By Tom Rivers, Editor Posted 23 March 2020 at 3:29 pm
MEDINA – Orleans County’s only hospital will expand its capacity from 15 beds to 23, said Mark Cye, CEO of Medina Memorial Hospital.
Gov. Andrew Cuomo today signed an executive order requiring hospitals in the state to increase bed capacity by at least 50 percent. The governor urged hospitals to have a goal of increasing capacity by 100 percent so they can handle an anticipated wave of cases with people suffering respiratory infections from the coronavirus.
Cye said the Medina hospital has also modified its CMR unit, which is no longer in use, but could provide additional beds if necessary.
“If we had a large influx we could accommodate 49 beds total,” Cye said.
Medina Memorial has staffing for 25 beds and will hire more staff if necessary, he said.
“We are being proactive and are in the process of reaching out for more staff in the event we need more,” Cye said. “We have also discontinued all out-patient services and are cross training our current staff to work in other direct care areas as needed.”
Medina Memorial also is working the state and local public health departments, and the Centers for Disease Control and Prevention for guidance to protect the health and safety of patients and staff, Cye said.
“And we are continually taking measures to limit the spread of the coronavirus In our community and to ensure we are prepared to care for those who are sick or injured,” he said.
Governor Cuomo announced today that an additional 5,707 coronavirus cases in New York State, bringing the statewide total to 20,875.
MEDINA/ALBION – General Physicians PC’s Medina and Albion offices remain open during the current COVID-19 outbreak.
In order to protect our patients and reduce chances of exposure to the corona virus we are changing some of our processes for patient visits and management.
Both Medina and Albion offices will remain open with regular office hours.
We have accelerated our adoption of telemedicine and will convert many visits to virtual visits using telephone, Skype, ZOOM or other interactive technology. Patients who require a procedure or physical examination will still come to and be cared for at the office in the usual fashion.
Dr. Madejski, Marcel Rozario ANP, Pamela Eaton ANP, Emma Leatham PA, and Pamela Eaton ANP will continue to see patients either through a telemedicine interface or in person in the office.
Dr. Madejski anticipates that 60-70% of visits can be done without coming to the office, reducing the chance of exposure of patients to healthcare workers and importantly to other patients who could potentially be carrying the virus and be a source of transmission while still asymptomatic. This is especially important for our elder patients with multiple medical issues.
Patients, as always, have options to reschedule visits but we recommend keeping regular follow-up and wellness visits as scheduled. This should keep your healthcare up to date and reduce the likelihood of problems arising due to deferral of care and testing. This is especially important for our patients with multiple chronic diseases. It will also assist in reducing the pressure to catch up with diagnostic testing and care when we return to normal in the next few weeks to months.
Due to the declaration of a National Emergency telemedicine visits are covered by insurance without any copayment. General Physicians is also able to see new patients via telemedicine without a pre-existing relationship during the crisis. Patients who have symptoms are welcome to call for guidance and help avoid additional burdens to our stressed inpatient healthcare system.
Dr. Madejski and the staff at General Physicians remain committed to helping the citizens of Orleans and Eastern Niagara Counties weather this storm and come out of it stronger.
Please call us with any questions at 585-798-3345 or 585-589-1322.
By Tom Rivers, Editor Posted 20 March 2020 at 7:29 pm
Pettit urges younger people to not feel invincible to coronavirus
In addition to the concerns over the coronavirus, the Public Health Department in Orleans and Genesee counties warn this has been one of the worst flu seasons on record.
Orleans County has 249 confirmed cases up to March 7, including 24 the week ending March 7. In Genesee County, there are 562 cases of the flu this season, including 32 cases the week ending March 7, Paul Pettit, the Public Health director, said during a daily news briefing today.
Pettit has been updating reporters and the community with 4 p.m. press briefings since Tuesday.
Orleans County had its first confirmed case of coronavirus on Thursday. That person over age 60 is currently on vacation out of state. The person likely caught the virus in Orleans and then developed symptoms out of state. The person is in isolation, away from other people.
Genesee County reported its first confirmed case of coronavirus on Wednesday.
Pettit made a point today to tell younger people they aren’t safe from the virus. In fact, the CDC reports that 38 percent of the people hospitalized in the United States are between the ages of 20 to 54.
“Younger folks can get this,” Pettit said during today’s conference. “Anybody can get Covid-19. We need to remind folks that just because you feel invincible, you feel strong, you can still get Covid-19.”
Younger people could be infected with the virus, but may not be as adversely affected by it as people who are elderly or immune-compromised. However, younger people can still spread the virus around the community, putting others at risk, Pwttit said.
He urged people to practice social distancing, staying at least six feet away from other people.
“Stay home if you’re sick,” he said. “We don’t want folks out and about if you’re sick.”
He urged people to wash their hands frequently, clean common areas such as door knobs, and call ahead to the doctor’s office if they are feeling symptoms of a respiratory illness.
Pettit said the Health Department and Emergency Management Office in both counties are pushing for more swabbing kits so more people can be tested for the coronavirus in Orleans and Genesee counties.
“We are still very frustrated by lack of swabbing kits,” Pettit said. “We’re doing our best and we’re working hard to get those.”
MEDINA – Orleans Community Health is implementing more changes in reposnse to the coronavirus of COVID-19.
With the presence of coronavirus, Orleans Community Health is continuing to take steps to protect the health and safety of its patients, visitors and staff.
Effective on Monday, March 23:
• All elective surgeries are being cancelled unless deemed medically urgent by the patient’s medical provider. If you have questions, please call Kim Gray, Director of Surgical Department at 585-798-8301.
• All radiology services including: x-rays, mammography, nuclear medicine, MRIs, etc. will be cancelled. If you have questions, please call Erica Chutko, Director of Imaging Services at 585-798-8039.
• Albion PT, OT and Speech services will be cancelled.
• Albion Healthcare Center will remain open by appointment only and for telemedicine. Please call 585-589-2273.
• The Lab at the hospital will be closed.
• Middleport and Albion outpatient labs will remain open.
• Dialysis in Medina and Batavia will continue to provide services.
• All visitation continues to be suspended except “special circumstances” (e.g. patients receiving end-of-life care, etc.). Such circumstances will be handled on a case by case basis.
• All associates and visitors will continue to be screened and have their temperature taken upon entering the hospital.
Orleans Community Health is taking these aggressive and prudent measures to limit the spread of Coronavirus in our community and to ensure our health system remains prepared to care for those who are sick and injured.
We continue to work closely with the CDC and local and state health officials to monitor and respond to this evolving situation.
Press Release, Mark O’Brien, director of Orleans County Department of Mental Health
ALBION – The Orleans County Department of Mental Health is announcing that effective Thursday, March 19, it will have the ability to do telephone counseling sessions for currently enrolled clients.
Anyone who feels the need to reschedule or cancel their appointment will now have the option of doing the session with their therapist from the comfort of their home. Of course, the clinic is still open for on-site sessions and has made all necessary adjustments to ensure the required “social distancing” necessary in this time.
For anyone new to the clinic, open access walk-in hours are still available and are on-site only. The clinic is spacious, comfortable and will have sufficient room to insure the health of any seeking services in these trying times.
The Department has posted to its site and to the Public Health site, tips for everyone to help cope with this crisis. The tips include suggestions for families with children and for caregivers who have elderly relatives. As always, the Care & Crisis Helpline is available 24/7 at (585) 283-5200 or Text Line 741741.
By Tom Rivers, Editor Posted 17 March 2020 at 6:22 pm
Photo by Tom Rivers: Paul Pettit, Public Health director for Orleans and Genesee counties, speaks during a news conference on Monday at the old Genesee County Courthouse in Batavia. Genesee County Sheriff Bill Sheron is at left. On Monday there weren’t any confirmed cases of coronavirus in either Genesee or Orleans. Pettit was notified at 3 p.m. today that Genesee has its first confirmed case. That person, a 65-year-old man, will be in isolation for at least the next eight days.
BATAVIA – Genesee County has its first confirmed case of the coronavirus after a positive test from the Erie County Health Lab for a 65-year-old man.
That person has been in a quarantine since symptoms started to appear and will remain in isolation for at least another eight days, until he is no longer sick from the virus, said Paul Pettit, the Public Health director for Genesee and Orleans counties.
Orleans doesn’t have a confirmed case, but Pettit said the county’s neighbors have confirmed cases. He suspects it’s only a matter of time before Orleans has its first positive test.
There are five people in mandatory quarantine in Orleans County. Genesee also has 11 people in precautionary quarantine and two others in mandatory quarantine.
Wyoming County, another nearby rural county, also has its first confirmed case of coronavirus.
Pettit urged people to maintain a six-foot social distance if they are out in public, and to wash their hands frequently and wipe down common areas, such as doorknobs, with disinfectants.
“We do have community spread,” he said. “Hopefully this will be short-lived. In order to do that we need to be compliant and adore to the guidance that is being put out there.”
(Click here to see a video from the Batavia Daily News of the news conference this afternoon in Batavia.)
The Genesee & Orleans Health Departments is trying to get more swabbing kits so more people can be tested. Pettit said there is a big demand for those kits.
If people are feeling a respiratory illness, he said it may also be the flu which remains prevalent in the community.
He urged the public to take precautions to protect themselves and others from the virus. He is especially concerned for senior citizens and immune-compromised people who are more vulnerable to be harmed by the virus.
The 65-year-old man from Genesee County hadn’t traveled. That shows evidence of community spread, that the virus is within the community, Pettit said.
The Genesee County Department of Health has begun an investigation to identify potential close contacts of the individual who tested positive for the virus. Once identified, any close contacts will be notified of their potential exposure to COVID-19 and placed under mandatory quarantine to monitor for symptoms.
In order to hamper the spread of the virus, residents can practice social distancing and proper germ prevention practices:
• Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Avoid people who are sick.
• Disinfect high-traffic surfaces often.
If you have questions about recent travel and symptoms regarding COVID-19, please call the NYSDOH Coronavirus hotline: 1-888-364-3065.
Oak Orchard Health, which runs health centers locally in Albion, Lyndonville and Brockport, has issued these guidelines for patients and other considering coming to Oak Orchard for care:
Because of increased spread of the coronavirus, if you or your child have a cough and fever without difficulty breathing please do NOT come into the office. Stay home and care for yourself or your child as you would a cold or mild respiratory illness.
If you have questions or concerns about COVID-19, there is a hotline that you can call, 1-888-364-3065. You may also call our office for guidance. If you or someone in your care has severe illness, or breathing difficulty, consult the emergency room.
(Editor’s Note: There are no confirmed cases of coronavirus in Orleans or Genesee counties, and both counties each have two people under precautionary quarantine, according to the Orleans County Department of Health’s website.)
Press Release, Public Health Departments in Orleans & Genesee
“There are currently no confirmed cases of COVID-19 in Genesee and Orleans counties,” stated Paul Pettit, Director of Genesee & Orleans Counties Departments of Health. “While the risk of community transmission is currently low, things are rapidly evolving with this outbreak. In response, our departments are proactively taking actions to safeguard our communities.”
The Health Departments are aware of a second positive case of COVID- 19 in Monroe County. “We continue to encourage social distancing where people avoid gathering in public places, limit contact with others; stay home if you are sick; if you are older and/or are immunocompromised with underlying health conditions stay home,” stated Pettit.
COVID-19 may cause symptoms including:
• Cough
• Fever
• Trouble breathing
• Pneumonia
“It is important to remain calm and focus on trusted, accurate information listed below,” stated Pettit. “We understand everyone wants to be updated but want to make sure the information is factual.”
For more information about prevention the state health department has an information call center for questions and answers about travel and symptoms regarding COVID-19. The number is 1-888-364-3065. Or you can visit the following websites:
Press Release, Public Health Departments in Orleans and Genesee Counties
The Public Health Departments in Orleans and Genesee counties are geared up to respond to a positive case of coronavirus in the two counties. So far there hasn’t been a confirmed case in either Genesee or Orleans, said Paul Pettit, public health director for the two counties.
“In response to Monroe County releasing a travel-related positive case of COVID-19 we want to assure Genesee and Orleans County residents that our health departments are continuing efforts to be prepared and ready for action when COVID-19 is diagnosed in one of our residents,” Pettit said. “It has been determined there is no indication of community transmission in the Monroe County case. We currently have one person under precautionary quarantine and is not displaying signs of illness. Our responsibility in this outbreak is four fold: 1. To prepare and be ready. 2. Detect, protect and treat. 3. Reduce transmission and 4. Innovate and learn.”
“Our departments have been preparing for events such as this. We are diligently in conversation with the New York State Department of Health and Centers for Disease Control and Prevention for updated guidance. As we move forward with this outbreak we will be working with those returning from travel from Level 3 and Level 2 Travel Health Notice Countries as well as those who may have contact with someone who traveled and are displaying symptoms,” stated Pettit. “We encourage residents to remain calm; be prepared by making sure you have supplies on hand including a thermometer, fever-reducing over-the-counter medication, such as ibuprofen; and listen to factual reports from the CDC, NYSDOH, and Genesee and Orleans County Health Departments,” stated Pettit. “You can also call the NYS Coronavirus Call Center: 1-888-364-3065 for questions and answers about travel and symptoms .”
It is important for everyone to be aware of how they can reduce transmission, not just for COVID- 19, but other respiratory related illness, such as the flu. For the majority of individuals infected with COVID-19 they will have mild symptoms. However, for those at risk, such as older people or those with underlying health issues such as heart, lung, diabetes, etc. they are at a higher risk of potentially life threatening symptoms. Limiting exposure to large group events and staying home when unwell are important steps. Organizations should start planning how they will meet the needs of their constituents if there is community transmission in our counties.
While there is currently no vaccine to prevent COVID-19, these simple steps can help stop the spread of this and other respiratory viruses, including the flu (influenza) which is currently widespread:
• If you need to go to your primary care provider, a health center or the emergency room, call ahead to let them know your symptoms, travel and contact history.
• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home if you are sick. If you have a fever, vomiting and/or diarrhea you should stay home at least 24 hours after the last incident without fever-reducing / anti-diarrhea medications.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If you don’t have a tissue cover your mouth with your elbow.
• Clean and disinfect frequently touched objects and surfaces.
By Ginny Kropf, correspondent Posted 10 March 2020 at 10:35 am
Photo by Ginny Kropf: Health care professionals at Orleans Community Health’s Walk-In Clinic in Albion demonstrate the new machine which can detect strep throat and flu in minutes. From left is Stephanie Wilson, clinic supervisor, and Connie Woroszylo, nurse practitioner. The Clinic is seeing an increased number of people with flu in recent weeks.
ALBION – Flu and strep are on the rise in Orleans County, according to health care professionals at Orleans Community Health’s Walk-In Clinic in Albion.
Nicole Helsdon, practice manager, said they are seeing as many as five people a day with the flu, but with acquisition of a new Cobas Liat machine, they are able to detect the virus in minutes.
Connie Woroszylo, nurse practitioner, and clinic supervisor Stephanie Wilson explained the process.
If strep is suspected, the nurse swabs the patient’s throat and then thrusts the swab into a vial, which is inserted into the Cobas Liat machine. A similar procedure is done to diagnose flu, except the patient is asked to blow his nose and then the nasal cavity is swabbed. With either illness, lab confirmed results are ready in 20 minutes.
“If we had to send the sample out for a culture, it would take days,” Woroszylo said. “This machine will detect both type A and B flu.”
Patients being seen at the clinic have mostly flu, with a few strep cases, Helsdon said.
We are at the peak of the flu season, Wilson said, and she stressed everyone should have a flu shot.
“It’s still not too late to get one,” she said. “The flu season runs through the end of May.”
She said the older population – over 60 – need a higher dose than would be available at a doctor’s office, and they can get it at their pharmacy.
The flu vaccine is recommended for ages beginning at six months, Wilson said. The vaccine usually lasts the entire year and the new vaccine typically comes out in August.
When people come in with flu symptoms, Helsdon said they are asked to put on a mask. As a precaution, she said her office is being very diligent in wiping down the surfaces often where people touch. She said when someone is diagnosed with the flu, they may be prescribed Tamiflu, which is a prescription which lessens symptoms, but doesn’t cure the flu.
“Otherwise they may be told to practice the traditional cures of rest, drink lots of fluids and stay home,” Helsdon said.
In light of the coronavirus impacting individuals in Western New York, Assemblyman Steve Hawley (R,C,I-Batavia) is urging residents to remain calm but take basic precautions to avoid becoming infected or ill.
To date, there have been 142 total confirmed cases of coronavirus in New York, with 8 people hospitalized. The highest at-risk populations are seniors, those with underlying illnesses and those with compromised immune systems.
“The state is taking an expedited and thorough approach to ensuring the well-being of our residents and executing the appropriate steps to stop the spread of coronavirus,” Hawley said. “My office has been in close contact with state leaders and the most important thing residents can do is to remain calm, practice thorough hygiene and avoid travel and contact with those thought to be infected.”
Gov. Cuomo announced today that hand sanitizer will be provided to New Yorkers free of charge and paid sick leave will be given to individuals under quarantine. In addition, there are new guidelines for those visiting correctional facilities and for nursing homes.
“The 18 students who have returned from Italy are asymptomatic but are being quarantined in an empty dorm at SUNY Brockport out of precaution. School officials are doing everything necessary to keep the student population safe and the Brockport community will be given additional info in the days to come,” Hawley continued. “Please remain vigilant and precautionary, and seek medical attention if you think you’ve become infected.”
NYS Price Gouging Hotline: 1-800-697-1220
NYS Department of Health Phone Number (888-364-3065) and website (click here).
(Editor’s Note: Governor Andrew Cuomo today confirmed 16 additional cases of novel coronavirus in New York State since his last update, bringing the statewide total to 105 confirmed cases. Of the 16 new cases identified since the Governor’s last update, 12 are in Westchester County, one in New York City in the Bronx, one in Nassau, one in Suffolk, and one in Ulster. Additionally, the Governor today called on the federal government to expedite their approval of private labs and automated and manual testing to expand New York State’s testing capacity. He also encouraged New Yorkers to work from home, telecommute and avoid densely populated spaces whenever possible to help contain the spread of the virus.)
Press Release, Public Health Departments in Orleans & Genesee counties
“With Governor Andrew Cuomo’s declaration of a state of emergency in New York in response to COVID-19, the Genesee & Orleans County Health Departments are focusing on preparedness to respond to potential positive cases of COVID-19 in both counties,” stated Paul Pettit, Director, Genesee & Orleans County Health Departments.
New guidance from the Centers for Disease Control and Prevention (CDC) and the New York State Department of Health (NYSDOH) has authorized health care providers to order testing for COVID-19. There is no evidence of the disease reaching Western New York, however, this is a rapidly evolving situation and the likelihood of more cases being identified in the coming days is possible. We will continue to update with local media as appropriate.
In Genesee and Orleans counties, we’ve had 12 people undergo precautionary quarantine based on travel history – 11 have been cleared, with none becoming ill, while one person remains in quarantine with no current illness and will remain under observation through the 14-day period.
“We encourage residents to remain calm; be prepared by making sure you have supplies on hand including a thermometer, fever-reducing over-the-counter medication, such as ibuprofen; and listen to factual reports from the CDC, NYSDOH, and Genesee and Orleans County Health Departments,” stated Pettit. “Our social media platforms will continue to post pertinent information/trusted links and can be found on Facebook, Twitter and Instagram with GOHealthNY as our user name. You can also call the NYS Coronavirus Call Center: 1-888-364-3065 for questions and answers about travel and symptoms or visit the CDC web site at www.cdc.gov/coronavirus.”
While there is currently no vaccine to prevent COVID-19, these simple steps can help stop the spread of this and other respiratory viruses, including the flu (influenza) which is currently widespread:
• If you need to go to your primary care provider, a health center or the emergency room, call ahead to let them know your symptoms, travel and contact history.
• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home if you are sick. If you have a fever, vomiting and/or diarrhea you should stay home at least 24 hours after the last incident without fever-reducing / anti-diarrhea medications.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If you don’t have a tissue cover your mouth with your elbow.
• Clean and disinfect frequently touched objects and surfaces.
Cuomo warns businesses against price gouging for cleaning products
Photo by Darren McGee, Office of the Governor: Gov. Andrew Cuomo and Melissa DeRosa, secretary to the governor, speak during a briefing today. They confirmed additional cases of novel coronavirus including two cases upstate in Saratoga County, bringing the statewide total to 76 confirmed cases (which was later increased to 89).
Gov. Andrew Cuomo has declared a state of emergency due to the rising number of confirmed cases of coronavirus in the state. Today, the governor announced there are 32 more confirmed cases, bringing the total statewide to 76.
UPDATED at 7:25 p.m.: Cuomo confirmed 13 additional cases of novel coronavirus in New York State, bringing the statewide total to 89 confirmed cases. The 13 new cases identified since the Governor’s last update are located in Westchester County.
“I have officially [declared a state of] emergency which gives us certain powers,” Cuomo said. “We’re going to be doing purchasing and hiring more staff, especially to help local health departments that are very stressed. We’ve said to the local health departments you have to do the monitoring on the quarantine, the mandatory quarantine. So this is labor intensive. We need the staffing, we need the purchasing. Under the declaration of emergency, we have a more expedited purchasing protocol.”
Additionally, the Governor directed the New York State Department of State’s Consumer Protection Division to launch an investigation into reports of unfair price increases of consumer products such as household cleaning supplies and hand sanitizer amid the novel coronavirus outbreak, and launched a toll-free hotline – 1-800-697-1220 – for New Yorkers to report suspected price gouging.
“I want businesses to be aware that you could lose your license for price gouging,” Cuomo said. “This is serious. It is not just price gouging. It is price gouging in an emergency situation where you are being exploitive of the public. And there are specific legal provisions for price gouging in an emergency situation. If you are a store, you can lose your license and we are very serious about this. For the few dollars that you are going to make during this situation it is not worth your while.”
This state of emergency declaration allows, among other things:
• Expedited procurement of cleaning supplies, hand sanitizer and other essential resources
• Allowing qualified professionals other than doctors and nurses to conduct testing
• Expedited procurement of testing supplies and equipment
• Expedited personnel onboarding
• Expedited leasing of lab space
• Allowing EMS personnel to transport patients to quarantine locations other than just hospitals
• Providing clear basis for price gouging and enforcement investigation
The 32 new cases identified today are located in New York City and Westchester and Saratoga counties. Of the 89 total individuals in New York State who tested positive for the virus, the geographic breakdown is as follows:
Press Release, Public Health Departments in Genesee and Orleans counties
As of this morning, there are currently two people who have tested positive for COVID-19 in New York State. One individual is a New York City resident and had returned from travel in Iran, and the other is a Westchester County resident who did not travel to a COVID-19 region, but had traveled to Florida so is considered a community spread transmission (person-to-person contact not knowing how or where they came in contact with the virus).
In Genesee and Orleans Counties, 9 people have returned home from travel to China, although none were at Wuhan, China. All 9 were placed in voluntary quarantine and 7 of the 9 have been released after their 14-day confinement, none of whom became ill.
Quarantine is for those who have returned healthy from COVID-19 regions where COVID-19 is spreading person-to-person or have had close contact with someone who was there and is ill. They are asked to remain in quarantine for up to 14 days from the day they left the country under restriction.
There is no evidence of the disease reaching Western New York, however, this is a rapidly evolving situation and the likelihood of more cases being identified in the coming days is evident. We will update with local media on a weekly basis.
While there is currently no vaccine to prevent COVID-19, these simple steps can help stop the spread of this and other respiratory viruses, including the flu (influenza) which is currently widespread:
• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home if you are sick. If you have a fever, vomiting and/or diarrhea you should stay home at least 24 hours after the last incident without fever-reducing/anti-diarrhea medications.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If you don’t have a tissue cover your mouth with your elbow.
• Clean and disinfect frequently touched objects and surfaces.
