Ask the Doctor January-February 2022

Ask The Doctor is CNJ’s only magazine that only contains editorial regarding health and wellness.


NEWS YOU CAN USE: • Kids’ Health • Beauty • Eating Well • Fitness • Aging • ...and more Local Physicians Answer Your Health Questions

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Q: LEADERS IN LEAST INVASIVE PAIN & SPINE PROCEDURES How can Platelet Rich Plasma Treatment Help Shoulder and Knee Pain?


Platelet Rich Plasma erapy also referred to as PRP erapy, is a progressive non-surgical treatment to treat a variety of conditions including arthritis, ten- don injuries, and ligament injuries. PRP is part of a group of state-of-the-art treatments collectively referred to as Regenerative Medicine. PRP treats an injured area naturally using your body’s own growth factors to accelerate healing. It has been shown to be safe and e ec- tive for numerous joint and so tissue injuries. It has been extensively researched in numerous medical journals and publications all over the world. Some of the many uses of Platelet Rich Plasma include osteoarthritis (degenera- tive arthritis) of the spine, knee, shoulder, hip, hands, and feet, as well as menis- cus tears, plantar fasciitis, and rotator cu tears. e procedure is simple and is performed in the o ce.  e PRP process begins when a small amount of the patient’s blood is removed from the arm and placed into a special container.  e blood is then placed into a device called a centri- fuge which spins the blood to help the separate the portion of the blood which becomes concentrated with platelets, thereby giving the procedure its name. ese platelets are important because they release growth factors to recruit stem cells and to assist in healing an injured area naturally. Once the PRP is isolated, it is injected to the injured area under the guidance of an ultrasound machine to help accelerate healing and reduce pain.

is healing works on the simple principle that your body is perfectly capable of healing itself. Your blood contains all the essential components that the body produces to repair tissue damage. Each time you have an injury, the platelets in your blood along with growth factors, stem cells, cytokines, and other elements create a sca olding on the site. e damaged tissues use this framework to regenerate and repair.  e entire process takes approximately one hour, and pa- tients are sent home the same day. Patients on average report more than 50% improvement in 6 weeks and up to 100% improvement in 12 weeks. is may eliminate the need for more aggressive and expensive treatment options such as long-term medication or surgery. In a recent study, researchers at Hospital for Special Surgery gave patients with early osteoarthritis an injection of PRP and then monitored them for one year. A er one year of the PRP injection, physicians evaluated the knee cartilage with magnetic resonance imaging (MRI). While previous studies have shown that patients with osteoarthritis can lose roughly ve percent of knee cartilage per year, the Hospital for Special Surgery investigators found that a large majority of patients in their study had no further cartilage loss. At minimum PRP also prevented further knee deterioration.

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OUR DEPARTMENTS Health Articles and Q&A....................5 Your questions answered from local physicians, medical news and information As We Age............................................9 Articles and physician information just for seniors Family Matters ................................. 15 Information, resources and news related to the health and well-being of your families future The Healthy Palate............................ 18 Recipes to enjoy and local dining options for eating out Healthy Home.................................... 19 Here you will find expert tips to make your home healthier, safe and fabulous


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H E A L T H A R T I C L E S A N D Q & A

What have expert organizations said about the cancer risk from cell phone use?

In 2011, the International Agency for Research on Cancer (IARC)Exit Disclaimer, a component of the World Health Organization, appointed an expert working group to review all available evidence on the use of cell phones. The working group classified cell phone use as “possibly carcinogenic to humans,” based on limited evidence from human studies, lim- ited evidence from studies of radiofrequency radi- ation and cancer in rodents, and inconsistent evi- dence from mechanistic studies. The working group indicated that, although the human studies were susceptible to bias, the findings could not be dismissed as reflecting bias alone, and that a causal interpretation could not be excluded. The working group noted that any interpretation of the evidence should also consider that the observed associations could reflect chance, bias, or confound- ing variables rather than an underlying causal effect. In addition, the working group stated that the in- vestigation of brain cancer risk associated with cell phone use poses complex research challenges.

The American Cancer Society’s cell phones page- Exit Disclaimer states “It is not clear at this time that RF (radiofrequency) waves from cell phones cause dangerous health effects in people, but studies now being done should give a clearer picture of the possible health effects in the future.” The National Institute of Environmental Health Sciences (NIEHS) states that the weight of the current scientific evi- dence has not conclusively linked cell phone use with any adverse health problems, but more research is needed. The US Food and Drug Administration (FDA) notes that studies reporting biological changes associated with radiofre- quency radiation have failed to be replicated and that the majority of human epidemiologic studies have failed to show a relationship between exposure to radiofrequency radiation from cell phones and health problems. FDA, which originally nominated this exposure for review by the NTP in 1999, issued a statement on the draft NTP reports released in February 2018, saying “based on this current information, we believe the current safety limits for cell phones are acceptable for pro- tecting the public health.” FDA and the Federal Communications Commission (FCC) share responsibility for regulating cell phone technologies. The US Centers for Disease Control and Prevention (CDC) states that no scientific evidence definitively answers wheth- er cell phone use causes cancer. The Federal Communications Commission (FCC) concludes that currently no scientific evidence establishes a definite

link between wireless device use and cancer or other illnesses. What are other possible health effects from cell phone use?

The most consistent health risk associated with cell phone use is distracted driving and vehicle accidents. Several other potential health effects have been reported with cell phone use. Neurologic effects are of particular concern in young per- sons. However, studies of memory, learning, and cognitive function have generally produced inconsistent results.

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Dr. Steven Linker, OD

QUESTION: What is Optomap retinal imaging?


The optomap ultra-widefield retinal image is a unique technology that captures more than 80% of your retina in one panoramic image while traditional imaging methods typically only show 15% of your retina at one time. Your retina (located in the back of your eye) is the only place in the body where blood vessels can be seen directly. This means that in addition to eye conditions, signs of other diseases (for example, stroke, heart disease, hypertension and diabetes) can also be seen in the retina. Early detection of life-threatening diseases like cancer, stroke, and cardiovascular disease. It also facilitates early protection from vision impairment or blindness. Early signs of these conditions can show on your retina long before you notice any changes to your vision or feel pain. While eye exams include a look at the front of the eye to evaluate health and prescription changes, a thorough screening of the

free. It is suitable for every age, even children. The capture takes less than a second. Images are available immediately and you can see your own retina and exactly what your eye care practitioner sees in a 3D animation. Most importantly, early detection means successful treatments can be administered and reduces the risk to your sight and health.

H E A L T H A R T I C L E S A N D Q & A

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retina is critical to verify that your eye is healthy. Getting an optomap image is fast and pain-

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H E A L T H A R T I C L E S A N D Q & A

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Were American Homes Ready for the Pandemic? Not Enough Rooms in Many U.S. Homes for Effective COVID-19 Quarantine By: ALEX RHODES AND KATIE GUSTAFSON The COVID-19 pandemic has made many individuals reevaluate how to keep themselves and others safe. It has also changed the way they manage space in their homes during a nationwide shift toward working and learning from home. But how many U.S. households are limited in ways they can effectively respond to the pandemic because they don’t have enough rooms or amenities in their home? About 38% of all U.S. households in multi-person homes (34 million households) did not have at least two full bathrooms and enough bedrooms to keep one person completely isolated, according to the 2019 American Housing Survey (AHS). The Census Bureau conducts the AHS, which is sponsored by the Department of Housing and Urban Development. When more than one person lives in a home, a limited number of bedrooms or bathrooms can make self-isolation challenging. When exposed to the COVID-19 virus, quarantining is critical to prevent further spread, according to the Centers for Disease Control and Prevention (CDC). As a recent Annals of Internal Medicine article explores, however, many Americans do not live in housing that can accommodate quar- antine as the CDC recommends. When more than one person lives in a home, a limited number of bedrooms or bathrooms can make self-isolation challenging. A lack of amenities, like a washer and dryer or a full kitchen, may also inhibit self-isolation. Housing characteristics don’t just impact a household’s ability to quarantine during a pandemic. They also affect how Americans work and learn at home. The COVID-19 pandemic has led to school, business and office closures across the country, forcing many students to learn virtually and workers to do their jobs remotely — mostly from home. Is available workspace an issue for these households? Bedrooms and Bathrooms As the CDC recommends, those infected with COVID-19 should stay in a separate bedroom and use a separate bathroomwhen possible to limit close contact with other household members and avoid spreading the virus through air and surfaces. But that’s easier said than done in many multi-person households that don’t have the room to create a separate space for self-isolation. Around 36% of the 32 million multi-person homes in the United States did not have at least two full bathrooms in 2019. Continued on page 20...




CRUISE LINES INTERNATIONAL ASSOCIATION Statement in Response to CDC Warning Against Cruise Travel The decision by the CDC to raise the travel level for cruise is particularly perplexing considering that cases identified on cruise ships consistently make up a very slim minority of the total population onboard — far fewer than on land — and the majority of those cases are asymptomatic or mild in nature, posing little to no burden on medical resources onboard or onshore. No setting can be immune from this virus — however, it is also the case that cruise provides one of the highest levels of demonstrated mitigation against the virus. Cruise ships offer a highly controlled environment with science-backed measures, known testing and vaccination levels far above other venues or modes of transportation and travel, and significantly lower incidence rates than land. • Protocols encompass the entirety of the cruise experience, incorporating testing, vaccination, screening, sanitation, mask-wearing and other science-backed measures. • Many of our members have announced additional measures in response to the Omicron variant, including strengthening testing, masking and other requirements, as well as encouraging booster vaccine doses for those eligible. • Over 100 cruise ships have returned to U.S. waters, carrying nearly more than one million people from a U.S. port since late June 2021. • The cruise industry is the only industry in the U.S. travel and tourism sector that is requiring both vaccinations and testing for crew and guests. • Vaccination rates onboard a cruise ship typically are upwards of 95 percent — significantly higher than the overall U.S. population which is hovering at 62 percent. • In the U.S. alone, the cruise industry administers nearly 10 million tests per week — 21x the rate of testing in the United States. • The latest data show that, even with higher rates of testing, the cruise industry continues to achieve significantly lower rates of occurrence of COVID-19 — 33 percent lower than onshore. While we are disappointed and disagree with the decision to single out the cruise industry — an industry that continues to go above and beyond compared to other sectors — CLIA and our ocean-going cruise line members remain committed to working collaboratively with the CDC in the interest of public health and safety. • Cruise industry protocols are unique in their approach to effectively monitor, detect, and respond to potential cases of COVID-19.

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The Fawn Trauma Response By Valeria Mancuso What is the Fawn Trauma Response?

The fawn trauma response is the process of putting your emotions aside to benefit or please someone else’s needs. It can be used as a de- fensive structure because you may be acting out of fear, sadness, anger, guilt etc. If you feel as if you are in a dangerous environment, you may respond by trying to please the person who is making you feel unsafe to avoid a worse situation. The fawn response can lead to co-dependence, depression, self-harm, illness, etc. This is especially common in children because it involves trying to please a person who is both a care provider and a source of threat. Childhood Trauma

Children who grow up in an abusive environment tend to go through the process of the Fawn Response. They are conflicted between the need to flee a threatening environment and their need to attach to their par- ents/guardians. Children rely on the fawn response because they are making a difficult environment, that they are unable to escape, some- what bearable. They respond to neglect or abuse out of fear of it be- coming worse. They put the caregivers needs before their own. They are ‘taking care’ of their parents emotions. Dissociative symptoms follow through to adulthood in order for the person to avoid remembering or relieving the abuse they suffered as a child. As a result of the fawn response, children will turn their negative feelings towards themselves causing self-criticism, self-loathing or self-harming behaviors which can later lead to mental illness. Physiological Aspects


Physiological speaking, responding to abuse by putting someone else’s needs before your own involves reading the social and emotional cues of the other person. You read their emotions and respond in a way that benefits them and hides your genuine feelings. This can lead to symptoms where you feel as if you are disconnected from body sensa- tions like you are going ‘numb’ from your own needs. You feel as if the world around you is not real, as if your body and actions are not apart of you. Recovering from a Fawn Response Healing and recovering from a fawn responses involves recognizing your behavior and actions. It will take time to heal and take better care of yourself. You can do two things to help in the recovery process, access your inner wisdom and speak your truth. Accessing your inner wisdom in- volves connecting with your embodied knowing. You must connect with the constant flow of sense and actions that occur within your life. Recognize the way your intuitions connects with your senses. Act and behave from your intu- ition and what you would want to do. Do not try to please someone else’s emotions. When responding to trauma by people-pleasing you tend to stray away from your genuine thoughts and emotions. Speaking your truth can help you heal from the fawn response because it allows to genuinely express yourself without fear, abuse or neglect.

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Resources: The Fawn Response in Complex PTSD | Dr. Arielle Schwartz





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Homeownership and taxes: Things Taxpayers Should Consider When Selling A House

It’s important for taxpayers to under- stand how selling a home may affect your tax return. When filing taxes, you may qualify to exclude all or part of any gain from the sale from your income. Here are some key things homeown- ers should consider when selling a home: Ownership and use To claim the exclusion, the taxpay- er must meet ownership and use tests. During a five-year period ending on the date of the sale, the homeowner must have owned the home and lived in it as their main home for at least two years. Gains


Taxpayers who sell their main home and have a gain from the sale may be able to exclude up to $250,000 of that gain from their income. Taxpayers who file a joint return with their spouse may be able to exclude up to $500,000. Homeowners excluding all the gain do not need to report the sale on their tax return. Losses Some taxpayers experience a loss when their main home sells for less than what you paid for it. This loss is not deductible. Multiple homes Taxpayers who own more than one home can only exclude the gain on the sale of their main home and must pay taxes on the gain from selling any other home. Reported sale Taxpayers who don’t qualify to exclude all the taxable gain from their income must report the gain from the sale of their home when they file their tax return. Anyone who chooses not to claim the exclusion must report the taxable gain on their tax return. Taxpayers who receive Form 1099-S, Proceeds from Real Estate Transactions must report the sale on their tax return even if they have no taxable gain. Possible exceptions There are exceptions to these rules for some individuals, including persons with a disability, certain members of the military, intelli- gence community and Peace Corps workers. Worksheets Worksheets included in Publication 523, Selling Your Home can help taxpayers figure the adjusted basis of the home sold, the gain or loss on the sale and the excluded gain on the sale. Share this tip on social media -- #IRSTaxTip: Homeownership and taxes:Things taxpayers should consider when selling a house. https://




Certified by the Supreme Court of New Jersey as a Civil Trial Attorney Member of New Jersey and New York Bars JOHN T. BAZZURRO, Esq. David P. Levine, Esq. Of Counsel to the Firm Michael B. Shaw, Esq., Associate Attorney 200 Meco Drive, Millstone Twp., NJ • BAZZURROLAW.COM Third, with regard to damages to your vehicle, you should obtain a copy of the police report as soon as possible (typically police departments will be able to provide same within a few days) for purposes of identifying the other drivers’ insurance company. Once the insurance company is identified, they should be contacted and advised that your vehicle sustained damage due to the negligence of their driver. However, when speaking to the other insurance company, no statements should be given concerning how the accident occurred or the nature and extent of any injuries suffered. Instead, you should only provide them with a copy of the police report to show them how the accident happened. If you provide the other insurance company with a statement, that statement may be used against you in any future litigation (including traffic court) concerning the accident. Finally, any and all “evidence” should be recorded and maintained in the event a lawsuit arises. For instance, photographs should immediately be taken of the damage to your vehicle as well as the other vehicle if possible. Additionally, photographs of any injuries sustained (bruises, cuts, scrapes, abrasions, casts and bandages) should also be taken. If anyone approaches you at the scene of the accident you should take down their contact information for potential future use. If you are aware of these issues and comply with the actions suggested, it will make it easier for you and your attorney to properly and efficiently pursue any claims against the other drivers. However, your failure to abide by all or some of the suggestions, your failure to do so may make any claims much more difficult to pursue. Of course, if you have any questions concerning the above, please do not hesitate to contact our office for a consultation. WHAT YOU SHOULD KNOW AFTER BEING INVOLVED IN A CAR ACCIDENT? By John Bazzurro In my practice, clients will typically come in for a consultation concerning injuries sustained in a motor vehicle accident more than one month after the accident has occurred. In general, it is after this time that people realize that they have sustained personal injuries,which warrant a visit to an attorney for advice. However, what a person does or does not do in the first 30 days after a motor vehicle accident may have a significant impact on their ability to bring a lawsuit in the future. First and foremost, it is important that individuals involved in motor vehicle accidents report their accident to the local police or proper authorities to ensure that there is a record of the accident and to obtain the other drivers’ information. In fact, N.J.S.A 39:4-130 specifically requires that any motor vehicle accident in which a person is injured or in which the property damage is greater than $500.00 be reported to the local police department. Often times clients will tell me that they and the other driver decided not to report the accident to the police in order to avoid having to “put it through” their insurance. In these instances, the other driver may attempt to deny that the accident even occurred. Thus it is important that the accident be reported promptly-especially where significant property damage or personal injuries are involved. Second, it is important to know that any and all medical treatment that is required as a result of injuries sustained in a car accident be paid for by the applicable motor vehicle insurance policy as opposed to a health insurance policy. New Jersey law provides that automobile policies of insurance provide Personal Injury Protection coverage (PIP) to allow for those injured in motor vehicle accidents to receive proper medical treatment. If such medical bills are paid for by health insurance as opposed to automobile insurance, issues may arise in the future concerning the potential need to repay the health insurance company for any benefits paid. Thus, when visiting an emergency room or physician for treatment related to a car accident, you should provide themwith your automobile insurance policy information.


Large Firm Representation With Personal Attention

AREAS OF PRACTICE: • Municipal Court Practice, Including Defense of DWI, Traffic Tickets and Non-Indictable Offenses • Workers Compensation

• Personal Injury • Motor Vehicle Accidents • Nursing Home Neglect • Wills

• General Civil Litigation • Employment Law • Residential and Commercial Real Estate Transactions

Certified by the Supreme Court of New Jersey as a Civil Trial Attorney Member of New Jersey and New York Bars

David P. Levine, Esq. Of Counsel to the Firm Michael B. Shaw, Esq., Associate Attorney 200 Meco Drive, Millstone Twp., NJ Email: 732-410-5350 •

Jewish lifecycles are a time of growth when we express ourselves through ritual. Cantor Barbra is available to serve your needs whether it is a Bar/Bat Mitzvah for your child, your own wedding, or the naming of your child. Celebration and Education for Your Family Celebration and Education FOR YOUR FAMI LY

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Sweet Potato Nachos

Ingredients • 1 sweet potato • 1 teaspoon Olive Oil • Dash of Cayenne • Dash of Chili Powder • 3 mini sweet red/orange peppers, sliced • 1/4 white onion, sliced


• 3 tablespoons salsa • 1/4 cup black beans • 2 tablespoons jalapenos • 1/3 avocado, cubed Directions 1. Preheat oven to 375 degrees. 2. Using a sharp knife or mandolin, slice 1 sweet po- tato thinly and lay flat on a lined baking sheet. 3. Drizzle lightly with olive oil and toss with cayenne and chili powder. 4. Roast for 10-15 minutes depending on thickness of your potato slices. 5. While potatoes are roasting, add peppers and on- ion to a saucepan over medium heat and cook until softened. 6. Remove potatoes from oven, arrange them togeth- er as you would nacho chips, and top with salsa, black beans, roasted peppers, jalapenos, and avo- cado. 7. Put back into the oven for about 5 more minutes, top with cilantro, and enjoy!

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Continued from page 12...

For multi-person homes with an individual who is at higher risk of hospitalization from COVID-19 because they are 65 years old or older, the percentage without two full bathrooms drops to 31% (7.2 million). The AHS excludes group quarters, so these metrics do not include nursing facilities. When someone quarantines alone in a bedroom in a multi-per- son home, others may be forced to double up and share bedrooms. About 1 in 10 multi-person households (11%, or 9.8 million) did not have enough bedrooms for an exposed individual to quaran- tine alone without forcing more than two people to stay in one of the remaining bedrooms. That number drops to 6% (1.3 million) in households with an individual 65 years old or older. Enough bedrooms is defined as a two- or three-person house- hold having at least 2 bedrooms, and a household of four or more having enough bedrooms to allow one person to isolate in a bed- room without forcing three or more people in the household to share a remaining bedroom. A lack of bedrooms and bathrooms to isolate was more prev- alent in lower-income homes. Among multi-person households with a total annual income below the federal poverty level, 61% (5.5 million) did not have at least two full bathrooms and enough bedrooms. In contrast, only 28% (15 million) of households with an income at least 300% of the federal poverty level did not have enough bedrooms and bathrooms to accommodate someone who had to quarantine. Differences existed by race, as well. Around 35% (1.8 million) of homes with an Asian householder did not have at least two bathrooms and enough bedrooms to isolate one member without forcing more than two other household members to share a re- maining bedroom. In high-density cities, where housing is at a premium and units are often smaller, multi-bedroom and multi-bath housing may not be attainable. For example, 59% (2.9 million) of multi-person homes in the New York City metropolitan area did not have at least two full bathrooms and enough bedrooms for one household member to isolate without forcing more than two other people in the house- hold to share a remaining bedroom. In contrast, in the Atlanta metro area, only 16% (260,000) of multi-person homes do not have enough bathrooms and bed- rooms. Kitchen and Laundry Households that do not have a washer and dryer or a full kitchen in their unit may have to make more trips outside of the home, potentially increasing their and other household members’ expo- sure to the infection. Around 19.6 million households (16%) did not have a washer and dryer and about 1.4 million households (1%) did not have a complete kitchen in 2019, according to AHS. About 5 million households (14%) with an individual 65 years old or older did not have a washer and dryer and about 460,000 (1%) did not have a complete kitchen. As was the case for homes with no extra baths and bedrooms, the lack of a full kitchen and a washer and dryer was more common in lower-income households. For households with a total income below the federal poverty level, 35% (6 million) lived in a home without both a full kitchen and a washer and dryer. Among households with an income at least three times the federal poverty level, only 9% (6.2 million) didn’t have those amenities. Among homes where the race of the householder was White

Alone, 13% (13 million) did not have both a full kitchen and a washer and dryer. Among homes where the householder was Black Alone, 29% of homes (4.9 million) did not have a full kitch- en and a washer and dryer. In the same way that housing costs in some areas affect the size of homes and apartments, they also affect home amenities. For example, over 29% of homes in the New York City (3.3 mil- lion) and Los Angeles (1.4 million) metropolitan areas did not have a full kitchen and laundry in 2019. Less than 10% (150,000) of homes in Atlanta did not have a full kitchen and laundry amenities — the lowest percentage among the 15 largest metro areas. Working from Home According to the U.S. Census Bureau’s Household Pulse Survey, tens of millions of Americans have had to work or study from home more during the pandemic. Based on the survey’s estimates for the Jan. 20-Feb. 1, 2021 peri- od, about 37% (91 million) of adults have substituted some or all in-person work for telework because of the pandemic. Approxi- mately 84% (43 million) of adults with children in their house- hold have seen children’s classes moving to distance learning. When both working-age adults (ages 18-64) and school-age chil- dren (ages 6-17) must work and study from home, it may be best but not always possible for everyone to work in their own room. Among households with at least two working or school-age indi- viduals, 6% (4 million) did not have at least one room (excluding kitchens, bathrooms, and laundry rooms) per working age adult and school-age child, according to AHS. For households with a total income below the federal poverty level, 14% (930,000) did not have enough rooms for each work- ing-age and school-age individual to work in their own room compared to roughly 3% (1 million) for households with income of 300% of the federal poverty level or higher. When broken down by race, 5% of homes (2.8 million) with a householder who is White Alone did not have at least one room (excluding kitchens, bathrooms, and laundry rooms) per work- ing age adult and school-age child compared to 20% (55,700) of homes with a householder who is Pacific Islander. Location may also play a role in how many rooms are available for working and learning from home. Among the top 15 metro areas, 17% (1.6 million) of homes in the Los Angeles-Long Beach metro area did not have one or more rooms per working-age adult and school-age child. In contrast, 3% (520,000) of homes in Detroit metro area did not have at least one room per working-age adult and school-age kid. Staying Safe Many Americans have responded to the COVID-19 pandemic by reevaluating how they use the space in their homes and by be- ing careful about how they limit their exposure to infection. Having a certain number of bedrooms and bathrooms or ame- nities like a full kitchen and an in-unit washer and dryer may make it easier for some individuals to reduce their exposure. The nationwide shift to working and learning at home caused by the pandemic may also have altered households’ needs for rooms available for working and learning. This article shows how households with different income levels and in different metro locations throughout the country may face dif- ferent challenges in responding to the COVID-19 pandemic. Alex Rhodes and Katie Gustafson are statisticians in the Social, Econom- ic, and Housing Statistics Division of the U.S. Census Bureau.








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