‘It will not be pretty’: State preparing to make life-or-death decisions if coronavirus overwhelms health care system | The Seattle Times

Washington state and hospital officials have been meeting to consider what once was almost unthinkable — how to decide who lives and dies if, as feared, the coronavirus pandemic overwhelms the state’s health care system.

“We don’t want to do it. We don’t think we should have to do it,” said Cassie Sauer, chief executive of the Washington State Hospital Association, which along with state and local health officials has been involved in refining what Sauer called a”crisis standard of care” — essentially guidelines to health care officials on who should receive treatment and who should be left to die.

“If we have to do this, then we want to do it in a fair and rational and thoughtful way,” Sauer said.

Dr. Vicki Sakata, the senior medical adviser to the Northwest Health Care Response Network, said a group of medical officials and other experts have been discussing how the state would deal with a crisis that overwhelmed the medical system. She prefers to add the word “planning” to the idea of “crisis standard of care” because, in her mind, the goal is to avoid a crisis in the first place.

That said, the state is prepared to act if it has to and has developed guidelines that will be implemented across the system, from the bedside doctor to hospital systems.

“We will do it as a state under ethical framework that is part of the state plan,” she said. “It will be overseen by an objective team who has been thoroughly briefed on the protocols and processes, and will be undertaken in a transparent and equitable manner.

“But, make no mistake, it will not be pretty,” said Sakata, who is a practicing emergency medicine physician. “That’s why we are taking the steps we are taking now, the social distancing, the hand washing, all of that, so sometime down the road nobody is left having to decide who gets resources, and who doesn’t.”

Sakata said her network, which comprises 15 Western Washington counties, has been working on crisis standard-of-care planning since 2012, and wanted to assure the public that all efforts and resources are being aimed at managing the COVID-19 outbreak so that the health care system doesn’t collapse under the strain of too many patients at once.

The orders restricting gatherings and urging people to practice social distancing is all aimed at slowing the outbreak and spreading the cases that do appear out over time so the system is not swamped.

Sauer said she was talking about the plan in hopes of convincing the federal government to release additional medical stores from the Strategic National Stockpile, where it keeps much-needed ventilators and other equipment necessary to treat the sickest of the COVID-19 victims.

“This is America,” she said. “We have resources. We should not be in this position.”

The New York Times reported on Friday that state and health care officials held a conference call to discuss the triage plan. It reported the plan will assess factors such as age, health and likelihood of survival in determining who will get access to full care and who will merely be provided comfort care, with the expectation that they will die, the newspaper reported.

State Department of Health (DOH) officials told The Seattle Times on Friday they were meeting to further refine guidelines. DOH Director Dr. Kathy Lofy declined an interview but issued a euphemistic acknowledgment of the crisis triage plan.

“Over the past several years, a group of clinical experts in the Puget Sound area developed guidance around how health care might need to be delivered differently during emergencies if supplies, staffing, and or hospital beds become limited,” Lofy wrote. “We are doing everything possible to slow the spread of the virus and increase resources within the health care system so that resources will be available for everyone who needs them.”

DOH spokeswoman Lisa Stromme said the department will release information on the triage guidelines soon, saying it is “one of our top priorities.

“However, it will not be discussed externally until we can discuss it internally in the right way,” Stromme said. “It’s too crucial.”

Sauer is concerned that it is too early to determine whether the social distancing order by state and local officials and the shuttering of restaurants, schools and public places will effectively slow the spread of the virus. If not, Sauer said most projections indicate that regional hospitals will be swamped with COVID-19 patients over the next several weeks.

Some projections put Seattle’s outbreak on the same scale, but just a few weeks behind, northern Italy, where on Thursday alone there were more than 5,300 new COVID cases reported. Italy has reported 41,000 infections and more than 3,400 people have died, some because doctors there have had to make choices like Sauer and her colleagues were talking about in Seattle on Friday.

Sauer said the guidelines are being finalized and she hopes they are never implemented. If they are, then treatments will be allocated to “the greatest number of people who are likely to survive,” with others provided comfort care and allowed to die.

The decision will be made regionally, so no one doctor or hospital will have to make the decision, Sauer said. At that point, it is anticipated that every hospital would be overcrowded and resources would be limited.

The coronavirus has proven to be particularly virulent among the aged and individuals suffering from underlying health problems. If a triage plan has to implemented, Sauer said, decisions will be mostly be based on people in those two categories.

“They will be less likely to receive care, and more likely to die” so that people with a better chance of recovering can live, she said.

How is this outbreak affecting you, if at all?

Are you changing your routine or going about your business as usual? Have you canceled or postponed any plans? What kinds of discussions are you having with family members and friends? Are you a healthcare worker who’s on the front lines of the response? Whoever you are, we want to hear from you so our news coverage is as complete, accurate and useful as possible. 

Do you have questions about the novel coronavirus?

Ask your question in the form below and we’ll dig for answers. If you’re using a mobile device and can’t see the form on this page,

This content was originally published here.

Riccobene Associates Family Dentistry Donates to Local Food Banks

Riccobene Associates Family Dentistry is working hard to do all they can to help those in need during the COVID-19 outbreak. Since the company’s founding over 19 years ago, the dental group has always given back to the communities they serve. This week and in weeks to come, the Riccobene staff will be teaming up with local food banks to help carry out their mission in providing food and support for those in need. Each of the 30+ Riccobene locations across North Carolina will be participating in this community initiative, donating non-perishable food items, including canned fruits and vegetables, cereal, peanut butter, juice boxes and other needed food items. 

The Riccobene team encourages allwho are able, to support their local food banks. With many schools and businesses shutting down to prevent the spread of COVID-19, thousands will be left without food. Smiles on Us, a community outreach program Riccobene Associates started to give back to local communities, is determined to take advantage of this opportunity to make a big impact. 

“We’re proud to participate in the community’s efforts to help children and families across North Carolina who are in need. It’s the right thing to do, and it’s who we are as a company,” says Whitney Suiter, Director of Marketing at Riccobene Associates.

To encourage donations, Riccobene Associates has provided a list of food banks across North Carolina. 

List of Local Food Banks

Raleigh

1924 Capital Boulevard, Raleigh, NC 27604

Wake Forest

149 E Holding Avenue, Wake Forest, NC 27587

Knightdale

111 N First Ave, Knightdale, NC 27545

Cary

187 High House Road, Cary, NC 27511

Apex

1600 Olive Chapel Road, Suite 408, Apex, NC 27502

Garner

209 S Robertson Street, Clayton, NC 27520

Clayton

Samaritan Shelf Food PantryWest Clayton Church of God // 143 Short Johnson Rd, Clayton, NC 27520

Selma

401 W Anderson St, Selma, NC 27576

Goldsboro

Community Soup Kitchen112 West Oak St. Goldsboro 27530 (no website) 919-731-3939

Greensboro

3210 Summit Avenue, Greensboro, Nc, 27405

Charlotte

500-B Spratt Street, Charlotte, NC 28206

Fayetteville

Hunger Can’t Wait406 Deep Creek Road, Fayetteville, NC 28312

Clemmons

2585 Old Glory Road, Suite 109, Clemmons, NC 27012

Benson

Deliverance Church- 103 E Main St, Benson, NC 27504

Rocky Mount

1725 Davis Street, Rocky Mount, NC 27803

Holly Ridge

12395 NC Hwy 50, Hampstead, NC 28443

Oxford

ACIM (Area Congregations In Ministry) – 634 Roxboro Rd, Oxford, NC 27565

Wilmington

1314 Marstellar Street, Wilmington, NC 28401

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This content was originally published here.

If U.S. doesn’t ‘flatten the curve,’ severe cases of COVID-19 will overrun health system | PBS NewsHour

Judy Woodruff:

One term you’re likely hearing a lot about to help deal with the coronavirus is what’s known as flattening the curve.

Epidemiologists say, if not enough protective measures are taken, there’ll be a sharply rising number of cases, as shown in this pale blue spike, a huge jump over a very short period of time. That would strain the capacity of our health system.

But flattening the curve, reflected by the lower gray swell, is achieved by taking strong measures, like physical and social distancing, to make sure the number of cases increases more gradually.

Dr. Asaf Bitton has been talking about this very issue. He’s with Brigham and Women’s Hospital in Boston. And he joins us now.

Dr. Bitton, between Washington and the states, are the American people now being given enough guidance to induce them to do the right thing?

So while people who work perhaps in nonessential services may want to continue that work, and I’m very sympathetic to it, unfortunately, the speed of the rise of this epidemic may make necessary more involuntary closures or restrictions.

Asaf Bitton:

Well, we have — according to the American Hospital Association a couple of years ago, we have a little over 900,000 beds. We have about 50,000 medical ICU beds that are staffed and another 50,000 other type of ICU beds that are staffed, and, in total, about 160,000 vents.

What that means is, even in a moderate scenario, like predicted by the John Hopkins Center for Health Security, if it came at once, we wouldn’t really have the capacity. That would overwhelm that existing capacity.

So what is needed now is for people to take the community mitigation and social distancing strategies to flatten the curve, to spread that out, so that, if those cases emerge — and it’s hard to predict, but it’s possible at this point — it at least can emerge over an increased amount of time.

Otherwise, this is going to be very difficult on our health system and our health care workers.

This content was originally published here.

Henry Ford Health officials confirm life, death protocols letter

Henry Ford Health officials confirm letter outlining life and death protocols for COVID-19

Phoebe Wall Howard
Detroit Free Press
Published 2:39 AM EDT Mar 27, 2020

Henry Ford Health System has officially confirmed the accuracy of a detailed letter being circulated by doctors and others on social media outlining life and death guidelines for use during the pandemic. 

The @HenryFordNews Twitter account responded at 11:22 p.m. Thursday  to Nicholas Bagley, a University of Michigan law professor, who shared content that appeared to be on hospital letterhead outlining how doctors would make decisions at the Michigan hospital network about who gets treated during the COVID-19 crisis with limited resources.

People had immediately replied with shock and sadness and challenged the authenticity of the letter.

Henry Ford Health System responded directly to Bagley as the response to his tweet grew more heated.

“With a pandemic, we must be prepared for worst case,” the tweet said. “With collective wisdom from our industry, we crafted a policy to provide guidance for making difficult patient care decisions. We hope never to have to apply them. We will always utilize every resource to care for our patients.”

The original Henry Ford Health System letter that triggered discussion said:

“To our patients, families and community:

Please know that we care deeply about you and your family’s health and are doing our best to protect and serve you and our community. We currently have a public health emergency that is making our supply of some medical resources hard to find. Because of shortages, we will need to be careful with resources. Patients who have the best chance of getting better are our first priority. Patients will be evaluated for the best plan of care and dying patients will be provided comfort care.

What this means for you and your family:

1. Alert staff during triage of any current medical conditions or if you have a Do Not Resuscitate (DNR)/Do Not Attempt Resuscitation (DNAR) or other important medical information.

2. If you (or a family member) becomes ill and your medical doctor believes that you need extra care in an Intensive Care Unit (ICU) or Mechanical Ventilation (breathing machine) you will be assessed for eligibility based only on your specific condition.

3. Some patients will be extremely sick and very unlikely to survive their illness even with critical treatment. Treating these patients would take away resources for patients who might survive.

4. Patients who are not eligible for ICU or ventilator care will receive treatment for pain control and comfort measures. Some conditions that are likely to may make you not eligible include:

5. Patients who have ventilator or ICU care withdrawn will receive pain control and comfort measures:

6. Patients who are treated with a ventilator or ICU care may have these treatments stopped if they do not improve over time. If they do not improve this means that the patient has a poor chance of surviving the illness — even if the care was continued. This decision will be based on medical condition and likelihood of getting better. It will not be based on other reasons such as race, gender, health insurance status, ability to pay for care, sexual orientation, employment status or immigration status. All patients are evaluated for survival using the same measures.

7. If the treatment team has determined that you or your family members does not meet criteria to receive critical care or that ICU treatments will be stopped, talk to your doctor. Your doctor can ask for a review by a team of medical experts (a Clinical Review Committee evaluation.)

In recent days, the CEO of Beaumont Health described the current crisis as “our worst nightmare” and the novel coronavirus health crisis as a “biological tsunami.” He warned the public of limited supplies and the need to stay at home to limit the spread. Gov. Gretchen Whitmer issued an executive order on March 23 requiring residents to stay in place until April 13.

On Thursday, President Trump discussed providing medical aid with military assistance in New York.

More: Beaumont Health CEO describes coronavirus pandemic as ‘our worst nightmare’

More: President Trump slams Gov. Whitmer as he weighs disaster request for Michigan

More: Beaumont Hospital in Wayne closing ER, non-coronavirus patients to be moved as cases surge

Before Henry Ford Health System provided public confirmation on Twitter, Bagley, the Ann Arbor professor with more than 26,000 Twitter followers, removed the letter and wrote at 11:30 p.m., “I’m going to take this down until it can be independently verified. The memo is circulating among doctors, but Henry Ford apparently can neither confirm nor deny it yet.”

Minutes later, Henry Ford Health System responded to Bagley.

‘Response planning’

The hospital network responded directly to a Free Press request for confirmation, providing a statement explaining that the Henry Ford Health System letter is part of a larger policy document developed for an absolute worst case scenario. It is not an active policy within Henry Ford, but a part of emergency response planning, as is standard with most reputable health systems.

The hospital network provided the following statement after midnight Thursday from Dr. Adnan Munkarah, executive vice president and chief clinical officer of Henry Ford Health System:

“With a pandemic of this nature, health systems must be prepared for a worst case scenario. Gathering the collective wisdom from across our industry, we carefully crafted our policy to provide critical guidance to healthcare workers for making difficult patient care decisions during an unprecedented emergency. These guidelines are deeply patient focused, intended to be honoring to patients and families. We shared our policy with our colleagues across Michigan to help others develop similar, compassionate approaches. It is our hope we never have to apply them and we will always do everything we can to care for our patients, utilizing every resource we have to make that happen.”

Contact Phoebe Wall Howard at 313-222-6512 or phoward@freepress.com. Follow her on Twitter @phoebesaid. 

This content was originally published here.

Florida megachurch pastor arrested for holding services despite health order

A Florida pastor was arrested on Monday for holding services at a Tampa megachurch in violation of a public health order prohibiting large gatherings to stem the spread of the coronavirus.  

Pastor Rodney Howard-Browne was charged with misdemeanor counts of unlawful assembly and violation of the public health rules, according to Fox 13, Tampa Bay’s local affiliate.

Howard-Browne’s apprehension came after he held two Sunday services with up to 500 attendees, even offering bus service to the church.

“His reckless disregard for human life put hundreds of people in his congregation and thousands of residents who may interact with them this week in danger,” said Hillsborough County Sheriff Chad Chronister, who issued an arrest warrant earlier Monday.

Despite social distancing measures to curb person-to-person transmission of the coronavirus, the River at Tampa Bay Church announced earlier this month that it intended to remain open to comfort those in need, even as the number of confirmed coronavirus cases rose across the country.  

“In a time of national crisis, we expect certain institutions to be open and certain people to be on duty. We expect hospitals to have their doors open 24/7 to receive and treat patients. We expect our police and firefighters to be ready and available to rescue and to help and to keep the peace. The Church is another one of those essential services. It is a place where people turn for help and for comfort in a climate of fear and uncertainty,” the church said in a statement.

The River at Tampa Bay Church was one of several regional churches that drew hundreds of worshipers recently despite bans on public gatherings amid the coronavirus pandemic.

Earlier in March, a Louisiana church held a service attended by about 300 people despite a ban on gatherings of more than 50 people by Gov. John Bel Edwards (D). The Rev. Tony Spell of Life Tabernacle Church in East Baton Rouge Parish said at the time that the virus was “not a concern.”

President TrumpDonald John TrumpCuomo grilled by brother about running for president: ‘No. no’ Maxine Waters unleashes over Trump COVID-19 response: ‘Stop congratulating yourself! You’re a failure’ Meadows resigns from Congress, heads to White House MORE last week said during a Fox News town hall at the White House that he would “love to have the country opened up and just raring to go by Easter,” describing his April 12 target date as a “beautiful timeline” and adding that he hoped to see “packed pews.”  

But Trump reversed course on Sunday, announcing the White House would keep its guidelines for social distancing in place through the end of April to try to blunt the spread of the coronavirus.

This content was originally published here.

‘Now Is the Time for Solidarity’: Bernie Sanders Addresses Health and Economic Crisis Facing US as Coronavirus Spreads

Good afternoon, everybody. In the last few days, we have seen the crisis of the coronavirus continue to grow exponentially.

Let me be absolutely clear: in terms of potential deaths and the impact on our economy, the crisis we face from coronavirus is on the scale of a major war, and we must act accordingly.

Nobody knows how many fatalities we may see, but they could equal or surpass the U.S. casualties we saw in World War II.

It is an absolute moral imperative that our response — as a government, as a society, as business communities, and as individuals — meets the enormity of this crisis.

As people work from home and are directed to self-quarantine, it will be easy to feel like we are in this alone, or that we must only worry about ourselves and let everyone else fend for themselves.

That is a very dangerous mistake. First and foremost, we must remember that we are in this together.

Now is the time for solidarity. We must fight with love and compassion for those most vulnerable to the effects of this pandemic.

If our neighbor or co-worker gets sick, we have the potential to get sick. If our neighbors lose their jobs, then our local economies suffer, and we may lose our jobs. If doctors and nurses do not have the equipment and staffing capacity they need now, people we know and love may die.

Unfortunately, in this time of international crisis, the current administration is largely incompetent, and its incompetence and recklessness has threatened the lives of many people.

So today I’d like to give an overview of what we must do as a nation.

First – we are dealing with a national emergency and the president should declare one now.

Next, because President Trump is unable and unwilling to lead selflessly, we must immediately convene an emergency, bipartisan authority of experts to support and direct a response that is comprehensive, compassionate, and based first and foremost on science and fact.

We must aggressively make certain that the public and private sectors are cooperating with each other. And we need national and state hotlines staffed with well-trained people who have the best information available.

Among many questions, people need to know: what are the symptoms of coronavirus? When should I seek medical treatment? Where do I go for a test?

The American people deserve transparency, something the Trump administration has fought day after day to stifle. We need daily information — clear, science-based information — from credible scientific voices, not politicians.

And during this crisis, we must make sure we care for the communities most vulnerable to the health and economic pain that’s coming — those in nursing homes and rehabilitation facilities, those confined in immigration detention centers, those who are currently incarcerated, and all people regardless of immigration status.

Unfortunately, the United States is at a severe disadvantage, because, unlike every other major country on earth, we do not guarantee health care as a human right. The result is that millions of people in this country cannot afford to go to a doctor, let alone pay for a coronavirus test.

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So while we work to pass a Medicare for All single-payer system, the United States government must be clear that in the midst of this emergency, that everyone in our country — regardless of income or where they live — must be able to get all of the health care they need without cost.

Obviously, when a vaccine or other effective treatment is developed, it must be free of charge.

We cannot live in a nation where if you have the money you get the treatment you need to survive, but if you’re working class or poor you get to the end of the line. That would be morally unacceptable.

Further, we need emergency funding right now for paid family and medical leave.  Anyone who is sick should be able to stay home during this emergency, and receive their paycheck. 

What we do not want to see is at a time when half of our people are living paycheck to paycheck, when they need to go to work in order to take care of their family, we do not want to see people going to work who are sick and can spread the coronavirus.

We also need an immediate expansion of community health centers in this country so that every American will have access to a nearby healthcare facility.

Where do I go? How do I get a test? How do I get the results of that test? We need greatly to expand our primary health care capabilities in this country and that includes expanding community health care centers.

We need to determine the status of our testing and processing for the coronavirus. The government must respond aggressively to make certain that we in fact do have the latest and most effective test available, and the quickest means of processing those tests.

There are other countries around the world who are doing better than we are in that regard. We should be learning from them.

No one disputes that there is a major shortage of ICU units, and ventilators that are needed to respond to this crisis. The federal government must work aggressively with the private sector to make sure that this equipment is available to hospitals and the rest of the medical community.

Our current healthcare system does not have the doctors and nurses we currently need. We are understaffed. During this crisis, we need to mobilize medical residents, retired medical professionals, and other medical personnel to help us deal with this crisis.

We need to make sure that doctors, nurses and medical professionals have the instructions and personal protective equipment that they need.

This is not only because we care about the well-being of medical professionals — but also because if they go down, our capability to respond to this crisis is significantly diminished.

The pharmaceutical industry must be told in no uncertain terms that the medicines that they manufacture for this crisis will be sold at cost. This is not the time for profiteering or price gouging.

The coronavirus is already causing a global economic meltdown, which is impacting people throughout the world and in our own country, and it is especially dangerous for low income and working families the most. People who today, before the crisis, were struggling economically.

Instead of providing more tax breaks to the top one percent and large corporations, we need to provide economic assistance to the elderly – and I worry very much about elderly people in this country today, many of whom are isolated and many of whom do not have a lot of money.

We need to worry about those who are already sick. We need to worry about working families with children, people with disabilities, the homeless and all those who are vulnerable.

We need to provide in that context emergency unemployment assistance to anyone who loses their job through no fault of their own. 

Right now, 23 percent of those who are eligible to receive unemployment compensation do not receive it. 

Under our proposal, everyone who loses a job must qualify for unemployment compensation at least 100 percent of their prior salary with a cap of $1,150 a week or $60,000 a year. 

In addition, those who depend on tips – and the restaurant industry is suffering very much from the meltdown – gig workers, domestic workers, and independent contractors shall also qualify for unemployment insurance to make up for the income that they lose during this crisis.

We need to make sure that the elderly, people with disabilities and families with children have access to nutritious food. That means expanding the Meals on Wheel program, the school lunch program and SNAP so that no one goes hungry during this crisis and everyone who cannot leave their home can receive nutritious meals delivered directly to where they live.

We need also in this economic crisis to place an immediate moratorium on evictions, foreclosures, and on utility shut-offs so that no one loses their home during this crisis and that everyone has access to clean water, electricity, heat and air conditioning.

We need to construct emergency homeless shelters to make sure that the homeless, survivors of domestic violence and college students quarantined off campus are able to receive the shelter, the healthcare and the nutrition they need.

We need to provide emergency lending to small and medium sized businesses to cover payroll, new construction of manufacturing facilities, and production of emergency supplies such as masks and ventilators.

Here is the bottom line. When we are dealing with this crisis, we need to listen to the scientists, to the researchers, to the medical folks, not politicians.

We need an emergency response to this crisis and we need it now.

We need more doctors and nurses in underserved areas.

We need to make sure that workers who lose their jobs in this crisis receive the unemployment assistance they need.

And in this moment, we need to make sure that in the future after this crisis is behind us, we build a health care system that makes sure that every person in this country is guaranteed the health care that they need. 

This content was originally published here.

Orthodontist, dentist practices told to shut down offices

TROY – Cooney Orthodontics, one of the region’s larger practices, is closing its two offices for 11 days except for emergency cases per recommendations from the the American Dental Association, the American Association of Orthodontics and the New York State Dental Association Board of Trustees.

Other practices have announced the same, such as The Smile Lodge pediatric dentistry office in Clifton Park, which serves children from the Mohawk Valley, Capital Region and Adirondacks.

“At this point, taken together with Governor Cuomo’s announcement closing additional businesses, we have decided for the safety of our patients and staff to temporarily close both our Troy and Ballston Lake offices starting Tuesday March 17th through Friday March 27th,” Cooney wrote. “If you have an appointment scheduled during this time, we will be reaching out to reschedule shortly,” the practice said in an email to patients.

This content was originally published here.

NYC declares war on ‘rim jobs’ in Health Dept. report

NYC’s Department of Health is bending over backwards to warn the public about a whole new threat — “rim jobs.”

The city’s health agency issued graphic guidelines for safe sex practices during the coronavirus pandemic Saturday, and while many were quick to take jabs at the agency for declaring masturbation as safer than sex with a partner, most missed the backdoor rim shot.

Yes, the city specifically called out rimming — or using the tongue on the anal rim of another person for sexual pleasure — as particularly dangerous in a jaw-dropping section of the public safety alert.

“Rimming (mouth on anus) might spread COVID-19. Virus in feces may enter your mouth,” the city warned in the section titled, “Take care during sex.”

Eagle-eyed Twitter users, naturally, had a field day with the bizarre bullet point, whipping it into the butt of jokes online.

“The NYC Health Department has a document about sex and coronavirus that includes a statement about rimming,” one person wrote. “tl;dr ‘Stay at least six feet from other people, and be sure not to lick anyone’s anus.’”

“Day 13 of quarantine: my parents read the NYC coronavirus sex guidelines and are now discussing rimming at the dinner table. Need evacuation ASAP,” one person wrote.

Day 13 of quarantine: my parents read the NYC coronavirus sex guidelines and are now discussing rimming at the dinner table. Need evacuation ASAP

— WFH Stan Account (@plerer) March 23, 2020

Others were shocked the Department of Health didn’t let this particular sex act fall through the cracks — and in fact added it right after the section on kissing.

“The nyc coronavirus sex advice goes from kissing straight to rimming a-s which just goes to show how badly nyc was begging for a plague,” another joked.

It’s not always better to love the one you’re self-isolating…

Some, however, were impressed the city poo-pooed the sex act, commonly known as a “rim job,” which is popular for many same-sex partners.

“Important, inclusive, informational. I’m here for this,” one person said.

The Department of Health reiterated advice to social distance to prevent the spread of coronavirus on Saturday, days before the Big Apple became the epicenter of the virus with more than 13,000 cases and as many as 125 deaths from COVID-19.

The agency urged city dwellers to remain six feet apart from one another, but the document also offered “some tips for how to enjoy sex and to avoid spreading COVID-19.”

“You are your safest sex partner,” the document read. “Masturbation will not spread COVID-19, especially if you wash your hands (and any sex toys) with soap and water for at least 20 seconds before and after.”

The agency, however, didn’t knock bumping uglies with a virus-free partner or live-in mate.

“The next safest partner is someone you live with,” the document continued. “Having close contact– including sex — with a small circle of people helps prevent spreading COVID-19.

The document also encouraged seeking out sex in virtual form, including advising sex workers to turn to the web.

“If you usually meet your sex partners online or make a living by having sex, consider taking a break from in-person dates,” the document added. “Video dates, sexting or chat rooms may be options for you.”

So for those looking for rim jobs, best to try a Google search.

This content was originally published here.

As we work to protect public health, we also need to protect the income of hourly workers who support our campus – Microsoft on the Issues

As the impact of COVID-19 spreads in the Puget Sound region and northern California, Microsoft has asked its employees who can work from home to do so. As a result, we have a reduced need in these regions for the on-site presence of many of the hourly workers who are vital to our daily operations, such as individuals who work for our vendors and staff our cafes, drive our shuttles and support our on-site tech and audio-visual needs.

We recognize the hardship that lost work can mean for hourly employees. As a result, we’ve decided that Microsoft will continue to pay all our vendor hourly service providers their regular pay during this period of reduced service needs. This is independent of whether their full services are needed. This will ensure that, in Puget Sound for example, the 4,500 hourly employees who work in our facilities will continue to receive their regular wages even if their work hours are reduced.

While the work to protect public health needs to speed up, the economy can’t afford to slow down. We’re committed as a company to making public health our first priority and doing what we can to address the economic and societal impact of COVID-19. We appreciate that what’s affordable for a large employer may not be affordable for a small business, but we believe that large employers who can afford to take this type of step should consider doing so.

We’re committed to taking additional constructive steps to support the public during this challenging time. While this announcement is focused on Puget Sound and northern California, we’re exploring how best to move forward in a similar way in other parts of the country and the world that are impacted by COVID-19.

We also recognize the vital role that our technology plays in supporting people and organizations each day, especially those working tirelessly to reduce the impact of COVID-19. We’re actively pursuing additional steps around the world to help healthcare teams stay connected with telehealth solutions, schools and universities stay connected with students through virtual classrooms and online learning, and governments stay connected with their citizens with the latest guidance and resources made available online. Across the global economy, we’re working to enable employees to work remotely without sacrificing collaboration, productivity and security. In a time of fluid change and demanding challenges, we all have an important role to play.

This content was originally published here.

starsis applies terrazzo furniture to orthodontist surgery in south korea

in the south korean city of hwaseong-si, design studio starsis has realized the interior of an orthodontist practice. characterized by bright spaces and a rich material palette, the project has been formed by the architect to perfectly fit the needs and background of the client while creating a tranquil environment for awaiting customers.

all images © hong seokgyu

when approaching the design, starsis took inspiration from teeth and the layout of the human jaw to create a plan from rounded, overlapping shapes. after applying this idea to the architecture, it resulted in an internal space in which the oval forms overlap. by limiting straight lines and placing curves inside the tight space, the organic aesthetic is maximized, creating a soft and friendly atmosphere within the orthodontist surgery.

the reception desk and hardwood shelves made from terrazzo, viewed from the waiting area

the interior is defined by white walls lit with warm-colored lights, terrazzo furniture, wooden fittings built into the walls and plants full of lush greenery to provide a sense of ease and relaxation for those who visit the practice for treatment. these materials are combined by the steel furniture, which is finished with paint and placed above the terrazzo floor in perfect harmony.

the entrance viewed from the corridor, and wooden and steel furniture for waiting customers

the furniture and reception desk viewed through the glass window

the wall with the reception desk and hardwood shelves made from terrazzo

the walls are 3.7m high and made of steel for solidity

there is an inspection room, a corridor and a powder room

the triage room viewed through the glass where the floor and walls are finished with 50 x 50mm white tiles

the corridor leading to the examination room

the corridor leading to the consulting office and photography room

on the wall there is built-in furniture where examination instruments can be placed and stored

steel pillars with sketches of spatial symbols and geometric shapes

project info:

project name: malocclusion ; offbeat teeth

location: 127-5, dongtansunhwan-daero, hwaseong-si, gyeonggi-do, south korea

total area: 2198.31 ft2 (204.23 m2)

designboom has received this project from our ‘DIY submissions‘ feature, where we welcome our readers to submit their own work for publication. see more project submissions from our readers here.

edited by: lynne myers | designboom

This content was originally published here.

In just 24 hours, 1,000 retired health care workers volunteered to help fight coronavirus in New York City – CBS News

In just 24 hours, 1,000 retired health care workers in New York City volunteered to join the fight against coronavirus, Mayor Bill de Blasio said in an interview with WCBS 880 on Wednesday. The mayor likened their bold decision to his parents’ generation entering war.

“This is going to be like a war effort. Most New Yorkers haven’t experienced what this city and this country is like in a full-scale war,” de Blasio said. “My parents both served in the war effort in WWII. I heard these stories from the youngest years of my life.”

“When the entire community, the entire city, the entire nation are in common cause, it’s a different reality and everyone is going to have to work together to overcome this crisis, and we’re going to use every tool, every building, every resource to get us through this,” the mayor said.

He added that he asked earlier this week for retired health care workers to return to work, and he had good news: “In the last 24 hours, 1,000 New Yorkers who are retired medical personnel have volunteered to join the effort to fight coronavirus. I think that’s so inspiring. So many people are coming forward to help and that’s how we’re going to beat this back.”

Last week, other elected officials called on “former” health care workers to rejoin the workforce, including Colorado Governor Jared Polis and New York Governor Andrew Cuomo.

According to Polis, former health care workers include anyone retired or working in another field whose medical license is still active or can be reactivated.

Health care workers have been struggling to balance providing care with the fear of exposing their families to the illness. Some say they do not have the protective equipment they need.

“We are two weeks or three weeks away from running out of the supplies that we need most for our hospitals,” de Blasio said Thursday, according to The Associated Press

Lack of hospital beds has also been a concern — especially in New York City. In his interview with WCBS 880, de Blasio said the city is looking to convert large spaces like hotels into health care facilities or logistics staging. On Wednesday, Cuomo said President Trump agreed to send a Navy ship to New York City that will function as a hospital. 

This content was originally published here.