and the health department had been communicating closely with the facility.

As of Wednesday, local health officials have recorded 608 coronavirus cases in the county - with 29 of those cases still pending confirmation - and 28 deaths, up by three from Tuesday's totals.

The care facilities with cases include:

- Ann Grady

- Lutheran Village of Wolf Creek

- Charter Senior Living of Oak Openings

- National Church Residency

- Concord Care Center

- Northwest Ohio Developmental Center

- Custom Home Group Home

- Orchard Villa

- Darlington Nursing Home

- Precious Places Group Home

- Divine Rehabilitation and Nursing at Sylvania

- Pristine Senior Living

- Foundation Park Alzheimer's Care Center

- Ridgewood Manor

- Friendship New Vision

- Senas Quality Adult Care

- Garden of St. Francis

- Spring Meadows

- Goerlic Center

- Sunset Village

- Heathdowns Rehab and Residential

- Sunshine Communities

- Kingston Of Sylvania

- The Laurels of Toledo

- Lakes of Monclova

- Waterville HealthCare

- Landings of Oregon

- Wiley Group Home

- Luther Home of Mercy

- Ziegler Homes


Cleveland.com Cloth masks in public might be here to stay. Here's what you need to know.

4-15-20 Seth Richardson

[https://www.cleveland.com/coronavirus/2020/04/cloth-masks-in-public-might-be-here-to-stay-heres-what-you-need-to-know.html<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cleveland.com%2Fcoronavirus%2F2020%2F04%2Fcloth-masks-in-public-might-be-here-to-stay-heres-what-you-need-to-know.html&data=02%7C01%7Csmithj%40ohio.edu%7C0c622e7d5ca44f44c0c608d7e21a82f0%7Cf3308007477c4a70888934611817c55a%7C0%7C0%7C637226475838710472&sdata=sdA2fhCSMaGCICP1LLrDQT2RAfAU5GcoEOfI8Neu6Kg%3D&reserved=0>]

CLEVELAND, Ohio - Wearing masks is now a part of everyday life in Ohio and the rest of the country as we all do our part to get through the coronavirus pandemic.

And health officials said that's not likely to change for at least a year. Masks will be as ubiquitous as key chains, wallets, and purses.

This culture change has led to a lot of questions: What kind of mask should I wear? How many do I need? How do I keep it clean?

Many readers raised these and other questions through our From the Editor Subtext account with cleveland.com executive editor Chris Quinn, which you can find more information on here. So we set about getting some answers and came up with this guide to mask care and etiquette.

What kind of mask?

For starters, it's important to distinguish which kind of masks are recommended for the public versus which kind are necessary for health care workers and first responders.

Surgical masks and other personal protective equipment, such as N95 masks, should be reserved for people at the highest risk of coming into contact with coronavirus every day - health care workers. There's a shortage, and hospitals currently don't have the appropriate amount.

The public has taken to making their own cloth masks at home instead. The Centers for Disease Control and Prevention now recommends the public wear cloth masks when going out in public and even provides crafting and use guidelines on its website.

Other instructions making cloth masks are readily available online. And here's a handy video.

Dr. Neil Korman, professor of dermatology at Case Western Reserve University and University Hospitals Cleveland Medical Center, said cotton-based materials are the best option for preventing discomfort with masks. The CDC also recommends cotton fabrics.

Elastic bands are the recommended way of securing the mask to the head. But the constant rubbing of elastic against skin can cause some irritation.

Dr. Susan Massick, a dermatologist at Ohio State University's Wexner Medical Center, said there are several workarounds to make masks fit more comfortably.

"People have been coming up with pretty clever ideas for headband styles with buttons," Massick said. "You can actually put safety pins on a baseball cap and pin the loop to the cap instead of the ear."

Prepping your face

We promise some fun stuff is coming in a bit, but first, let's talk about the daily routine.

Putting a mask on seems simple enough, but some basic prep should be undertaken both to minimize the possibility of infection and increase comfort.

People should consider their morning skin-cleansing routine as masks become more commonplace, Korman said. Some medications, particularly for acne, may irritate the skin, which could be exacerbated by having a mask covering the face for a prolonged period of time, he said.

"It might be reasonable for the person to cleanse their skin with gentle soap and water and maybe put a moisturizer on their face that doesn't clog their pores when they keep it on," he said.

That applies to makeup as well, which can quickly dirty the inside of the mask. Plus, nobody is really seeing your face anyway, so what's the point?

"Just don't wear it," Massick said. "First of all, if you're wearing a mask, no one is going to see behind the mask. You don't need foundation. That residue gets on the mask. Just skip the makeup."

For the men out there, the biggest hindrance to properly wearing a facemask is facial hair. Full beards can particularly get in the way of making sure the mask fits snugly.

The CDC put out guidelines for health care workers with facial hair for tight-fitting respirators. A cloth mask isn't the same as those types of masks, but generally speaking, the same guidance can be applied for those beards you've been working on. Most mustaches are good to go, and it's probably time we brought mustaches back anyway.

While wearing a mask, it's important to make sure the face cover doesn't get saturated with moisture from your breathing.

"If you're breathing through it or it gets saturated, you can kind of get an acne breakout," Massick said. "What we encourage people to do is just take the mask off and let the mask dry out. That's really important. As it becomes saturated it's not effective."

As for filtration, it's important to realize that these masks will not provide the same protection as the N95 masks. They are to prevent your respiratory droplets that potentially carry coronavirus from transferring to other people - a sneeze guard of sorts.

Two layers of cloth is fine for the do-it-yourself kind of mask, especially since tampering with and trying to customize filters can potentially be dangerous, Massick said. More layers of cloth fabric are perfectly acceptable, but too many layers might make it harder to breathe.

Mask care

Greater Cleveland Food Bank had over 4,000 preregistrations for latest food distribution, April 9, 2020
Members of the Ohio National Guard guide donned some colorful masks during Greater Cleveland Food Bank's food distribution drive, April 9, 2020, at the South Marginal Road Parking lot in Cleveland. John Kuntz, cleveland.com

Washing your hands with soap and water for 20 seconds both immediately before putting the mask on and after taking it off is paramount, said Dr. Aaron Hamilton, a hospitalist and interim chief safety and quality officer for the Cleveland Clinic hospital system.

"It feels very basic, and coronavirus is complex and has people very anxious and worried, and there are some unknowns with it," Hamilton said. "But one thing we do know is basic hand hygiene - soap and water for 20 seconds - is important to do before you put your mask on and after you take your mask off."

Masks should be washed after every use to remain most effective, Hamilton said. Taking the mask straight from your face to the laundry machine is the most effective method, though it can also be sequestered for later wash.

Hamilton said running a mask through a washing machine and dryer might not be practical for some. In lieu of that, hand-washing a mask can be effective (coupled with washing your own hands before and after, of course).

"Just soap and water and agitation is probably enough," Hamilton said. "But also, five minutes in boiling water in addition to soap and water can help. That's kind of a throwback to the old days before washing machines."

Widely shared online posts recommend different ways of sterilization that are either ineffective or outright dangerous.

Some of those posts advocate microwaving the masks to clean. This is probably inadvisable for a number of reasons.

"I would not advocate for microwaving masks for a whole host of reasons," Hamilton said. "It doesn't include the soap and water aspect. Sometimes even cloth masks will have a little metal nose bridge in them that can cause a problem in a microwave."

That little metal part on the nose bridge might literally set your house on fire. Metal and microwaves simply don't mix. And certain types of cloth are very combustible.

"I can say from the fire perspective that microwaving cloth isn't a good idea," said Cleveland Fire Department spokesman Mike Norman. "We would be concerned that is a fire hazard."

Beyond potentially burning your house down, there's also a question over whether a microwave would even do the trick.

Technically speaking, high heat can kill coronavirus. But microwave settings are not standard. It's the same reason why cooking times for microwave popcorn vary from microwave to microwave. Uneven heating patterns could damage that mask you worked so hard on.

Antibacterial cleaning wipes or sprays are also a bad idea, Hamilton said. Those products are made for surface cleaning and with cloth masks having two surfaces and an internal pocket, products like Lysol simply aren't going to do the trick.

"An external wipe just doesn't do everything you need, whether it's whatever brand," Hamilton said.

Using any chemical besides soap and water also puts your skin at risk for irritation, Massick said.

"The problem with spraying Lysol all over a mask and then putting it on your face, there's a potential to cause some irritation to the skin with some antibacterial components of the Lysol," she said.

Instead, it's probably best for you to treat your mask like it's one of your favorite pieces of clothing when washing it.

Should you have more than one?

You wouldn't - or at least you shouldn't - wear the same pair of underwear every day. It's prudent to apply that logic to cloth touching your face as well.

"It's good to have backups," Hamilton said. "In my house, we have a couple cloth masks for every household member. They don't have to be the fanciest things. They have to fit snugly but comfortably. They have to be secured with elastic bands or ties."

Having multiple masks allows you to get into a routine as well, Hamilton said. When you take a dirty mask to the wash, you can then replace it with a clean mask in a place where you'll remember to have it on your person out in public. Hamilton leaves his clean masks in his car, so he knows he has them when he reports to work, but what routine people undertake is really up to them.

There is no set number for how many masks a person should have, as wearing them more often becomes the norm. It's really up to how many a person feels are necessary to make sure they're consistent and safe with their mask wearing.

How long a mask lasts can depend. Functionally, they're protecting other people from your germs, not so much protecting you from their germs.

The basic guidelines essentially say that so long as the mask fits correctly and snugly on the face, it's good to go, according to the CDC.

The easiest way to think about masks is as another part of your wardrobe. Everyone owns a certain number of shirts that they cycle through. They wear shirts they like more than ones they don't, but there's still a set amount of shirts they have to be both comfortable and clean.

Protecting your skin

Your face includes some of the touchiest skin on your body (but don't touch your face).

"Facial skin is more sensitive in general," Korman said. "The epidermis, the top layer of the skin, is thinner and more sensitive."

That can lead to skin irritation caused by the snug fit or the elastic bands.

Luckily, there are already several remedies for any number of these problems, Massick said.

"There are quite a few products out there that can help prevent pressure sores and pressure wounds," she said.

Massick listed several, such as DuoDerm patches and Mepilex dressings, which can be shaped to cover the afflicted areas of the skin. Moleskin bandages, which are used for blister prevention and protection, and silicone gel sheets used to treat scars are other options, Massick said.

To treat already irritated areas, Massick said a number of products are available to apply directly to the irritation, such as petroleum jelly, MediHoney, or antibacterial ointment.

How often should you expect to see masks?

Busch's employees work through the pandemic
Customers wear protective face masks while grocery shopping at Busch's in Ann Arbor, Michigan, on Wednesday, April 15, 2020. Jenna Kieser

Probably a lot. A vaccine is still a year away, and Gov. Mike DeWine this week said he expects masks to be part of everyday life for a while. And it looks like he'll be pressing businesses to require masks when they start opening back up.

"I can't imagine a business that's going to open up without employees all wearing one of these," DeWine said.

If Hamilton, the Cleveland Clinic doctor, gets his way, masks will become more culturally acceptable over the course of the pandemic.

"What I worry about is someone that wears a mask is marginalized societally. It needs to be the reverse," Hamilton said. "I think societally we need to have people feel pressure. Like, 'Oh, I forgot to wear my mask. I better go home to get it.'"

Matthew Donahue, professor at Bowling Green State University's pop culture department, said it's likely that masks will go from being just a public health recommendation to a pop culture phenomenon.

"The other day, Cardi B was in a mask speaking to her fans," Donahue said. "I think what you're going to see is a lot of encouragement from fans and these icons to get their fans to go along with the program in terms of masks or staying at home and these other recommendations. That will be an influence upon the public. The public is always influenced by other pop culture icons."

With the coronavirus a worldwide issue, everyone has been affected by it to varying degrees, whether it's knowing someone who has been infected or simply missing out on sports that have been canceled.

As such, Donahue foresees a scenario where masks become part of the cultural zeitgeist in the West. Comedy is usually at the forefront, Donahue said, and he expects shows like "South Park" or "Saturday Night Live" will end up commenting and critiquing their daily use to some degree.

Online celebrities figure to be another significant source of making mask-wearing more normal, Donahue said.

"That's kind of already happening. What you're finding even now is there are YouTube videos or TikTok videos either encouraging other people to wear masks, or they're in masks themselves, maybe speaking to their fans and that sort of thing," he said.

It's safe to assume that masks will figure into cinema and television to a wider degree at some point, Donahue said. Coronavirus storylines are certain, especially because of the shared experience that the audience will be able to relate to.

Masks as fashion

Right now, mask making and wearing is mostly on a need-based or do-it-yourself system, but commercialization is almost certainly coming.

Linda Ohrn-McDaniel, professor in fashion design and merchandising at The Fashion School at Kent State University, said that's a new concept to Western culture, but the phenomenon has been a part of Asian culture for decades.

"When we look at the Asian cultures where wearing a facemask is not a strange thing, it's part of your wardrobe for many of them and a pretty normal thing," Ohrn-McDaniel said.

Many clothing designers have switched their production over to mask-making already in a bid to help with the coronavirus effort. Gucci, Prada, Louis Vuitton, Dior, and Balenciaga are just some of the high-end fashion names involved with mitigating the worldwide shortage of masks for health care professionals.

"I don't know how long it will take, but in a month or so when we've filled the immediate need, I'm guessing more companies will be able to look at how they can make money off of it," Ohrn-McDaniel said.

Commercialization has already started to some degree. Entrepreneurial people on Etsy and Amazon Handmade are already offering their wares. MaskClub, which offers either single-purchase and monthly subscriptions for masks and donates a medical grade mask one-for-one, started on April 4. Custom Ink, which sells custom branded merchandise in bulk, is offering masks as well.

Donahue said it's likely a cultural industry will pop up around masks if they end up becoming commonplace. Instead of stores that specialize in clothing like T-shirts, shops may pop up, offering different masks.

"I think it already transfers into the masks people are making," Donahue said. "They're taking their favorite T-shirt or bandanna or piece of cloth and making their own mask out of those things."

Ohrn-McDaniel's students are already incorporating masks into some of their portfolio projects. As people return gradually to more public life, they'll want to have a personal connection to which masks they decide to wear, such as matching it with their wardrobe, she said.

"The more we get used to it, the more it will naturally become part of our wardrobe," Ohrn-McDaniel said. "But it will also become a statement opportunity as any piece of fashion is."

That's not necessarily a bad thing, Hamilton said.

"It's a public health responsibility that we all have," he said. "Making it fun and something you enjoy doing is important. I hope it does catch on in that way."


NPR: People with Disabilities Fear Pandemic Will Worsen Medical Biases

4-15-20 Joseph Shapiro

[https://www.npr.org/2020/04/15/828906002/people-with-disabilities-fear-pandemic-will-worsen-medical-biases<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.npr.org%2F2020%2F04%2F15%2F828906002%2Fpeople-with-disabilities-fear-pandemic-will-worsen-medical-biases&data=02%7C01%7Csmithj%40ohio.edu%7C0c622e7d5ca44f44c0c608d7e21a82f0%7Cf3308007477c4a70888934611817c55a%7C0%7C0%7C637226475838710472&sdata=NLDPpYIMVR56neYR%2FdyLKjigxbkOtjhv4iCKT7mhhPI%3D&reserved=0>]

It's a moment that people with disabilities have long feared: there's a shortage of life-saving equipment, like ventilators, and doctors say they may be forced to decide who lives and who dies.

People with disabilities worry those judgments will reflect a prejudice that their lives hold less value.

State health officials have drafted rationing plans that exclude some people with significant disabilities from ventilators and other treatment.

Mostly, though, the belief among people with disabilities that they will get lesser treatment is based on something even more concrete - their own harsh experiences in the medical system before the pandemic.

Almost every person with a disability, or their family, can tell a story of a time when they were treated dismissively or even denied the care they needed.

That includes people like Lex Frieden. He's a research scientist and a professor at the University of Texas Health Science Center at Houston now and was the staff director of the federal agency that wrote the first version of the Americans with Disabilities Act, which prohibits discrimination against people with disabilities.

But none of that helped Frieden when he went to the emergency room.

"A car ran a red light and hit us on the side of the vehicle," he recalls. "The impact literally threw me from the wheelchair onto the floor of the vehicle."

Frieden is a quadriplegic - the result of another car accident, years before - so couldn't tell if he'd been injured.

But at the emergency room, the doctor told him his hip had been crushed.

"The doctor who was attending me said: 'You've got a badly broken injured hip. We've also observed that you're not walking.'" Frieden says. "And I said, 'No sir, I broke my neck in 1967, and I haven't walked since then.' And he said, 'Well, we're not going to repair the hip then.'"

The doctor's decision - that it didn't make sense to fix the broken hip of a man who would never walk anyway - led to years of pain for Frieden.

He still needs to sit up in his wheelchair, but now can't put weight on his broken hip. All the weight on his good hip causes pain, limiting how many hours he can sit in his wheelchair. And that limits how much he can get around.

Months after the accident, in 2006, Frieden went back to the hospital and argued he got the wrong care.

The hospital changed its policy.

"People who go to that emergency room with disabilities are looked at in a different framework," says Frieden. "And I'm happy about that."

Three laws protect the civil rights of people with disabilities in medical settings: The ADA, Section 504 of the Rehabilitation Act, and the Affordable Care Act.

In April and March, disability groups cited those laws when they filed complaints against the "crisis of care" guidelines in several states. Kansas and Tennessee, according to lawyers who filed the complaint, would cut care to some people who rely upon home ventilators to breathe, although many use them to lead active lives. New York's plan says that a person who shows up at a hospital with their personal home ventilator could have it taken from them and given to someone else. And Washington State would factor in old age and disability. Similar complaints have been filed from Pennsylvania, Utah, and other states.

On March 28, the Office for Civil Rights at the Department of Health and Human Services announced it had opened or would open investigations based on these complaints and warned states that any guidelines for triage of care could not put disabled people and the elderly "at the end of the line" for care.

On April 8, the civil rights office announced its first case resolution in one of these investigations. Alabama said a policy no longer applied that would have allowed doctors to deny ventilators to some adults and children with intellectual disabilities or people with "moderate to severe dementia."

"Particularly, we're concerned that crisis standards of care may start relying on value judgments as to the relative worth of one human being versus another, based on the presence or absence of disability," Roger Severino, director of the HHS civil rights office, told NPR. "We're concerned that stereotypes about what life is like living with a disability can be improperly used to exclude people from needed care."

U.S. Hospitals Prepare Guidelines For Who Gets Care Amid Coronavirus Surge

People with significant disabilities, including quadriplegics like Frieden and even those who use home ventilators, say their lives are full. They work, go to school, and are part of families. They are not - as some rationing plans suggest - people close to death. Some are, however, because of their underlying health conditions, at a higher risk if they contract COVID-19.

But the public, and many in the medical community, can underestimate the lives of people with disabilities.

Dr. Lisa Iezzoni, a physician and researcher at Havard Medical School, recently conducted a nationwide survey that aimed to assess doctors' attitudes about disability. A "vast majority" rated the quality of life of people with significant disabilities as a little to a lot worse than that of others.

"I was horrified," Iezzoni says.

People with significant disabilities tell Iezzoni they rate their lives as the same or better than others. Iezzoni is one of them. She has multiple sclerosis and has used a wheelchair since 1988.

Dr. Lisa Iezzoni and her friend, Michael Ogg, crossing the George Washington Bridge, over New York's Hudson River, in their motorized wheelchairs, after Ogg survived a cancer diagnosis. Iezzoni has written about another doctor who declined to do a physical exam of Ogg. Merely lifting his shirt would have revealed evidence of cancer, she says.

"There's a lot of us roaming around with significant disabilities and who feel we have a pretty good quality of life," she says.

Those misconceptions have come up in other moments when the health care system has faced decisions to ration care. In the days after Hurricane Katrina in 2005, doctors and staff at Memorial Medical Center - where generators, lights, and sewage went out - first rescued patients who could walk. One doctor said he left when colleagues spoke of euthanizing other patients. A state homicide investigation later found 20 had died with elevated levels of morphine in their system, even though only a few of them had been prescribed it for pain. A grand jury later declined to bring charges.

People with disabilities often have complex relationships with their medical providers. They distrust the system, but they work hard to find understanding doctors who provide care that keeps them healthy and independent.

"Any doctor we know we can trust is practically a secular saint in the community," says Riva Lehrer, a Chicago writer, and artist who was born with spina bifida. At the start of the pandemic, her personal care physician called her at home and "read me the riot act." Stay at home, her doctor told her, and if you go outside and someone approaches, make sure you turn your body away from them.

Growing up in California, Rebecca Cokley's parents took her to conventions of little people where doctors who specialized in dwarfism would come and give free medical care.

At these conventions, little people formed friendships - including Cokley as she grew up - with the sympathetic doctors. "I've sat at the bar and had scotch and cigars with my neurosurgeon," Cokley says. "I've sung karaoke with geneticists. These are people I have known pretty much my entire life, and I would trust 100 percent with my care."

So she was caught off guard in 2013 when, lying on the operating table after she'd just given birth to her second child, she overheard the anesthesiologist talking to the obstetrician.

"He made a comment to her and said: 'While you're down there, why don't you go ahead and just tie her tubes,'" she recalled.

Cokley and her husband objected: "I said what are you talking about? And he said, 'Now that you've had two, you don't need to have more kids.'"

"It was really mind-blowing to me," she says, "in that position of ultimate vulnerability - literally, being opened up on an operating room table - that I would have to sit there and actively advocate for my rights at that moment."

A few years ago, Cokley, who runs the Disability Justice Initiative at the Center for American Progress, went back to that same hospital in Washington - with no problems - for the birth of her third child.

It's easy for doctors and health care providers, she says, to pick up the biases of a system that views people with disabilities as "the problem."

Doctors, for example, Cokley, says, "are trained to prevent birth defects. They are trained to provide a level of care so that people don't acquire underlying conditions."

When Alisha Hauber's son, Lane, was born with life-threatening disabilities, and rushed to the neonatal intensive care unit of a Fort Worth hospital, she and her husband noticed paperwork on the baby's crib with some unfamiliar letters: DNR.

When her husband asked a nurse what it meant, she was silent. Later, the Haubers were summoned to a room with doctors and hospital administrators. DNR, they were told, stands for Do Not Resuscitate. Without asking the parents, the doctors decided they would not do anything to rescue the boy if he went into distress. And the doctors declined to perform the surgery they said was needed to repair the baby's heart.

The Haubers were given no choice in the matter. "I just didn't know any better how to fight for him at the hospital at the time," Alisha Hauber says. "When you have big people at a huge hospital, you know, looking at you, telling you: You don't have a choice. So I trusted what they were telling me."

Their doctors sent the Haubers home with their son and told them to be ready for him to die.

But the doctors were wrong.

Lane is 11 now.

"He is full of personality," Hauber says with a laugh. "He is the sweetest boy."

Lane doesn't walk or use words but communicates with sounds and can shake his head yes or no. He laughs at jokes. He smiles when his mother reads books to him, and he turns the pages. Hauber says he is more at risk because doctors declined to give him that early heart surgery.

"He's a huge part of our family. All of his siblings love him. We love him. He makes us laugh all the time," Hauber says.

Many people with disabilities fight, not just for life-saving care, but even to get access to care at all. Research shows disabled people get lesser routine medical care. Sometimes it's simply because an examination table is too high to get up on, or a doctor declines to give a full exam to someone who can't easily get out of a wheelchair.

That happened to a close friend of Iezzoni, Michael Ogg. Iezzoni has written in medical journals about how Ogg's doctor said he could not lift him out of his wheelchair to give him a physical exam. It was an assertion that "lacked merit," Iezzoni wrote in the New England Journal of Medicine. "Merely lifting his shirt would have revealed his protuberant abdomen," a sign of the untreated cancer.

Studies have found that disabled women are less likely to get mammograms and Pap tests. Another study found that those who get breast cancer are less likely to receive standard treatments and, as a result, are more likely to die.

Angel Miles has a PhD, and is the health policy analyst at Access Living, a Chicago disability center, but she still fights to be treated seriously when she visits doctors.

Even with her expertise, when she seeks treatment, she says she's dismissed as a black woman in a wheelchair. She reels off a list of frustrations: The doctor's office that insists she bring someone with her to help her get onto their inaccessible examination table; the people in medical offices who don't even talk to her directly.

"I'm often ignored," she says. "I'm often spoken at, and not to. Sometimes, the person next to me is addressed instead of me. And I don't even know them half the time."

In February, Miles sued a hospital that, twice, gave her hospital rooms that she says were inaccessible for her with her wheelchair.

She sued, in part, because - with her education and her job - she feels she can make change. And that's especially important in a pandemic.

"Right now...we cannot afford to have these barriers. We can't afford to have these biases. Because they literally are life and death," she says.

Alice Wong worries about those biases, too. Now 46, she was born with a progressive neuromuscular disease.

Wong's portable ventilator is on the back of her wheelchair. She speaks through a plastic mask and the tube to the ventilator.

She says people, including medical providers, see her and underestimate the quality of her life.

"It's not easy," she says, "but my life is so rich."

She's an on-line organizer, a founder of the Disability Visibility Project. A book she edited about disability will be published this spring.

"It's ironic," Wong says from her home in San Francisco, "but at a time when I'm really the most disabled I've ever been in my entire life, I've been the most active in the things I want to do in my life and in choices I'm making."

Alice Wong says she's more disabled than she's ever been, but that her life is richer than ever, too. She's an organizer, and she's edited a new book, "Disability Visability." She worries whether she'd get treatment if she gets sick.

Technology and the medical system - especially some devoted doctors - allow her to live that active life.

But she's still afraid of a system that's overwhelmed by the pandemic. "I really don't think I could survive if I was affected," she says. "I think about that a lot. I think about how much of a priority will I be given? Will I even get tested? Will I even have access to treatment?"

Late last year, the little known National Council on Disability released a series of reports looking at discrimination in health care against people with disabilities. It highlighted problems like insurance companies that use "quality of life" scores to deny medications and treatment; and organ transplants refused to people with autism, intellectual disabilities, mental illnesses or with HIV, even though scientific studies show their results with transplants are as good or better than the population at large.

The studies, from those months before the spread of the coronavirus, did not consider discrimination in medical care during a pandemic.

"But for people with disabilities, almost every day is a pandemic," says Neil Romano, chair of agency that issued the reports. "Because quite often they have to worry about what kind of care they're going to get, the quality of care, or if someone's even going to give them care."


USA Today 'We are dead': People with disabilities fear they will be on losing end of doctors' life - or- death choices amid coronavirus crisis

4-15-20 John D'Anna Arizona Republic

[https://www.usatoday.com/story/news/nation/2020/04/14/coronavirus-people-disabilities-worry-covid-19-care/2994471001/<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.usatoday.com%2Fstory%2Fnews%2Fnation%2F2020%2F04%2F14%2Fcoronavirus-people-disabilities-worry-covid-19-care%2F2994471001%2F&data=02%7C01%7Csmithj%40ohio.edu%7C0c622e7d5ca44f44c0c608d7e21a82f0%7Cf3308007477c4a70888934611817c55a%7C0%7C0%7C637226475838720464&sdata=u1JE9SnBv2vGb7FX8b7XPKFSrx2Uxp9f2ycYnpfGPHM%3D&reserved=0>]

Shona Eakin is 50 and has cerebral palsy. She uses a wheelchair and is fairly independent though she needs help getting dressed and getting ready for bed.

Her husband, Mike, is 58 and has muscular dystrophy. He has been on a ventilator full- time for 24 years.

"We've been hoping and praying we don't end up in the hospital for anything," Shona said.

"Typically, when he goes into the hospital, they let him bring his own ventilator in. The worry now," she continues, is, "Will they take his ventilator and use it for someone who has COVID-19?"

As the number of COVID-19 cases and corresponding deaths accelerates across the country, one of America's most vulnerable - and most overlooked - groups of citizens worry not just about how to get food and pay rent in a locked-down nation, but whether they will even be considered treatable if they get sick.

Concerns: People with disabilities are afraid they will be denied health care because of coronavirus

In essence, it comes down to the question of who chooses who will live and die when allocating scarce health care resources.

Federal and state health officials have been warning for weeks of critical ventilator shortages, so much so that President Donald Trump recently invoked the Defense Production Act to force General Motors to retool an automobile assembly line to produce ventilators.

But as the novel coronavirus peaks in New York, New Jersey, New Orleans, and Detroit, people with disabilities fear they will wind up on the losing end of the life-and-death choices doctors are forced to make.

"Are we going to be valued as an individual and given the same quality of treatment as somebody else?" said Shona, who lives in Pennsylvania.

US coronavirus map: Tracking the outbreak

Her husband owns his ventilator, but she worries that rental companies might try to recall and reallocate equipment to people to someone who might be better able to survive, or worse, better able to pay.

"It's always in the back of your mind," she said. "What could they do if you're in a state of shortage and don't have enough equipment, and it comes down to somebody's judgment?"

What happens if care is rationed?

Gabe Trujillo, 36, of Arizona, also worries that if he has to go to the emergency room, his wheelchair and his asthma could put him at the end of the queue for treatment.

"That's definitely scary just to think about as a person with a disability," said Trujillo, who has Hopkins Syndrome, an extremely rare form of permanent paralysis triggered by a severe asthma attack.

"It definitely has me worried now, not just for myself, but other people with disabilities," he said.

Eakin and Trujillo are not alone in their fears.

Gabe Trujillo, a content producer for 12News, works from home during the COVID-19 outbreak. Trujillo became disabled after a severe asthma attack when he was 14 years old. He is considered high risk for the Corona virus and worries that people with disabilities might not have the same access to medical care.
According to Pew Research Center, more than 40 million Americans have some sort of disability, the most common of which involves mobility impairment.

Disability activist Valerie Novack, a fellow with the Center for American Progress who works on the organization's Disability Justice Initiative, said that when the COVID-19 crisis erupted, her first concern was getting resources to people with disabilities.

"We don't have the infrastructure in place to simultaneously ask people to not leave their homes and get them the things they need," she said.

Those concerns quickly shifted.

"I'm very, very scared, particularly for our community, that people will die, not because they contract COVID-19, not because of physical distancing or quarantining or because they didn't get access to food or a home health aide or something like that, but because they're being refused treatment, because we don't have enough things like ventilators or hospital beds," she said.

What choices would doctors make?

More recently, advocates point to Italy, where the COVID-19 virus overwhelmed the country's medical system. There were stories of doctors and nurses who were moved to tears because they could not provide care for everyone who needed it.

In a March 18 article in the New England Journal of Medicine, correspondent Dr. Lisa Rosenbaum interviewed Italian doctors who were dealing with critical shortages of medical equipment in the grip of the pandemic.

"What they seemed to find far more unbearable was watching people die because resource constraints limited the availability of ventilatory support," she wrote.

One doctor, she said, "offered a hypothetical scenario involving two patients with respiratory failure, one 65 and the other 85 with coexisting conditions. With only one ventilator, you intubate the 65-year-old."

Another doctor said his hospital was taking into consideration "in addition to the number of comorbidities, the severity of respiratory failure and probability of surviving prolonged intubation, aiming to dedicate its limited resources to those who both stand to benefit most and have the highest chance of surviving."

Comorbidity refers to situations where patients have more than one serious medical condition, for instance, COVID-19 and kidney disease, and it's a subject that is being debated in the U.S. medical community in the context of how to allocate scarce resources.

Dr. David Beyda, chair of bioethics at the University of Arizona College of Medicine-Phoenix, said the decision on who gets treatment should not be made solely on whether a person has a disability.

"A person is a person, no matter what," he said, adding that treatment decisions should always be decided on a case-by-case basis and that health-care professionals must not let stereotypes or biases against people with disabilities enter into their decisions.

In a scenario where two people are in need of heroic lifesaving measures, but only one can be treated, the patient who is likely to have the best outcome is the person who should be treated, he said.

"Look at what the prognosis would be for each one of them. The one who has the better prognosis of coming out is the one who should get the ventilator," he said. "It should not be directly related to age, special needs, race, ethnicity, etc., etc. ... It really comes down to the prognosis - who has the better chance of getting through this - and then go with that."

The duty to treat patients
Competing schools of thought among medical ethicists advocate using a first-come-first-served approach or a lottery to decide who gets care, but Beyda said those approaches could favor those who have the financial resources or are able to shop for care.

He acknowledged that a patient's underlying medical condition, whether it's a physical, cognitive, or intellectual disability or a chronic condition like heart disease or diabetes, likely would be a factor in a treatment decision.

To balance that factor, Beyda said it's important for people with disabilities to have advocates in the discussion to ensure health care providers aren't allowing individual biases to color their decisions.

And even if the decision is made to not provide heroic measures, doctors still have a duty to treat the patient, Beyda said.

"If you have a comorbidity  that has a poor prognosis, I still have a duty and obligation to not only care for you but to care about you and to take care of you," he said. "And that would be me saying, 'OK, let's talk about what can we do here. ... What are some of things we can help you with?' as opposed to saying, 'Well, you know what, you've got no chance, so have a nice day."

Still, the very idea of comorbidity scales might mean some people with disabilities would be automatically relegated to palliative care as soon as they walk in the door, and that's not a comforting thought, said Paul Timmons, founder of Portlight.org, a national organization that focuses on providing disaster strategies and relief for people with disabilities.

"I don't like to call it triage," Timmons said. "Let's call it what it is, which is care rationing - someone indiscriminately choosing that your life is a higher quality than my life because I am in a wheelchair, and therefore you get to live, and I do not. This is the real fear that's happening right now."

For Timmons and other disability advocates, COVID-19 is just the latest battle in a long war for recognition and equal treatment. More battles loom on the immediate horizon, and they may involve fighting on multiple fronts.

While the federal Americans with Disabilities Act prevents discrimination against people with disabilities and the 1988 Stafford Act guarantees equal access to services in an emergency, the threat of compound natural disasters along with the ongoing COVID-19 crisis means providers will be taxed, even more, putting people with disabilities at even greater risk of losing access to care.

"Nashville, Tennessee, saw a tornado at the beginning of March. Salt Lake City, Utah, had an earthquake last month. Jonesboro, Arkansas, just had a tornado. These are things that are happening just right now," said Shaylin Sluzalis, co-executive director for the Philadelphia-based Partnership for Inclusive Disaster Strategies.

"Now that we're seeing COVID-19 as sort of our overarching tsunami on top of everybody's roofs, ... what will that look like for our community?" she said.

She said that in any disaster, "the disability community is disproportionately impacted" in every facet of life, whether it's access to personal assistants, shelter, or medical care.

"Honestly, people with disabilities die in those instances," she said. "We are dead. We are forgotten."


CNBC: Receiving SSI benefits? You will get your coronavirus stimulus payment automatically, government says

4-15-20 Lorie Konish

[https://www.cnbc.com/2020/04/15/ssi-beneficiaries-will-get-coronavirus-stimulus-payments-automatically.html<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cnbc.com%2F2020%2F04%2F15%2Fssi-beneficiaries-will-get-coronavirus-stimulus-payments-automatically.html&data=02%7C01%7Csmithj%40ohio.edu%7C0c622e7d5ca44f44c0c608d7e21a82f0%7Cf3308007477c4a70888934611817c55a%7C0%7C0%7C637226475838720464&sdata=KhdePZ5Jd8WYxVQdo3HxrPrHBHLIHf%2Fl1iCIPgCVmYU%3D&reserved=0>]

If you're receiving Supplemental Security Income benefits, you will get your coronavirus stimulus payment automatically, the government said on Wednesday.

The payments will come the same way you typically receive your benefit payments, either by direct deposit, a Direct Express debit card, or paper check.

"SSI recipients will receive these automatic payments no later than early May," the Treasury Department said in a statement.

The announcement clears up confusion for individuals who rely on these benefits, who are generally elderly, disabled or blind, and have little to no taxable income.

The government had previously said Social Security beneficiaries will not have to do anything to receive their stimulus payments. But SSI recipients do not fall in that group, nor do they typically file tax returns, which led many to fear they would have to register in order to receive the money.

"SSI recipients with no qualifying children do not need to take any action in order to receive their $1,200 economic impact payment. The payments will be automatic," Treasury Secretary Steve Mnuchin said in a statement.

There were approximately 8 million SSI beneficiaries in the U.S. as of March, according to data from the Social Security Administration.

If you are on SSI and do have qualifying dependents (children under 17), you are encouraged to use the government's web portal to ensure you get your $500 payments.

"If SSI beneficiaries in this group do not provide their information to the IRS soon, they will have to wait until later to receive their $500 per qualifying child," the government said.

In order to use the web portal, you will need to have the full names and Social Security numbers for yourself, your spouse, and your dependents. You also need to provide your mailing address and bank information (account type and account and routing numbers).

Other individuals who will also receive their stimulus payments automatically include those receiving Social Security retirement, disability (SSDI), or survivor benefits, as well as Railroad Retirement benefits.

You need to have a valid Social Security number. You also must meet certain income requirements.

If you earn up to $75,000 as an individual, $112,500 as head of household or $150,000 as a married couple filing jointly, you are eligible for the full amount.

However, payments are reduced above those levels and phase out completely if your adjusted gross income is more than $99,000 for individuals, $136,500 for head of household, and $198,000 for married filing jointly.


WKBN 27: Local Developmental Disabilities Board Seeks Help from Soup Kitchen to Feed Clients

4-15-20 Gerry Ricciutti

[https://www.wkbn.com/news/local-news/local-developmental-disabilities-board-seeks-help-from-soup-kitchen-to-feed-clients/<https://nam03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.wkbn.com%2Fnews%2Flocal-news%2Flocal-developmental-disabilities-board-seeks-help-from-soup-kitchen-to-feed-clients%2F&data=02%7C01%7Csmithj%40ohio.edu%7C0c622e7d5ca44f44c0c608d7e21a82f0%7Cf3308007477c4a70888934611817c55a%7C0%7C0%7C637226475838730458&sdata=XomLcUfFOpaFP8%2BiQi2w8h6Tjruveujw%2BfnC1s8nsp0%3D&reserved=0>]

YOUNGSTOWN, Ohio (WKBN) - Employees with the Mahoning County Board of Developmental Disabilities are used to seeing students and clients coming into their facilities.

But, the ongoing pandemic now has those workers reaching out to help those in need.

Like a growing number of groups, MCBDD's staff is now looking to Our Community Kitchen for help.

They stopped by Wednesday morning to pick up meals to be delivered to more than 50 of their clients.

"They're scared to have their kids go out, and they have low immune systems. So they really would like the help to be able to get people to bring the food in," said MCBDD's Jenna Nameth.

In recent weeks, the soup kitchen has seen double the amount of people stopping by for hot meals. Besides those with low incomes, workers have been providing food for local church and veterans groups to the point where the kitchen is running low on funding.

"But we're continuing to work out resources and United Way promised us more help, and a couple other people have said they would help also," said Our Community Kitchen's Skip Barone.

While Barone and his staff appeal for more donations, workers with MCBDD are now finding themselves reaching out to their clients and families to be sure they're alright.

"We call them on the phone, try to email them, message them. Whatever we can do to get ahold of our people to ask them what their needs are," Nameth said.

Nameth said Wednesday's deliveries will act as sort of a pilot program. If it works out, they may try to continue it.