Lessons on Coronavirus Testing From the Adult Film Industry - The New York Times

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As more states open up and people return to work, companies are looking for guidance on how to keep workers safe from infection. Some experts suggest looking to what may seem an unlikely model: the adult film industry. It survived a different pandemic — an outbreak of H.I.V. infections in the late 1990s that almost shuttered the multibillion-dollar industry.

“We can actually learn a lot about safety guidelines by listening to producers of porn,” said Perry N. Halkitis, dean of the School of Public Health at Rutgers University. “Thinking back to the H.I.V./AIDS crisis, the adult film industry had to learn how to keep their workers safe.”

He recommends following its lead by using what he calls the Four Ts: Target, Test, Treat and Trace. The adult film industry uses a nationwide program called PASS, for Performer Availability Screening Services, that requires performers to be tested every 14 days for H.I.V. and other sexually transmitted infections in order to be cleared for work. If a worker tests positive, he’s treated, and his partners are traced.

“We have to get over that this information is coming from the porn industry,” said Dr. Ashish Jha, director of the Harvard Global Health Institute. “If we’re trying to get our economy back, a major component of that is building confidence for when we engage in regular activities such as going to a restaurant, getting on a plane, or going back to work.”

The suggestion of using the adult film industry as a model was reported by Stat News in May. Of course, the incubation period of the coronavirus means that it’s possible that people could have negative test results indicating it’s safe to travel but be contagious by the time they get on a plane.

“It’s not foolproof,” Dr. Jha said, but “we’re going to see more testing to make decisions in our lives.”

The adult film industry, which has been largely shut down since March 15, just released guidelines on how to get back to work. Mike Stabile, communications director for the Free Speech Coalition, which is the adult entertainment trade association, has been meeting with others in the industry over Zoom twice a week to discuss how to proceed once they get greenlighted to open back up. They consult with medical professionals regularly.

“We’ve looked at coronavirus testing, temperature checks, wearing masks on sets when not filming, and having couples who live together work together,” he said. The coalition created a web page for Covid-19 resources for the adult film industry.

For H.I.V. tests, Mr. Stabile said, “we use a highly sensitive PCR-RNA test, which can detect the virus within seven to 10 days after infection.” He said the frequent testing “and other controls used by performers, such as not having sex outside the tested performer pool or using condoms when doing so, further minimizes the risk of H.I.V.”

But because Covid-19 is transmitted by droplets via coughing or even breathing, rather than by sex, he said, “there are a million more exposures from who did you work with on the set to who did you come into contact with before testing positive? Everyone’s happy to comply with testing because no one wants to work on a set where they can get infected.”

If an infection were to occur, the production would shut down. Everyone on the set — those infected and those who tested negative — would be out of work. Most people in the adult film industry are independent contractors; if they’re not working, they’re not getting paid, so the incentive to keep working is high.

Back in 1998, there was an H.I.V. outbreak in the adult film industry. Marc Wallice, an adult film actor, falsified his H.I.V. test certificate and infected a handful of actresses. H.I.V. tests, at the time, were printed out on paper and could be easily forged.

Sharon Mitchell, a former actress with a doctorate in human sexuality and training taking blood samples, formed the Adult Industry Medical health care foundation that year, formalizing the protocols that would eventually become PASS.

“While the acronyms and organizations have changed, and the testing improved, the general principles are the same,” Mr. Stabile said.

The system brought a major shutdown in 2004 and two shorter ones in 2013.

“I only perform on sets where the PASS system is in place,” said Maitland Ward, an adult film star with three Adult Video News Oscars and a former star on the sitcom “Boy Meets World.” “Professional porn follows very strict guidelines on a regular basis,” Ms. Ward said. When production resumes, in addition to the coronavirus testing, “extra precautions will be in place on sets, such as temperature checks and social distancing among crew members,” she said.

“Health screenings are the norm for us. I think the adult industry is far more prepared than mainstream” film sets or other businesses. “This is just one more thing we need to be cautious and vigilant about. Honestly, I think mainstream will be looking to how the adult industry handles this because we are the standard-bearer when it comes to health and safety on sets.”

Dr. Jha agreed. He said he would like to see a database much like the PASS program where people can register online to show they were tested for the coronavirus. “It should be run by a nonprofit or private business, not the government,” he said. “I’m not opposed to the government doing it. It’s that a lot of people would not be comfortable with the government running it.”

In the adult film industry, when people get tested and get a negative result, they get a green check next to their names. If they test positive or don’t take the test, they get a red X.

The Coronavirus Outbreak

• Frequently Asked Questions and Advice

  Updated June 16, 2020

  • I’ve heard about a treatment called dexamethasone. Does it work?

    The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

  • What is pandemic paid leave?

    The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

  • Does asymptomatic transmission of Covid-19 happen?

    So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

  • What’s the risk of catching coronavirus from a surface?

    Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

  • How does blood type influence coronavirus?

    A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

  • How many people have lost their jobs due to coronavirus in the U.S.?

    The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

  • Will protests set off a second viral wave of coronavirus?

    Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

  • My state is reopening. Is it safe to go out?

    States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

  • What are the symptoms of coronavirus?

    Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

  • How can I protect myself while flying?

    If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

  • How do I take my temperature?

    Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.

  • Should I wear a mask?

    The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

  • What should I do if I feel sick?

    If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

  • How do I get tested?

    If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

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Green checks show producers and others who do the hiring that performers are cleared to work. According to Mr. Stabile, “People want to work and they want to work in a safe space, so they take the test.”

Dr. Jha understands that if the model is adopted for coronavirus testing, not everyone will want to be tested and notes that testing should be voluntary, much as it is in the adult film industry.

Dr. Jha believes most people would want to know that their work area, the restaurant they go to, or the airplane they fly on is safe. “If Delta or American Airlines said, ‘you have to take this test to show us you don’t have Covid,’ you’d feel safer flying on that airline,” Dr. Jha said. “The airlines could purchase thousands of tests and charge their customers $5 or $10 to take it. Knowing everyone on that plane, everyone in that restaurant, and all of your co-workers are safe builds confidence.”

Although he acknowledged that there could be false negatives and that Covid has an incubation period of five to seven days and can show up in as little as two, he said he believed that most people would respond favorably.

As possible models, he pointed to the private charter company Set Jet and Emirates Airline, which have experimented with rapid testing, with results in 10 minutes.

Dr. Robert Gallo, a co-discoverer of H.I.V. in the 1980s and co-founder and director of the Institute of Human Virology at the University of Maryland School of Medicine, noted, “H.I.V. and the coronavirus are very different viruses. It’s like comparing a rabbit to a squirrel.”

Still, when it comes to fighting the coronavirus, he said, “Following the adult film industry example of testing is smart.”

Despite the stigma associated with adult films, Dr. Halkitis said, “We need to take any tools we have, even ones from the adult film industry, and apply what worked to limit the spread of the coronavirus.”

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