by Adam Ganucheau, Mississippi Today
April 15, 2020

It was designed for the flu, but the coronavirus put it into motion.

More than 10 years ago, Mississippi health and government officials began developing a comprehensive plan in preparation for a pandemic of a novel influenza strain — not a coronavirus strain — for which there is no human immunity, vaccine or treatment. 

Commissioned in 2009 by former Gov. Haley Barbour and completed in June 2019, the final 447-page document is serving as a playbook for health experts, emergency management officials and dozens of state government agencies. 

The document, titled the Mississippi Pandemic Influenza Incident Annex, anticipates mass deaths as well as a crippled state economy.

“A large number of cases will increase the burden to hospitals and other healthcare infrastructure,” reads the plan, obtained by Mississippi Today. “All areas of the public and private sectors will be adversely affected by a pandemic… The pandemic may last up to 18 months and may occur in multiple waves, with varying morbidity and mortality.”

The plan forecasts a potentially devastating economic outlook: “The economic impact on the state of Mississippi could be in excess of $4.9 billion in a severe pandemic… The flow of critical goods and services provided by vendors, contractors and consultants may be interrupted.”

The pandemic plan, which has been heralded by Gov. Tate Reeves and other officials in recent days, also details chains of command, guides department heads the responsibilities for their agencies and chronicles priorities across the entire state government before, during and after the pandemic.

Though the plan’s workflow considerations have been closely adhered to, health officials have had to scrap much of the plan because of the inherent differences in an influenza pandemic and a coronavirus pandemic.

“With influenza there’s a subset of people who are already immune, but with coronavirus we don’t have any of that. So that’s a bigger challenge,” said State Health Officer Thomas Dobbs, who sat on the committee that developed the pandemic plan. “The social distancing interventions in the plan, for instance, are a lot softer than what we’re doing now. The other piece is we don’t have a lot of the tools in place (for coronavirus), such as pharmaceutical interventions like Tamiflu and (other influenza treatments).”

Several key components of the plan were conceptualized and put on paper but were not tested as of last summer. Some of those untested components include: 

• Ensuring the continuity of food supply systems, considering “many of the usual venues for obtaining food, such as school lunch programs, farmers’ markets and grocery stores, may be closed or have very restricted access during periods in which strict community protection measures (e.g., social distancing, sheltering-in-place directives) must be observed.”

• Mitigating the impact of a pandemic on the state’s workers as most agencies are responsible for “how they can share pandemic prevention and preparedness information with their constituents and how they can assist them in responding to protect worker health and safety during a pandemic event.”

• Implementing comprehensive telework plans that give state employees access to vital records and databases with secure encryption technology.

And state officials have diverted from some of the plan’s recommendations in response to the novel coronavirus outbreak.

The plan did not offer any guidance on what should be deemed “essential businesses” during a shelter-in-place order or some other form of societal shutdown, though the plan did list 41 state governmental bodies considered “essential.” The only non-governmental essential entity listed in the plan was the American Red Cross.

Reeves last month issued a broad definition of “essential businesses,” which exempted most private industries and businesses  from adhering to any shelter-in-place order. Reeves asked agency heads to allow state employees to continue their work from home, if possible, though many are unable to do so.

Another point of diversion deals with the closing of schools. The pandemic plan calls for county health department and local schools officials to make decision about school closures. In the case of the coronavirus, Reeves took the matter out of the hands of local health and education officials, issuing a statewide order that closed all of the state’s schools indefinitely following most other governors. This week, he announced that the state’s schools would remain closed through the rest of the school year.

“Was it perfect? Of course it wasn’t,” Reeves said of the pandemic plan on Wednesday. “I don’t know if anyone could write 460 pages about any topic that was perfect. But it was well thought out, and it laid a framework and guideline for the various steps we’re taking.”

The pandemic plan is split into operational phases, as recommended by the U.S. Centers for Disease Control and the World Health Organization. Officials are currently operating in the second phase of the three-part plan: “Response.” The first is “Preparedness” and the final is “Recovery.”

The “Recovery” section of the plan, defined as “steps taken to return the state to normal functioning,” offers insight into what the next few weeks could look like in Mississippi.

Some of the top priorities in the plan’s next phase include facilitating recovery of public health and health-care institutions, preparing for a potential subsequent wave of infections and replenishing stockpiles of resources. Mental health is also a focus of the “Recovery” section of the plan.

“Mental health of the workforce is a function that will need to be addressed throughout a pandemic response and will be a critical factor in returning to normalcy across the state,” the plan reads. “All agencies are responsible for identifying resources to support their staff.”

Focusing on the importance of administering a vaccine when one becomes available, the pandemic plan offers guidance in all three operational phases for how state officials can distribute a vaccine to Mississippians. Citing studies from national researchers, the Mississippi plan suggests that a vaccine may not be available for at least the first four to six months of the pandemic and will initially have limited availability. That estimate was developed for a novel influenza strain, and a COVID-19 vaccine is expected to take longer.

“Due to limited quantities and production capacity of (influenza) vaccine, vaccination of the population may take up to 20 months to complete once vaccine is initially available,” the plan reads. “The overall impact of vaccination during a pandemic depends on how rapidly a vaccine becomes available, its effectiveness in preventing infection and disease, its supply levels and the ability to allocate and administer it.”

More sobering parts of the plan include five pages on how state officials should handle high mortality rates. The plan estimates that a severe pandemic could cause up to 15,000 deaths in Mississippi, which would “place extraordinary demands on local jurisdictions and the families of victims.”

As of Wednesday morning, the state health department had reported 3,360 identified coronavirus cases and 122 related deaths. At least 273 new Mississippi cases were reported on Tuesday, which is the most known new cases in a single day since the pandemic reached the state, and at least 11 people died on Tuesday.

The plan guides 11 state entities and associations, including the Mississippi Coroners Association and Mississippi Funeral Directors Association, on how to handle a spike in deaths.

“The timely, safe and respectful disposition of the deceased is an essential component of an effective response,” the plan reads. “Accurate, sensitive and timely public relations are crucial to this effort.”

The plan itself was initiated by a commission that Gov. Barbour appointed in 2009. The commission was chaired by the state epidemiologist, and a number of state agency representatives also sat on the committee. Other state agency heads and officials added to the plan over the years contributed information for final version, approved in June 2019.

When asked why he commissioned the plan, Barbour told Mississippi Today in an interview that Hurricane Katrina and its lessons inspired action. 

“After Hurricane Camille hit in 1969, a lot of people, long before I was governor, planned for the next terrible hurricane,” Barbour said. “The problem was (that) Katrina didn’t turn out to be anything like Camille. However, just by having a plan, having practice and having lots of people on the ground who were familiar with what we were trying to accomplish if we had a terrible hurricane, our people were much better off.”

Barbour continued: “I hope that this (pandemic) plan is getting Mississippi the best performance and will reduce our health risks and leave us with fewer deaths.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

After Being Tested: What You Should Do

If you have been tested for COVID-19, take the following steps to monitor your health and avoid spreading the disease to others:

Isolate yourself

• While waiting for results, you should immediately isolate yourself at home. DO NOT GO TO WORK OR LEAVE YOUR HOME.
• Stay in a specific room and away from other people in your home to the extent possible. Use a separate bathroom, if available. Household members can consider staying in a separate location, if available, to decrease their risk of exposure.
• For more information, see the CDC’s guidance on preventing the spread of COVID-19 at home.
• If you must leave home, such as to seek medical care, wear a surgical mask if available.
• If your results are positive, you will need to isolate for 14 days from the time your symptoms started.

Monitor your health

• Get plenty of rest, stay hydrated and if needed, take medication to reduce your fever.
• If your symptoms get worse and you need to seek healthcare, call ahead and tell the provider that you have been tested for COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.

Practice healthy habits

• Cover your cough, or sneeze into your elbow or a tissue.
• Wash your hands often with soap and water for at least 20 seconds, or use alcohol-based hand rub if soap and water are not available.
• Clean and disinfect objects and surfaces regularly, including your phone.

Guidance for your household contacts

• While waiting for the results of your test, your household contacts should stay at home.
• They should not go to work or school and should avoid all public places.
• If your results are positive, your household contacts should immediately quarantine themselves for 14 days.
• Household contacts should monitor for fever, cough and shortness of breath and contact their healthcare provider with symptoms. If they need medical assessment, they should call the health clinic or hospital before they visit.

If your results are negative (or not detected) continue to reduce your risk of illness

• Isolate yourself until fever-free for at least 48 hours (if fever was present)
• Practicing social distancing
• Wash your hands
• Avoid non-essential outings

A philosopher answers everyday moral dilemmas in a time of coronavirus

Lee McIntyre, Boston University

Like a lot of people, we here at The Conversation are facing ethical decisions about our daily life as a result of the coronavirus. Here ethicist Lee McIntyre answers some of our editors’ queries. If you have a question you’d like a philosopher to answer, send it to us at us-ethicalquestions@theconversation.com

1. I’m 65 years old. My son, who is 32, has offered to pick up the groceries. But he has asthma. I’m in a quandary as to who should go?

One of the leading ethical theories is “utilitarianism,” which says that moral decisions and actions should be made on the basis of their consequences.

Although this idea stretches back to antiquity, it was 19th-century philosophers Jeremy Bentham and John Stuart Mill who articulated the most developed form of this theory, arguing that ethical judgments were a matter of assessing “the greatest good for the greatest number.”

In balancing risk, you are anticipating likely consequences, which is a very utilitarian thing to do. But, as an ethicist, I would urge you to be careful.

Please consider whether you have all of the relevant information. It has now been shown that although at a much lower risk, younger people too can become dangerously sick with COVID-19. And with asthma as an underlying condition, that raises the stakes for your son.

You must also take into account your own risk profile: age, underlying health and other factors.

But, according to the utilitarian, you’ve still got to deal with another issue. Your son may be younger than you, but that means he’s also got many more life years to enjoy. According to utilitarian theory, if something were to happen to him, it would be a greater tragedy than if it happened to you, because he has more overall “utility” at stake.

Perhaps you could hire Instacart and have someone else’s son or daughter, presumably without asthma, deliver your groceries? But here is where it gets tricky. According to the utilitarian, you cannot prefer your own or your son’s happiness over that of a stranger.

It’s all about the “greatest good” for all concerned. If you think the ethical thing is to maximize happiness, then it shouldn’t matter whose happiness we are talking about.

Utilitarianism offers a method for thinking through this problem, but not an answer. You’ll have to think through each outcome – taking everyone’s happiness, health, age and risk into consideration.

2. I have a renter in my house who isn’t obeying social distancing rules and goes out all the time. What should I do?

As the renter lives in the same house you do, his or her behavior is endangering your health, which warrants some action.

Ethical egoism – which says that the ethical thing is that which brings about the greatest happiness for oneself – is a relevant ethical theory in this situation. You might think that your renter is an egoist, because he or she is presumably only concerned with his or her own welfare.

But that might open the door for you to claim that you are an egoist too. If you believe that it’s ethical for someone to care only about himself or herself, then perhaps you are justified in evicting the renter. But first you might want to check why he or she is going out. Perhaps it’s to take care of someone else.

So, first I’d have a talk with the renter and point out that – in a communal environment, especially in times of a public health crisis – everyone’s actions affect everyone else.

If that doesn’t work, you might guiltlessly embrace egoism as your own moral philosophy and say to the renter “if you don’t stop endangering my health, there will be consequences … for you.”

3. I don’t have a car and I have flu-like symptoms. Should I take a cab or Uber to go to the hospital?

Absolutely not, unless you plan to tell the driver in advance what you are doing. Eighteenth-century philosopher Immanuel Kant said that the guiding principle behind ethical behavior was to follow the “categorical imperative.” This says that everyone should act as if their behavior could form the basis for a universal law of human conduct.

So just ask yourself: What would happen if everyone who likely had COVID-19 just thought of themselves and took a cab or Uber? The disease would likely spread, which would be disastrous for many people beyond just you. The utilitarian too would agree.

A better course of action might be to call the hospital and ask for their help in arranging how to get there. If that fails, you could always call an ambulance. You might balk at the expense, but the alternative is to pass that expense, in the form of a life threatening illness, on to others – without their consent. And according to Kant, that is not an ethical thing to do.

[You’re smart and curious about the world. So are The Conversation’s authors and editors. You can get our highlights each weekend.]

Lee McIntyre, Research Fellow, Center for Philosophy and History of Science, Boston University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Lester Caudill, University of Richmond

Editor’s note: The question everyone in the world wants answered is how far the new coronavirus will spread and when the pandemic will begin to ebb. To know that, epidemiologists, public health authorities and policymakers rely on models.

Models are not meant to predict the future perfectly – yet they’re still useful. Biomedical mathematician Lester Caudill, who is currently teaching a class focused on COVID-19 and modeling, explains the limitations of models and how to better understand them.

What are infectious disease models?

Mathematical models of how infections spread are simplified versions of reality. They are designed to mimic the main features of real-world disease spread well enough to make predictions which can, at least partly, be trusted enough to make decisions. The COVID-19 model predictions reported in the media come from mathematical models that have been converted into computer simulations. For example, a model might use a variety of real world data to predict a date (or range of dates) for a city’s peak number of cases.

Why is modeling the spread of COVID-19 challenging?

In order for a model’s predictions to be trustworthy, the model must accurately reflect how the infection progresses in real life. To do this, modelers typically use data from prior outbreaks of the same infection, both to create their model, and to make sure its predictions match what people already know to be true.

This works well for infections like influenza, because scientists have decades of data that help them understand how flu outbreaks progress through different types of communities. Influenza models are used each year to make decisions regarding vaccine formulations and other flu-season preparations.

By contrast, modeling the current COVID-19 outbreak is much more challenging, simply because researchers know very little about the disease. What are all the different ways it can be transferred between people? How long does it live on door knobs or Amazon boxes? How much time passes from the moment the virus enters a person’s body until that person is able to transmit it to someone else? These, and many other questions, are important to incorporate into a reliable model of COVID-19 infections. Yet people simply do not know the answers yet, because the world is in the midst of the first appearance of this disease, ever.

Why do different models have different predictions?

The best modelers can do is assume some things about COVID-19, and create models that are based on these assumptions. Some current COVID-19 models assume that the virus behaves like influenza, so they use influenza data in their models. Other COVID-19 models assume that the virus behaves like SARS-CoV, the virus that caused the SARS epidemic in 2003.

Other models may make other assumptions about COVID-19, but they must all assume something, in order to make up for information that they need, but that simply does not yet exist. These different assumptions are likely to lead to very different COVID-19 model predictions.

How can people make sense of the different – sometimes conflicting – model predictions?

This question gets at, perhaps, the most important thing to know about mathematical model predictions: They are only useful if you understand the assumptions that the model is based on.

Ideally, model predictions like, “We expect 80,000 COVID-related deaths in the U.S.” would read more like, “Assuming that COVID-19 behaves similar to SARS, we expect 80,000 COVID-related deaths in the U.S.” This helps place the model’s prediction into context, and helps remind everyone that model predictions are not, necessarily, glimpses into an inevitable future.

It may also be useful to use predictions from different models to establish reasonable ranges, rather than exact numbers. For instance, a model that assumes COVID-19 behaves like influenza might predict 50,000 deaths in the U.S. Rather than trying to decide which prediction to believe – which is an impossible task – it may be more useful to conclude that there will be between 50,000 and 80,000 deaths in the U.S.

Why do the same models seem to predict different outcomes today than they did yesterday?

As COVID-19 data becomes available – and there are many good people working tirelessly to gather data and make it available – modelers are incorporating it so that, each day, their models are based a little more on actual COVID-19 information, and a little less on assumptions about the disease. You can see this process unfold in the news, where the major predictive COVID-19 models provide almost daily revisions to their prior estimates of case numbers and deaths.

Can a model that’s (probably) not accurate at predicting the future still be useful?

While models of infections can provide insights into what the future might hold, they are far more valuable when they help answer, “How can policies alter that future?”

For instance, a baseline model for predicting the future number of COVID-19 cases might be adapted to incorporate the effects of, say, a stay-at-home order. By running model simulations with the order, and comparing to model simulations without the order, public health authorities may learn something about how effective the order is expected to be. That can be especially useful when comparing the associated costs, not only in terms of disease burden, but in economic terms, as well.

One step further, this same model could be used to predict the consequences of ending the order on, say, June 10 – the current target date for the stay-at-home order in Virginia – and compare them to model predictions for ending the order on, say, May 31 or June 30. Here, as in many other settings, models prove to be most useful when they’re used to generate different scenarios which are compared to each other. This is different than comparing model predictions to reality.

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Lester Caudill, Professor of Mathematics, University of Richmond

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Congress gave the IRS the job of sending out coronavirus rescue checks. But the underfunded agency is struggling, while for-profit companies like Intuit have started circling, hoping to convert Americans in need into paying customers.

by Justin Elliott and Paul Kiel April 15, 5 a.m. EDT

Congress has approved billions of dollars of checks for Americans hard hit by the biggest round of layoffs in U.S. history. But millions of Americans will have to wait months for that money — and millions more may never get the money at all.

That’s because the rescue legislation left it to the IRS, an agency gutted by Congress, to organize the complex logistics of delivering the money to those entitled to it. As the IRS has struggled, for-profit tax preparation companies, notably Intuit, the maker of TurboTax, have stepped in with websites to help people get their checks.

But Intuit is not just acting as a conduit: It is also misleading unwary Americans by steering them to paid services that they could otherwise get for free.

The job Congress gave to the IRS in its $2 trillion CARES Act is seemingly straightforward: Identify the Americans who qualify and send them money. This turns out to be far more complicated than it sounds.

Tens of millions of Americans have not provided the IRS with their banking account information, if they have one. Some of these people have filed taxes, so they should eventually receive money but will have to wait weeks or even months for a check to come in the mail.

Another group of Americans did not file taxes because they make so little money. Getting stimulus checks to them, an estimated 6 million households, is challenging. They now must file a new form online notifying the IRS who they are, or the tax agency has to find them. If they don’t, these people will never get the checks of $1,200 and up.

The CARES Act, passed in late March, did not provide any mechanism to reach many of these low-income Americans. So far, the extent of the IRS’ public outreach has been the creation of what the agency calls “e-posters,” to be circulated online, describing the program and letters written by the commissioner to several nonprofits encouraging them to get involved.

Intuit has had a much more nimble approach. On April 4, the company rolled out a new “stimulus registration product” as part of its new Coronavirus Tax Center. But the site, marketed as “free,” sometimes steers customers into products that cost money, in the same way ProPublica hasdocumented over the past year. What’s more, customers who use it are signing away their personal data to the Silicon Valley firm, which the company can use to pitch third-party financial products to their customers.

The coronavirus rescue checks are yet another manifestation of a problem that has existed for decades. As ProPublica has documented, the IRS has long deferred to private industry instead of creating its own tax preparation and filing apparatus. The result has been that millions of Americans have paid billions of dollars to corporations for tax preparation they should have been able to get free of charge. This year, anyone who made under $69,000 does not need to pay to file; they are eligible to file taxes for free through an IRS program called Free File.

Now, Americans who desperately need checks to help cushion the coronavirus crash are being targeted by companies all over again.

“This vulnerable group of Americans might end up having to pay for tax prep that they could get for free,” said Dennis Ventry, a tax law professor at University of California, Davis. “And this is a treasure trove of data for Intuit. The company can harvest the personal data of people who previously made up a universe of Americans that the tax prep companies didn’t interact with.”

Intuit trumpeted its program as a user-friendly way for people to get their money. “In partnership with the IRS,” the company’s press release announced, “TurboTax volunteered to create an innovative solution to help this group easily get their stimulus payment.”

But the people coming to the site do not merely enter basic information that would be sent to the IRS in order to get their check processed.

Instead, the site invites users to try TurboTax’s paid tax preparation products with multiple buttons to “Start for Free” — even though the products may charge fees of $100 and up.

In recent days, people who used Intuit’s product to register for the stimulus were bombarded with a series of marketing emails with subject lines such as “E-file with direct deposit for your fastest refund and stimulus check.” The emails push users to TurboTax’s paid tax prep products.

Intuit said this was done in error. The company’s spokesman said, “When we realized those creating accounts specifically for the Stimulus Registration product were receiving this general new account email it was turned off.”

One thing missing from Intuit’s coronavirus page is a link to the IRS’ Free File program. To use it, taxpayers have to find the IRS’ Free File page, which then sends users through to special pages operated by the tax prep companies. The Free File site is a collaboration between the IRS and these companies, which, led by Intuit, conceived of the program as a way to keep the government from building its own system.

Asked why Intuit is steering people toward its paid products on its coronavirus site, a company spokesman said that those looking for the Free File option should go to IRS.gov. The spokesman also pointed to a press release that says: “TurboTax volunteered to create an innovative solution to help this group easily get their stimulus payment — the TurboTax Stimulus Registration product was designed to help millions easily file a minimum tax return with the IRS.” The IRS did not respond to questions.

Things got even more confusing on Friday, when, a week after the TurboTax site launched, the IRS announced a separate IRS.gov tool for people who don’t need to file their taxes to register to receive their checks.

Users reading the fine print on the IRS tool would find that it, too, was created by Intuit.

Even though the same company created both tools, they look very different. The TurboTax version created by Intuit offers a slick design and user-friendly Q&A to enter personal data, along with multiple digital off-ramps to paid TurboTax products.

The IRS.gov version, also created by Intuit, is a clunky PDF-style form filled with jargon and small type. It is titled, “Non-Filers: Enter Payment Info Here.”

An Intuit spokesman said the company “volunteered at no charge to deliver a solution” for the government. The spokesman did not respond to a question about why Intuit launched the TurboTax tool a week earlier than its IRS.gov tool.

“This crisis has highlighted the consequences of a decade of IRS budget cuts,” Sen. Ron Wyden, the ranking member of the Senate Finance Committee, said in a statement to ProPublica. “The IRS should be less dependent on private companies to distribute refund payments to millions of Americans. Over the long term we need to ensure that the IRS has the resources to more quickly respond especially in an economic downturn.”

Last year, ProPublica reported extensively on Intuit’s and other companies’ efforts to downplay the Free File program, including by blocking Google from indexing their Free File pages. The coverage led to a lot more focus on Free File by Congress, state attorneys general and the rest.

That additional publicity seems to have boosted Free File usage. Through late March, according to an internal IRS report obtained by ProPublica, Free File usage was up 26% compared with the prior year, a jump of about 400,000 people. It’s a significant increase, but, given that over 100 million Americans are eligible for the program and fewer than 3 million actually used it last year, not transformative.

The logistics of getting almost $300 billion in COVID-19 payments out to Americans were always going to be challenging and the details confusing. For that, thank the U.S.’s maddeningly complex tax system and the IRS’ limited capacity.

The easy part is sending money to people who have already given their bank account information to the IRS.

Many Americans file taxes but don’t give the IRS their bank account information and it’s a group that tends to earn less income. According to a ProPublica analysis of tax filing data, 20 million households in 2018 received a refund but didn’t use direct deposit, and most of them had income below $25,000. Many of these people don’t have a bank account at all.

If they take no action, those households will have to wait for the IRS to mail them a paper check. Taxpayers who have shared their bank information with the service started receiving money this week. Others could wait months for postal delivery. The process of sending checks will start in May and continue into August, according to Rep. Steven Horsford, D-Nev., who sits on the committee that oversees the IRS.

For those people, the IRS has promised a different solution: a portal that will allow taxpayers to provide the agency with updated bank account information. This tool, distinct from the non-filers portal already launched, will be up by this Friday, the IRS said in a press release.

And then there are people who didn’t file taxes. They fall into two broad groups. First, there’s those who should have filed but did not. That group numbers in the millions, but the exact number is hard to pin down. It has likely grown in recent years because of lax enforcement by the IRS, which has cut its investigations of nonfilers to a small fraction of what they were.

Tens of millions of poor Americans don’t have to file because they don’t have taxable income. Most of them, around 20 million, are on Social Security. They were a key focus in the CARES Act.

Because the Social Security Administration regularly channels money to these people, lawmakers specifically stated in the CARES Act that the government could send those people money the same way — without them having to file a tax form.

But a couple days after the bill passed, the IRS announced that these people would, in fact, have to file a tax return. The Social Security Administration is not in charge of the CARES payments. What this would mean then, is that the IRS would have to sort through Social Security data to identify people who had not already filed their taxes. After an outcry, however, the IRS reversed itself, saying that these people did not have to file after all.

Actually, the best advice is more complicated, experts say. If these people want to see their CARES money as fast as possible, they should file their taxes. They can do so through the IRS’ Free File program or via the new portal the IRS set up just for the CARES payments. If they don’t file, it will take the IRS a while to figure out how to send Social Security recipients money.

The final group of people who are owed CARES money is the hardest for the IRS to reach: those who didn’t file for taxes because they earned income, but too little to require filing (for a single person, that’s under $12,200; for a married couple, under $24,400). It’s a group that numbers in the neighborhood of 6 million, according to an estimate by the nonprofit New America.

These people will not receive a CARES payment at all unless they file something with the IRS. Maybe some will find their way to the IRS’ Free File page or the agency’s “Non-Filers: Enter Payment Info Here” site. And maybe some will find themselves on TurboTax’s Coronavirus Tax Center page.

Hannah Fresques and Will Young contributed reporting.