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COVID-19 Advisory: Elevators ~ California Face Coverings II ~ Scoring by Country

June 22, 2020
To: Distribution
From: Pandemic Working Group
Re: COVID-19: Elevators ~ California Face Coverings II ~ Scoring by Country

Elevator Safety
One of our colleagues recently asked about coronavirus and elevators – are they safe? What should we do to protect ourselves? It so happens that ABCNews covered this very subject just last week. There are three potential ways that COVID may spread in an elevator – through the exhalation of a person riding with you, the exhalation of one who left the elevator car just before you, or, possibly, through touching a surface that had been contaminated. Given that an elevator is a small room (of sorts), one might think that they could be an area of higher risk. In fact, according to studies, elevators are not. As per a study done in a multi-story building in Seoul, Korea last March, while riders from all floors routinely shared elevator rides, and persons on one floor were found to be infected, there was virtually no spread to the other floors. According to infectious disease specialist Dr. Todd Ellerin, “This argues that elevators are not a hot spot for transmission.” Dr. Ellerin goes on to say that, “Time is our biggest risk reducer. The short time people spend on elevators together will mitigate against large amounts of transmission.” 

Brevity should not be our sole defense, however. Experts highly recommend that, when in an elevator, we wear a face covering, keep our distance and touch as little as possible. Some buildings (like our offices in Newport) permit only two passengers per elevator car. If you find that your elevator appears to be more crowded than you like, take the next one. And if you have to touch some buttons on the way up or down, then wash or sanitize your hands when you arrive at your destination.

California Face Covering Redux
As we reported last Friday, the California Department of Public Health issued an order relating to the mandatory use of face coverings in the state of California in certain situations. Two areas of particular interest are the requirement that people in the state wear face coverings at work when “i) working in or walking through common areas, such as hallways… and ii) in any room or enclosed area where other people (except for members of the person’s own household or residence) are present when unable to physically distance.” Before tackling these specifically, let’s set the stage. We have been following a policy of social distancing at all our locations, including those within the state of California. Further, we will be issuing a set of written protocols for the Newport Beach office this week and are incorporating this latest order into that set. As to the first clause of the order relating to walking through common areas and hallways, we take recourse once again to infectious disease expert, Dr. Erin Bromage, for the proposition that “Dose x Exposure = Infection,” and, to that end, recommend that when using our own hallways or common areas (such as break rooms) to the extent that you must be within six feet of another person then put on a face covering unless you are just passing by. In other words, when in motion, even if the distance between you and another is short, the risk of transmission is low. However, if you find yourself in a common area – like a kitchen – are stationary for more than a few minutes and within six feet of another, please put on a face covering. This approach is consistent with the second clause of the order, which covers situations in which you find yourself in any enclosed space and are unable to physically distance.

Scoring by Country
As reported by the Global Forecasting team of the Economist Intelligence Unit (EIU), we provide you with an index that ranks the quality of the policy response to the coronavirus among 21 OECD countries. Countries were graded against three “quality of response” criteria, including tracking and testing, the continued provision of non-COVID healthcare services and the excess death rate per million. In addition, the score was adjusted for mitigating factors, including relative level of elderly in the population, prevalence of obesity and number of international arrivals. As per the graph, a 4.0 on the vertical axis means that the country showed the best response, while a 4.0 on the horizontal axis means that that country had the highest risk. According to the EIU, Australia, Israel and Germany showed the best response (in locations with moderate risk), while Austria, Norway and New Zealand showed the best response among countries with higher risk. At the lowest end of the index were Italy and Spain (among higher risk countries) and UK, Belgium and Netherlands (among those having moderate risk). Interestingly, despite having no mandatory lockdown, Sweden’s death rate per million was better than that of Italy and Spain, which – in their defense – were the first EU countries hit by the pandemic.

On a Closing Note
In the category of worst signage I have ever seen is this COVID elevator sign from in which the building manager offers, as a helpful hint, that we should keep one alligator length away from fellow riders. This, to me, seems problematic. First, what are the chances that the alligator was already in the car when these guys walked in – or do you suppose that he was hanging around the hall and slipped in as the door was closing? Second, when did alligators – which vary greatly in size – become a standard of measure? I mean, they’re not like floor tiles. Also, we’re talking about an airborne virus here, not a man-eating reptile. Third, if these two people are six feet tall, then that alligator has got to be about nine feet long. And finally, there’s no way that that guy to the right would be standing still. No way. – TD

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COVID-19 Advisory: Elevators ~ California Face Coverings II ~ Scoring by Country