State takes new action to contain virus

Calling for calm but acknowledging the likelihood of the continued spread of coronavirus in Rhode Island, Gov. Gina Raimondo on Monday declared a state of emergency and announced new steps aimed at protecting the most vulnerable members of the community – including the elderly – and supporting workers affected by the virus.

“This isn’t a time for panic. The risk to the average Rhode Islander remains low. However, it’s a time for action … We fully expect that there will be more cases. We are seeing that in other parts of the world and we are seeing that in other states,” Raimondo said during a Monday afternoon media briefing.

She added later: “Our response here in Rhode Island has been swift and aggressive and that’s because we want to keep everybody safe.”

The emergency declaration cites the “dangers to health and life posed by COVID-19” – the formal name for the virus – and directs the Rhode Island Emergency Management Agency to activate its emergency operations center and related response plans. It additionally authorizes the Rhode Island National Guard to activate its personnel to assist in the response if necessary.

“It gives us more tools in our toolbox to take the necessary steps,” the governor said.

State’s additional actions

Raimondo on Monday additionally announced that the state’s Department of Labor and Training and Department of Health have taken a “series of new COVID-19 preparedness and response measures to support employers, employees, and nursing homes throughout the state.”

Those include waiving the seven-day waiting period requirement for Unemployment Insurance claims and claims filed through the WorkShare short-term compensation program; waiving the seven-day out-of-work requirement for Temporary Disability Insurance and Temporary Caregiver Insurance; and waiving medical certification requirements for people under quarantine due to potential exposure to COVID-19.

Raimondo said the state’s Department of Labor and Training has set up a hotline and email address – 462-2020 and dlt.covid19@dlt.ri.gov – to provide guidance to employers and employees who might be affected by the virus.

“I’m fully aware that what I’m asking businesses in Rhode Island isn’t easy, isn’t convenient … [but] based upon everything that we know, it is in everybody’s long-term best interest that if they are sick or in quarantine they stay at home, and in the end it will benefit all of us,” the governor said.

She added: “The stock market tumbled today, the economy is slowing down … We have arrows in our quiver to take action. Don’t panic. Act. Be proactive. And that includes doing the right thing – protecting employees, particularly low-wage, hourly employees who deserve the opportunity to take care of their health and stay home if they’re sick.”

Additionally, new visitation rules have been imposed for nursing homes. According to a statement from the governor’s office, the restrictions place limits on visitation hours; bar visitors under the age of 18; prohibit residents from leaving for reasons other than medical appointments; and require active screening of “visitors, staff vendors, entertainers, and anyone else who enters for illness and recent travel history.”

“In special circumstances, exceptions can be made from this policy, given the importance of mental and emotional health to the overall wellness of older adults,” the statement reads. “Families should work with nursing home administrators regarding special circumstances. RIDOH is partnering with Rhode Island’s Long-Term Care Ombudsman, Kathy Heren, in supporting nursing homes.”

Dr. Nicole Alexander-Scott, the state’s health director, addressed the nursing home visitation restrictions during Monday’s briefing.

“We held a big call with nursing home leadership on Friday and again this afternoon, and I want to credit the nursing home leadership who have been responsive, understand what’s at stake and doing what they can to make sure their residents are protected. It is absolutely critical, critical, that people who are sick not go into nursing homes right now,” she said.

She added: “This is the current approach today. It is urgent and critical to be able to protect our seniors and nursing homes … The approach we’re taking may sound a little severe to some people, but this illness is much more dangerous to older adults.”

Raimondo said: “It is crystal clear this is a virus that has the greatest impact on the elderly, particularly the elderly with underlying health conditions. I want to make special pleas to all Rhode Islanders who have elderly and sick family members. We recognize children are doing relatively better with this disease. The greatest risk is to elderly who have underlying lung or heart or health issues and we have to do everything we can to protect them.”

Where the virus stands in RI, globally

As of Tuesday morning, the number of confirmed COVID-19 cases in Rhode Island remained at three.

During Monday’s briefing, Alexander-Scott said 53 people have tested negative for the virus and another six tests were still pending. She said approximately 290 people were in self-quarantine.

Neighboring Massachusetts, meanwhile, has seen its number of COVID-19 cases jump significantly. As of Monday, the Massachusetts Department of Health reported 41 positive tests for the virus. Hundreds more remained in quarantine due to potential exposure.

CVS on Tuesday announced that an employee at its corporate office in Lincoln has tested positive for COVID-19. That employee is a resident of Massachusetts.

Citizens Bank also announced that a contractor who was providing training to a “small number” of employees at its Johnston campus has tested positive for the virus, and those workers – who have not exhibited any symptoms to this point – have been asked to self-quarantine.

Additionally on Tuesday, a passenger on a flight from Orlando, Florida, to T.F. Green Airport was taken to the hospital upon landing after exhibiting flu-like symptoms during the flight.

COVID-19 is part of a family of viruses that cause respiratory illness. Symptoms include fever, cough and shortness of breath and can range in severity.

The first two Rhode Island cases – which have been confirmed through the Centers for Disease Control and Prevention – were in a man in his 40s and a teenage girl who took part in a trip to Europe organized through Saint Raphael Academy in Pawtucket.

The third case, which remained a “presumptive positive” on Tuesday morning pending CDC confirmation, was announced Friday. It involves a woman in her 60s who “had direct, face-to-face contact with a person with confirmed COVID-19 in New York in late February,” according to a press release.

“The woman is said to be recovering at home with mild symptoms. She is employed at Smithfield Avenue Nursery School in Smithfield, and state officials said contact tracing for children and adults at the facility is being conducted.

“Initial studies of COVID-19 indicate that the virus does not affect children as severely as adults,” the release states.

According to the World Health Organization’s March 9 update, nearly 110,000 cases of COVID-19 have been confirmed across 104 countries. As has been the case to this point, the vast majority of cases – approximately 81,000 – are in China, where the outbreak originated. South Korea, Italy, Iran, France, Germany, Spain and Japan have also experienced significant outbreaks.

In the United States, the CDC’s March 9 update placed the total number of cases at 423 across 35 states, including the District of Columbia, with 19 reported deaths.

The number of total cases includes both “presumptive positives” and those that have been confirmed by the CDC. The agency advises that data from individual states – which are testing and reporting their own cases – may be more current than its own figures. 

WHO places the total number of global deaths from COVID-19 at roughly 3,100 in China and nearly 700 elsewhere across the globe.

In terms of preventing the spread of the virus, Rhode Islanders are being urged to get a flu shot if they have not yet done so; wash their hands regularly using warm water and soap, or alcohol-based hand gel; keep surfaces such as beside tables and bathroom counters clean; cough or sneeze into a tissue or one’s elbow; avoid touching one’s eyes, nose or mouth; and remain at home if experiencing symptoms.

Health care providers take steps

On Monday, Lifespan announced it has suspended adult visitation at its hospitals and enacted other restrictions aimed at curbing the spread of what is known officially as COVID-19.

“Effective immediately, no visitors will be allowed in adult units at our Lifespan hospitals,” Lifespan’s statement reads. “Hasbro Children’s Hospital and Bradley Hospital will have modified policies to allow for accompaniment by one parent. Newport Hospital maternity services will allow for a birthing partner only.”

Additional exceptions will be made based on various circumstances, according to Lifespan, such as end-of-life care or cases requiring the presence of a medical guardian or decision-maker.

“We have decided after great deliberation to take this step in these highly unusual circumstances to protect our patients and our workforce,” Timothy J. Babineau, president and CEO of Lifespan,” said in the statement. “We understand this is a great hardship to both patients and families, but we know that older and sicker people are most vulnerable to this novel coronavirus, and after careful evaluation of the evolving risks of transmission, we felt it was the most prudent thing to do.”

Elsewhere, Blue Cross & Blue Shield of Rhode Island announced Friday it will cover the cost of COVID-19 tests and waive co-pays and cost-shares for diagnostic testing related to the virus.

“This policy change covers testing performed at an in-network lab and applies to commercial (fully insured), Medicare Advantage and direct pay members who meet the testing guidelines set by the Centers for Disease Control and Prevention (CDC),” a statement reads.

CVS on Monday announced it will waive charges for home delivery of prescriptions and take other steps aimed at easing the refill process.

Nonprofit group Family Service of Rhode Island on Monday issued a call seeking support for its “Be Safe” program, which is designed to provide low-income children, families and seniors with essential items needed to help prevent the spread of COVID-19. The agency hopes to provide kits containing items like antibacterial soap, disinfecting wipes and alcohol-based hand sanitizers to at least 200 of the families it serves.

Those wishing to contribue may text “BESAFE” to 44321 or visit familyserviceri.org.

“We work in schools and communities across Rhode Island, and in recent weeks so many families have asked how they can get help to buy the products recommended to prevent the spread of the coronavirus,” Margaret Holland McDuff, head of Family Service of Rhode Island, said in a press release. “So many of our neighbors are already struggling to make ends meet – and they raised that these extra costs for recommended products are out of reach for them. In addition, we’re working in countless homes across Rhode Island with babies, seniors and others who are high risk and have very limited incomes. We want to make sure they have the right products to be safe.”

In his statement, Reed said he is “urging the Trump Administration to be more proactive in helping Rhode Island and other states increase their testing capacity.”

“In order to stop the spread of the virus, public health officials must have a firm grasp of how prevalent the disease is, how fast it is spreading, and where,” he said. “The lack of testing kits has hampered that effort and it needs to be addressed. We must all work together to protect people, especially the most vulnerable among us.” 

Impact on education, community events

Local colleges and universities have also taken measures aimed at containing the spread of the virus. On Saturday, the Community College of Rhode Island announced that it has suspended all college-sponsored international travel “for the near future.”

“This includes any international travel associated with the college as a CCRI employee or student, including travel funded by a government grant, foundation, company or other private entity,” a statement from the college reads.

It later adds: “At this time, there are no restrictions on domestic travel. However, we are urging everyone to carefully monitor updates in the areas to which they are planning to travel to help avoid travel disruptions because of unexpected local health conditions.”

Additionally, all CCRI faculty, staff and students who have visited China, Iran, Italy, South Korea and Japan in the last two weeks are being required to notify the college and remain at home until they have been symptom-free for 14 days.

Brown University, Roger Williams University and the University of Rhode Island have also each taken steps aimed at preventing the spread of the virus.

At RWU, 15 students and one faculty member have entered self-quarantine after attending a February Conservative Political Action Conference that has been linked to a case of the virus. At Brown, three students were in self-quarantine while being tested for COVID-19. Brown and URI, meanwhile, have suspended all international travel.

During Monday’s briefing, Alexander-Scott said closing schools is “something we are currently exploring and discussing.”

“We are one of the states that has the CDC team with us on the ground now,” she said. “Their focus is to help us understand the best approach with schools. What works well in terms of closing, how to understand and learn from transmission that may occur.”

Alexander-Scott said health officials are also “exploring the best approaches to mass gatherings.”

“We certainly understand that gatherings at this point that have numerous participants, 500 to 1,000 or more, are ones that would be looked at closely for rescheduling … because also we do not yet have community-wide transmission, that allows us the opportunity to slow down that process,” she said. “This is a rapidly evolving situation. We are continuing to reassess the best approach in engaging with school leadership across the state.”

Local, federal support

In a Monday statement, U.S. Sen. Jack Reed called the emergency declaration a “needed, proactive step that will help ensure the state can expedite the purchasing of medical equipment and public health supplies.”

“I support the governor’s decision,” Reed said. “The declaration isn’t cause for alarm. It activates legal mechanisms allowing the state to better coordinate the response and get more medical resources swiftly and effectively in the event that they are needed. Our highest priority is the safety and well-being of all citizens and this declaration will ensure the governor has all the tools available to protect people and public health.”

On Twitter Tuesday, Rhode Island Senate President Dominick Ruggerio reminded residents they can written testimony on legislation in lieu of providing in-person testimony before the General Assembly. 

“Constituents who wish to take every precaution against the spread of COVID-19 by avoiding public gatherings may submit testimony” to slegislation@rilegislature.gov, he wrote. 

In the wake of Raimondo’s emergency declaration, Adanjesus Marin, coordinator of the advocacy group Raise the Bar on Resident Care, said the COVID-19 situation illustrates the need to address staffing at the state’s nursing homes.

“The need for better staffing in Rhode Island’s nursing homes is underscored during a public health crisis such as the coronavirus outbreak as there is a direct correlation between staffing levels and infection control in nursing homes,” Marin said in a statement. “The Rhode Island Department of Health’s actions to contain the coronavirus outbreak are important and necessary to protect the health and welfare of nursing home residents. Moving forward, it is vital that Rhode Island increases staffing levels so residents get the quality care they deserve.”