The nation’s foremost public health agency is learning that it is not immune to the complex effects of the coronavirus pandemic.
Recently, the Centers for Disease Control and Prevention told employees that some office space it leases in the Atlanta area would be closed again after property managers of the buildings discovered Legionella, the bacteria that causes Legionnaires’ disease, in water sources at the sites. No employees were sickened. The announcement was reported on Friday by CNN.
That the C.D.C. is contending with this problem highlights the seriousness of Legionella in the aftermath of coronavirus lockdowns, and how complicated it can be to prevent it.
The C.D.C. itself warns that Legionnaires’ disease, a respiratory illness, can be fatal in 1 in 10 cases. Since various jurisdictions in the United States have put in effect lockdowns to contain the spread of the new coronavirus, some experts have been warning of the risk of Legionnaires’ outbreaks when people return to buildings left unoccupied for months. The bacteria that causes the illness, Legionella pneumophila, can form in warm, stagnant water that is not properly disinfected. When sinks are turned on or toilets flushed, the bacteria can then be sent through the air and inhaled.
While most earlier research focused on the growth of Legionella during weekends and short holiday periods, scientists are only beginning to learn about how the bacteria proliferates during periods of long-term stagnation, and which methods are most effective to protect against it.
“Legionella is something that even though we’ve known about it since the 1970s or so, we’re still learning about it everyday,” said Caitlin Proctor, a postdoctoral fellow at Purdue University in Indiana who has been studying the bacteria during lockdown.
Traditionally, flushing, the process of turning on taps and showers, for example, and sending fresh water through the building, can help. But the length of the lockdown during the coronavirus outbreak is saddling building owners with new challenges.
The C.D.C. has published voluntary guidelines to aid building owners and property managers aiming to prevent Legionella from spreading as facilities reopen. But Andrew Whelton, an associate professor of civil, environmental and ecological engineering also at Purdue, thinks that the guidelines are often not specific enough.
“This is by design,” he said. “Generally, federal guidance that’s issued is generic, and what building owners need is prescriptive advice.”
“It’s possible that these guidelines weren’t enough,” Dr. Proctor said.
States, counties and cities also have their own rules that in some cases may not match the C.D.C.’s advice.
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Frequently Asked Questions
Updated August 6, 2020
Why are bars linked to outbreaks?
- Think about a bar. Alcohol is flowing. It can be loud, but it’s definitely intimate, and you often need to lean in close to hear your friend. And strangers have way, way fewer reservations about coming up to people in a bar. That’s sort of the point of a bar. Feeling good and close to strangers. It’s no surprise, then, that bars have been linked to outbreaks in several states. Louisiana health officials have tied at least 100 coronavirus cases to bars in the Tigerland nightlife district in Baton Rouge. Minnesota has traced 328 recent cases to bars across the state. In Idaho, health officials shut down bars in Ada County after reporting clusters of infections among young adults who had visited several bars in downtown Boise. Governors in California, Texas and Arizona, where coronavirus cases are soaring, have ordered hundreds of newly reopened bars to shut down. Less than two weeks after Colorado’s bars reopened at limited capacity, Gov. Jared Polis ordered them to close.
I have antibodies. Am I now immune?
- As of right now, that seems likely, for at least several months. There have been frightening accounts of people suffering what seems to be a second bout of Covid-19. But experts say these patients may have a drawn-out course of infection, with the virus taking a slow toll weeks to months after initial exposure. People infected with the coronavirus typically produce immune molecules called antibodies, which are protective proteins made in response to an infection. These antibodies may last in the body only two to three months, which may seem worrisome, but that’s perfectly normal after an acute infection subsides, said Dr. Michael Mina, an immunologist at Harvard University. It may be possible to get the coronavirus again, but it’s highly unlikely that it would be possible in a short window of time from initial infection or make people sicker the second time.
I’m a small-business owner. Can I get relief?
- The stimulus bills enacted in March offer help for the millions of American small businesses. Those eligible for aid are businesses and nonprofit organizations with fewer than 500 workers, including sole proprietorships, independent contractors and freelancers. Some larger companies in some industries are also eligible. The help being offered, which is being managed by the Small Business Administration, includes the Paycheck Protection Program and the Economic Injury Disaster Loan program. But lots of folks have not yet seen payouts. Even those who have received help are confused: The rules are draconian, and some are stuck sitting on money they don’t know how to use. Many small-business owners are getting less than they expected or not hearing anything at all.
What are my rights if I am worried about going back to work?
What is school going to look like in September?
- It is unlikely that many schools will return to a normal schedule this fall, requiring the grind of online learning, makeshift child care and stunted workdays to continue. California’s two largest public school districts — Los Angeles and San Diego — said on July 13, that instruction will be remote-only in the fall, citing concerns that surging coronavirus infections in their areas pose too dire a risk for students and teachers. Together, the two districts enroll some 825,000 students. They are the largest in the country so far to abandon plans for even a partial physical return to classrooms when they reopen in August. For other districts, the solution won’t be an all-or-nothing approach. Many systems, including the nation’s largest, New York City, are devising hybrid plans that involve spending some days in classrooms and other days online. There’s no national policy on this yet, so check with your municipal school system regularly to see what is happening in your community.
Some buildings, depending on how long they were locked down, require a higher dose of chlorine than is traditionally used. The C.D.C.’s post-lockdown guidelines are not specific about how much flushing is required and often buildings do not flush for a long enough time or throughout the entire building
It is unclear whether the managers of the buildings where the C.D.C. closed its offices had followed the agency’s published guidelines or another set of rules. A C.D.C. spokeswoman said in a statement that “during the recent closures at our leased space in Atlanta,” the agency, working through the federal General Services Administration, which provides offices for much of the U.S. government, had “directed the landlord to take protective actions.”
Dr. Whelton said that building owners were often insufficiently communicative with their tenants about water management plans.
“The C.D.C. is a tenant,” he said, “just like many businesses across the country who have to rely on the good will and faith of building owners to do the right thing.” For any company, it can be difficult to ensure appropriate measures have been taken for its offices.
The C.D.C. buildings affected will be closed until the problem is fixed.
“That the C.D.C. can’t prevent Legionella contamination in their buildings is a sign that we all need to be proactive about this issue,” Dr. Proctor said.