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Saturday, June 13, 2020

Coronavirus tracing apps could be used by hackers to access your personal data

Cybercriminals could trace your device or access sensitive personal data through contact-tracing apps built for the coronavirus pandemic, a new report says.
In a report released Thursday, cybersecurity firm Check Point noted that U.S. developers are working on contact tracing apps that measure Bluetooth signal strength to detect the distance between device users. The basic idea is, if two devices are close enough, within 6 feet, an infected user could potentially transmit the virus. If somebody is infected, other app users would be notified and could self-quarantine and get tested.
GPS can also be used to determine location. This approach allows health authorities to analyze the geography of the infection spread and take preventative measures. MIT’s SafePaths app, for example, uses GPS technology.
Checkpoint researchers laid out a number of concerns about the apps, including issues with the following:
  • Bluetooth: If not implemented correctly, hackers can trace a person’s device by matching devices and the “identification packets” they send out.
  • GPS: If GPS is used, it can give away sensitive information, revealing where users are traveling and their location during previous days or weeks.
  • Personal data: Apps store contact logs, encryption keys and other sensitive data on devices. This data could be vulnerable if not encrypted and stored in the application “sandbox.”
  • There is also a danger that identity could be exposed if phone number, name or other identifying data is associated with a tracing app.
  • “The jury is still out on how safe contact tracing apps are. After initial review, we have some serious concerns,” Jonathan Shimonovich, Manager of Mobile Research at Check Point, said in a statement.
“Contact tracing apps must maintain a delicate balance between privacy and security, since poor implementation of security standards may put users’ data at risk,” he added.
Google and Apple made news in April when they announced a framework based on Bluetooth for registration of contact events. Each device generates keys to send to nearby devices and the devices store the contact IDs locally.
According to the framework, if a user decides to report a positive diagnosis of COVID-19 to their app, they will be added to the positive diagnosis list – managed by a public health authority – so that other users who came into range of the infected person’s Bluetooth “beacons” can be alerted.
Check Point has offered some pointers on how you can protect yourself from exposing your data:
  • Install apps from reputable stores only such as the App Store and Google Play Store. Those stores only allow authorized government agencies to publish such apps.
  • Use mobile security: install mobile security software to scan applications and protect the device against malware.
https://nypost.com/2020/06/12/coronavirus-tracing-apps-could-be-used-by-hackers-to-access-your-personal-data-report-says/

Insurers fight off small biz claims over coronavirus losses

US property and casualty insurers have cast the coronavirus pandemic as an unprecedented event whose massive cost to small businesses they are neither able nor required to cover.
The industry has warned it could cost them $255 billion to $431 billion a month if they are required, as some states are proposing, to compensate firms for income lost and expenses owed due to virus-led shutdowns, an amount it says would make insurers insolvent.
The estimate, made by the American Property Casualty Insurance Association, a trade group, was recently used by the industry to successfully lobby against state and city lawmakers’ efforts to legislate to make the sector pay.
Insurers say business interruption policies only apply when actual physical property damage prevents a business from operating and any attempt to apply cover beyond that, for a pandemic, are unconstitutional.
The stance has discouraged some policyholders from filing claims and prompted others to take legal action.
A Reuters examination of APCIA’s estimate, however, suggests the possible bill may not be so onerous.
The APCIA estimate is an industry worst-case scenario based on all small firms with business interruption coverage being able to claim. It also assumes that 60 percent to 90 percent of businesses with fewer than 100 employees will be affected by COVID-19.
Only about 40 percent of small firms have business interruption coverage, according to the Insurance Information Institute, and most of the policies explicitly exclude pandemics, according to Tyler Leverty and Lawrence Powell, professors who specialize in insurance at the University of Wisconsin and the University of Alabama, respectively.
Powell has estimated that insurers could be on the hook for a maximum of $120 billion a month in claims on the basis that half of small firms have business interruption insurance.
Leverty said that if the estimate counted only businesses without explicit exclusions for pandemics, “it would be in the millions per month.”
The APCIA said it stood by its numbers, which it said reflect the unique and widespread impact of the virus. It declined to comment on Powell’s analysis.
“Yes, these are eye-popping figures,” APCIA Chief Executive David Sampson told Reuters, referring to the association’s estimate. “This pandemic is unprecedented in its scale, reach, and economic impact.”
New Jersey’s business interruption bill, a model for others, is stalled while Roy Freiman, the lawmaker who introduced it, waits for an alternative plan from the industry.
“I said, ‘Look, we don’t want insolvency, but surely there is some place between 100 percent denial and insolvency that you can operate within,’” Freiman told Reuters.
The city council in Washington, DC, shelved a similar plan in early May after “pretty intense” lobbying, Council Member Charles Allen, a supporter, told Reuters. APCIA’s cost estimate was cited in council discussions along with an association white paper describing the plan as unconstitutional.
Chairman Phil Mendelson, who introduced the plan, withdrew it after members voiced fears of a lengthy court fight and insurer insolvency.
“Obviously, our concerns were heard,” Sampson told Reuters at the time.
Trade groups say the industry’s stance has deterred many claims.
“Businesses are being told if you file they will probably deny you,” Andrew Wrigie, executive director of the New York City Hospitality Alliance, which represents 2,500 bars and restaurants in New York City, told Reuters.
“We’re telling them to seek counsel and be on record filing claims.”
That’s not an option for George Sizemore, owner of Bit of England Darts & Games Shoppe in Virginia Beach.
Sizemore’s insurance agent told him it would be pointless to claim for the $40,000 in revenue he said he lost while his store was shut because his policy does not cover pandemics.
“The only way I could file a claim would be to have a lawyer,” said Sizemore. “I just don’t have the money.”
There are currently dozens of lawsuits in US courts seeking compensation on behalf of small businesses for lost earnings due to the pandemic.
Legal experts said that while many policies exclude pandemics, some do not and there is precedent for courts requiring insurers to pay for physical loss without physical damage, such as when pollution or asbestos make property uninhabitable.
“It’s not anywhere near as clear-cut as the industry says,” said John Ellison, a partner at Reed Smith who has represented policyholders for three decades.
https://nypost.com/2020/06/12/small-businesses-dont-qualify-for-covid-19-claims-insurers/

Pre exposure Hydroxychloroquine tied to reduced Covid risk in healthcare workers

Raja Bhattacharya, Sampurna Chowdhury, Rishav Mukherjee, Anita Nandi, Manish Kulshrestha, Rohini Ghosh, Souvik Saha

Abstract

Abstract Background: While several trials are ongoing for treatment of COVID-19, scientific research on chemoprophylaxis is still lacking even though it has potential to delay the pandemic allowing us time to complete research on vaccines. Methods: We have conducted a cohort study amongst Health Care Workers (HCW) exposed to COVID-19 patients, at a tertiary care center in India where there was an abrupt cluster outbreak within on duty personnel. HCWs who had voluntarily taken hydroxychloroquine (HCQ) prior to exposure were considered one cohort while those who had not were considered to be another. All participants with a verifiable contact history were tested for COVID-19 by rtPCR. The two cohorts were comparable in terms of age, gender, comorbidities and exposure. The primary outcome was incidence rates of rtPCR positive COVID-19 infection amongst HCQ users and non – users. Results: 106 healthcare workers were examined in this cohort study of whom 54 were HCQ users and rest were not. The comparative analysis of incidence of infection between the two groups demonstrated that voluntary HCQ usage was associated with lesser likelihood of developing SARS-CoV-2 infection, compared to those who were not on it, X2=14.59, p<0.001. None of the HCQ users noted any serious adverse effects. Conclusions: This study demonstrated that voluntary HCQ consumption as pre-exposure prophylaxis by HCWs is associated with a statistically significant reduction in risk of SARS-CoV-2. These promising findings therefore highlight the need to examine this association in greater detail among a larger sample using Randomised Controlled Trials (RCT).

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

No funding was received.

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https://www.medrxiv.org/content/10.1101/2020.06.09.20116806v1

83% Of Patients Had Fewer Migraines After Cognitive Behavioral Therapy

Migraine headaches are notoriously difficult to treat with pain medications, which perform no better than placebo in studies. Now, a new paper in the journal Headache finds that 83% of patients who completed a short course of cognitive behavioral therapy (CBT) had fewer headaches. The researchers believe that changes in a key brain area for pain management explains how CBT helps with migraines. But what’s most interesting about these findings is the way it challenges the way we classify these headaches in the first place.
Migraines hurt. Badly. Patients often describe the throbbing headaches as so painful, all they can do is lie down in a dark room. The mainstay of treatment for migraines has long been medication, but medications for acute migraines often don’t work. It gets even harder when people have frequent or chronic migraines, where preventative medicines are thought to work only about 20% of the time.
When medications don’t work, doctors prescribe other methods like biofeedback training, acupuncture or stress reduction therapy. But because migraine is considered a medical problem, these treatments are second line.

Therapy for migraine headaches

That’s why this new study is so important. Most of the 18 adolescents in the study with frequent migraine headaches saw a reduction in their migraines. Unlike many studies which run special protocols that no one can access outside the lab, this one used an easily available remedy. Cognitive behavioral therapy is the one of most widely taught and available types of psychotherapy in the U.S. today.
To sort out how the therapy might have helped, researchers ran MRIs on the study participants both before and after their time in CBT. The adolescents had 15 + or – 7.4 headaches a month before enrolling in the study. They then participated in 8 weekly sessions of CBT. After the eight weeks, their headache frequency decreased to 10 + or – 7.4 a month.
The technical details: the MRIs were a particular type called structural and resting-state blood-oxygen-level dependent contrast scans. They also used arterial spin labeling to look at brain activation during the resting state and compared the left and right amygdala to assess connectivity. They also looked at voxels, or 3D pixels, across the whole brain over time.

Therapy activated the brain’s pain control areas

After CBT, the scans showed greater brain activations in the frontal regions associated with cognitive regulation of pain. So these were the areas in the frontal cortex where we can consciously think about our pain and cope with it. The MRIs also found increased connectivity between the amygdala and frontal regions after CBT. So the amygdala, which is the stress and raw emotion center of our brain, was talking more with the frontal area where we can think through our pain. In other words, cognitive behavioral therapy helped the part of our brains that freaks out about pain listen to calming thoughts from the brains’ higher levels.
That’s pretty cool. When medical problems are treated more effectively by talk therapy than by medication, it raises questions about the nature of the problem in the first place. It would be easy to wonder if migraine headaches are really an emotional or psychosomatic problem; an “all in our heads” sort of thing. It’s an old idea, passed down from ancient Greek ideas that formed a foundation in western culture: that the mind and body are separate. It leads us to ask questions like, “Is this a medical problem or this is a psychological problem?”

Mind and body are a single biological system

Studies like this highlight the growing understanding that there is no separation between our minds and our bodies. Neither is there a meaningful separation between our thoughts, emotions or our physical symptoms.
We exist as one biological system with different access points.
That idea can be challenging at first. But once we wrap our minds around it, humans make more sense. If we are a single interconnected and unified system with lots of inputs and outputs, recent findings in medical science stop seeming so weird.
Here’s one example: it’s a mind-bender to consider the role of the gut microbiome. The “guest” bacteria living in our gut impact a host of “separate” systems in our bodies. Evidence suggests that the population makeup of gut bacteria determines whether we have inflammation that leads to heart disease. AND those bacteria also impact our serotonin levels, making us happy or depressed.
How can the bacteria in our gut be the reason we are depressed? We have cherished the idea that depression is in the realm of mind and that it’s something we can control. Yet recent science suggests that organisms who live inside us are a big part of it. That only makes sense if we think of our bodies and minds as a single system.
Going to talk to a therapist because you have migraines may be giving you a lot more than just coping skills. It may be actually rewiring your brain.
https://www.forbes.com/sites/alisonescalante/2020/06/12/83-of-patients-had-fewer-migraine-headaches-after-doing-therapy/#63a50f96251f

Prelim Data Suggest Low-Dose Radiation May Successfully Treat Severe Covid-19

Human medical trials have begun on severely ill COVID-19 patients using low-doses of radiation. The first results on a very small group were published this week in a non-peer-reviewed journal that exists to get critical results out quickly to the scientific and medical community.
The results were quite extraordinary.
Researchers at Emory University Hospital, led by Dr. Mohammad Khan, Associate Professor of Radiation Oncology, treated five COVID-19 patients with severe pneumonia who were requiring supplemental oxygen and whose health was visibly deteriorating. Their median age was 90 with a range from 64 to 94, four were female, four were African-American, and one was Caucasian.
These patients were given a single low-dose of radiation (1.5 Gy) to both lungs, delivered by a front and back beam configuration. Patients were in an out of the Radiotherapy Department in 10 to 15 minutes.
Within 24 hours, four of the patients showed rapid improvement in oxygenation and mental status (more awake, alert and talkative) and were being discharged from the hospital 12 days later. Blood tests and repeated imaging of the lungs confirmed that the radiation was safe and effective, and did not cause adverse effects – no acute skin, pulmonary, gastrointestinal or genitourinary toxicities.
The gray (Gy) is a dose unit of ionizing radiation defined as the absorption of one joule of radiation energy per kilogram of matter. The Gy replaces the older unit of the rad, and 1 Gy = 100 Rad.
This treatment is critical because severe COVID-19 cases cause cytokine release syndrome, also known as a cytokine storm. Such a storm is a deadly uncontrolled systemic inflammatory response of the body’s immune system resulting from the release of great amounts of pro-inflammatory cytokines, which act as a major factor in producing acute respiratory distress syndrome, or ARDS, which is what kills.
It’s why we need ventilators and ICU beds so badly, and why this pandemic threatens to overwhelm our hospital systems.
One reason why this trial is so important, and why the success rate was so exciting, is COVID-19’s increasing fatality rates with age – 8% for patients aged 70 to 79 and 14.8% for those aged 80 and over – so showing this treatment is safe and effective for these elderly patients was vital. Mortality rates are even higher if you get hospitalized and are in the ICU, over 50%.
It’s the anti-inflammatory effects of radiation, not its antiviral action, and it’s these anti-inflammatory effects that is invaluable in helping patients with COVID-19 and that were demonstrated in this trial.
We are already completely set up for these radiation treatments at almost every hospital and cancer center – no new preparation, additional equipment, or training is needed. There is no supply chain issue with this treatment.
As discussed previously, several medical institutions are starting radiation therapies for COVID-19. The Clinicaltrials.gov website gives information on these trials, including an Italian clinical trial, a Spanish clinical trial and others that have begun and more have recently been added to the ClinicalTrials.gov website, with five of them currently recruiting patients. The countries represented are USA(2), Spain(2), Italy (1), Iran(1), and India (1).
Dr. James Welsh at Loyola University Medical Center, and former Chairman of the Board of the American College of Radiation Oncology and Editor-in-Chief of the Journal of Radiation Oncology, is moving to begin a national trial within the next few months on this treatment using low-dose radiation to the lungs.
Welsh and colleagues from Beaumont Health, University of Ohio, Baptist Health Miami and Barrow Neurological Institute, just published an article on the basic science behind this method (see figure below from this publication, published and modified, with permission, from Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X, et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ 2020; 27:1451– 4. © 2020 Radiation Research Society).
These studies indicated possible mechanisms by which low doses of radiation mitigates inflammation and facilitates healing, one being the polarization of macrophages to an anti-inflammatory or M2 phenotype. The M1 type tends to overstimulate the immune system which can lead to a cytokine storm, while the M2 type tends to suppress the overreaction of the immune system.
We kind of knew this would work because we did the same thing 70 to 80 years ago. Dr. E. J. Calabrese at the University of Massachusetts School of Public Health & Health Sciences and Dr. Gaurav Dhawan at the University of Massachusetts reviewed how X-ray therapy was used during the first half of the 20th century to successfully treat pneumonia, especially viral pneumonia like that caused by this coronavirus.
As Welsh puts it, for COVID-19 patients who progress to severe disease where there is no established treatment and death is a significant possibility, low-dose radiation would appear to be a relatively safe strategy that could be widely implemented, once evidence of efficacy is produced. This can be readily achieved with small, pragmatic and expeditious clinical trials, with an extremely rapid clinical signal of benefit.
As the other human radiation trials move forward, it will be exciting to see the results because we need an easy, quick and safe treatment for the most dangerous virus of our time.
https://www.forbes.com/sites/jamesconca/2020/06/12/1st-human-trial-successfully-treated-covid-19-using-low-doses-of-radiation/#195f75f0dc69

Safely Resume Playing Youth Sports

There is no one-size-fits all way to resume, as the risks of Covid-19 transmission vary from region-to-region and sport-to-sport. Youth leagues should follow local public health and government guidelines and parents should seek the advice of a medical professional before allowing their child to return to a sport.

  • Phase-in team practices, first focusing on ways individuals can practice skills six feet apart from other players with minimal touching of shared equipment.
  • Dr. Rishi Desai, a pediatric infectious disease specialist and chief medical officer at online medical educator Osmosis, recommends practicing outside with fewer than 10 kids who are old enough to wash their hands alone and understand social distancing. Young children who need to be constantly reminded to follow safety rules should not yet return to team sports.
  • Athletes should wear a mask while playing whenever possible, though not if it obstructs breathing.
  • The safest sports are those that have a strong individual component, take place outside, can be done wearing a mask, and don’t involve much equipment, such as track and field, according to Desai.
  • Sports with shared equipment are at higher risk for virus spread. The main concern with sharing an object like a ball is that an athlete could rub their mouth, nose or eyes before or after touching it, says Desai. Any equipment should be frequently cleaned.
  • Avoid indoor sports, contact sports, and travel sports outside of a local municipality.
  • Participating on a swim or dive team in a well-maintained pool that is constantly circulating is generally safe, since the virus isn’t known to spread in chlorinated water. Each team member should have their own towel and goggles. Water polo is not recommended since it is a contact sport involving a shared ball.
  • Locker rooms at youth sports facilities should not be used. Public drinking fountains should be turned off.
  • Coaches, officials, and volunteers should wear masks. Spectators should be limited, and those who attend should socially distance and wear masks.
  • Half of parents are concerned their child will get sick by returning to sports, according to a survey by The Aspen Institute’s Project Play. Youth sports leagues should aim to exceed safety and social distancing guidelines, train coaching staff, and offer the lowest-risk forms of training including individual drills.
  • Parents should review the youth sport league’s guidelines and protocols with their child’s pediatrician.
  • Coaches should frequently communicate with parents and athletes about how practices will be run, what drills they will do, and expectations and goals for players.
  • A recent survey of 37,000 student-athletes by the NCAA found that a majority reported experiencing high rates of mental distress since the outset of the pandemic. The top concern was a fear of exposure to Covid-19 (43%), followed by a lack of motivation (40%), feelings of stress or anxiety (21%), and sadness or depression (13%).
  • Positive Coaching Alliance CEO Chris Moore says coaches must step back from being results-driven and prioritize supporting the emotional, social well-being of athletes. Focus on life skills so kids will be more coachable and productive.
Little League Baseball and Softball is implementing changes this season to protect players, coaches and spectators. “America’s pastime is going to look a lot different this year,” says Nina Johnson-Pitt, central region director, Little League International. “Above all we want parents and coaches to have patience especially with the kids as they figure this all out.”
Players are not required to wear masks on the field but the Little League encourages them to be worn when on the sidelines. Dugouts should have a tape mark or sign every six feet and assigned spots for players. They also banned sunflower seeds and gum in dugouts and mandated that coaches and players refrain from spitting. Bats, water bottles, and gloves must be kept outside in a designated spot for each player, and there is no sharing of any of these items. Coaches, umpires and players should all have their own hand sanitizer.
New ball rules are also in effect. Baseballs and softballs will be rotated on a regular basis and sanitized in between use. If one goes foul, the league wants catchers to retrieve them, not the umpire or fans in the stands. High-fives, piling on the home-run hitter at home plate, and the post-game handshake between teams are also not allowed.
Ripken Baseball, which hosts youth camps and tournaments, has closed all bleachers, picnic tables and other dining seating areas. Fans are asked to bring their own seating and to remain six feet apart.
Youth leagues should not be asking for signed commitments and payment from players ahead of state and local governments lifting restrictions on play, and local sports facilities implementing proper social distancing and safety protocols. Facilities that have not been deeply cleaned and sanitized should not be used. Coaches and officials who treat safety and social distancing protocols as optional should be reported to league offices.
While teamwork is important, the focus on individual skills could help players fine tune accuracy in scoring, throwing, hitting and other mechanics. This could also be a blessing in disguise for children with performance anxiety, since restrictions on the number of spectators may reduce the number of parents behaving badly and coaching from the stands.
https://www.forbes.com/sites/christinasettimi/2020/06/12/how-to-safely-resume-playing-youth-sports/#61e5780a1985

CDC: 10 Ways To Dine Safely At A Restaurant With Coronavirus Around

As the Covid-19 coronavirus pandemic continues, the Centers for Disease Control and Prevention (CDC) have now released new “Deciding to Go Out” guidelines. So if you are considering dining out, it may be time to “digest” what they say about visiting and eating at a restaurant. Here are the 10 recommendations that they served up, each paraphrased a bit:
1. Check, please: search the restaurant’s website and social media for their Covid-19 safety guidelines.
If the restaurant website or social media does not mention of Covid-19 or the coronavirus, that’s not a great sign. That would be like ignoring the elephant in the room. Actually, it would be more like ignoring the elephant that’s playing Taylor Swift songs on the accordion in the room. Beware of restaurants that are acting as if the pandemic were no big deal.
2. Make the call: call ahead to ask if their staff are wearing face coverings at work.
Prior to the pandemic, calling a restaurant and asking, “hey, do people wear masks at your restaurant,” might not have gotten the best reaction. But nowadays, it should be expected. If the restaurant is shocked or offended by your query, that’s also not a good sign. Your safety should be their concern.
3. Face the facts: wear face coverings when you are indoors or less than 6 feet apart from others.
The CDC did specify cloth face coverings in case you were thinking of wearing a metal bucket on your head. Of course, when you are ready to drink or eat, you can uncover your mouth. Otherwise, trying to shove a hot dog through a face covering ain’t going to work.
4, Stay distant: try to stay at least 6 feet apart from people who do not already live with you.
If you are dining with people who don’t regularly live with you, this isn’t the time to whisper sweet nothing into their ears. Keep your distance. Act as if they were constantly farting.
5. Park yourself: choose self-parking instead of valet service.
Treat your car as you would your genitalia. Don’t just hand it to a stranger, give the person a tip, and walk away.
6. Wait for it: stay at least six feet away from others in entryways, hallways, or waiting areas.
Where you eat is not the only place to keep your distance. This applies to anywhere other people may be. Always think about Denzel Washington, who is around six feet tall. Always. When you are in a waiting area, hallway, entry way, or anywhere else, try to keep at least one Denzel away from everyone else, as I have written before for Forbes.
7. Wash your hands when entering and exiting the restaurant.
If you aren’t already frequently and thoroughly washing your hands, then what exactly is going to convince you to start do so? When washing your hands, lather up with soap for at least 20 seconds. As I have mentioned before for Forbes, that means singing through at least the first “Oh no, oh no, oh no” of the Divinyls song, “I Touch Myself.” Don’t actually touch yourself while singing the song, because that would defeat the whole purpose. When singing the song, don’t stare directly at strangers, because that’s kind of weird.
8. Maintain proper table settings: try to sit outdoors at tables that are at least six feet apart from other people.
Unless there is an active tornado going on, it’s a better to dine outdoors where the wind can provide natural ventilation. Even when you are outside, try to keep the tables at least six feet apart. If people aren’t staying six feet away from you, loud and heavy moaning may work.
9. Don’t be so self-serving: avoid self-serve food and drink options so that you don’t have to touch shared items.
Being self-serving these days can be bad in more ways than one. It can result in your touching things such as utensils, handles, buttons, touchscreens, and other things that people have been panting on and touching.
10. Check the rest of the restroom: before you use a bathroom, check that there is enough soap and paper towels or hand sanitizer with at least 60% alcohol.
You are going to need to wash your hands after using the bathroom, whether you are going number one, number two, or number one-two-one-two-one-two. After all, a bird in hand is, well, pretty dirty. So is anything else that may be in your hands while you are in the bathroom. Don’t wait until you’ve done the deed before realizing that the soap dispenser is empty, the faucet doesn’t work, or the paper towels available are dirtier than your underwear. Instead, treat your bathroom trip like a tennis match. Scope out the place first and have a game plan before serving up whatever you are going to throw out onto the court.
The CDC does offer additional tips when you are considering going out in general. Be aware of the local orders and how prevalent Covid-19 may be in your community. That Baconator sandwich may not be worth the risk if the virus is actively spreading in your area. Always consider how many people you will be interacting with and for how long, as well as whether it will be feasible to at least one Denzel away from everyone. Avoid situations that may put you at higher risk, such as a restaurant that requires naked Twister. You may want to avoid such a restaurant in general. When dining out, don’t bite off more risk than you can chew.
https://www.forbes.com/sites/brucelee/2020/06/13/cdc-10-ways-to-dine-safely-at-a-restaurant-with-coronavirus-around/#26b547df6444