Category: Covid-19

A few weekends ago, while trying to convince my 4-year-old son that pants are still required for afternoon hikes, my pocket buzzed with a text message that canceled everything.

COVID19 Community Tracing Collaborative: We have information about the status of your test. We need to speak with you and will call you back.

Having written about efforts to trace people exposed to Covid-19, I knew what it meant. Sure enough, a few hours later, a contact tracer called to deliver the bad news: Id tested positive. She told me I needed to isolate, and she asked for the names and phone numbers of those Id been in close contact with so that they could be alerted.

Read all of our coronavirus coverage here.

It was worrying of coursebut also baffling. I had no symptoms, to my knowledge I hadnt been near anyone sick, and Im always careful about mask-wearing, handwashing, and social distancing.

Id barely left the house in weeks, in fact. As I explained to the tracer, the only interaction Id had with anyone outside my family bubble in the past week was meeting an old friend, but that was outside, both of us wearing masks and staying at least 6 feet apart. My son is in daycare, and weve been in a bubble with another family whose child also attends. But his school has introduced all sorts of precautions, with teachers and parents voluntarily testing regularly, a new air filtration system, and countless cleaning and safe-distancing protocols. It all seemed like a shocking reminder of how sneaky the virus really is.

After a few days pacing my hotel room, however, I was less sure. By then, my wife and son had both received several negative results; my friend and the other family had too, along with about two dozen parents and kids at the daycare.

I took a second test three days after the first, and the results came back overnight: negative. At my doctors suggestion, I took a third, three days after that at a different location. That too came back all clear. As per the guidelines at the time from the Centers for Disease Control and Prevention, I remained in quarantine for two weeks. But increasingly it felt like maybe something had gone wrong.

I began to wonder what it means to test positive. A Covid test is not a binary thing. There is no single, standard way to detect the virus; different labs set their own thresholds for signaling a positive result. Some experts now think that the sensitivity of a test, and how much virus it detects, should be factored into behavioral guidelines and the public health response.

My initial test was at a drive-through site run by the city of Cambridge, Massachusetts. A swab from my nose went from there to the Broad Institute, a biomedical research center created by Harvard and MIT that converted its genomics lab into a Covid-19 testing facility in March.

The Broad uses a technique known as polymerase chain reaction (PCR) to detect viral genetic material in a sample. A PCR test typically takes a day or more to produce a result, but it is considered the gold standard of Covid testing, because its so good at picking up minuscule fragments of the virus. Rapid tests, which detect specific proteins on the surface of the virus, are cheaper and faster, but they are less accurate than PCR and work best when someone has high levels of the virus.

Testing is not a foolproof strategy to allow anyone to go about their normal daily lives without also using the other mitigation strategies.

Matthew Binnicker, Mayo Clinic

A PCR Covid test involves preparing a sample using chemical reagents to isolate fragments of RNA and enzymes to generate complementary strands of DNA. The lab then amplifies this DNA by adding compatible strands carrying fluorescent markers that break off and activate after binding. This process is repeated over and over. If the virus is present, then the chamber containing the sample should start to glow.

The number of cycles required to trigger a result is crucial. The more virus someone is carrying, the fewer cycles needed; more cycles mean the patient likely has only a low level of infection. Labs generally do not disclose the number of cycles required to get a resultonly whether or not there is one. Broad uses 40 cycles as the limit for its tests, as recommended by the CDC. If the sample doesnt glow by 40 cycles, the result is considered negative. But some other labs use different thresholds.

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I Tested Positive for Covid-19. What Does That Really Mean? - WIRED

HAMPTON, Va. (WAVY) As the number of coronavirus cases continue to rise in Hampton Roads, the Peninsula Health District wants to get the word out about several upcoming COVID-19 testing events.

According to peninsula health officials, the demand for testing has increased dramatically since Thanksgiving.

The following testing events are all FREE and are available to ages 12 and older, except where noted with an asterisk (*). Starred events are open to all ages.

Testing will be available during the scheduled times, or as long as supplies last.

The City of Hampton is a co-sponsor of the testing event at the convention center. Due to the expected number of people at this location, organizers said everyone attending the event must remain in their vehicle.

The health district partnered with Mako Medical, a private laboratory, for the event at the Hampton Roads Convention Center. Test results are expected between 48 and 72 hours after the samples get to the labs.

Check the Peninsula Health District Facebook page for updates, including potential weather cancellations.

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Large drive-through COVID-19 testing event to be held at the Hampton Roads Convention Center - WAVY.com

Updated: 8:30 p.m.

Minnesotas death toll from the COVID-19 pandemic climbed past 4,400 on Sunday, with state health officials reporting more than 80 deaths on four of the past five days.

That includes the 85 additional COVID-19 deaths reported Sunday, as the daily average over the past week climbed to nearly 66, a record high.

The grim death toll continues as the number of new cases and hospital admissions each day continues to trend downward. The average test positivity rate over the past week also dropped, to below 9 percent the first time thats happened since October.

Here are Minnesotas current COVID-19 statistics:

4,444 deaths (85 new)

378,823 positive cases (3,439 newly reported); 341,530 off isolation (about 90 percent)

4.89 million tests, 2.76 million people tested (about 48 percent of the population)

8.9 percent seven-day positive test rate (officials find 5 percent or more concerning)

The average number of new cases reported each day over the past week is about 4,014 the lowest that number has been since the first week of November. It peaked at more than 7,100 in late November.

The average number of new COVID-related hospital admissions each day over the past week dropped below 190 on Sunday the first time thats happened in a month.

Minnesota officials continue to anticipate a wave of COVID-19 cases and hospitalizations originating from Thanksgiving holiday celebrations.

It hasnt happened yet, though. Because of that, health leaders are somewhat hopeful that many families heeded public pleas to not gather in big groups for Thanksgiving, and so the worst-case scenarios of a post-holiday surge might not materialize.

Gov. Tim Walz echoed that hope on Friday, noting the slowing case counts as well as a recent decline in positive test rates, a key metric in judging the spread of the disease.

Health Commissioner Jan Malcolm urged caution, though, saying it was still too soon to judge whether a Thanksgiving surge was coming. While the states caseloads have eased, we are still at a very vulnerable place, she told reporters.

Walz must still decide soon whether to extend the states current monthlong ban on in-person bar and restaurant service, which is set to run through Dec. 18.

While a decision had been expected Monday, a Walz spokesperson said Friday that the governor has now pushed it back until Wednesday because he wants the most up-to-date data before deciding.

The newest numbers put Minnesotas total of confirmed or probable cases at more than 378,000 to date. In about 90 percent of those cases, people have recovered to the point where they no longer need to be isolated.

The deaths reported Saturday raised Minnesotas count to 4,359. Among those whove died, about two-thirds had been living in long-term care or assisted living facilities; most had underlying health problems.

COVID-19 is now killing Minnesotans at a rate far higher than any recent flu season. Roughly one-third of all recent deaths in Minnesota are tied to COVID-19.

In the past few years, respiratory illnesses have been a major contributing factor in about 5 to 10 percent of all deaths in Minnesota, depending on the time of year.

They accounted for around 20 percent of deaths during the states May COVID-19 wave.

Now its even higher: nearly 40 percent of all deaths in Minnesota in recent weeks have been attributed to a respiratory illness such as COVID-19, influenza or pneumonia.

People in their 20s still make up the age bracket with the states largest number of confirmed cases more than 72,000 since the pandemic began, including nearly 39,000 among people ages 20 to 24.

The number of high school-age children confirmed with the disease has also grown, with more than 26,000 total cases among children ages 15 to 19 since the pandemic began.

Although less likely to feel the worst effects of the disease and end up hospitalized, experts worry youth and young adults will spread it to grandparents and other vulnerable populations.

Its especially concerning because people can have the coronavirus and spread COVID-19 when they dont have symptoms.

Central and western Minnesota drove much of the increase in new cases over the past five weeks, while Hennepin and Ramsey counties showed some of the slowest case growth in the state.

After a spike in confirmed cases through much of November, all regions of the state have seen new case numbers plateau or start to fall.

Hot spots continues to pop up in rural counties relative to their population.

In Minnesota and across the country, COVID-19 has hit communities of color disproportionately hard in both cases and deaths. Thats been especially true for Minnesotans of Hispanic descent for much of the pandemic.

Distrust of the government, together with deeply rooted health and economic disparities, have hampered efforts to boost testing among communities of color, officials say, especially among unauthorized immigrants who fear their personal information may be used to deport them.

Similar trends have been seen among Minnesotas Indigenous residents. Counts among Indigenous people jumped in October relative to population.

Officials continue to plead with Minnesotans to wear masks in public gathering spaces, socially distance, stay home if they dont feel well and otherwise stay vigilant against the spread of COVID-19.

State health officials on Thursday noted that several of the newly reported deaths included people in their 20s, 40s and 50s, emphasizing the disease isnt simply focused on the very old.

This is not just a problem for the elderly, for our fellow Minnesotans who have medical conditions. It is a problem for all of us, state epidemiologist Dr. Ruth Lynfield told reporters.

Until we have safe and effective vaccines, we really need to do everything we can to stop transmission between fellow Minnesotans, she added. We know this is hard. It is taking a big toll on so many areas of our lives. But we have to hang in there and we have to do the best we can.

The Minnesota Department of Public Safety on Sunday suspended the liquor license of an East Grand Forks, Minn., bar that had been operating in violation of state COVID-19 restrictions.

The Boardwalk Bar and Grill reopened to in-person service last week. Owner Jane Moss said her business would go under if she could not serve patrons in person.

The 60-day liquor license suspension announced Sunday is set to expire in February; another violation could result in a five-year license revocation.

The action follows a temporary restraining order issued Friday by a Polk County District Court judge, ordering the bar to close to in-person service.

Minnesotas monthlong shutdown of in-person bar and restaurant service, along with youth sports and other activities, is set to expire at 11:59 p.m. Friday. Gov. Tim Walz has not yet said whether he'll extend the restrictions.

Representatives of a group called the Reopen Minnesota Coalition told KARE-TV on Friday that dozens of businesses plan to defy the governor's order in the coming week.

MPR News staff

What's in Santa's bag? Masks, plexiglass and Zoom: With surging COVID-19 cases nationwide and new restrictions in place throughout Minnesota to help curb the spread of the disease, Santas lap is off limits this year. That has spurred creativity in Santa's workshops.

Burnout is the new normal for hospital workers: As the weeks go by with hospitals beds full and staff in short supply, doctors and nurses are under incredible pressure. One Minnesota doctor says shes worried itll lead to an exodus of providers after the pandemic ends.

Data in these graphs are based on the Minnesota Department of Health's cumulative totals released at 11 a.m. daily. You can find more detailed statistics on COVID-19 at theHealth Department website.

You make MPR News possible. Individual donations are behind the clarity in coverage from our reporters across the state, stories that connect us, and conversations that provide perspectives. Help ensure MPR remains a resource that brings Minnesotans together.

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Dec. 13 update on COVID-19 in MN: 85 more deaths as toll climbs past 4,400 - Minnesota Public Radio News

For Immediate Release: December 11, 2020

Today, the U.S. Food and Drug Administration issued the first emergency use authorization (EUA) for a vaccine for the prevention of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 16 years of age and older. The emergency use authorization allows the Pfizer-BioNTech COVID-19 Vaccine to be distributed in the U.S.

The FDAs authorization for emergency use of the first COVID-19 vaccine is a significant milestone in battling this devastating pandemic that has affected so many families in the United States and around the world, said FDA Commissioner Stephen M. Hahn, M.D. Todays action follows an open and transparent review process that included input from independent scientific and public health experts and a thorough evaluation by the agencys career scientists to ensure this vaccine met FDAs rigorous, scientific standards for safety, effectiveness, and manufacturing quality needed to support emergency use authorization. The tireless work to develop a new vaccine to prevent this novel, serious, and life-threatening disease in an expedited timeframe after its emergence is a true testament to scientific innovation and public-private collaboration worldwide.

The FDA has determined that Pfizer-BioNTech COVID-19 Vaccine has met the statutory criteria for issuance of an EUA. The totality of the available data provides clear evidence that Pfizer-BioNTech COVID-19 Vaccine may be effective in preventing COVID-19. The data also support that the known and potential benefits outweigh the known and potential risks, supporting the vaccines use in millions of people 16 years of age and older, including healthy individuals. In making this determination, the FDA can assure the public and medical community that it has conducted a thorough evaluation of the available safety, effectiveness and manufacturing quality information.

The Pfizer-BioNTech COVID-19 Vaccine contains messenger RNA (mRNA), which is genetic material. The vaccine contains a small piece of the SARS-CoV-2 viruss mRNA that instructs cells in the body to make the viruss distinctive spike protein. When a person receives this vaccine, their body produces copies of the spike protein, which does not cause disease, but triggers the immune system to learn to react defensively, producing an immune response against SARS-CoV-2.

While not an FDA approval, todays emergency use authorization of the Pfizer-BioNTech COVID-19 Vaccine holds the promise to alter the course of this pandemic in the United States, said Peter Marks, M.D., Ph.D., Director of the FDAs Center for Biologics Evaluation and Research. With science guiding our decision-making, the available safety and effectiveness data support the authorization of the Pfizer-BioNTech COVID-19 Vaccine because the vaccines known and potential benefits clearly outweigh its known and potential risks. The data provided by the sponsor have met the FDAs expectations as conveyed in our June and October guidance documents. Efforts to speed vaccine development have not sacrificed scientific standards or the integrity of our vaccine evaluation process. The FDAs review process also included public and independent review from members of the agencys Vaccines and Related Biological Products Advisory Committee. Todays achievement is ultimately a testament to the commitment of our career scientists and physicians, who worked tirelessly to thoroughly evaluate the data and information for this vaccine.

FDA Evaluation of Available Safety Data

Pfizer BioNTech COVID-19 Vaccine is administered as a series of two doses, three weeks apart. The available safety data to support the EUA include 37,586 of the participants enrolled in an ongoing randomized, placebo-controlled international study, the majority of whom are U.S. participants. These participants, 18,801 of whom received the vaccine and 18,785 of whom received saline placebo, were followed for a median of two months after receiving the second dose. The most commonly reported side effects, which typically lasted several days, were pain at the injection site, tiredness, headache, muscle pain, chills, joint pain, and fever. Of note, more people experienced these side effects after the second dose than after the first dose, so it is important for vaccination providers and recipients to expect that there may be some side effects after either dose, but even more so after the second dose.

It is mandatory for Pfizer Inc. and vaccination providers to report the following to the Vaccine Adverse Event Reporting System (VAERS) for Pfizer-BioNTech COVID-19 Vaccine: all vaccine administration errors, serious adverse events, cases of Multisystem Inflammatory Syndrome (MIS), and cases of COVID-19 that result in hospitalization or death.

FDA Evaluation of Available Effectiveness Data

The effectiveness data to support the EUA include an analysis of 36,523 participants in the ongoing randomized, placebo-controlled international study, the majority of whom are U.S. participants, who did not have evidence of SARS-CoV-2 infection through seven days after the second dose. Among these participants, 18,198 received the vaccine and 18,325 received placebo. The vaccine was 95% effective in preventing COVID-19 disease among these clinical trial participants with eight COVID-19 cases in the vaccine group and 162 in the placebo group. Of these 170 COVID-19 cases, one in the vaccine group and three in the placebo group were classified as severe. At this time, data are not available to make a determination about how long the vaccine will provide protection, nor is there evidence that the vaccine prevents transmission of SARS-CoV-2 from person to person.

The EUA Process

On the basis of the determination by the Secretary of the Department of Health and Human Services on February 4, 2020, that there is a public health emergency that has a significant potential to affect national security or the health and security of United States citizens living abroad, and then issued declarations that circumstances exist justifying the authorization of emergency use of unapproved products, the FDA may issue an EUA to allow unapproved medical products or unapproved uses of approved medical products to be used in an emergency to diagnose, treat, or prevent COVID-19 when there are no adequate, approved, and available alternatives.

The issuance of an EUA is different than an FDA approval (licensure) of a vaccine. In determining whether to issue an EUA for a product, the FDA evaluates the available evidence and assesses any known or potential risks and any known or potential benefits, and if the benefit-risk assessment is favorable, the product is made available during the emergency. Once a manufacturer submits an EUA request for a COVID-19 vaccine to the FDA, the agency then evaluates the request and determines whether the relevant statutory criteria are met, taking into account the totality of the scientific evidence about the vaccine that is available to the FDA.

The EUA also requires that fact sheets that provide important information, including dosing instructions, and information about the benefits and risks of the Pfizer-BioNTech COVID-19 Vaccine, be made available to vaccination providers and vaccine recipients.

The company has submitted a pharmacovigilance plan to FDA to monitor the safety of Pfizer-BioNTech COVID-19 Vaccine. The pharmacovigilance plan includes a plan to complete longer-term safety follow-up for participants enrolled in ongoing clinical trials. The pharmacovigilance plan also includes other activities aimed at monitoring the safety profile of the Pfizer-BioNTech COVID-19 vaccine and ensuring that any safety concerns are identified and evaluated in a timely manner.

The FDA also expects manufacturers whose COVID-19 vaccines are authorized under an EUA to continue their clinical trials to obtain additional safety and effectiveness information and pursue approval (licensure).

The EUA for the Pfizer-BioNTech COVID-19 Vaccine was issued to Pfizer Inc. The EUA will be effective until the declaration that circumstances exist justifying the authorization of the emergency use of drugs and biologics for prevention and treatment of COVID-19 is terminated, and may be revised or revoked if it is determined the EUA no longer meets the statutory criteria for issuance.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nations food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

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FDA Takes Key Action in Fight Against COVID-19 By Issuing Emergency Use Authorization for First COVID-19 Vaccine - FDA.gov

A scientist works at the mAbxience biosimilar monoclonal antibody laboratory plant in Argentina. Juan Mabromata/AFP via Getty Images hide caption

A scientist works at the mAbxience biosimilar monoclonal antibody laboratory plant in Argentina.

The Food and Drug Administration has issued emergency use authorizations for two monoclonal antibody treatments for COVID-19 one produced by Eli Lilly and another by Regeneron. But emergency use authorization doesn't assure the drugs are effective.

In this episode of Short Wave, NPR's daily science podcast, science correspondent Richard Harris explains how the new treatments work and whether they could really make a difference for patients with COVID-19.

Listen to more episodes of Short Wave on Apple Podcasts or Spotify.

Continued here:

How Effective Are Antibody Treatments For COVID-19? : Consider This from NPR - NPR

The West Virginia Department of Health and HumanResources (DHHR) reports as of December 13, 2020, there have been 1,312,273 total confirmatorylaboratory results received for COVID-19, with 63,217 total cases and 968deaths.

DHHR has confirmed the deaths of a 69-year old male fromGreenbrier County and a 66-year old male from Cabell County. I offer mydeepest sympathy to all who are grieving these losses today, said Bill J.Crouch, DHHR Cabinet Secretary.

CASESPER COUNTY: Barbour (555), Berkeley (4,449),Boone (796), Braxton (165), Brooke (990), Cabell (3,898), Calhoun (102), Clay(192), Doddridge (165), Fayette (1,366), Gilmer (254), Grant (584), Greenbrier(872), Hampshire (594), Hancock (1,265), Hardy (503), Harrison (1,957), Jackson(895), Jefferson (1,812), Kanawha (6,998), Lewis (340), Lincoln (540), Logan(1,215), Marion (1,226), Marshall (1,643), Mason (782), McDowell (738), Mercer(1,781), Mineral (1,813), Mingo (1,120), Monongalia (4,091), Monroe (468),Morgan (456), Nicholas (500), Ohio (1,986), Pendleton (173), Pleasants (171),Pocahontas (294), Preston (1,051), Putnam (2,460), Raleigh (2,026), Randolph(895), Ritchie (243), Roane (236), Summers (324), Taylor (473), Tucker (241),Tyler (225), Upshur (623), Wayne (1,326), Webster (106), Wetzel (518), Wirt(158), Wood (3,610), Wyoming (953).

Please note that delaysmay be experienced with the reporting of information from the local healthdepartment to DHHR. As case surveillance continues at the local healthdepartment level, it may reveal that those tested in a certain county may notbe a resident of that county, or even the state as an individual in questionmay have crossed the state border to be tested.

Please visit the dashboard located at http://www.coronavirus.wv.gov for more information.

There are many ways to obtain free COVID-19 testing in WestVirginia. Please visit https://dhhr.wv.gov/COVID-19/pages/testing.aspx.

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COVID-19 Daily Update 12-13-2020 - West Virginia Department of Health and Human Resources

In Ingham County, the virus rapidly bloomed.

The students came back anyway, and swooped down on bars and restaurants and other places and caused outbreaks in the community, said Debra Furr-Holden, a Michigan State epidemiologist and associate dean for public health integration. The university quickly pivoted, she said, trying to reach students and offering testing, but found it was difficult to convince them to follow rules.

We had an unintended negative consequence that these students were then not within our safety and protection and under our purview where we could better dictate testing, isolation, quarantine and all of that, she said.

The county went from having about 300 new infections in August to about 1,800 in September. On Sept. 14, health officials said a majority of the newest cases involved students at Michigan State and ordered people in many fraternities and sororities to quarantine. Virus deaths have more than tripled in the county since the end of August, to 141 from 41.

In mid-October, Dennis Neuner was driving home from a hospital in Lansing, having just dropped off his wife, Sharon, who was admitted. They had both tested positive for the coronavirus and she developed a nasty cough.

Mr. Neuner took a shortcut on M.A.C. Avenue, home to some of Michigan States sororities. He said he saw some 200 students dotting the lawns, celebrating a football game. Some had red Solo cups, some were playing beer pong and cornhole.

I didnt see one mask, he said.

Mr. Neuner made arrangements for a friend to watch his Jack Russell terrier, Daisy, then drove back to the hospital, where he was also admitted for respiratory distress.

By the next day, his symptoms had improved enough for him to recuperate at home. His wife, 71, who had been healthy and active before catching the virus, eventually developed a blood infection and could no longer breathe on her own. She died on Nov. 12.

The rest is here:

Young People Have Less Covid-19 Risk, but in College Towns, Deaths Rose Fast - The New York Times

A New York Times analysis has found that "as coronavirus deaths soar across the country, deaths in communities that are home to colleges have risen faster than the rest of the nation." The analysis was based on 203 counties where students compose at least 10percent of the population. The Times reported that "since the end of August, deaths from the coronavirus have doubled in counties with a large college population, compared with a 58percent increase in the rest of the nation. Few of the victims were college students, but rather older people and others living and working in the community."

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Counties With Colleges Have More COVID-19 Deaths - Inside Higher Ed

People line up to be tested for the coronavirus at a free testing site Wednesday, Nov. 18 in Seattle. Elaine Thompson/AP hide caption

People line up to be tested for the coronavirus at a free testing site Wednesday, Nov. 18 in Seattle.

Debbie Roberts wishes her stepbrother had just slid away from his advanced Parkinson's disease.

He died Nov. 29, just one person among many who died in an outbreak of COVID-19 at North Valley Extended Care in the Okanogan County town of Tonasket, Wash., population about 1,000. So far, at least 16 people at the facility have died since Thanksgiving.

"If only he hadn't contracted this COVID and left this world in such agony," Roberts says. "We sort of talk to him among ourselves. We say, 'Sorry Ken, we're so sorry you had to go this way.' "

She says that her stepbrother was confused, would constantly pull off his oxygen mask, and his eyes were pleading near the end of his life.

Ken was 66 years when he died.

Ken Roberts (left), his stepsister, Debbie Roberts, and her husband, Steve Kinzie, at a Christmas gathering at North Valley Extended Care in Tonasket in 2018. Ken died of COVID-19 on Nov. 29 at age 66. Courtesy of Debbie Roberts hide caption

Ken Roberts (left), his stepsister, Debbie Roberts, and her husband, Steve Kinzie, at a Christmas gathering at North Valley Extended Care in Tonasket in 2018. Ken died of COVID-19 on Nov. 29 at age 66.

Roberts doesn't blame the health care facility. But there are dozens more sickened including nearly half the staff. The town's health care system is in crisis, a striking example of the perilous state of rural health care.

Rural America has been the site of COVID-19 hotspots this year: prisons, nursing homes and meat packers. But there are few doctors, ICU beds and little backup when health care workers also get sick.

"When we want to get a COVID test we have to go 30 miles away to Omak (Washington)," Roberts says. "So we can't just go to our local hospital. They don't have enough."

Already filling up

Confluence Health is a health system that covers north-central Washington, including Tonasket. It has a dozen clinics across a wide swath of the region. Incoming CEO Dr. Douglas Wilson says as his hospitals fill with COVID-19 patients, they're crowding out victims of car accidents, heart attacks and head injuries.

"You hate to put someone on a helicopter or in an ambulance and fly them over the mountains in the winter, when they would've done better had they been able to receive care here locally without traveling," Wilson says. "That's a difference between life and death sometimes."

Carrie Henning-Smith is with the University of Minnesota Rural Health Research Center.

"Rural residents on average are older than urban residents," Henning-Smith says. "Rural residents have more underlying health conditions. And rural residents are less likely to have health insurance and reliable access to health care. And you put all those together it means that once COVID gets into a rural area and it's in virtually every rural area it's more volatile."

Rural COVID-19 patients may have it worse for the long haul because COVID-19 has many symptoms needing specialty care that isn't usually available in rural areas. Some counties don't even have a single physician, says doctor Eyal Kedar, who's been with the St. Lawrence Health System in New York State for about five years.

Kedar says when he first arrived, "There was no nephrologist, there was no infectious disease person in my health system, we didn't even have a (full-time person) for pulmonology."

"There was no neurologist, no dermatologist in my health system, there was and still is no dialysis capability in my health system and this is just a small list," he says.

Kedar says he is the system's first rheumatologist. And he says his health system is a model rural health system.

"By rural standards, we're pretty good," he says. "If you're in a rural area and you need a subspecialist, there's a very good chance that there's not going to be someone around to help you."

He says even physical barriers like adequate transportation, high mountains and snow can keep rural residents from the care they need.

"There are two Americas here. There is nothing like rural underserved," Kedar says. "Rural America has suffered from a lack of attention. We're not seeing the cracks in the walls of the system. We're seeing the absence of walls."

Grant county 0utbreak

A 300-person November wedding near Ritzville, Wash., in Adams County has been linked to an outbreak in a neighboring Grant County school and long-term care facilities. So far this year, at least 65 people in Grant County have died from COVID-19 more than half have come in the past six weeks.

Theresa Adkinson is the Public Health Administrator for Grant County.

"I am done with COVID, I am burned out," Adkinson says. "My staff are exhausted."

There are so many sick that her office has largely stopped contact tracing in the community. Some schools and one county hospital are doing their own contact tracing and outreach to help.

Adkinson says it's disheartening to put out press releases with brutal death counts, and then see lifelong friends posting about unmasked gatherings on Facebook.

"The vaccine is coming," Adkinson says. "We can see the finish line. But it's a ways out there. And how sad is it the people we lose just before we get to the finish line?"

Slow to vaccinate

Rhonda Piner leads nursing for North Valley Extended Care in Tonasket. She kept working from home even after she got the virus. But then, the day after Thanksgiving, her 25 years of nursing experience kicked in.

"And I knew that I could no longer take care of myself, and so I called 911," Piner says.

Piner was hospitalized for six days. She says the prospect of returning to her remaining residents at the care center is daunting.

"I don't know all the names (of the dead)," Piner says. "I started crying, I will tell you. I will be sad to know who didn't make it and who did. So, yeah it's gonna be tough when I go back, it really is."

It may be even tougher than she knows. Experts say without adequate ways of implementing super-cold storage that vaccines require, rural areas may wait longer to get the much-anticipated doses.

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Rural Healthcare Systems Stretched To Limit Due To COVID-19 - NPR

A Dartmouth College study found that nurses and other long-term care staff who work multiple jobs may be more likely to spread COVID-19 among elderly residents.

With higher rates of second job-holding among direct care workers and nurses in long-term care than other workers, and many of these workers moving across health settings from their first to second jobs, this creates a potential pathway for COVID-19 transmission, said Kristin Smith, a visiting sociology professor.

Smith co-authored the study, which links the high rates of illness and death in long-term care facilities to the economic challenges of many nurses and staffers at these facilities.

New Hampshire has the nations highest percentage of COVID-19 in long-term care facilities (81%), Smith wrote, so understanding employment dynamics and disparities in this sector could never be more timely than now.

The study found that many direct-care workers have relatively low wages and limited hours, compelling them to find extra work. In fact, according to the study, nurses and other direct-care workers are 32% to 35% more likely to hold at least one other job.

Newports Woodlawn Care Center experienced an outbreak after a staffer likely brought in the illness, infecting more 13 staff members and more than half of the 40 residents. Four deaths were associated with the outbreak.

In Hanover, the Hanover Terrace home is currently dealing with an outbreak that has infected 68 of the 74 residents. Administrators at that home also believe the illness was brought in by an employee.

The Sullivan County Nursing Home in Unity has been disease-free so far. Administrator Ted Purdy said that early in the pandemic, he made the decision not to use any per diem staff working at other facilities.

Because of the COVID-19 issues, weve really worked hard to make sure people only work for us. Thats been important to us, Purdy said.

Smiths study was based on second job data from 2010 to 2019 from the Current Population Survey.

While low wages and limited hours applied to both nurses and direct-care workers, lower hours were correlated more with registered nurses and licensed practical nurses.

The results also showed that nurses with children and Black nurses were more likely to hold second jobs than White nurses. Female and married nurses were less likely to have a second job.

Nurses had higher wages than direct-care workers and worked 30% more hours.

The COVID-19 pandemic is shining the spotlight on inequalities throughout our society, particularly in health care systems, where we are now seeing real-life implications for loved ones in nursing homes, who are such a vulnerable population, Smith said.

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Nurses working multiple jobs tied to COVID-19 spread - The Union Leader