Category: Corona Virus

"What will be done is a registry ... of those people who have been offered it and simply rejected it," Illa told Spain's La Sexta TV channel.

But health care professionals have warned that the idea presents potential dangers.

"The most important thing is to know how the registry will be used," said Jose Luis Cobos, deputy direct of the Spanish General Council of Nursing.

"If it's for public health purposes, to better understand COVID, and it's anonymous, that's one thing," he said.

"But if it's 'I'm now on the list of the bad people,' that's another thing. We don't think a registry should be used to infringe on liberties, or for employers against people," he added.

Vaccine rollout underway

Hours after Illa's television interview on Monday, the head of Spain's Medicines Agency, Maria Jesus Lamas, told Spain's SER radio that the new registry would be used "to understand the causes behind declining the vaccination ... doubt or rejection."

"The registry is anonymous," she added. "There's no chance of identifying anyone in the registry."

Spain's 17 regional governments administer vaccines across the nation.

In the southern region of Andalusia, people currently appear in a registry if they are given a vaccine, including its batch number and who administered, it for quality control purposes, an Andalusia health department spokeswoman told CNN.

The spokeswoman also noted that there is no registry for members of the general public who decline vaccinations, although Andalusia health care workers must sign a document if they refuse a vaccination.

Spain has the world's ninth largest number of coronavirus cases, at more than 1.8 million, and the tenth highest number of deaths, at just over 50,000, according to Johns Hopkins University.

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Spain will keep a register of those who refuse the coronavirus vaccine - CNN

Another seven Mainers have died as health officials on Tuesday reported 590 new coronavirus cases across the state.

Tuesdays report brings the total number of coronavirus cases in Maine to 22,909, according to the Maine Center for Disease Control and Prevention. Thats up from 22,319 on Monday.

Of those, 19,582 have been confirmed positive, while 3,327 were classified as probable cases, the Maine CDC reported.

A man in his 70s from Androscoggin County, a woman in her 80s and a woman in her 90s from Cumberland County, a woman in her 80s from Oxford County, a man in his 60s and a woman in her 70s from Penobscot County and a woman in her 80s from York County have succumbed to the virus, bringing the statewide death toll to 333. Nearly all deaths have been in Mainers over age 60.

Maines seven-day average for new coronavirus cases is 453.3, up from 434.6 a day ago, up from 430.7 a week ago and up from 163.6 a month ago.

Health officials have warned Mainers that forceful and widespread community transmission is being seen throughout the state. Every county is seeing high community transmission, which the Maine CDC defines as a case rate of 16 or more cases per 10,000 people.

There are two criteria for establishing community transmission: at least 10 confirmed cases and that at least 25 percent of those are not connected to either known cases or travel.

So far, 1,041 Mainers have been hospitalized at some point with COVID-19, the illness caused by the new coronavirus. Of those, 184 people are currently hospitalized, with 48 in critical care and 19 on ventilators.

As of Tuesday, 19,634 Mainers have been vaccinated against the coronavirus.

A majority of the cases 13,368 have been in Mainers under age 50, while more cases have been reported in women than men, according to the Maine CDC.

As of Tuesday, there have been 1,158,549 negative test results out of 1,187,533 overall. Nearly 2.4 percent of all tests have come back positive, Maine CDC data show.

The coronavirus has hit hardest in Cumberland County, where 6,879 cases have been reported and where the bulk of virus deaths 94 have been concentrated. Other cases have been reported in Androscoggin (2,533), Aroostook (528), Franklin (448), Hancock (514), Kennebec (1,727), Knox (353), Lincoln (291), Oxford (1,081), Penobscot (1,923), Piscataquis (111), Sagadahoc (363), Somerset (723), Waldo (376), Washington (343) and York (4,703) counties. Information about where an additional 13 cases were reported wasnt immediately available.

As of Tuesday morning, the coronavirus had sickened 19,334,975 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 335,623 deaths, according to the Johns Hopkins University of Medicine.

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7 more Mainers die as another 590 coronavirus cases are reported across the state - Bangor Daily News

Health researchers say wearing masks and washing your hands often is more important than wiping down surfaces when it comes to protecting yourself from the coronavirus. Rodin Eckenroth/Getty Images hide caption

Health researchers say wearing masks and washing your hands often is more important than wiping down surfaces when it comes to protecting yourself from the coronavirus.

At the start of the pandemic, stores quickly sold out of disinfectant sprays and wipes. People were advised to wipe down their packages and the cans they bought at the grocery store.

But scientists have learned a lot this year about the coronavirus and how it's transmitted, and it turns out all that scrubbing and disinfecting might not be necessary.

If a person infected with the coronavirus sneezes, coughs or talks loudly, droplets containing particles of the virus can travel through the air and eventually land on nearby surfaces. But the risk of getting infected from touching a surface contaminated by the virus is low, says Emanuel Goldman, a microbiologist at Rutgers University.

"In hospitals, surfaces have been tested near COVID-19 patients, and no infectious virus can be identified," Goldman says.

What's found is viral RNA, which is like "the corpse of the virus," he says. That's what's left over after the virus dies.

"They don't find infectious virus, and that's because the virus is very fragile in the environment it decays very quickly," Goldman says.

Back in January and February, scientists and public health officials thought surface contamination was a problem. In fact, early studies suggested the virus could live on surfaces for days.

It was assumed transmission occurred when an infected person sneezed or coughed on a nearby surface and "you would get the disease by touching those surfaces and then transferring the virus into your eyes, nose or mouth," says Linsey Marr, an engineering professor at Virginia Tech who studies airborne transmission of infectious disease.

So people were advised to clean common areas with disinfectant, wipe down cans and boxes from the grocery store and even wear gloves.

In retrospect, Marr says that was "overkill." Today, she says, "all the evidence points toward breathing in the virus from the air as being the most important route of transmission."

Scientists now know that the early surface studies were done in pristine lab conditions using much larger amounts of virus than would be found in a real-life scenario.

Even so, many of us continue to attack door handles, packages and groceries with disinfectant wipes, and workers across the U.S. spend hours disinfecting surfaces in public areas like airports, buildings and subways.

There's no scientific data to justify this, says Dr. Kevin Fennelly, a respiratory infection specialist with the National Institutes of Health.

"When you see people doing spray disinfection of streets and sidewalks and walls and subways, I just don't know of any data that supports the fact that we're getting infected from viruses that are jumping up from the sidewalk."

Marr says focusing on cleaning surfaces is not the best way to slow infection.

"Instead of paying so much attention to cleaning surfaces, we might be better off paying attention to cleaning the air, given the finite amount of time and resources," Marr says.

Fennelly agrees, noting that airborne transmission is more likely in indoor public places like restaurants.

"Why aren't we doing more to figure out ways to ventilate those areas?" he asks. "It would be better to use ultraviolet germicidal irradiation, which we know can kill these viruses in the air."

Figuring out how to prevent coronavirus transmission in office buildings, schools, bars and restaurants is definitely a challenge, he says, but "we have a lot of really smart engineers and architects and industrial hygienists who know how to handle airborne infection."

Spraying disinfectant is not only unproductive, but it's potentially dangerous, according to Delphine Farmer, an atmospheric chemist at Colorado State University.

Heavy use of disinfectants, like bleach and hydrogen peroxide, can "produce toxic molecules that then we breathe," she warns.

And breathing in toxic particles can affect our health, Farmer says. The molecules can react directly with the cells in lung tissue and cause oxidative stress. And certain molecules are known to be toxic. "It's like breathing in poison," she says.

Early on in the pandemic, Farmer says, many people were making cleaning mistakes: "There were a lot of cases of people cleaning their groceries with bleach and vinegar, which is a recipe to create some very nasty chlorine gas, and people were getting quite ill from those side effects."

Bottom line: Health experts emphasize that the most important way to avoid infection is to stay away from crowds and wear a mask whenever you leave the house. Limit the time you spend in any indoor space with people outside of your own household and wear a mask when you're in those spaces.

When you're out in public, be aware of surfaces you touch, and wash your hands often. It's much more effective to wash your hands thoroughly than try to clean everything you touch.

And if you do decide to keep wiping down canned goods or packages that arrive at your house, there's no need for fancy cleaning products; "old-fashioned soap and water" will do just fine, Farmer says.

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Disinfecting Surfaces And Parcels To Fend Off The Coronavirus May Be Overkill : Shots - Health News - NPR

What happened March 4 before the dawn and into the night haunts her.

The sirens seemed to blare endlessly outside the Life Care Center in Kirkland, Washington.

"That was the night (we had) like five ambulances in the parking lot," she said.

It was the night she sent patients to the hospital whom she expected would be treated and eventually released. They never came back.

It was the date she figured out "the whole cascade of symptoms" of a virus the nursing home learned had invaded just four days earlier.

It was also the day she had to make some gut-wrenching phone calls.

One at 3 a.m. she can't shake from her mind. She remembers the conversation with the woman on the other end of the line.

"I realized this was early in the morning, and this is very difficult to say that I am really sorry that your mom has passed away," Earnest said. "I cried with her."

The two, who had never met, shared a heartbreaking moment. Ten months later, they still sometimes talk, Earnest said.

Earnest, a registered nurse, volunteered to help out the Kirkland nursing home from her position as a nursing director at another Life Care Center in the state.

They needed all the help they could get. Nearly 70% of the staff had tested positive for coronavirus in March.

She had no idea that the inconspicuous building on a tree-lined street in a quiet residential neighborhood in Kirkland would become America's first epicenter of the coronavirus outbreak.

"It was like chasing a ghost," she told CNN in March. "You're in a battlefield where supplies are limited. The help's slow to get to you and there's lots of casualties. And you can't see the enemy."

Ten months since the initial outbreak, she and other frontline health care workers here are finally getting the best weapon available to battle the virus: the vaccine.

Alice Cortez, a nursing manager at Life Care Center of Kirkland, was the first to get the vaccine here.

"This is an exciting day for everybody especially my team," she said as her voice cracked with emotion.

"What I feel right now is a new life, a new beginning, but a better life."

Coronavirus remains a threat at nursing homes

But everyone here is well aware that the virus is still raging and remains a threat to the most vulnerable people: The people they are charged with caring for.

As of December 13, the Center for Medicare and Medicaid Services, which oversees nursing homes, says 441,000 nursing home patients have tested positive for coronavirus across the United States and 86,775 nursing home residents have died from Covid-19. And 1,258 staff members have perished, too.

"There is not a day that goes by where I don't get a phone call or a message that we have a new positive patient or staff," said Nancy Butner, vice president of Life Care Centers of America Northwest division. Butner said some of her staff have been hospitalized recently. And more patients have died in other facilities.

"It is relentless," Butner said.

Initially, some families and the public blamed the nurses, doctors and staff at Life Care Center of Kirkland for the outbreak and not controlling it better.

The phones never stopped ringing. Families couldn't get through -- sometimes doctors couldn't -- because of other unwanted calls.

"It was very hard to go into a patient's room and hear the phone. And you think it's a doctor, and you get there and it's some person saying they have the cure for Covid giving you a recipe that is as crazier than they are," Earnst said.

Too often, it was the most jarring kind of call: death threats, enough to require security. Earnest was afraid to go to her car one night after treating patients.

"My husband said, 'Make sure you have your gun,'" she said, able to laugh about it now. But he was serious and so were the threats.

Then there was the sight of the devastated families who showed up every day.

Some had lost their mom or dad at the facility, and others had family still inside infected with Covid-19. They sat in chairs outside their family member's room window, eating lunch with them and having muffled conversations through the glass.

Inside, the staff was dealing with a virus no one knew enough about.

It was before the public was told to wear masks, before the elbow bump became the new handshake, before all of the symptoms were known. And it was before tens of thousands of people began getting sick and dying in New York City, which soon became the second epicenter of the virus.

Life Care Center appealed the ruling. In September, a state administrative judge largely sided with the Life Care Center of Kirkland, not the state findings, which mimicked the federal ones.

The judge said the state agency "provided relatively little evidence that the facility actually failed to meet any expected standard of care or failed to follow public health guidelines."

The federal appeal has not been decided.

Changes made since the March outbreak

In the beginning, there were not enough coronavirus tests, and it took days to get results. Now, they have rapid tests that take minutes.

In some rooms, there were three patients. Now, that's down to one -- or two if they can be properly distanced.

Before the virus, the facility accepted as many as 124 patients. Now they've capped it at 97.

Back then, there was a constant worry about a lack of personal protective equipment. Now, a nearby facility has a large room stuffed with boxes of masks, gloves and other gear.

But 10 months after the initial viral outbreak, the chairs for family members remain outside the windows of the rooms. Room numbers are scrawled on the windows.

That has become a semi-permanent fixture because visitors still aren't allowed inside.

There is no family hand-holding or hugs and kisses. It is simply too dangerous, the virus too contagious. The staff knows that now.

In the beginning, Earnest, a registered nurse, was informing doctors and members of the Centers for Disease Control and Prevention of what she was seeing in patients. Now, they get constant updates and new safety protocols from government agencies.

Covid-19 impacts staff inside and outside the nursing home

Butner says what people don't often think about is that the staff has to battle the virus at work and at home.

Earnest lost an uncle to Covid-19 this year. So before Christmas she had to have "the talk" with her mother about how she wanted to die.

"If she got it, what did she want? Did she want to be on a ventilator or did she want to be ... let go?"

It was the hardest conversation she's had with family. But she says she couldn't avoid it. No one should.

It is too awful when they are taken away and isolated and you don't get to know their wishes. Sometimes you don't get to say goodbye, she said.

Earnest said she hopes the vaccine will make these conversations less urgent. But not everybody at the nursing facilities is looking forward to getting it.

"We did a survey with the staff at our facilities before we did education on the vaccine. Twenty percent said no, never. They would not get vaccinated," she said.

For now, she says, Life Care Centers of America isn't making it mandatory. The reason is simple.

"We simply could not lose 20% of our staff," she said. "Another effect of this virus is an extreme shortage of nursing staff for all of health care."

She is hoping that with education, the percentage will shrink.

For physician's assistant Christy Carmichael, her decision to get the vaccine made everyone gasp. Last week she had promised one of her patients who had survived Covid-19 that she would be able get the vaccine.

"I said sure you can. Unfortunately she passed away," Carmichael said, before dissolving into tears after getting her vaccine shot. "I did promise her that she would get it, so it's just sad that she didn't get to see this today."

CNN's Leslie Perrot and Mallory Simon contributed to this report.

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The first coronavirus epicenter in the US gets the vaccine, but threat of the deadly virus lurks - CNN

Weve basically had a complete abdication of the federal response, Gregg Gonsalves, an assistant professor in epidemiology of microbial diseases at Yale, told me when asked about the interplay between public health and economic struggles.

If we want people to take individual actions to help curb the spread of the virus, we also need to invest in their ability to do so. The government could send every household masks a plan the Trump administration nixed early on. It could pay Americans to stay home if they feel sick, test positive or work for a business that should close for public health reasons, to avoid choosing between their health and their bills.

If you want people to do the right thing you have to make it easy, and weve made it hard, Dr. Gonsalves noted. States, too, have been told theyre on their own, with Congressional Republicans refusing to agree to the money Democrats want to send to help fill the vast hole left by the pandemic. In response, some governors seem to be prioritizing businesses over public health, handing out ineffectual curfews to restaurants and bars rather than just shutting them down.

But to help small businesses, and to return to strong economic growth, tamping down the pandemic still has to come first.

Theres no realistic prospect of fostering a complete and durable recovery until the public health situation has been brought under control, said David Wilcox, an economist and senior fellow at the Peterson Institute for International Economics.

The last 10 months have given us a very clear message: We are inextricably connected to each other. We cant stay healthy unless our neighbors can do so, too. The economy cant properly function if Americans are sick and dying. The economy is only a means to an end, a way to improve living conditions. The economy should serve us we cannot sacrifice our lives at its altar.

The Times is committed to publishing a diversity of letters to the editor. Wed like to hear what you think about this or any of our articles. Here are some tips. And heres our email: letters@nytimes.com.

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Opinion | When the American Way Met the Coronavirus - The New York Times

Let's be real, though. Most of us pick our noses some 91% according to the only (small and old) study that seems to have ever been done on the subject, perhaps revealing how little even scientists want to think about it. Looking around the world, however, it's not exactly uncommon to see someone with a finger up their nose, either discreetly or not so much, like Queen Elizabeth.

Jokes aside, nose picking is deadly serious.

Not only are people spreading their own bacteria and viruses onto everything they touch after a bout of digging for gold but you also "transfer germs from your fingertips into the nose, which is the exact opposite of what you want," said infectious disease specialist Dr. Paul Pottinger, a professor at the University of Washington School of Medicine in Seattle.

That means that you can spread coronavirus to others from your nose-picking session, and you are also more likely to bring that virus, along with others like influenza or rhinovirus (the common cold), directly into your body.

How the coronavirus enters your body

The nose is one of three main ways that viruses can enter the body the other two are the mouth and eyes. The nose has a number of defense systems to keep pathogens out, including hair at the front of the nostrils to block larger particles and the mucous membrane.

That moist lining of the nose "has microscopically small glands that can secrete mucus into the airway in response to foreign invaders. That includes big stuff like pollen and dirt and dust and also microscopic stuff, which would include bacteria and viruses," Pottinger said.

Some mucus is a good and healthy thing, keeping most invaders out. But when it dries up, along with whatever it has caught, it turns into what most of us call boogers (scientists call them crusts). When you feel one in your nose, it's easy to want to pick it out without thinking.

What many people don't realize is how delicate that skin inside the nose can be. Nose picking can create tiny cuts in the delicate epithelial linings in the nasal cavity, said molecular virologist Cedric Buckley, formerly an associate professor of biology at Jackson State University in Mississippi who now does STEM curriculum development.

"Once that barrier is breached, you're right into a capillary bed, which becomes the conduit for viral particle infection," explained Buckley, who also serves on the City of Jackson Covid-19 Task Force. This breach increases your chances of transmitting whatever germs are on your hands right into your bloodstream.

Breaking a habit

Nose picking is something that should more than ever during a pandemic be avoided. But habits can be hard to break, especially those that you do without thinking.

Picking the nose, like nail-biting, skin picking, lip chewing and hair pulling, is considered by mental health professionals to be a "body-focused repetitive behavior." Those are "actions that are directed at one's own body and that often focus on grooming or removing parts of the body," according to Dr. Elias Aboujaoude, clinical professor of psychiatry at Stanford University in California and director of the Obsessive-Compulsive Disorder Clinic there.

These behavioral habits can be a clinical disorder if they result in damage or significant impairment to someone's personal or professional life, Aboujaoude said via email. For many of us, though, they're just bad habits, not disorders.

Habit reversal therapy, a form of cognitive behavioral therapy, is a tool that psychiatrists use to help people with body-focused repetitive behaviors. This treatment "increases awareness of the behavior and its consequences, and trains the individual to replace nose picking with a 'competing response,'" Aboujaoude said. That means doing something less damaging and more socially acceptable with one's hands, like making a fist and holding it, or squeezing a stress ball.

This is where mask wearing can be especially useful. In addition to masks' effectiveness in reducing transmission of airborne particles that can contain coronavirus, they can also help reduce nose picking by physically blocking the habitual or unconscious finger-to-nose action.

"If they're eager to stop nose-picking, boy, what a great opportunity to take advantage of this moment in human history where everybody's supposed to be covering their face," Pottinger said.

Nasal health best practices

If you find your nose picking isn't a habit so much as a reaction to a constantly uncomfortable or clogged nose, get checked out by your doctor or at a local clinic. Your issue could have less to do with those nose crusts and more to do with another issue that needs to be addressed:

"You could have a deviated septum, you could have nasal inflammation, you could be prone to seasonal or chronic allergies, where your nasal membranes are constantly swollen," Buckley said.

The best way to get rid of boogers is to blow your nose into a tissue and then wash your hands, instead of picking out the crusts.

Neti pots or saline sprays are another option. "Remember, the booger is just a dried out piece of mucus. If you rehydrate the mucus, you should be able to blow it out or have it come out on its own," Pottinger said.

However, he said that everyone should get their own bottle no sharing, not even with intimate partners. It should be kept clean, and the tip wiped off on a regular basis so germs don't get transferred into the nose from use to use. And if you use a neti pot, Pottinger said, be sure to use sterilized water. Humidifiers to keep indoor air hydrated can also help reduce crust formation.

Prevent Covid and loss of smell

Caring for your nasal health, which definitely includes not picking your nose, will reduce the risk of catching coronavirus and passing it along.

Correction: An earlier version of this story misspelled Dr. Elias Aboujaoude's last name.

A former geologist, Starre Vartan is a science journalist and dog runner living on an island in Puget Sound near Seattle who still picks up rocks wherever she goes.

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Why picking your nose isn't just gross it's dangerous in the time of coronavirus - CNN

Life wasnt always like this for Libby Pederson.

She used to know how to dress herself in the morning without notes. Cooking dinner did not confound her.

That changed in November, when the 44-year-old got sick with the coronavirus and developed mysterious neurological symptoms that landed her in the hospital. Ever since, Pederson has been struggling to heal from what doctors say can be a little-known, little-understood consequence of the virus: persistent and debilitating brain and cognitive problems.

On the worst days, the days when she sits on her couch or stays in bed, Pederson wonders if shell return to being the busy and capable single mom and special education teacher at an Anchorage elementary school she was just two months ago.

I feel like Ive lost who I am, she said.

The way coronavirus wreaks havoc on some patients respiratory systems has been well documented. But scientists are just beginning to understand how the coronavirus can affect the brain.

Researchers around the world have been compiling documentation of COVID-19 patients with neurological symptoms ranging from psychosis to memory loss, according to an article published in the journal Nature in September. The people experiencing neurological damage often arent otherwise very sick. And they arent always older, either.

Libby Pederson at her home in Anchorage on Wednesday, Dec. 23, 2020. In November, a coronavirus infection left her hospitalized with a rare brain inflammation caused by the virus. Before the infection, she was very active. Now, some days she is unable to leave the couch. (Emily Mesner / ADN)

Weve seen this group of younger people without conventional risk factors who are having strokes, and patients having acute changes in mental status that are not otherwise explained, a UK neurologist said in the Nature article.

It isnt clear whether coronavirus actually has the ability to enter the brain, or whether a haywire immune response to the virus causes inflammation, according to Nature. Its also not known exactly how many people in Alaska have experienced neurological symptoms like Pederson.

Complications of COVID-19 infection are not reportable to the Alaska Department of Health and Social Services, so we do not know how many neurological complications have occurred in Alaska, said Joseph McLaughlin, chief of the Alaska Section of Epidemiology.

I was just wanting to die

Pedersons coronavirus experience began unremarkably: On Nov. 13, her daughter held up a scented candle for her to sniff and she smelled nothing. The next day her ability to taste vanished. Pederson hurried to get a COVID-19 test.

By the time she got the positive results back, her head was throbbing with a level of pain shed never experienced before, even as a longtime migraine sufferer. Headaches are among less common but still recognized symptoms of the coronavirus.

Pederson says she spent days curled up in the fetal position in her darkened bedroom. Her 20-year-old daughter took care of things around the house, she thinks.

It was just wanting to die in my room, she said. I really honestly dont know what happened that week in the house.

On Nov. 18, the pain drove her to the emergency room. The acute pain dissipated with time, but her thinking and speech remained murky -- like driving in the dark without headlights.

Libby Pederson, right, works with her occupational therapist, Nori Dixon, on memory and attention to detail during an appointment at Providence Rehabilitation Services on Tuesday, Dec. 22, 2020. If I didn't have this tight group I wouldn't know what I'd do, Pederson said of her speech, occupational and physical therapists. (Emily Mesner / ADN)

By early December, things just werent making sense, she said. She would turn on gas burners and wander away. She began to stutter. Her children found her dressed in snow gear, standing in the pantry. She couldnt explain what she was doing there.

When Pederson called her primary doctor for help on Dec. 2, her speech was so broken by stuttering she was told to hang up and head to the emergency room, she said.

Thats where she encountered Dr. Ben Westley, an Anchorage infectious disease specialist.

Westley said he was initially concerned that Pederson, because of her neurological symptoms, had viral encephalitis -- a very serious but straightforward diagnosis. Tests revealed she did not. A sensitive MRI of Pedersons brain did find inflammation, said Westley, who was authorized by Pederson to discuss her medical treatment.

The symptoms she continues to experience -- persistent, debilitating trouble with concentration, memory, attention, speech and fatigue -- fall into a category of COVID-19 damage thats poorly understood.

It seems pretty clear to me now that she has some form of other lingering symptoms related to COVID-19 that we really dont understand very well, he said.

What Pederson is experiencing is distressing, but hes confident that she will continue to recover, Westley said.

The whole thing is scary, he said. When you get it and you feel terrible and you just dont feel better -- thats stressful, hard thing for anybody.

Five weeks after her COVID-19 diagnosis, Pedersons days are filled with therapy appointments: occupational, physical and speech.

Libby Pederson works with her physical therapist during an appointment at Providence Rehabilitation Services in Anchorage on Tuesday, Dec. 22, 2020. (Emily Mesner / ADN)

At a recent physical therapy appointment, she practiced walking on a treadmill, working on her balance. At occupational therapy, she studied a sample electric bill, trying to answer questions like What is the total amount of your bills?

As an elementary school special education teacher, she finds herself applying techniques she uses with her young students, such as teaching them to break complex tasks down into smaller, more manageable chunks.

She leaves herself notes about the steps she needs to take to get dressed. Making dinner requires a detailed plan.

I have to constantly think through the whole meal: Turn the burner off. Wash the dishes. Things that were common sense before, she said.

Libby Pederson reads a monitor showing her blood pressure as she slowly walks on a treadmill during her physical therapy appointment at Providence Rehabilitation Services on Tuesday. If I didn't have this tight group I wouldn't know what I'd do, Pederson said of her speech, occupational and physical therapists. (Emily Mesner / ADN)

Theres no real long-term prognosis because what happened to her is so rare. Working with young special education students and their families has helped her both to see the work ahead, but also to have hope.

Some people think shes on vacation, or dont believe shes sick because she physically looks OK. COVID-19 affects every person differently, she said, and its just luck of the draw, how it affected me so bad.

Im not enjoying this. Im not having fun, she said. I feel like Ive gone to hell and Im trying to dig my way out.

ADN photojournalist Emily Mesner contributed reporting to this story.

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I've lost who I am: An Anchorage teacher's coronavirus infection affected her brain. Now she's having to relearn basic living. - Anchorage Daily News

Photographs and Text by Adam Ferguson

Hospitals in Gallup are nearly full. Most stores are empty. The unemployment rate in the county where the city sits is one and a half times the national average. Earlier this month, it had the most cases per capita of any metro area in the United States, according to a New York Times database.

As the pandemic has steadily marched across the country in recent months, places like Gallup have been among the hardest hit.

Perched between the Navajo Nation to the north and Zuni Nation to the south, almost half of Gallups residents are Native American, according to census data.

Native American communities have been particularly vulnerable to the virus, at one point accounting for nearly 40 percent of all cases in New Mexico, even though those communities make up less than a tenth of the states population. And some who have so far been spared by the virus are nonetheless reeling from the consequences of the economic slowdown.

Eric-Paul Riege, a 26-year-old artist, is the son of a veteran and hotel manager and a Navajo mother who taught him the art of weaving. His work has appeared in galleries and collections around the country. But paid projects this year all but dried up.

When I met Mr. Riege, he was working shifts at a diner called Grandpas Grill, processing orders for takeout food.

Route 66 cuts through Gallup. The town has relied on tourism to help drive its economy, counting on visitors to shop at local galleries and trading posts selling Native American art and crafts. But limits on activity in the area have made that hard.

When the region was experiencing an extreme wave of virus cases in May, the city locked down, and state police officers and the National Guard barricaded highway exits to prevent people who didnt live in Gallup from entering town unless it was an emergency.

Last month, long after the barricades came down, trading posts were open but closed for indoor shopping, limiting the chances of anyone passing by to stop and browse.

The iconic El Rancho hotel, where John Wayne and Katharine Hepburn and other Hollywood stars once stayed, was roughly a quarter full.

Gallup is in many ways a relic of conquered Indigenous lands and American expansion. Many of the trading posts, for example, are owned and operated by white people. Those small shops sit in the shadows of McDonalds, Walmart and other big American franchises, where cars and people often spill out of parking lots now.

Bill Lee, the head of Gallups Chamber of Commerce, said there has been a growing economic divide because of the restrictions put in place by local and state officials. Smaller businesses often have to operate with stricter guidelines, including rules preventing in-store shopping, while bigger box stores, especially those deemed essential, could operate with fewer limits. The governor has chosen winners and losers, Mr. Lee told me.

Dec. 28, 2020, 1:38 a.m. ET

When the barricades were erected earlier this year, Walmart was inundated by shoppers stocking up on weeks worth of supplies, especially because grocery stores on Indigenous lands are few and far between. The barricades, however, also had the effect of preventing members of Native American groups from coming into town to shop.

Indigenous groups in the area have long suffered from a lack of information and resources.

Even before the pandemic, the Indian Health Service, the government program that provides health care to the 2.2 million members of the nations tribal communities, had severe shortages of funding and supplies, in addition to a lack of doctors and aging facilities.

The virus made those weaknesses that much more apparent.

Amid the devastation of the pandemic, some people have gotten lucky. Dan Bonaguidi, the son of the towns mayor who owns Micheles Ready Mix Rock and Recycle with his wife, Michele, is one of them. His business has been thriving as government grants in the pandemic have led to greater demand for building materials for home renovations and projects like new or expanded health care facilities.

But even with bright spots, there are many more stories of businesses sitting empty or being shuttered small and large.

After an oil and natural gas boom in New Mexico and Texas in recent years, the pandemic has cut into oil demand and prices. Marathon Petroleum announced plans in August to shut down its operations in the area and lay off more than 200 workers roughly 1 percent of the citys population.

Operations like Marathons are vital to Gallups economy, and the job losses helped push the areas unemployment rate to 10.6 percent in October. Raul Sanchez is one of the workers who lost his job.

As I drove by his home on a hill overlooking the western part of town one afternoon two days before Thanksgiving, Mr. Sanchez was tinkering with a red pickup truck. Hed worked at Marathon for 10 years. No other jobs in this town pay as well, Mr. Sanchez, 39, said.

Its going to have an effect on us, the citys mayor, Louis Bonaguidi, said earlier this year about the closing of the Marathon plant. Its going to affect the housing market for sure. But its going to affect all the businesses, too.

When I drove through Gallup the day before Thanksgiving, the last few minutes of sun lit up the railroad rails Despite the towns struggles, I could still feel a sense a pride in the community as I drove around.

But the sense of vulnerability was just as apparent. Even before the pandemic hit, more than a quarter of the citys residents lived in poverty, and those numbers have swelled this year.

Not long after my visit to the Rehoboth medical center, I watched a group of Navajo men lower a bronze-colored coffin into a grave at a cemetery 50 miles north of Gallup. It was not the only virus-related funeral scheduled there that week.

Production by Renee Melides

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Scenes From Gallup, N.M., Where the Coronavirus Has Hit Hard - The New York Times

Reports of a new and more contagious coronavirus strain have prompted panic in Europe and beyond.

The new variant of the virus, whichmight be up to 70% more transmissible, was first detected in the UK in September but had since spread rapidly.

The new variant has brought some countries to close their borders and tighten their travel restrictions even further.

From Japan to Sweden, scroll down to see a list of countries where the new coronavirus strain has already been identified.

The rest is here:

New coronavirus variant: All the countries where its been identified - Business Insider - Business Insider

Ever since the race to develop a coronavirus vaccine began last spring, upbeat announcements were stalked by ominous polls: No matter how encouraging the news, growing numbers of people said they would refuse to get the shot.

The time frame was dangerously accelerated, many people warned. The vaccine was a scam from Big Pharma, others said. A political ploy by the Trump administration, many Democrats charged. The internet pulsed with apocalyptic predictions from longtime vaccine opponents, who decried the new shot as the epitome of every concern theyd ever put forth.

But over the past few weeks, as the vaccine went from a hypothetical to a reality, something happened. Fresh surveys show attitudes shifting and a clear majority of Americans now eager to get vaccinated.

In polls by Gallup, the Kaiser Family Foundation and the Pew Research Center, the portion of people saying they are now likely or certain to take the vaccine has grown from about 50 percent this summer to more than 60 percent, and in one poll 73 percent a figure that approaches what some public health experts say would be sufficient for herd immunity.

Resistance to the vaccine is certainly not vanishing. Misinformation and dire warnings are gathering force across social media. At a meeting on December 20, members of an advisory panel to the Centers for Disease Control and Prevention cited strong indications that vaccine denouncements as well as acceptance are growing, so they could not predict whether the public would gobble up limited supplies or take a pass.

But the attitude improvement is striking. A similar shift on another heated pandemic issue was reflected in a different Kaiser poll this month. It found that nearly 75 percent of Americans are now wearing masks when they leave their homes.

The change reflects a constellation of recent events: the uncoupling of the vaccine from Election Day; clinical trial results showing about 95 percent efficacy and relatively modest side effects for the vaccines made by Pfizer-BioNTech and Moderna; and the alarming surge in new coronavirus infections and deaths.

As soon as it is my turn to get the vaccine, I will be there front and center! I am very excited and hopeful, said Joanne Barnes, 68, a retired elementary school teacher from Fairbanks, Alaska, who told The New York Times last summer that she would not get it.

What changed her mind?

The Biden administration, returning to listening to science and the fantastic stats associated with the vaccines, she replied.

The lure of the vaccines modest quantities also cant be underestimated as a driver of desire, somewhat like the must-have frenzy generated by a limited-edition Christmas gift, according to public opinion experts.

That sentiment can also be seen in the shifting nature of some of the skepticism. Rather than just targeting the vaccine itself, eyebrows are being raised across the political spectrum over who will get it first which rich individuals and celebrities, demographic groups or industries?

But the grim reality of the pandemic with more than 200,000 new cases and some 3,000 deaths daily and the wanness of this holiday season are perhaps among the biggest factors.

More people have either been affected or infected by Covid, said Rupali J. Limaye, an expert on vaccine behavior at the Johns Hopkins Bloomberg School of Public Health. They know someone who had a severe case or died.

Dr. Limaye concluded: They are fatigued and want to get back to their normal lives.

A barrage of feel-good media coverage, including rapt attention given to leading scientists and politicians when they get jabbed and joyous scrums surrounding local health care workers who become the first to be vaccinated, has amplified the excitement, public opinion experts say.

There remain notable discrepancies among demographic groups. The divide between women and men has become pronounced, with women being more hesitant. Black people remain the most skeptical racial group, although their acceptance is inching up: In September, a Pew Research poll said that only 32 percent of Black people were willing to get the vaccine, while the latest poll shows a rise to 42 percent. And though people of all political persuasions are warming to the vaccine, more Republicans than Democrats view the shot suspiciously.

The association between vaccine attitudes and political affiliation is worrisome to many behavioral experts, who fear that vaccine uptake will become tied to partisan views, impeding the achievement of a broad immunity.

Dec. 28, 2020, 1:38 a.m. ET

Weve seen a growth among both Democrats and Republicans about their intent to vaccinate, said Matthew P. Motta, a political scientist at Oklahoma State University who studies political opinions and vaccine views. But its twice the size in Democrats, who, he added, had been souring on the vaccine following President Trumps avowal that it would arrive by Election Day.

A brighter indication, he said, is that two-thirds of the public say they are at least somewhat confident that a coronavirus vaccine will be distributed in a way that is fair, up from 52 percent in September.

The most pronounced pockets of resistance include rural residents and people between the ages of 30 and 49.

Timothy H. Callaghan, a scholar at the Southwest Rural Health Research Center at Texas A&M School of Public Health, said that rural residents tend to be conservative and Republican, characteristics that also show up among the vaccine hesitant. They also include immigrants and day laborers, many of whom do not have college degrees or even high school diplomas and so may be more dismissive of vaccine science.

They appear less likely to wear masks, less likely to work from home and there is an opposition to evidence-based practices, Dr. Callaghan said.

The resistance also springs from their hampered access to health care in remote areas. In addition, the need to take off several hours of work from the inflexible demands of farming for travel and recovery from vaccine side effects makes the shots seem even less compelling, he added.

About 35 percent of adults between 30 and 49 over all expressed skepticism about the vaccine, according to the Kaiser poll. Dr. Scott C. Ratzan, whose vaccine surveys in New York with the City University of New York Graduate School of Public Health echo findings similar to the national polls, noted that this group doesnt keep up on flu shots either. They are well out of the age range for routine vaccines.

There is no normalizing or habit for this age group to get vaccinated, he said.

Black people have remained the most resistant to taking a coronavirus vaccine, largely because of the history of abusive research on them by white doctors. But their willingness to consider it is ticking up. In the Kaiser poll, the share of Black respondents who believe the vaccine will be distributed fairly has nearly doubled, to 62 percent from 32 percent.

Mike Brown, who is Black, manages the Shop Spa, a large barbershop with a Black and Latino clientele in Hyattsville, Md. This summer he told The Times that he was happy to sit back and watch others get the vaccine, while he bided his time.

That was then.

The news that it was 95 percent effective sold me, Mr. Brown said. The side effects sound like what you get after a bad night of drinking and you hurt the next day. Well, Ive had many of those and I can deal with that to get rid of the face masks.

Still, he says, many customers remain skeptical. He tells them: What questions do you have that youre leery about? Just do your investigation and follow the science! Because if youre just talking about what you wont do, youre becoming part of the problem.

He does see progress. A couple of people who were more militant about not taking it are more quiet now, he said. The seeds are being planted.

Another group that has been uncertain about taking the vaccine is health care workers, who typically have high rates of acceptance for established vaccines. In recent weeks, some hospital executives have said that many on their staffs were balking. ProPublica reported that a hospital in the Rio Grande Valley in Texas had to offer some allotted doses to other medical workers in the area, because an insufficient number of their own workers came forward. A sheriffs deputy and a state senator got in line.

But other hospitals say that staff time slots for the vaccine are becoming a hot commodity.

For months, Tina Kleinfeldt, a surgical recovery nurse at Long Island Jewish Medical Center, a hospital in the Northwell Health network, had absolutely no intention of getting the vaccine until long after the science and side effects had been established.

Last week, she was randomly offered a rare vaccination slot. Still she refused, despite the admonitions of envious colleagues.

Then she began thinking of all the Covid-19 patients she had cared for and the new ones she would inevitably encounter. She thought about her husband and three children. She thought: Well, I can always cancel the appointment at the last minute, right?

Then she realized that doses were still so scarce that she might not get another opportunity soon. So she said yes. She became the first nurse on her unit to get the shot.

Afterwards , she felt some muscle soreness at the site of injection. But she also felt elated, excited and relieved.

I felt like I did a good thing, for myself, my family, my patients, the world, Ms. Kleinfeldt said. And now I hope everyone will get it. Isnt that crazy?

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How Early Covid Vaccine Doubters Now Show a Willingness to Roll Up Their Sleeves - The New York Times