Where people moved during the pandemic

In another look at migration through the lens of USPS change of address data, Bloomberg CityLab shows where people moved during the pandemic, focusing on movement in and out of metro areas. With the exception of San Francisco and New York, most areas didn’t see much movement distance-wise:

Even in the biggest metro areas, most people didn’t go very far. In the country’s 50 most populous cities, 84% of the moves were to somewhere within the perimeter of the central metro area, down just slightly from pre-pandemic levels. Many of the most local moves were likely related to the economic downturn: A February Pew Research Center survey of those who moved during the pandemic found that the most common reason people cited was financial distress including job loss.

See also similar conclusions by The New York Times and Financial Times.

While there wasn’t the mass exodus that some imagined, the pandemic did seem to speed up some trends. So as we wait for the 2020 Census count, which comes out out this afternoon, it’ll be interesting to see if the rate of change continues in the coming years.

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Pandemic migrations

With the restrictions of the pandemic, you might expect an unusually big wave of people leaving cities for more open space. Using USPS’s change of address data, Jed Kolko, Emily Badger and Quoctrung Bui, for NYT’s The Upshot, show that this was not quite the case.

This surprised me, because I live in a suburban area that saw a flux of home buyers, which made prices approach ridiculous ranges. I wonder what in- and out-migration look like separately, on relative and absolute scales.

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Stopping a pandemic before it starts

For Politico, Beatrice Jin provides an illustrated guide on stopping a pandemic before it starts. Some scientists suggest going to the source, which often is from interacting with animals, and as you’d expect, cutting off the livelihood of millions around the world would be a complex process.

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Pandemic timeline as animated dot density map

As a lead-in and backdrop to a timeline of the past year by The Washington Post, an animated dot density map represents Covid-19 deaths. “Every point of light is a life lost to coronavirus.”

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Pandemic Graphics Archive

The Pandemic Graphics Archive is a work-in-progress collection of floor signs and posters from our current days of distance and mask-wearing. [via swissmiss]

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Lab Culture Ep. 22: Life as a public health lab scientist testing for COVID-19

Matt Sinn and Jessica Bauer pose with the Missouri state flag

Jessica Bauer and Matt Sinn are scientists at the Missouri State Public Health Laboratory. On this episode, they shared their experiences performing COVID-19 testing, working long hours seven days a week, supporting their staff while trying not to burnout themselves. As they describe in this conversation, the experience has been nothing they ever could have expected.

Jessica Bauer, molecular unit chief
Matthew Sinn, molecular laboratory manager

Listen here or wherever you get your podcasts:


Missouri State Public Health Laboratory
APHL: Responding to the COVID-19 Pandemic
COVID-19 posts on APHLblog.org 

The post Lab Culture Ep. 22: Life as a public health lab scientist testing for COVID-19 appeared first on APHL Lab Blog.

AFM is Serious: Know the Symptoms. Act Fast.

Acute flaccid myelitis (AFM)

Acute flaccid myelitis (AFM) is a serious neurologic condition that causes limb weakness and paralysis. While uncommon, AFM affects mostly children, and can have devastating, long-term effects for patients and their families.

There have been three AFM outbreaks in the United States—in 2014, 2016, and 2018. If this biennial pattern continues, another outbreak might occur in 2020.

What AFM Might Look Like

Little boy doing physical therapy
Braden, who was diagnosed with AFM in 2016, doing his physical therapy. Braden needed a breathing tube for 3 years and was initially paralyzed from the neck down. Now Braden can walk short distances, and his breathing tube has been removed. Braden’s mom Rachel is a co-founder of the Acute Flaccid Myelitis Association.

Imagine your 5-year-old son, who is usually very excited to get up and get going in the morning, complains that his neck hurts, and he can’t move his left arm. You think nothing of it. Maybe he just slept wrong and his arm “fell asleep” and it will go away shortly.

You fix his favorite cereal and call him to come eat, but he doesn’t. It’s been almost half an hour since he woke up. Any other morning, he’d be running around, talking about this and that, and demanding his breakfast. You check on him again. He is still lying in bed and still complaining about his neck and arm.

You check his temperature, which seems fine. What could this be? You don’t think he’s making it up, especially since he was excited about an art project happening today.

You call the doctor’s office and get the nurse on the line. She asks you a series of questions, and you remember that his older sister was sick last week with a mild fever, but your son only had some sniffles. Your pediatrician wants to see your son right away, and after examining his reflexes and strength, he tells you to bring your son immediately to the nearest children’s hospital’s emergency department (ED). The pediatrician suspects your son may have a serious neurologic condition. Scared and worried, you rush to the ED.

AFM is a Medical Emergency

AFM can progress quickly to respiratory failure. Patients who develop AFM symptoms need immediate medical care. That’s why it’s very important that parents call their child’s pediatrician right away or go to the ED, and that clinicians recognize the symptoms of AFM early and hospitalize patients for further evaluation and monitoring.

When to Suspect AFM

You should suspect AFM when a person has sudden onset of arm or leg weakness. Also, did the person have a recent respiratory illness or fever? If so, this should heighten your suspicion for AFM.

Also, look for other signs and symptoms such as:

  • Loss of muscle tone and reflexes in the affected extremities.
  • Difficulty moving the eyes or drooping eye lids.
  • Facial droop or weakness.
  • Difficulty with swallowing or slurred speech.
  • Pain in arms or legs.
  • Pain in neck or back.

AFM & the COVID-19 Pandemic

How to Spot Symptoms of AFM in Your Child
View Printable Poster: How to Spot Symptoms of AFM in Your Child.

COVID-19 is likely on everyone’s minds and causing concern, uncertainty, and challenges for communities across the country.

It is not known how the COVID-19 pandemic and social distancing may affect AFM this year, or the health care system’s ability to promptly recognize and respond to it. However, even in communities with high COVID-19 activity:

  • Parents should act and get medical attention immediately if their child develops sudden arm or leg weakness. It may be AFM, which is serious and requires urgent care. It is very likely that the assessment of your child will require hospitalization if clinicians think your child might have AFM.
  • Clinicians should not “wait and see.” They should refer patients suspected to have AFM to the ED immediately. They should reference CDC resources on AFM symptoms, provide optimal medical management, collect specimens, and report cases to health departments. Clinicians can also contact an AFM expert for a clinical consult through the AFM Physician Consult and Support Portal.

Clinicians may consider reassuring parents about going to the ED during the COVID-19 pandemic for serious health problems. Clinicians can let parents know that hospitals are taking precautions to prevent exposures to COVID-19, such as providing separate entrances and rooms for those with respiratory symptoms, requiring hospital staff to wear appropriate protective equipment like face coverings and shields for all encounters with patients, and increasing access to hand sanitizer and disinfecting surfaces frequently.

AFM remains a public health priority for CDC. CDC is committed to investigating AFM, working with partners, supporting affected families, and responding to outbreaks. Clinicians are encouraged to review CDC’s AFM website, stay alert for AFM in late summer through fall, and promptly evaluate and hospitalize AFM patients.

Resources for Parents:

Resources for Health Care Professionals:

If you have questions, you may send them to AFMQuestions@cdc.gov.

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that the CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Curves for the 1918 flu pandemic

For National Geographic, Nina Strochlic and Riley D. Champine look back at the 1918 pandemic for clues about the future:

The 1918 flu, also known as the Spanish Flu, lasted until 1920 and is considered the deadliest pandemic in modern history. Today, as the world grinds to a halt in response to the coronavirus, scientists and historians are studying the 1918 outbreak for clues to the most effective way to stop a global pandemic. The efforts implemented then to stem the flu’s spread in cities across America—and the outcomes—may offer lessons for battling today’s crisis.

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3 Reasons Why Handwashing Should Matter to You

Unseen woman washing her hands with soap in a sink.

Most of us are familiar with the parental-like voice in the back of our minds that helps guide our decision-making—asking us questions like, “Have you called your grandmother lately?” For many that voice serves as a gentle, yet constant reminder to wash our hands.

Handwashing with soap and water is one of the most important steps you can take to avoid getting sick and spreading germs to loved ones. Many diseases are spread by not cleaning your hands properly after touching contaminated objects or surfaces. And although not all germs are bad, illness can occur when harmful germs enter our bodies through the eyes, nose, and mouth. That’s why it is critical to wash hands at key times, such as after a flood or during a flu pandemic, when germs can be passed from person to person and make others sick.

Washing hands with soap and water is the best way to reduce the number of germs on them, however during a disaster clean, running water may not be available. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs.

Here are three key reasons why you should always care about handwashing:Your hands carry germs you can't see. Wash your hands.

  1. Handwashing can keep children healthy and in school. Handwashing education can reduce the number of young children who get sick and help prevent school absenteeism.
  2. Handwashing can help prevent illness. Getting a yearly flu vaccine is the most important action you can take to protect yourself from flu. Besides getting a flu vaccine, CDC recommends everyday preventive actions including frequent handwashing with soap and water.
  3. Handwashing is easy! Effective handwashing is a practical skill that you can easily learn, teach to others, and practice every day to prepare for an emergency. It takes around 20 seconds, and can be done in five simple steps:
    1. Wet your hands with clean, running water, turn off the tap, and apply soap
    2. Lather your hands by rubbing them together with the soap
    3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice
    4. Rinse your hands well under clean, running water
    5. Dry your hands using a clean towel or air-dry them

Promote Handwashing in Your Community

Global Handwashing Day is celebrated annually on October 15 to promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world. This year’s theme, “Clean Hands—A Recipe for Health,” calls attention to the importance of handwashing at key times, such as before eating or feeding others, and before, during, and after preparing food.

Learn how you can get involved and promote handwashing at home, your child’s school or daycare, and your local community:

Personal Protective Actions You Can Take in a Flu Pandemic

Young woman under the covers in bed blowing her nose.

Every fall and winter the United States experiences epidemics of seasonal influenza (flu). Sometimes a flu pandemic occurs due to a new flu virus that spreads and causes illnesses around the world. We cannot predict when a flu pandemic will occur, but over the past 100 years, we have documented four flu pandemics resulting in close to 1 million deaths in the United States alone. 1Get a flu vaccine! The most important way to prevent the flu in everyone 6 months and older is to get a yearly flu vaccine.

When a flu pandemic happens, it can take up to 6 months before a vaccine against a new flu virus is available. Antiviral drugs can help manage the symptoms of the flu, shorten the time you are sick by 1 or 2 days, and prevent serious flu complications, like pneumonia. But, there may be a limited supply of these medications during a pandemic so nonpharmaceutical interventions (or NPIs) may be the only prevention tools available during the early stages of a pandemic.

There are things you can do, apart from getting vaccinated and taking medications, to help slow the spread of a flu pandemic. NPIs, also known as “community mitigation measures,” are important because they will be the first line of defense in the absence of a pandemic vaccine. NPIs may be more effective when used early and in a layered approach (i.e., using more than one measure at a time). During the 1918 pandemic, cities that put NPIs in place quickly reported fewer deaths.2,3 NPIs may be used in different settings, including homes, schools, workplaces, and places where people gather (e.g., parks, theaters, and sports arenas).

Personal protective measures to prevent flu at all times

Photo of someone washing their hands in a sink.CDC recommends using some NPIs to prevent seasonal flu and other respiratory infections. To help prevent the flu, you should always:

  • Stay home when sick and away from others as much as possible,
  • Stay away from people who are sick as much as possible,
  • Cover your coughs and sneezes with a tissue,
  • Wash your hands often with soap and water,
  • Avoid touching your eyes, nose, or mouth, and
  • Regularly clean surfaces and objects that you use a lot.

Personal protective measures to prevent flu during a pandemic

Many of these NPIs would still be recommended during a pandemic, but some would be reserved for use during a flu pandemic. Depending on the severity of a pandemic, CDC might recommend:

  • Stay home if exposed to a sick household member,
  • Use a face mask when sick and out in crowded community settings, and
  • Implement community measures to reduce exposure to pandemic flu (coordinating school closures, limiting face-to-face contact in workplaces, and postponing or canceling mass gatherings).

CDC is preparing for a flu pandemic

There is always a threat that a flu pandemic will arise, so CDC is taking steps to prepare. In 2017, CDC issued updated community mitigation guidelines to help state and local public health departments and their community partners make plans before the next pandemic happens. Visit www.cdc.gov/npi to access the updated guidelines; plain-language planning guides for the general public and community settings; and additional NPI communication, education, and training materials. You can find more information about seasonal and pandemic flu at www.cdc.gov/flu and at www.cdc.gov/flu/pandemic.


1 Past Pandemics: https://www.cdc.gov/flu/pandemic-resources/basics/past-pandemics.html

2 Hatchett RJ, Mecher CE, Lipsitch M. Public health interventions and epidemic intensity during the 1918 influenza pandemic. Proc Natl Acad Sci U S A. 2007; 104:7582-7.

3 Markel H, Lipman HB, Navarro JA, et al. Nonpharmaceutical interventions implemented by US cities during the 1918–1919 influenza pandemic. JAMA. 2007; 298:644-54.