Robert T Babbitt PLLC

Issue 10, Article 1

July 3, 2020

COVID 19, CASES RISE IN 40 OF THE 50 STATES, TEXAS CITIES AT THE HEART OF THE BATTLE

The Covid-19 pandemic has changed our tasks, our teams, and our projections. There are voices that are worried the phased re-opening of the economy was too early; there are those that want to press ahead. As managers it is vital to remain objective. There is no argument that Florida, Arizona and Texas are experiencing rapid increases in positive cases. There is no argument that expanded testing and large gatherings without social distancing or facial coverings are two reasons for the increase in positive cases. But there are critical issues to take on calmly and there are challenging issues that cannot be ignored.

One of the issues that CANNOT BE IGNORED is the hospital experience in the Valley, Houston and Dallas. There is nothing overstated about the crisis of the healthcare professionals giving their service under extreme conditions. At Houston’s Texas Medical Center hospitals COVID-19 surge plans went into effect this week. Since Intensive Care Unit patients exceed capacity, conversions of regular treatment areas to accommodate ICU patients are taking place. Officials at Methodist, Memorial Hermann and CHI Saint Luke’s hospital systems explained the conversion of regular patient care areas to Covid patient care. They also explained the steps being taken to reschedule less urgent inpatient surgeries and procedures.

In Dallas, Parkland Hospital is one of the facilities that has been overwhelmed by the surge in cases. This week the staff prepared a fourth Covid unit at the hospital. Each time a new unit is transformed, the staff hopes it will be the last. So far, they have been disappointed.

In Starr and Hidalgo counties both respective county judges issued emergency alerts on Friday, July 3rd. Starr county Judge Eloy Vera explained, “The local and valley hospitals are at full capacity and have no more beds available. I urge all of our residents to shelter in place, wear face coverings, practice social distancing and AVOID GATHERINGS.” 

The critical issues to TAKE CALMLY include realistic explanations of how the virus transmission occurs; not how it could possibly occur. Two studies identified millions of cases that were prevented or delayed by the stay at home orders that were so challenging. As we responsibly open our organizations, these three steps explain the vast majority of transmissions: coughing, singing, loud talking without facial coverings spreads virus droplets farther; enough virus has to move from the first person to another; the virus has to make it into the respiratory tract of the second person and that person’s ACE-2 receptors become the path to replication. Forty states are learning these steps, repeatedly.

For more details see: www.houstonchronicle.com (July 1, updated July 2, 2020)

              www.fox4news.com (July 2, 2020); www.ksat.com (July 3, 2020)

Issue 10, Article 2

COVIS 19, IMAGINE YOU WERE MANAGING A HOSPITAL DURING THIS PANDEMIC

It is quite challenging to manage a transit system this year. You must keep normal operations safe and friendly while you minimize the risks to the employee team members; minimize the risks to customers; and convince funding agencies to support the system in a manner that has never happened before.

But would you want to trade places with a hospital administrator?

Hospitals in the Valley, Houston and Dallas have exceeded the limits of the normal Intensive Care Units.

You might expect that transmission of Covid-19 from one positive case to another patient would be an enormous problem. It need not be a problem according to details from UT Southwestern Medical Center.

The comments from Dr. Seth Toomay, Health System Chief Medical Officer of UTSW, are instructive. He has not found a single case of any patient contracting Covid-19 while being treated for another condition at UTSW. On the other hand, 121 of the 18,000 employees contracted Covid-19. That is frustrating, yet it represents a smaller rate of infection per 100,000 than that of the population in Dallas County.

If you were running the hospital, one of the fears would be your medical staff contracting the disease from the positive case patients. That is extremely low in this case. Only 6% of the 121 cases were patient to staff cases.

Next, you might worry about employee to employee infections with so many potential exposures on touch points. That is a minor issue at this hospital also. Only 10% of the 121 cases were transmitted from employee to employee. That leaves team member exposure when they are not at work. Fully 84% of the 121 cases are evidence of community spread.

Consider this for a moment. With proper health and distancing protocols in the hospital, the infections were minimized. But at UTSW the infections outside of the hospital were five times more risk for the team.

This drives home two critical points for beating the disease. If we take the precautions that we know are working, our transit systems can be kept safe for our teams and our customers. And it reminds us that the avoidance of many of the protocols that we know are working is the most preventable element of the fight.  

For more details see: Dallas Morning News (July 5, 2020)

Issue 10, Article 3

COVID 19, EVERY NEWS MEDIA OUTLET IS TRYING TO TELL US WHEN THE NEW NORMAL WILL ARRIVE

Be alert during this tumultuous phase of news stories that proclaim that the economy will never recover or that we may never see a successful vaccine. These are challenging circumstances by any measure, but it is very important to keep a balanced perspective.

National data (except case counts and fatalities) are not often reported, since a reporter pointing out the problems in large hotspots generates more interest. But Hannah Miller of CNBC did just that. The nation is experiencing unusual patterns of returning to normal. Some functions are returning to prior levels quite slowly, some quite rapidly.

Each of these datasets compares the national data from January to the most recent available.

AIRLINE TRAVEL

The number of travelers passing through TSA checkpoints dropped by more than 90% from January to April and remained at the low level on a flat trajectory during the month. Beginning in May, the passengers increased steadily to “only” 80% below normal by the end of June.

HOTEL OCCUPANCY

It is simple to modify business or recreational travel in most cases. Simply drive rather than fly. To some extent this is happening. If all travel had switched to autos from airlines, we would expect the hotel occupancy to increase from prior year data. The facts are encouraging for hotels compared to airlines. In January occupancy rose for two weeks. It then flattened until early March. From early March to the end of the month, occupancy dropped 40%. Since the middle of April to the end of June, occupancy rose steadily from just over 20% to over 45%.

HOME PURCHASES

During January, February and March, home mortgage applications were steady at 10% greater than the prior year. From the beginning of March, it dropped from up 10% to down 35% in one month. In April it dropped for one week, then increased to up 15% for the year by late June.

DIRECTIONS ON APPLE MAPS

Not everyone uses Apple Maps, but of the large group that does, instant data is available of the increase or decrease in those seeking directions for transit, auto or walking trips. The comparison is invaluable as we consider how quickly our riders might return.

In February and March walking directions increased; from early March through mid-April the directions were flat; from mid-April to the end of June the directions grew rapidly to end up 10% compared to the down 50% in March.

Driving directions followed an almost identical pattern to walking directions.

Transit directions had a similar pattern yet fell farther (-75%) and rebounded (-50%) more slowly.

What Do These Trends Mean for Transit Managers?

Despite the noise on many channels, the housing mortgage applications point toward a stable economy.

Hotel occupancy and TSA data tell us that even the travel industry may become busy, though few are selecting to be seated next to someone they do not know for hours.

Directions data indicate that transit trips will return more slowly and steadily than other modes. It will be imperative to show transit customers the safety and disinfecting processes, the social distancing steps and the extra capacity that have been added to move customers apart while maintaining our essential mobility.

For more details see: www.cnbc.com (July 5, 2020)

Issue 10, Article 4

COVID 19, HAND SANITIZERS ARE NEEDED IF SOAP AND WATER ARE NOT AVAILABLE BUT FDA ISSUES WARNING ON DANGEROUS METHANOL BASED SANITIZERS

The Food and Drug Administration has warned that the hand sanitizer products that substitute methanol in hand sanitizer products are dangerous.

The Named Products in the recent (July 2, 2020 update) warning are:

              All-Clean Hand Sanitizer by Eskbiochem

              Esk Biochem Hand Sanitizer by Eskbiochem

              Lavar 70 Gel Hand Sanitizer by Eskbiochem

              The Good Gel Antibacterial Gel Hand Sanitizer by Eskbiochem

              CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol by Eskbiochem

              CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol by Eskbiochem (74589-003-01)

              CleanCare NoGerm – same product, different model (74589-005-03)

              Saniderm Advanced Hand Sanitizer by Eskbiochem

              Britz Hand Sanitizer Ethyl Alcohol 70% by Tropicosmeticos SA de CV

              Antiseptic Alcohol 70% Topical hand sanitizer Soluciones Cosmeticas SA de CV

              Bersih Hand Sanitizer Gel Fragrance Free by Soluciones Cosmeticas SA de CV

              Mystic Shield Protection hand sanitizer by Transliquid Technologies

              Hand sanitizer Gel Unscented 70% Alcohol by Grupo Insoma, SAPI de CV

A quick method to determine if a product is making false claims is the phrase “FDA Approved”. The Food and Drug Administration has not approved any hand sanitizers.

How can you be certain the product is safe? If your organization has used one type for a long period it is safest to remain with that product. There has been a rush of unsafe substitutes using methanol. But simply looking for methanol on the label is insufficient since several of these above have been falsely labelled.

Remember that 60% to 90% ethyl or isopropyl alcohol is used when soap and water are not available.

For more details of test results for methanol see: www.fda.gov (June 29, 2020)

Issue 10, Article 5

COVID 19, DESIGNING THE BEST OPERATOR PARTITION FOR COVID AND OTHER SAFETY ISSUES

The response to Covid-19 has led many transit systems to quickly devise an operator partition or sneeze barrier.

It is a simple idea to combat a troublesome issue: operators are exposed to unknown numbers of positive infection customers each day. The worst cases are often avoiding transit. But some may not know they are infected.

Whether your system is purchasing or designing/building the barriers, it is important to evaluate the impacts of the barriers on preventing the spread of viral droplets AND not creating any new safety issues of concern.

Simply stated, the design should be effective at reducing transmission of Covid-19 without introducing new, unacceptable, or unintended hazards.

First consider the operator line of sight. Though all barriers use clear plastic or glass panels, the mounting and bracing components are potential sight line hazards.

Second, no part of the barrier should be lower to the floor than twelve inches to prevent trip hazards.

Third, barriers that seal operator compartment completely should be carefully considered since these may introduce significant impacts on airflow from the HVAC system.

Fourth, any part of the barrier that interferes with ingress or egress must meet OEM and federal safety standards.

Fifth, the crashworthiness of the system structure and the safe breakage patterns of the materials should prevent any sharp edges or shards in the case of a collision or similar impact.

The idea of operator barriers is not controversial. Be certain that once the safe product design is complete and installation is tested, that the use and cleaning cycle are tested as well. The advantage of clear plastics is economy and availability. The challenge is the interaction of some cleaning products and chemicals may degrade the clarity or alter the color of the clear panel.

For more details see: www.ftson.org (June 8, 2020)

Weekly Update : Issue 10, Week of July 6-12. 2020: Cases Rise in 40 States, Managing Operations During a Pandemic, Anticipating The New Normal, and more

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