Tests

On March 11, Gov. Doug Ducey declared a state of emergency and signed an executive order to proactively provide health officials with guidance and tools to combat the novel coronavirus. Among other protections, the order requires insurance companies to waive all co-pays, coinsurance, and deductibles for consumers related to COVID-19 diagnostic testing and decrease co-pays for telemedicine visits. It also requires insurers to cover out of network providers, including out of plan laboratories and telemedicine providers.

All health care workers and visitors at skilled nursing facilities, nursing homes, and at assisted living facilities are required to have regular symptom checks.

Who qualifies for tests is another question. Coconino County Health and Human Service Epidemiologist Matthew Maurer spoke at a coronavirus briefing at the Page Police Department on March 1.

Criteria must be met. A person must have traveled to an area with community transmission or had contact with someone who has a confirmed case of COVID-19. Maurer said, “If you do not have those risk factors you are a very low risk.” He also stressed that closed indoor environments are the greatest risk, adding, “Outdoor environments are must less risk for transmission.”

“You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected. We have a simple message for all countries: test, test, test. Test every suspected case,” said Tedros Adhanom Ghebreyesus, director-general at the World Health Organization.

It’s not just the elderly who are at risk. Ghebreyesus said, “This is a serious disease. Although the evidence we have suggests that those over 60 are at the highest risk, young people, including children, have died.” Even countries with advanced health systems are struggling to cope.

“We have not seen an urgent enough escalation in testing, isolation and contact tracing – which is the backbone of the response.”

WHO has shipped almost 1.5 million tests to 120 countries.

Schools

Arizona joined a growing number of states and municipalities closing schools Monday. Attributing the decision to staffing, Ducey on Sunday said, “… staffing and potential absences are a concern in many districts. We are … announcing a statewide closure of all Arizona schools from Monday, March 16 through Friday, March 27.”  

Ducey added, “We're working together to provide assistance during this time and lessen the impact of all Arizona families.”

Arizona Superintendent of Public Instruction Kathy Hoffman said, “Efforts are underway to ensure that every child has access to meals while schools are closed. We have also worked with (the U.S. Department of Agriculture) to allow schools to begin summer food service operations and provide boxed meals as needed. Your local school will have more information about how and where to access meals.”

Ducey said the move would help operations issues, but “will not stop the spread of COVID-19.” He relayed the public health official’s advice that children not at school should remain at home as much as possible. He said, “For families that's not an option, we are coordinating with partners in the nonprofit faith-based and education communities ... to make available childcare options to families who need it.”

Ducey assured school employees that the state is working to ensure there are no disruptions in pay. Information on potential school makeup days will come later.

Restaurants, bars, gyms, and gatherings

In addition to school closings around the country, some states are mandating restaurants, nightclubs, movie theaters and gyms to close, and are calling in the National Guard to enforce the requirements. Maryland Gov. Larry Hogan of Maryland on Monday ordered the closure of restaurants, movie theaters, and gyms by 5 p.m. Drive-ups and takeout services are excluded from the ban. Many states and cities have similar executive orders in place, though they vary in severity.  He said, “We’re not fooling around anymore.”

Maryland, like many states, is banning gatherings of 50 or more people. Hogan said they are adding 6,000 hospital beds to help meet the demand.  According to The Washington Post, he’s also “called for a ban on evictions and utility shut-offs.”

The San Francisco Chronicle on Monday reported six Bay Area counties announced a “shelter in place” order for all residents, “the strictest measure of its kind yet in the country, directing everyone to stay inside their homes and away from others as much as possible for the next three weeks as public health officials desperately try to curb the rapid spread of coronavirus across the region.” The directive goes into effect 12:01 a.m. on Tuesday.

The Center for Disease Control and Prevention on March 15 recommended: “that for the next eight weeks, organizers (both groups and individuals) cancel or postpone in-person events that consist of 50 people or more throughout the U.S.” The CDC suggests events of any size should be continued only if they can be carried out with adherence to guidelines for protecting vulnerable populations, hand hygiene, and social distancing. They’ve suggested organizers could “modify events to be virtual.”

This week, President Donald Trump said limit groups to 10 people, avoid eating at restaurants, and try to work from home.

Some Page restaurants are taking extra precautions, like opening for only takeout or temporarily discontinuing salad bars. Safeway recently announced home delivery for prescriptions.

Travel

Locally, Paul Baughman informed the Chronicle that the Horseshoe Bend Obstacle Course Run scheduled for April has is postponed until Sept. 26.

Many of the tour bus companies that normally bring visitors to the Page area this time of year have adjusted. Tauck’s – operator of guided tours and river cruises – most recent update states, “We have accordingly decided to pause, and forgo operating our scheduled tours and cruises from March 17, 2020, through April 14, 2020.” Insight and Trafalgar begin later in the season, so it’s not clear what’s to come yet. Of course, all the dates, the school closings, international travel bans, and other restrictions are subject to change as the virus spread is better understood. Officials say it could go on for months.

People over 60 years old and those with preexisting conditions, such as diabetes, heart conditions, and respiratory illnesses, are at the greatest risk. Although CDC does not generally issue travel advisories within the U.S., they state, “Crowded travel settings, like airports, may increase your risk of exposure to COVID-19, if there are other travelers with COVID-19.”  

Arizona Health Services Department Director Dr. Cara Christ advises older people to avoid travel. She said, “I would recommend that my mother or my grandmother not take that trip at this time.”