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Health See other Health Articles Title: CDC: Japanese Data Show Indoor Coronavirus Transmission 18.7 Times Likelier, as Garcetti Moves L.A. Homeless to Rec Centers The Centers for Disease Control and Prevention (CDC) recently published a paper reporting that Japanese data showed that coronavirus transmission was nearly 20 times more likely indoors than outdoors. L.A. Mayor Eric Garcetti is moving hundreds of homeless people into recreation centers in residential areas — a policy that is receiving increasing scrutiny and criticism from residents and the media. The Los Angeles Times reported this weekend that there is growing discord in California about Garcetti’s plan to help the homeless: There has been pushback to using the recreation centers, though, and a fear that they could be incubators for spreading the novel coronavirus among an already high-risk population. While most health experts, advocates and some politicians agree that quick action will require using multiple types of shelter, they say single-occupancy spaces such as motel or hotel rooms are safer. The CDC paper, dated Mar. 18, 2020, has surfaced amidst debates about whether to move homeless people indoors to protect them from the coronavirus pandemic — or whether doing so would actually expose them to more risk. The paper, by Thomas R. Frieden — a former CDC director — and Christopher T. Lee, notes (footnotes included): Environmental factors [in trasmission] include population density and the availability and use of infection prevention and control measures in healthcare facilities. SARS and MERS had relatively low rates of person-to-person transmission but caused explosive outbreaks in healthcare settings (28). Rapid person-to-person transmission of COVID-19 appears likely to have occurred in healthcare settings, on a cruise ship, and in a church (3). In a study of 110 case-patients from 11 clusters in Japan, all clusters were associated with closed environments, including fitness centers, shared eating environments, and hospitals, the odds for transmission from a primary case-patient were 18.7 times higher than in open-air environments (H. Nishiura et al., unpub. data, External Link). SARS-CoV-2 is present in stool (33); ensuring cleanliness of toilets and other potentially contaminated surfaces is needed, and measures to prevent aerosolization from plumbing, as might have occurred in the Amoy Garden outbreak of SARS (24), might need to be implemented. Evidence of environmental contamination by SARS-CoV-2 through respiratory droplets and fecal shedding highlights the need for effective decontamination efforts and strict adherence to environmental hygiene, which are pertinent to prevention and control of transmission, including SSEs (34). New CDC guidelines on the care of homeless populations caution against clearing encampments during the outbreak, and suggest that moving them to individual housing units, rather than common spaces, is preferable. Post Comment Private Reply Ignore Thread
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