Harrison County Judge Chad Sims said his county has three new COVID-19 case, raising the total there to 272. Harrison County has seen 26 deaths, 181 recoveries and has 66 active cases.
“We have enjoyed a nice downward trend in our active cases,” Sims said in a statement. “Don’t let up now on the personal hygiene and social distancing.”
J.Harris: I read about COVID for several hours most days. I am convinced that the most important self preventive measure that folks can employ at this time — in this city, in this county, in this state, in this country is to WEAR A MASK when you are out and about around other people. Avoid the crowd, of course, and we will have a vaccine and treatment before long. Our area had a rough start, but look at us now! Masks work in the orient. They will work here.
These are up-to-date values for Rt, a key measure of how fast the virus is growing. It’s the average number of people who become infected by an infectious person. If Rt is above 1.0, the virus will spread quickly. When Rt is below 1.0, the virus will stop spreading.
TEXAS: 3 MO AGO 1.05
2 MO AGO 0.86
1 MO AGO 1.06
1 WK AGO 1.16
LATEST. 1.17
From Houston: Customers must wear masks while shopping. (no reprint available)
2. Amtrack cuts back service through Marshall to three times weekly.
3. 22 New COVID cases in Tyler.
J. Harris: Several counties are making or considering mandatory face masks for public places. I AGREE. Harrison County’s troubles are not over, but we are certainly lucky or doing something right lately. We need to remember that this is still the First Phase of the disease. Autumn and Influenza will be here soon. Flu shots will be more important to take that ever. Keep wearing your masks when out and about.
Researchers at the Italian National Institute of Health discovered the presence of the RNA of the virus in samples taken in the northern cities of Milan and Turin on Dec. 18, more than two months before the country’s first case was diagnosed on Feb 20. (NYT)
In this issue of JAMA, Fosbøl et al3 provide convincing evidence that ACEI/ARB therapy is not associated with ncreased susceptibility to SARS-CoV-2 infection or increased severity of COVID-1
J. Harris: This is the third big study demonstrating that ACE inhibitors and blockers, very common and effective blood pressure pills, don’t cause or worsen COVID infections.
From Johns Hopkins:
1. Structure-based Design of Antiviral Drug Candidates Targeting the SARS-CoV-2 Main Protease (Science) With no vaccine or proven effective drug against the virus that causes coronavirus disease 2019 (COVID-19), scientists are racing to find clinical antiviral treatments. A promising drug target is the viral main protease Mpro,…showed good antiviral activity in cell culture…had better pharmacokinetic properties and low toxicity when tested in mice and dogs, suggesting that this compound is a promising drug candidate.
2. Numerous US states continue to report concerning COVID-19 trends. The New York Times analysis indicates that 20 states are reporting significant increases in COVID-19 incidence, based on a 7-day average. Among these states, 12 appear to be reporting record daily incidence over the past several days. Texas reported its highest daily incidence and COVID-19 hospitalizations yesterday as well as its second-highest test positivity since April. Multiple hospitals in Florida are currently reporting that all of their intensive care unit (ICU) beds are occupied. According to data published by the Florida Agency for Health Care Administration (AHCA), 9 hospitals with a capacity of at least 25 ICU beds report no availability. Additionally, numerous smaller hospitals are also reporting zero available ICU beds, including 2 in Palm Beach, one of Florida’s current COVID-19 hotspots. Arkansas and North Carolina continue to report increasing COVID-19 hospitalizations. Notably, Arkansas is reporting nearly 4 times the number of hospitalized COVID-19 patients as it was in mid-May and more than 7 times the number of active community cases.
(J. Harris: remember a couple of weeks ago when Arkansas was “bullet proof” and bragging about their lack of antiviral practices statewide).
What was Forrest Gump’s email password? 1forrest1
Two windmills are standing in a wind farm. One asks, “What’s your favorite kind of music?” The other says, “I’m a big metal fan.”
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[Marshall, Texas] It is essential to note that the Marshall Public Library has been open and available for curbside service since May 1, 2020. We encourage patrons to avail themselves to access the library’s services through these means. Please contact info@marshallpubliclibrary.org or (903) 935-4465 to make arrangements for reading materials through this service.
When the city announced furloughs back in April, city leaders were careful to point out that they made such a decision concerning our response to protecting the pandemic for our citizens and budgetary considerations. The focus for the furloughs was mainly in areas that are destination-based, as opposed to safety services and utility operations based on our current circumstances. We are in a recession, which will be announced formally at the end of the month, after the second quarter. We have seen estimates in the drop of the Gross Domestic Product (GDP) for this second quarter ranging from 35-53%. This drop in the GDP will impact on our sales tax revenues, one of the city’s primary sources of income for providing services on almost every level. We won’t know how severe an impact it will have until we receive our latest sales tax report, which we anticipate in the next few weeks. Keep in mind; there is an approximate two-month delay between what happens at the cash registers in Marshall and when it shows up at City Hall. Although there has been a lot of rhetoric in the nation’s capital about aid to states and cities for lost revenue, there are no formal plans for providing that assistance. Assuming our citizens didn’t want the shortfall passed onto them via tax increases, city leaders have done the responsible thing and made adjustments as early as possible to mitigate the impact of the sales tax lost revenue. Whether we have to cut more, will be based on the subsequent reports.
When deciding on when to reopen city services to their normal state, the City of Marshall will use a combination of things, including a city advisory committee comprised of management personnel, the Governor’s Orders, local COVID-19 statistics, and budgetary considerations. The committee will continue to meet periodically to evaluate reopening the full complement of city services. A prompt announcement will be made by the city on decisions to change the status of building openings or city services.
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The CDC estimates more than a third of coronavirus patients don’t have any symptoms at all, and 40% of virus transmission happens before people feel sick. The figures are part of the agency’s new guidance for mathematical modelers and public health officials, and are not supposed to be predictions of how many people could have or contract Covid-19. The CDC has also released mortality figures and scenarios intended to help public health preparedness. Under the most severe of the five scenarios outlined, the CDC lists a symptomatic case fatality ratio of 0.01, meaning that 1% of people overall with Covid-19 and symptoms would die. But some experts say the figures lowball the proportion of people who are succumbing to the disease.blic pools it is impossible to prevent viral spread).
“…I understand the importance of opening up the economy. The worry that I have is that we haven’t put in place a public health system — the testing, the contact tracing — that’s commensurate to sustain the economy…”
TEST DATA AND SWEDEN’S SITUATION FROM J. HOPKINS:
SWEDEN SEROLOGICAL STUDY Sweden’s Public Health Authority announced preliminary results from a serological study, based on more than 1,100 specimens collected across 9 regions. The study is ongoing and aims to collect 1,200 specimens per week over an 8-week period. The preliminary results described in the press release correspond to Week 18 (April 27-May 3). During that period, 7.3% of participants in Stockholm had SARS-CoV-2 antibodies, the highest of the regions tested. The press release included results from two other regions—4.2% in Skåne and 3.7% in Västra Götaland. Among the specimens tested, participants aged 20-64 years had the highest seroprevalence (6.7%), followed by 0-19 years (4.7%) and 65-70 years (2.7%). Sweden has previously reported results of studies conducted using molecular tests (e.g., PCR). Molecular tests only detect active infection, whereas serological testing can identify individuals who were previously infected. Sweden has been criticized for not implementing more restrictive mandatory community mitigation measures. Sweden continues to report elevated per capita incidence compared to most of Europe, and its daily per capita deaths is currently the highest in Europe.
Kawasaki’s Disease Report: An unusual vasculitis seen is some children with Covid is also showing up in young adults — just as many of the young had decided that they were “bulletproof.”
COLLIN PUN FOR THE DAY: A rubber – band pistol was confiscated from an algebra class, because it was a weapon of math disruption.
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May 20, 2020 – Today we have 11 additional positives to report in Harrison County. That brings our total to 223 in HARRISON COUNTY
May 21 Tyler Newspaper:
Smith County coronavirus cases increased by three Wednesday for an active case count of 49, according to the Northeast Texas Public Health District.
Total confirmed positive cases in Smith County are at 195.
In Smith County, there are 49 active coronavirus cases, 142 recovered patients and four coronavirus deaths.
Tyler hospitals are currently treating 24 patients from East Texas for the coronavirus.
Of the 195 cases, 161 are in Tyler, nine in Flint, six in Whitehouse, six in Lindale, four in Troup, two in Bullard, two in Overton, two in Arp and one each in Hideaway, Winona and rural Smith County near Mineola.
One hundred and sixty-two cases are a result of community spread and 33 are travel-related.
Here is the breakdown of cases:
• 0-20, 14 cases
• 21-40, 74 cases
• 41-59, 61 cases
• 60-79, 42 cases
• 80 and over, 4 cases
Of the 195 cases, 100 are men and 95 are women.
Tyler hospitals are currently treating 24 patients from East Texas for the coronavirus. Some of those patients may not reside in Smith County.
Through May 18, a total of 3,418 tests were performed on patients from Smith County.
PLEASE STUDY THE SMITH COUNTY (TYLER) DATA ABOVE. THESE ARE NOT JUST A BUNCH OF OLD FOLKS OR NURSING HOME PATIENTS WHO ARE POSITIVE FOR COVID 19 OR PATIENTS UNDERGOING TREATMENT IN A HOSPITAL. MOST OF THESE POSITIVE TESTEES ARE WALKING AROUND IN TOWN AND MANY ARE WORKING. 135 OF THE CASES ARE UNDER 60. ALL AGE GROUPS NEED TO TAKE PREVENTATIVE MEASURES….IF YOU ARE GETTING AROUND, YOU NEED TO STAY AWAY FROM GRANDMA. THERE ARE ESTIMATES THAT THERE ARE 40 CARRIERS WHO ARE UNTESTED FOR EVERY POSITIVE TEST OBTAINED. MAYBE MORE? BE CAREFUL THE PANDEMIC IS NOT OVER.
MARSHALL HAS A HIGHER PROPORTION OF ILLNESS AND POSITIVE TESTS THAN SMITH COUNTY DOES.
FROM THE HOUSTON PAPER: Using cellphone data, national study predicts huge June spike in Houston coronavirus cases
Houston is one of several cities in the South that could see spikes in COVID-19 cases over the next four weeks as restrictions are eased, according to new research that uses cellphone data to track how well people are social distancing.
The updated projection, from PolicyLab at Children’s Hospital of Philadelphia, found that traffic to non-essential businesses has jumped especially in Texas and Florida, which have moved aggressively to reopen.
America’s Patchwork Pandemic Is Fraying Even Further JHarris: Medically, this article is sound and VERY important and worth reading carefully. You don’t have to agree with the author’s political or sociological opinions. His explanation about the timing and patterns of disease spread in the U.S. is proving to be very accurate, and I agree with him. Incidentally, were I young and unemployed, I’d learn how to track medical cases, and when I got good at it, I’d start my own tracking company — like the “Danile Boone and Sam Spade Trackers, LLC.”
“—The patchwork is not static. Next month’s hot spots will not be the same as last month’s. The SARS-CoV-2 coronavirus is already moving from the big coastal cities where it first made its mark into rural heartland areas that had previously gone unscathed. People who only heard about the disease secondhand through the news will start hearing about it firsthand from their family. “Nothing makes me think the suburbs will be spared—it’ll just get there more slowly,” says Ashish Jha, a public-health expert at Harvard…..“It’s inevitable that we’ll see stark increases in infections in the next weeks,” says Oscar Alleyne of the National Association of County and City Health Officials. The experiences of other countries support that view. Success stories like South Korea, China, Singapore, and Lebanon all had to renew or extend social-distancing measures to deal with new bursts of cases. And they had all restrained the virus to a much greater extent than the U.S., which despite having just 4 percent of the world’s population has 31 percent of its confirmed COVID-19 cases (1.5 million) and 28 percent of its confirmed deaths (92,000)…..The better strategy is not to try and prevent the virus from traveling, but to build a public-health system nimble enough to catch it when it arrives. Don’t build one big wall; instead, ready a thousand nets….
May 19, 2020 – Today we have no new cases to report and 5 new recoveries. That’s the good news. I also must report 3 new fatalities. Thank you all for your continued prayers for these affected families. We remain at 212 total cases, our fatalities have increased to 22, our recoveries have increased to 39 and our current cases have dropped down to 151.
As businesses and activities begin to return to normal, don’t forget to act responsibly and take precautions for your safety and those around you. In an earlier Facebook post today I provided additional information about the Governor’s latest directive.
EXCELLENT AND PRACTICAL GUIDE ABOUT WHAT YOU CAN DO NOW. READ IT ALL
“…you’ll have to try to make an informed decision about what’s safest for you and others… “It depends on your own health, your age, preexisting conditions, how much risk you’re willing to tolerate, and the benefit that the activity could provide to you.” Another crucial variable: how much risk you might be introducing for everyone else around you.
Case tracking works if reliable testing for the virus is available.
FROM JOHNS HOPKINS:
The New York Times continues to track state-level COVID-19 incidence, with a focus on state policies regarding social distancing. This tracker has been updated to differentiate between states that have relaxed social distancing measures statewide and those that have done so on a regional basis. After holding relatively steady for several weeks—approximately April 7-26—Texas has reported increasing incidence over the past 3 weeks, including a record high daily incidence (1,801 new cases) on May 16. Texas’ “stay at home” order expired on April 30, and non-essential businesses, including restaurants, barbershops/salons, retail stores, gyms, and movie theaters were permitted to reopen. Texas’s COVID-19 incidence was beginning to increase when the statewide order expired, and it has continued that trend in the weeks since. Texas also reported its 2 highest daily death totals on May 14 and 15—58 and 56 new deaths, respectively. Notably, Texas’ testing capacity has increased as well, more than doubling since the “stay at home” order expired. The positivity ratio decreased over that time, from approximately 6% to 4.5%.
Marshall Small Business Revolving Loans Tackle COVID-19
[Marshall, Texas] To assist businesses that are suffering from the effects of the coronavirus (COVID-19) and helping companies to grow, the City of Marshall has allocated a portion of the funds from the CARES Act to create a small business revolving loan program. The initiative of supporting a small business loan program is a goal that came out of the citizen-driven Mobilize Marshall plan. These efforts to assist new businesses and encourage existing businesses to grow would promote the creation of a “Cradle of Entrepreneurship” program within the City.
The City of Marshall Small Business Revolving Loan Fund is designed to assist small and emerging businesses with projected gross revenue of less than $1 million and employ 50 or fewer employees. Companies must be located within the city limit of Marshall to apply.
Approved loans will not exceed the available funding in the revolving loan fund account and not exceed $10,000 or 75% of the total project cost, whichever is less. Approval for a small business revolving loan focuses on the character, credit, and reliability of the borrower. No predetermined percentage of equity will be required, nor is adequate collateral a determining factor, but loans will be secured by collateral when possible.
Eligible Loan Purposes:
• Acquisition and development or improvement of land, easements, and rights-of-way. Overhead expenses such as certifications, licenses, advertising, incorporation, insurance, etc.
• Rent and utilities.
• Training, technical assistance, business services (such as web site development, etc.) to increase the capacity of recipients to carry out or broaden services.
• Labor expenses (excluding owner), business inventory and supplies.
• Capital or equipment purchases necessary for the business operation.
The source of funding for the Small Business Revolving Loan Program is provided primarily through the U.S. Department of Housing and Urban Development Community Block Development Grant and through funds awarded to the City by a U.S. Department of Agricultural Rural Business Enterprise Grant.
The loan application process will begin with a pre-application consultation with City Staff and a completed application with supporting documentation. For more information on application, please contact Morrison.wes@marshalltexas.net.
mLife, a privately held company in Marshall, has launched the mLife True device from concept to production within 30 days. It is a coronavirus test kit, which is designed to be used anywhere, without a medical practitioner. It has a vial and a special preservative, and the specimen is delivered the next day to a lab with a capped bottle (resolving potential leak problems with other collectors). The current test is for detection of the virus based on viral RNA detection. Antibody tests using the mLife True kit are under development. Results are expected within about twenty-four hours. Working in Marshall, mLife heard the call for “back to work,” and this kit suits this application.
The City of Marshall Cradle of Entrepreneurship program is designed to grow business from incubations to accelerators and finally thriving companies. This new program is assisting mLife in the recruitment of testing subjects as a component of the Cradle program, and helping mLife collect data for submission to the FDA as part of the approval process for an at-home kit. The ideal setting for initial testing is a group facility with a Registered Nurse or medical officer who has prescribed nasal swabs for likely symptomatic positives, and who are willing to try the much-less-invasive mLife True oral swab as a confirmation test. Then, mLife will provide funding for the lab testing of the prescribed nasal swabs and the mLife oral swabs at the same time.
Through this initiative, mLife hopes to make more coronavirus testing available to the market as soon as possible, and the city would like to make this one of the first successes of our Cradle program.
Visit mlifedx.com for more information. To register your facility’s interest in free testing participation, please contact Stormy Nickerson, City of Marshall Communications Coordinator, at (903) 934-7995.
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[Marshall, Texas] Mayor Terri Brown has issued a New Declaration of Local Disaster and Public Health Emergency Related to Communicable Disease on May 6, 2020. The declaration shall continue in effect until the Marshall City Commission terminates its consent to the continuation of this declaration or until the Mayor terminates this declaration, whichever occurs first. This declaration is a direct reflection of Executive Order GA-21 issued by Governor Greg Abbott on May 5, 2020.
Effective at 12:01 a.m. on May 8, 2020, these local orders allow the opening of hair salons, nail salons, cosmetology salons, barbershops, and tanning salons. Governor Abbott issued the following provisions in GA-21 in order for these facilities to be open.
• One customer per stylist.
• The appointment system is requested.
• If allowing walk-ins, customers are allowed to wait inside only if they are keeping six feet of separation.
• There must be six feet of separation between all operating work stations.
• Wearing facemasks is strongly recommended.
The current declaration also issued the opportunity for the opening of swimming pools on May 8, 2020, under the provisions listed below.
• Indoor swimming pools may operate at up to 25 percent of the total listed occupancy of the pool facility.
• Outdoor swimming pools may operate at up to 25 percent of normal operating limits as determined by the pool operator.
• Local public swimming pools may be allowed to open if permitted by the City of Marshall.
Beginning on May 18, 2020, gyms and exercise facilities will have the opportunity to open with the following stipulations.
• Gyms may operate at no more than 25 percent capacity (this doesn’t include outside activity). Showers and locker rooms must remain closed. Restrooms may be open.
• Disinfect every piece of equipment after use by each patron.
• Customers must wear gloves that cover their fingers at all times.
• Must maintain social distancing of six feet inside the gym.
• If a customer brings equipment, like a yoga mat, sanitize the material before and after use.
This declaration allows manufacturing facilities and office buildings that were not deemed essential services might choose to open in limited ways beginning on May 18, 2020.
• Manufacturers may open with a 25 percent occupancy limitation and staggered workforce, if necessary.
• Manufacturing employees must maintain a six-foot separation.
• Achieve a six-foot separation between employees, or the employer must use controls like Plexiglas between work stations.
Businesses located in office buildings may also open on May 18. These businesses may open their offices to either five employees or 25 percent of the workforce, whichever is greater, provided that employees maintain appropriate social distancing.
GA-21 and this declaration have clarified the position on attending weddings and funerals in the State of Texas. Wedding and funeral venues and the services required to conduct weddings; provided, however, that for weddings held indoors other than at a church, congregation, or house of worship, the facility may operate at up to 25 percent of the total listed occupancy of the facility. Wedding reception and funeral services for facilities that operate at up to 25 percent of the full listed occupancy of the facility; provided, however, that the occupancy limits do not apply to the outdoor areas of a wedding reception or outdoor wedding receptions.
The City of Marshall “New Declaration of Local Disaster and Public Health Emergency” dated May 6, 2020, the City of Marshall maintains the requirement for food establishments within the city limits to have all employees wear a face mask at all times. Separate employees must perform cash handling functions and food serving function.
In providing or obtaining essential services or reopened services, individuals and businesses should follow the minimum standard health protocols recommended found at www.dshs.texas.gov/coronavirus. As COVID-19 positive tests continue to rise, residents should implement social distancing, work from home if possible, use recommended hand sanitizing, maintain environmental cleanliness. Individuals are encouraged to wear appropriate face coverings, but no jurisdiction can impose a civil or criminal penalty for failure to wear a face covering.
The City of Marshall will perform inspections to verify the proper implementation of all policies and procedures. Failure to comply with any of the mandated provisions of this Order constitutes an imminent threat to public health. Per Texas Government Code §418.173, a person who knowingly or intentionally violates this Order commits an offense punishable by a fine up to $1,000.00, confinement in jail for a term not exceed 180 days. Each violation shall constitute a separate offense.
Best practices to prevent the spread of COVID-19 include:
1. Restrict physical contact and publicly used areas.
2. Maintain Social Distancing with a safe distance of six (6’) feet between all individuals.
3. Every person shall avoid large gatherings.
4. Residents shall not visit nursing homes, retirement, or long-term care facilities unless to provide critical assistance.
5. Regularly wash hands with warm soap and water for at least 20 seconds.
6. Avoid touching eyes, nose, or mouth.
7. If soap is not available, use at least a 60% alcohol-based hand sanitizer.
8. Avoid close contact with people who are sick. All persons should remain in the house if one person in the home exhibits symptoms.
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The City of Marshall and Harrison County have remained on alert to safeguard the health of our community members as we face the coronavirus (COVID-19) pandemic together. To that end, the Marshall Police Officers, Health Inspector, and Fire Marshal have been on inspections to verify compliance with the Amended Declarations of Local Disaster and Public Health Emergency Due to a Communicable Disease. While it is their goal to ensure that everyone remains peaceful and follows the orders, the Marshall Police Department has made numerous warnings and three arrests due to significant violations. The Fire Marshal has also issued multiple warnings and closed nonessential businesses who failed to agree to close.
The City of Marshall and Harrison County asks all residents and businesses to follow the CDC, Governor Abbott’s Executive Orders, and Local Declarations of Local Disaster and Public Health Emergency Due to a Communicable Disease. Your health, the safety of your family, and the stability of our economy are our highest concerns. As your local government leaders, we cannot accomplish these goals without your immediate compliance. The Marshall Police Department, Harrison County Sherriff’s Department, the Health Inspector, and the Fire Marshal will continue inspections with warnings, fines and jail time if orders are not followed.
At the request of the Emergency Management Team, the City of Marshall and Harrison County request all businesses in Harrison County implement the following two guidelines. First, businesses should assign a safety monitor at the entrance to maintain social distance, to ensure that best-hygiene practices are in place and to limit the number of shoppers entering the store. Second, businesses should limit occupancy within their stores to 5 persons per 1000 square feet, with a maximum of 450 people. This maximum number of shoppers shall be posted on the front door.
The City of Marshall and Harrison County have seen a significant increase in positive COVID-19 tests in recent days. Therefore, The City of Marshall and Harrison County will work together to increase enforcement.
Third Amended Declarations of Local Disaster and Public Health Emergency Due to a Communicable Disease
The new local orders stipulate that retail establishments will be able to operate as “Retail-to-Go” as delineated in the Texas Governor’s Executive Order GA-16, effective April 24, 2020. “Retail-to-Go” was defined by Governor Abbott as a safe, strategic reopening of select services and activities in Texas. This order establishes a temporary “Retail-To-Go” model that will allow select retail outlets in Texas to reopen beginning Friday, April 24. Under this model, reopened establishments are required to deliver items to customer’s cars, homes, or other locations to minimize contact. Customer admittance in the store will not be allowed under this provision.
In addition, the new local orders will require every Harrison County food establishment to have all employees wear a face mask at all times. In transactions with customers, cash handling functions and food serving functions are also required to be handled by separate employees.
Citizens are urged to follow following the Centers for Disease Control’s (CDC) national guidelines, Executive Orders by Governor Greg Abbott and the Local Amended Declaration Local Disaster and Public Health Emergency Related to Communicable Disease.
1. Restrict physical contact and publicly used areas.
2. Maintain Social Distancing with a safe distance of six (6’) feet between individuals.
3. Every person in Texas shall avoid social gatherings in groups of 10 or more per Executive Order of Governor Abbott.
4. Residents should not visit nursing homes, retirement, or long-term care facilities unless to provide critical assistance.
5. Per the CDC, people shall avoid eating or drinking at bars, restaurants, and food courts, or visiting gyms or massage parlors. Residents may still utilize drive-thru, pickup, or delivery options through the Executive Order.
6. Regularly wash hands with warm soap and water for at least 20 seconds.
7. Avoid touching eyes, nose, or mouth.
8. If soap is not available, use at least a 60% alcohol-based hand sanitizer.
9. Avoid close contact with people who are sick. All persons should remain in the home if one person in the house exhibits symptoms.
10. Only one adult should conduct essential errands from the household. Other family members should remain sheltered at home.
11. CDC recommends wearing a cloth face mask in public. The mask will fit snugly, be secured with ear loops, and be able to be laundered and machine dried often. A mask should not be placed on children under age 2, anyone who has trouble breathing, or unable to remove the mask without assistance. A mask with multiple layers of fabric should allow for breathing without restriction. The cloth face coverings recommended are not surgical masks or N-95 respirators as those critical supplies that must continue to be reserved for healthcare workers and first responders.
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