What we should know about the pandemic (Part 2) with Dr. H. Westley Clark

The views expressed on today’s program are those of the speakers and are not the views of Today’s Workplace, the speaker’s firms or clients, and are not intended to provide legal advice.

Summary:

As scientists race to find a vaccine for the novel virus known as COVID 19, countries around the world have placed strict rules and restrictions to reduce the speed at which this virus can spread to its citizens. However, The United States finds itself lagging in the fight against the coronavirus as their cases set new domestic records which were once held by their European counterparts. This has not only affected the health of the citizens in the country but it has also had a tremendous impact on the economy and the mobility of American citizens, whether it is between states or traveling internationally.

Credible sources such as the CDC and WHO are playing second fiddle to a stream of misinformation and confusion, making it harder for people to follow important guidelines, therefore increasing the rate at which the virus spreads.

The notion of communication and personal behavior, as well as the idea of information tracking then becomes critical. Leaders have to be held accountable for setting stricter rules and regulations. Citizens must consider how their conduct may help to reduce the spread of the virus, and employers/employees, along with the various institutions, must take the necessary steps to assist in the fight against this pandemic within their workplaces and encourage social distancing.

Joining us again today is H. Westley Clark, MD, JD, MPH. Dr. Clark is currently the Dean’s Executive Professor of Public Health at Santa Clara University in Santa Clara, California.

He contributed to the US Surgeon General’s Report on Alcohol, Drug Abuse and Health as a Section Editor for Treatment. He is a member of the National Advisory Council of NIDA. He is a member of the Board of Directors of the non-profit Felton Institute, He is also on the Board of Directors of the Pacific Institute for Research and Evaluation.

Dr. Clark received a B.A. in Chemistry from Wayne State University; he holds a MD and a MPH from the University of Michigan; He obtained his Juris Doctorate from Harvard University Law School. Dr. Clark received his board certification from the American Board of Psychiatry and Neurology in Psychiatry. Dr. Clark is licensed to practice medicine in California, Maryland, Massachusetts and Michigan. He is also a member of the Washington, D.C., Bar.

Contact

Today’s Workplace: https://todaysworkplacepodcast.com/

Dr. H. Wesley Clark

27s What does it take to identify a virus?

4m 04s What are the steps other countries take to control the virus and open back the country?

7m 51s What are some of the factors that organizations should consider in assessing the risk?

4m 50s What is contact tracing?

21m 17s We do we get reliable information

25m 59s What are the risks of traveling

Narrator: Welcome to today’s workplace. The podcast created to keep employers current on the latest employment law trends while providing proactive solutions to the everyday issues arising in today’s rapidly changing workplace. Is your business prepared for today’s workplace? Let’s find out with your hosts, Barbara Johnson and Belinda Reed Shannon.

Barbara Johnson: I mean, there’s a lot of talk about a virus, like back in March, everybody was talking about, Oh, we’re going to have a virus. We’re going to have a cure real soon. There’s going to be a virus. So, why don’t you tell us about, talk to us about the reality of what it takes to identify a virus that will be effective against a COVID-19, and what the prospects are for doing that anytime soon?

Dr. Clark: Well, again, this is still evolving. I want to make that point clear cause I don’t want to be pessimistic and I don’t want to be optimistic. We want to be careful. A vaccine, there are over 120 candidates for vaccines and people are working. Dr.ug companies are working on it. It’s being worked on across the world. So, if we’re not careful, the first vaccines may not be as successful as we would like to think. On the other hand, they may be more successful. So, the question is, will those hunDr.ed and twenty candidates produce what we need for them to produce? You can’t answer that. If we’ve got a dozen candidates for vaccine that are in clinical trials, then we can expect within the next six months to a year to have possibilities and that’s what we’re looking at. You have to go through the FDA. There’s a rational structure to these things because as you know, people often rush out and say they have a cure and then turns out they don’t, they have a treatment. It turns out they don’t; the treatment is worth worse than the disease. So, we have all of these things that we have to deal with. So, the FDA by definition is trying to move carefully and deliberately, but quickly, if we can have all of those words in the same voice.

Belinda Reed Shannon: All that at one time.

Dr. Clark: All that, one time. So, there are these dozen candidates in various phases of the FDA trial. So, our hope is that we will have something in the next six months to a year. But, in a sense, it’s kind of meeting with us because what we should be learning from this is, as the phrase goes, we’re all in this together. We are all in this together. I don’t care whether you’re in the Hallows of Appalachia, the Barrios of Los Angeles, the ghettos or the neighborhoods of Washington, DC. However, you want to characterize it, a private island, unless you really want to stay in your home 24/7, you’re going to interact with other people and as long as you’re interacting with other people, you’re dependent on those other people, doing what they’re supposed to do. That’s what we’ve learned from air travel, train travel, buses, planes. You don’t know who’s going to get it. As you see in the media, rich people have gotten it, poor people have gotten it, old people have gotten it, young people who have gotten it and so this notion that I can run and hide is a fiction.

Belinda Reed Shannon: Right

Dr. Clark: Whereas they say you can run. Yeah, but you can’t hide.

Belinda Reed Shannon: Well, we’ve seen by now that obviously even United States is struggling with this because we’ve had, you know, some big cities and some states we’ve had them, you know, try to phase into opening up and then they had to pull back and retreat and shut down again because of spikes in the disease, but we’ve also seen countries outside of the United States who have been able to at least arrest the spread of it. They, if not, we know there’s no cure, but they’ve arrested the spread enough to open back up their economies. What’s the biggest difference between what we’re experiencing there, in what these other countries who were able to open up, have done. What’s the biggest difference and how can we get to that?

Dr. Clark: Back to we’re all in this together phrase, we in the United States value our personal Liberty, value our ability to do whatever it is we want to do as long as we’re not hurting anybody else, to the extent where that’s a problem in an area where infectious diseases are applicable. So, we’ve got countries like Finland that have a few cases. They managed to get her under control, Cambodia, Cyprus, Iceland, Ireland, Jamaica, Jordan Latvia, Lithuania, Cuba, Cambodia. As I mentioned there, they’re doing it. Then we’ve got the United States. We’ve got Nordic countries that are trying to do it, that they’re making progress. So, Canada, Austria, China, France, Germany, Italy, they’re doing it and then you’ve got the United States. So, you have to ask, and the United States is not alone in not doing well. United States ranks up there with Brazil and Bulgaria and Chile and Colombia and Bolivia, Armenia and Argentina but we’ve got the greatest nation in the world and we’re not doing it. We’re not doing it because as you found out, when these other States renewed their restrictions because people went whole hog and said, I’m not going to wash my hands. I’m not going to wear a mask. I’m not going to socially distance. So there.

Barbara Johnson: Not doing it.

Dr. Clark: So, if you want to know how we’re going to change the outcome of this pandemic, then we have to change our respective behaviors. We all have to own it and we all have to say, we have to do our share. Fortunately, most people are doing it. The problem is you need more than most people doing it. You need a lot of people to do it; need everybody actually to do it, so.

Barbara Johnson: You know, there are just so many questions as employers, as communities struggle with, what do we do? I mean, school systems, for example, do you know going back to school and the fall? kind of the political football right now of, oh yes, we want students in the classroom, in the fall, versus, oh that looks pretty risky. What are some of the factors that organizations should consider in assessing the risk?

Dr. Clark: Well, you have to look at your workplace and you have to look at your workforce. So, your target population, both WHO and CDC and coupled with OSHA have guidelines that companies should look at If they’re going to adDr.ess this as an issue, but you start with workplace, workforce and your context. So, if you interact with a lot of customers because you are retail activity, that requires one approach. If you are manufacturing activity that may require another approach. Back to the issue of people, having an opportunity to wash their hands. People have an opportunity where the mask, people have an opportunity to socially distance, people have an opportunity to wipe down their worksite. Can you do that? What some universities are doing, I’m a professor at Santa Clara University, we are allowing some professors to teach remotely. So, and in fact, part of the lockdown had a number of employees who were working remotely. So if you’ve got a type of economy in your workplace where people can work remotely, then your question is, well, should we continue that? if they can’t do that because you are retail for instance, and you’ve got a pedal, your products with face to face, that’s an issue. So, you need a different strategy. If you’ve got a mixed business where you can do some remote and some face to face, then that face to face has to deal with the issue of disease containment or infection containment, infection control.

Belinda Reed Shannon: What do you think the university systems need to do? You know, you’re in the university system and we all know, you know, half of college, life is academic affairs and the other half is student affairs. And both of them provide knowledge and growth during those years that you’re matriculating and so how do we do this? How do university systems achieve this under these circumstances?

Dr. Clark: The issue is risk management. There’s zero risk. You can’t have a situation where there’s zero risk. So, what can the universities do? They well, they’re proposing to do exactly what we’ve been talking about. Have some classes move online, reduce the volume of students in any situation. Use seals so that professors aren’t exposed to the students or the students aren’t exposed to each other.

Belinda Reed Shannon: So that’s the academic side. What about the whole student affairs site? Everything else.

Dr. Clark: Okay. So..

Belinda Reed Shannon: The college experience.

Dr. Clark: You want to separate your college’s university from your elementary, middle school and high school, because by the time you’re 18, what you telling me what to do? You’ve got people who are, view themselves as adults, and they’re going to do what they want to do. So, part of what we’re trying to do is infuse them with the notion of personal responsibility.

Belinda Reed Shannon: Well, I don’t want to beat this into the ground, but I will tell you that part of the sell, the sale job as a parent of a recent high school grad, part of the sale job of universities are these wonderful 21st-century living and learning communities and so the whole living part is a huge, huge piece and you know, we’re paying for that. That’s you know…

Dr. Clark: That’s what you’re paying for and that’s what you want

Belinda Reed Shannon: Yeah

Dr. Clark: And that’s what your chilDr.en want. They want that, to get the heck out of Dodge. So, but the schools also have a responsibility. So, that responsibility is not just their responsibility, as a parent you need to make sure let’s say your high school student is going to college, that they’re aware of these realities and so the question is, can they contain themselves? Can they behave responsibly? And maybe this will be the true test. Remember, this is a case of first impression, not since 1918, have we dealt with this? You can ask, well, how did we deal with the flu? Well, they didn’t deal with the flu because you know, I’ve been to many universities, we’ve never really adequately dealt with the flu. We had the swine flu. We had this flu and then that flu, we didn’t deal with the flu, H1N1. We didn’t deal with the flu, but we have to deal with this one. If you would think about it, how many of the college presidents, the professors, the fraternities and sororities were dealing with this in 1918? So, it’s a case of first impression. So, if we go ahead; if we pursue it looking for who’s responsible for the problem, then we’ve got a problem by ourselves. If we pursue it as if we’re all in this together, and I hate using that phrase, it’s almost trite, but it’s true. Then we all have a responsibility and that’s the only way we’re going to keep these infectious diseases from affecting us because right now we’ve got SARS-CoV-2. What about SARS-CoV-3 or some other infectious diseases? If we don’t have these, a theme of we’re all in it together, we all need to do some things. Then we’ve got a problem. Just because you’re 22 and healthy doesn’t mean that you can’t be a silent carrier or you can’t get the disease. So, what should you be doing?

Barbara Johnson: Yeah. You know, in future episodes, we’re going to be talking more about what employers should be doing, but certainly, flexibility is got to be, has got to be a key in terms of adDr.essing issues and, you know, as almost an employer by employer response, to some extent, depending on the kind of workforce, the kind of workplace spend my observation, that many employers who are able to allow people to continue to work from home have said, okay, we’re going to be flexible. You can continue to work from home but I do think that flexibility is certainly going to be key in going forward. Couple of other technical things I wanted to ask you about. Talk to us about contact tracing because that’s something that employers are looking at. You know, there’s contact tracing, there’s taking temperatures. You know, what are some of the scientific things, you know, out there that employers can, should be doing to act responsibly? So, let’s start with contact tracing.

Dr. Clark: If you test positive, then if you’re at an Orthodox facility, then your name would be turned over to the health department. Health department will assign someone in to interview you so that they can determine the circumstances and the conditions under which you might’ve been exposed. Remember, a lot of people won’t, depends on their behavior, so if I went to a while and unruly party where with 50 people, I may not remember who was there, but the whole notion of contact tracing is you tracked on all the people who were possibly exposed and if they get tested, then you determine the prevalence of the exposure. So if I know Sam Smith is positive that he was at the party, or he was at the workplace, or he was at the, wherever. Then what I do from there is to find out whoever Sam Smith and direct. So that’s where the contact tracing comes in and then you go from that person to that person. So, you have this whole web of, cascade of interactions, so that you get a better sense of the prevalence of the disease, the infectivity of the disease, and what’s going on in our community. So, 50 people were there and only Sam and Suzie got converted. That means that the disease isn’t spreading that rapidly in this particular population. If 50 people were there and 15 people got converted and that event was the only event to which you could attribute that conversion, then you realize that you’ve got something that’s more infectious. Remember, you’re also dealing with the virus that can mutate. So, you also need to be able to keep that in mind. So, part of this whole effort is to track down somebody who may have been exposed, were you on that plane, were you in that car? Were you on that bus? Were you at that party? Were you at that event and to see how many other people were infected because those people can go on and infect other people. So, I inform you, yo, you are positive. You need to chill out for two weeks. That becomes an important thing, but you don’t know that, and we’ve had cases where people just merrily went along their way, they’ve been exposed, they converted and then they go and they expose other people. Some of whom, maybe very vulnerable.

Belinda Reed Shannon: So, it’s like a multiplying effect?

Dr. Clark: It’s a multiplying effect. It’s definitely a multiplying effect and it’s a major concern. So, with contact tracing, we can adDr.ess that issue. Now the employer doesn’t do the contact tracing, normally. That’s generally delegated because there are confidentiality issues. There are also some other issues. What some employers are doing is doing the temperature check, which is not a great way. It is something, but it’s not really a reliable way of determining whether someone has been exposed, is a carrier, but it is, if someone is symptomatic, that’s helpful from that point of view, you can send them back home, but it’s not a foolproof technique, but it does show that the employer is doing the best he or she can to adDr.ess the issue, because again, we’re all in this together and we want employers to be responsible and flexible, but they can only behave, can only do so much.

Belinda Reed Shannon: Yeah, I think a lot of the employers who have started returning their workforce back to a workplace environment are taking baby steps. I recently had an experience in the TV and film industry, where they open the setback up and they had extreme steps that they were taking, not only to test up, to do a temperature test of everyone entering the set but keeping people socially distance while on set, as well as doing periodic safety briefings to remind people, you know, more than one safety briefing a day to remind everyone what it is we needed to do but nevertheless, there’s still a lot of employers who are still trying to sort it out and I think that’s what we’re going to be talking about in our next episode, right?

Barbara Johnson: Yes, absolutely.

Dr. Clark: Information, sharing that information and making that information readily available and I like this notion that you describe, constantly reminding people of this because again, we’re lax and we want to hang out with our friends. We want to chit chat and as well as get the job done and we need to be reminded, minimize the risks.

Belinda Reed Shannon: Yeah. It certainly represents a huge social and cultural shift that not only, we will have to make in practice in our personal lives, but absolutely in the workplace

Dr. Clark: And depending upon where you work and what you do, and the work population that your workforce may have these cultural dynamics that people find hard to transit and so you have to take that into consideration. So, if you’ve got people with cultural rituals that they hate to break, then you’ve got to speak to that because the workplace then becomes a place for communication.

Barbara Johnson: Well, certainly, you know, we encourage employers to look at science. It’s probably the reason we’re talking with you today. What are some of the best sources of information for employers to go to for reliable, scientific information on what’s going on? You know, what guidance can you give? Because there’s so many myths out there. I know I’m sure that, both of you, like me, heard all kinds of conspiracy theories and it’s at 5G. I mean, there are just so many theories out there that were coming at us left and right. So, if you, if you want reliable information, where do you go?

Dr. Clark: Alright, that’s a very good point. So, depending on your staffing pattern, you would have someone check at least weekly, the CDC. It has information, both for professionals. Well actually from professionals, for employers, for consumers. So, it’s all broken down and it’s all available. So, if you are somebody who’s very knowledgeable and you don’t think that getting information in simple terms befits you, then you can step up. WHO, same thing, information for professionals, information for employers, the business community and government officials, information for consumers. If you want to know most recent data, Johns Hopkins University has a website. You have some newspapers who are capturing the information from the CDC and WHO and the academic literature. So, those websites also contain information. Your state health departments often are information brokers. So, you can get information from the state health department, just put in state health department in your state. If you’re from Maryland, if you’re from Idaho, if you’re from California, from Texas, you’ll find a wealth of information about COVID-19, all on those websites. Some of them state-based websites who also give you information about where you can get your COVID-19 test. So good information from CDC, state health departments and WHO. Other information, a number of your popular media sites are tracking this. Now the problem with the further away you get from the health departments, the CDC and WHO, you start getting into the conspiracy theories and you find people just pretending that it isn’t true and we’ve had some situations where these pundits to talk about the diseases if it was a fiction and then oops, they get it themselves

Belinda Reed Shannon: Or their family member gets it.

Dr. Clark: Or their family member gets it and then they’re singing a slightly different song but, yeah. I think people need to use the official sites and then, you know, if you want to listen to the conspiracy theories, you can, but protect yourself. And then you can have the debate, whether enough resources were made available, whether this political party versus that political party moved fast enough or didn’t move, et cetera but as citizens and as employers, in business, you want to deal with what’s best for your particular group and denying that there is no pandemic is sure fire way of causing havoc in your workforce.

Barbara Johnson: You know, one of the challenges, if you’re a multi-state employer or even a global, is just trying to figure out what’s going on in various jurisdictions and I know that there are some organizations, some law firms that are tracking exactly what’s going on in terms of the stay at home orders, the quarantines, whatever, and we’ll post those to our websites so that folks can take a look at those because it’s so challenging. If you have employees in a variety of jurisdictions, even to know, okay, well, these people can’t go to work. These people can’t go to work. These, you know, it’s, it’s quite challenging,

Dr. Clark: Indeed. So, depending upon the employer, if you are doing business and only a few countries, those countries will probably have websites. Also, the issue is if the information in a language you can understand, so this is where the, your consultants in law firms might be helpful. They can translate or arrange to have translated that information. You want to make sure you’re able to read it. WHO often will do the translations. So again, multiple responsible sites focusing on the science and the public health, focusing on what the communities are doing and so that, that’s it

Barbara Johnson: What’s your view about travel? I mean, a lot of employers have pretty much stopped non-essential travel through the end of the year. In some cases, what is the risk of, say, airline travel at this point?

Dr. Clark: Well, now that we know that this is an airborne disease, traveling in an airplane is at a higher risk. Some airlines have made efforts to allow as many people as reasonable to travel. Southwest puts people, every other seat. Other airlines have been chocked full of bodies. Some airlines have insisted that you wear a mask in order to board. Other airlines are more interested in the cost of the seat. So then, allow people to not wear masks. So, it is more hazardous, but if you gotta travel, you gotta travel, so again, your risk goes up.

Belinda Reed Shannon: Yeah, but again, when you think about the impact on businesses, particularly those who operate globally, or those who operate, you know, across multiple states in the United States with these individual jurisdictions, putting in place rules on who can and cannot come into the jurisdiction. I mean, that’s totally changed up some of the mobility. You know, the mobility culture that a lot of corporations have followed in terms of having, you know, multinational, you know, business units, where they have one executive that travels between countries and things like that. Well, now that executive, if he’s originating in the United States, there’s a whole bunch of countries right now that are not going to allow anyone from the United States to come in.

Dr. Clark: but that’s Barbara’s point. You need somebody who’s tracking that because if they’re not going to accept me, I’m not going. So, the issue isn’t that, the issue is if they do accept me, what’s my risk. So, if the country insists on a quarantine, Israel is requiring, and I don’t know if that’s still in effect, that was requiring a 14-day quarantine.

Belinda Reed Shannon: Like South Korea. My daughter is stationed over in South Korea. She’s been over there since July with the United States Army and her husband had to finish up his tour of duty here in the United States. So, he just recently, this past weekend was able to actually move to South Korea and start a new assignment there with his family. His first 14 days there, he literally is under quarantine in, in some barracks. So, he can’t join his family immediately. He has to stay in the barracks and as a funny side note, my daughter happens to be head of the human resources organization that intakes all of the soldiers and so any soldier coming into the peninsula reports into her for the first 14 days. So, we just were having a good laugh in the family about how her husband now has to report to her for the first 14 days that he’s over there.

Dr. Clark: So, but that’s, that’s exactly the point. So, you do, as Barbara points out in, as you’re observing, you need to know what the host country policies are, but you also need to know the risk even if the host country says fine, come on in. Then the question is, who are the, who are these other people that are on the plane? Who am I traveling with? Who have nothing to do with my company? What policies do they have? Do they wipe down the plane? Now, Sarah, some people who very wisely advise you to make sure you…

Belinda Reed Shannon: Have your own, right.

Dr. Clark: And your wipes, and you wipe down your stout, depending on who you see yourself as being, I mean, if you’re flying first class, do you do something as tacky wipe down your whole area? Well..

Barbara Johnson: Oh well

Belinda Reed Shannon: Nothing crappy about that nowadays.

Dr. Clark: If you get sick then that, you know, that first-class trip suddenly loses its appeal because you’re definitely ill. So, that’s why some people do that. So, they bring their own water. They bring, or they make sure they get water at the airport, bottled water and not on the plane. Southwest, no longer hands out the multiple snacks they used to hang it. And others are using sort of, you know, meals ready to eat as a way of dealing with it. So again, you want to check out the airline before you get on it. You want to check out the train before you get on it. You want to know what their policies are. If they’ve got very casual policies where people are sitting any place they want, they don’t have to wear a mask, then that’s a much more hazardous situation. If they’ve got more restrictive policies that that’s less hazardous, nevertheless, your risk goes up because you have the issue of airborne. You have the issue of surface contact, how long the virus remains on a surface. That’s an issue.

Barbara Johnson: Well, it’s, it’s certainly a lot. And as we mentioned earlier, employers definitely will have to turn a practical eye towards the workplace environment and re-imagining it and redefining it in this post-COVID-19 existence that looks like we’re going to be in for a while.

Dr. Clark: Well, it could last up to two years and so yes, it will be a while. We’ve got to get through the flu season, IE distinguishing between COVID, SARS-CoV-2 and the annual flu, which can have two or three permutations, right? So, you’re not people who get the flu vaccine will often complain that gee I got the vaccine now I still have the flu, which shows you the limitations of vaccines. If the thing mutates, then you got a new one…

Belinda Reed Shannon: A new strain. So, we will know a lot more after this first year, the whole notion of communication, information tracking and personal behavior, as well as employer behavior becomes critical and so, again, we’re all in this together, again, using that phrase and it means that everybody has a task to perform. Employees have a task to perform, Employers have a task to perform, public health authorities have a task to perform, governmental authorities have a task to perform, and depending on how well each of those does his or her task, will determine how well we do in the long run with regard to the spending

Barbara Johnson: You know, Dr. Clark has made it clear that the COVID-19 has presented one of the greatest challenges that we’ve had to face in our lifetimes, for sure and certainly lawyers are really going to struggle, have struggled, and will continue to struggle with what the best approach is to maintaining a workforce, keeping their folks working. How do you do that? And, you know, we can look at regulations, whether it be EOC regulations, OSHA regulations, the department of labour regulations, in terms of giving some guidance but going back to what I said earlier, it’s really a matter of flexibility and understanding what’s going on from a scientific perspective, as well as looking at what’s going on in terms of the guidance that we’re getting from these various agencies on how to proceed.

Belinda Reed Shannon: Yeah. I think, thinking outside of the box is going to be very necessary practice that employers, as well as the people who advise them like their HR teams and their legal teams, will have to do moving forward

Dr. Clark: And avoid succumbing to the mythologies associated with this, do those practical things that we’ve been talking about. And then I’m sure when you two start talking about the regulatory and the legal issues, practical things will help adDr.ess those issues.

Belinda Reed Shannon: Well, on our next episode, we’re going to take a closer look at a list of the adjustments and the precautions that will now define today’s workplace in this post-Coronavirus era that we’re in.

Barbara Johnson: And we’d certainly like to thank Dr. Clark for providing us with so much valuable information and insights about COVID-19 from a scientific perspective, it’s very valuable for employers to understand the science. And so, thank you so much for joining us today.

Dr. Clark: The pleasure is mine

Belinda Reed Shannon: Thank you, Dr. Clark.

Dr. Clark: The pleasure is mine

Belinda Reed Shannon: Well, Dr. Clark, you certainly have provided us with a lot of information and a very easy to understand manner so that as employers we can, and the people who advise them, we can actually wrap our hands around this big issue and use that as some great contexts to solving the problems of the workplace now, that we have to make these cultural and social shifts. So, thank you so very much for spending time with us today and giving us all of that great information

Dr. Clark: And thank you for inviting me, Belinda and Barbara. The pleasure was mine. It is very important that all of us recognize our respective roles and adDr.essing the spread of COVID-19 disease.