COVID hospitalizations hit 300, as many healthcare workers call in sick – KHON2

HONOLULU (KHON2) The state has reported more COVID cases in the first 10-days of January than the past three months combined.

And about 1,500 healthcare workers are out sick, as COVID hospitalizations reach above 300.

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On Monday, January 10, Queens Health Systems declared an internal state of emergency at Queens West, where the rate of hospital admissions outpaced the number of beds available.

As of 3 p.m. Monday, Queens West was at 112% capacity, and 96 providers were out due to COVID exposure.

The hospital said higher-risk patients may be transferred to Queens Punchbowl.

More than 10% of the healthcare workforce has had to quarantine because theyve also got omicron, explained Lt. Governor Josh Green. So what it means is, we have ambulances go past one hospital to another where theres more space, and usually its for a very temporary short period of time, like an eight-hour shift or a 12-hour shift, until were able to catch up with all the admissions because there are nurses and doctors and other, you know, social workers and so on that are out.

Hospitalizations typically rise three to four weeks after infection rates climb.

The state has been doubling COVID infections weekly.

On Friday, January 7, there were 247 people in the hospital who had COVID-19, by Monday, January 10, there were 311, according to the Healthcare Association of Hawaii.

Thats a fairly material jumped over the last few days, said Hilton Raethel, Healthcare Association of Hawaii president and CEO. The good news is that our ICU numbers are not going up at a very high rate.

He said 11-12% of COVID hospitalizations involve an ICU stay, compared to delta where 20 to 30 percent of people hospitalized with COVID ended up in the ICU.

Raethel said he expects hospital numbers to climb through the month.

We fully expect given the infection rate and the positivity rate in the state that we will get close to or perhaps even exceed the hospitalization rate that we had during the Delta surge, he said.

The surge comes as staff fall sick, or come into close contact with omicron. Raethel estimated between 1,400 and 1,500 healthcare workers across the state were currently out due to covid.

About 30 nurses were out at Hilo Medical Center and the hospital is currently full.

Today, we have 12 holds in the emergency department, theyre waiting for beds upstairs, explained Elena Cabatu, Hilo Medical Center director of marketing.

Raethel said there are about 100 patients statewide in emergency rooms waiting for beds.

Which is a high number much higher than what we would normally have, he said.

He said it also stems from a staffing issue at nursing homes and long-term care facilities as well.

The hospitals are having trouble discharging patients to nursing homes because the nursing homes dont have sufficient staff to staff all their beds, Raethel explained. Its not a bed issue, its a staffing issue. So until we can figure out how to get more staff into our long-term care facilities, this will continue to be a problem.

For now, experts believe omicron will peak in late January.

Find more COVID-19 news: cases, vaccinations on our Coronavirus News page

A CDC forecast shows a similar timeframe with the surge peaking in about two weeks.

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COVID hospitalizations hit 300, as many healthcare workers call in sick - KHON2

Latinos in U.S. often live in ‘deserts’ where adequate housing, groceries are hard to find – USA TODAY

Justice Dept. sues Texas over redistricting maps

The Department of Justice has sued Texas over new redistricting maps, saying the plans discriminate against voters in the state's booming Latino and Black populations (Dec. 6)


Latinos, who will represent more than one-quarter of all people in the U.S.by 2050, are often concentrated in areas that lack services ranging from adequate housing to health care, according to a recentreport.

Those disparities were among the many highlighted in "The Economic State of Latinos in America: The American Dream Deferred,'' a report by McKinsey & Company that detailed the obstacles slowing or hindering the economic advancement of the 60 million Latinos who live in the U.S.

The challenges the Latino community faces in making upward economic gains are only deepened by living in these deserts,'' saysBernardo Sichel, partner at McKinsey and one of the report's authors. "These deserts have an impact on a range of outcomes, such as health and nutrition, options for services, productivity and budget. All these factors are impacted by the limited choices, necessity to travel for resources, and higher prices on consumer goods.

Latino familiestypically spend71% of their income on groceries and other consumer items and servicesbut often struggle to find or access options.

"Latinos tend to disproportionately live in segregated and poor areas where they are cut off from opportunities and services and consumer items that most Americans take for granted,'' Rogelio Senz, a professor in the department of demography at the University of Texas at San Antonio, said in an email."Latinos ... disproportionately also do not have easy access to parks, libraries, book stores, high quality schools that are well funded, (and) banks.''

Senzwas not connected with the McKinsey study.

Here's whatthe McKinsey report found:

Among Latinos, 42%, or roughly 21.2 million, lived in a census tract that lacked affordable housing in 2019. Nearly 9 in 10 of the Latino residents in such communities lived in five states: California, Florida, New Jersey, New York and Texas.

Latinos were 3.1 times more likely than their non-Latino white counterparts to live in those housing deserts, which the report defined as low-income communities where the amount of affordable and available housingper 100 "extremely low income" householdsfell below the national level.

Job growth slows: 'Hiring is being held back': Economy added just 199K jobs in December as worker shortages persisted and omicron began spreading in U.S.

Stocks slip: Wall Street sees slide after a mixed jobs report and slumping tech stocks

Accessing health care services is a challenge for many Latinos in the U.S.:42%, or 21.4 million, live in neighborhoods that don't have enough medical providers to match the number of residentsor lack such services overall.

Latinos were 2.5 times more likely to live in a health care desert than their white peers, and those areas were often urban communities in Arizona, California, Florida, New York and Texas,according to the report.

Among Latinos in the U.S.,15% live inlower-income areas where supermarkets are hard to find. That's compared with 11% of non-Latino whites who live in lower-income urban neighborhoods where the closest grocery store is more than a mile away, or in rural areas where a large number of residents have to travel at least 10 miles to find a supermarket.

"Latinos tend to live in food deserts where they do not have access to fresh fruits and vegetables,'' saysSenz, theUniversity of Texas at San Antonio professor. "There are more likely to be convenience stores, liquor storesand other stores. ... Because they are a captured market, the prices of those unhealthy foods are also more expensive than in neighborhoods that are better off economically."

Roughly 34.5 million Latinos livein areas where a higher-than-average number of residents do not have a bank account. Among households that are underbanked or have no accounts at all, 14% are Latino compared with 3% of white households.

Latinos, as well as Black Americans,are disproportionately represented among the unbanked and underbanked who are often deterred from opening accounts by high fees and adistrust of financial institutions. But not being banked can cost both money and time as consumers rack up check-cashing fees and have to find transportation to get money orders or pay bills in person.

Nearly half of Latinoslive in communities that have limited access to broadband, which can make it difficult to complete tasks ranging from paying bills to remote learning.

Broadband deserts are defined in the report as census tracts where there is less than 80% coverage for every 1,000 homes.

Nearly 3 in 4 Latinos in the U.S. live in counties where there is a below-average number of supercenters or membership retail clubs that allow shoppers to buy clothing, appliances and other products.

"Earning a fair wage is one thing,'' the report said. "But what if you're unable to spend it on needed goods and services?"

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Latinos in U.S. often live in 'deserts' where adequate housing, groceries are hard to find - USA TODAY

J.P. Morgan Healthcare Conference Starts With Lots of Deals, No Blockbuster M&A – Barron’s

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The biggest healthcare industry conference of the year opened Monday with a wave of announcements and partnerships, but no blockbuster biotech acquisitions.

That could be a disappointment to investors, who had been hoping for a busy 2022 for biotech M&A. The sector performed miserably last year and into early January.

The first morning of the J.P. Morgan Healthcare Conference is often a stage for big pharmaceutical companies to unveil major deals. On the first day of 2019s conference, for example, Eli Lilly (ticker: LLY) announced the $8 billion acquisition of Loxo Oncology.

Nothing like that has happened yet on Monday morning. With the Biotech sell off accelerating in the first week of January, the lack of any M&A at JPM is unwelcome news for anyone long the space, Jefferies healthcare equity strategist Will Sevush wrote in a note to investors early Monday.

While investors hoping for a big biotech acquisition may be disappointed, there has been plenty of healthcare news announced to coincide with the start of the conference. Here are some highlights so far.

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com

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J.P. Morgan Healthcare Conference Starts With Lots of Deals, No Blockbuster M&A - Barron's

[PODCAST] The Pandemic and Beyond: Navigating Disputes Within Health Care Systems – JD Supra

A podcast from JAMS featuring neutrals Christopher Keele, Esq., and Adrienne Publicover, Esq., on disputes within health care systems and how parties can best navigate and mitigate these disputes

In this podcast, JAMS neutrals Christopher Keele, Esq., and Adrienne Publicover, Esq., discuss common types of disputes within health systems and the impact that the pandemic continues to have on disputes. They delve into specific areas where disputes tend to arise, particularly physician employment agreements and whistleblower claims. Their conversation explores the themes that underpin common conflicts within health care systems, including tension between business and clinician interests as well as between health care providers and their respective investors. They also share their thoughts on how the financial pressure brought on by the pandemic has impacted hospital systems and what parties should be thinking about now to get ahead of those disputes.

[00:00:00] Moderator: Welcome to this podcast from JAMS. Today, we're focusing on internal disputes within health care systems. Since the start of the pandemic, we've seen new disputes arise and old ones take on new significance. To walk us through how parties can best navigate and mitigate these disputes, we have two JAMS neutrals with significant health care experience.

Adrienne Publicover in San Francisco and Chris Keele in San Jose, California. So, thank you both for joining us. Chris, can you just first clarify, what do we mean when we talk about health systems? What are they and who are the major players within a system?

[00:00:39] Chris Keele: Health systems, first, there are various definitions and concepts of health systems. Health care think tanks provide some guidance on this and have defined health systems of at least one hospital plus one group of physicians or other professional providers.

I take a more simple and broad view of health systems and simply view it as a business or organization that delivers health care services. The organization has some form of common ownership or other contractual connection. But very simply, it's a business that provides health care.

Major players within health systems include two groups. One is the professional or clinical providers, including physicians, nurses, other clinicians and with that, we have to recognize that patients, the consumer of the health care service, are a major player within health systems. The second sort of core group of a health system is the business and financial management of the business, including employees, officers, directors, various departments, such as HR, finance, legal contracting, and billing and collection, which is sometimes termed as revenue cycle management.

[00:02:06] Moderator: Adrienne, what are some of the most common disputes that arise in a health system?

[00:02:09] Adrienne Publicover: Within the arbitration space, we see a lot of what is commonly referred to as provider payer dispute. It generally involves a hospital or a hospital system suing a health plan for recovery of alleged either nonpayment or underpayment on a group of claims.

Those cases we've had for a while. I think the thing that's changed this past year and a half has been that a lot of the arbitrations now are proceeding virtually over Zoom, even for the foreseeable future. I think that the parties and the council involved in those cases have been really pleased with the virtual model in terms of trying to resolve those disputes.

Then, in the mediation space, we see a lot of employment cases and it's generally hospital employees or physicians. Those can be contractual disputes, wrongful termination, harassment, whistleblower claims.

[00:03:13] Chris Keele: I think Adrienne hit it on the head when she said employment is a big area of disputes. Employment and staffing are a big area. I also think that physician and provider compensation is a big area.

[00:03:28] Moderator: What about new disputes arising since the beginning of the pandemic, like vaccine mandates, for example?

[00:03:34] Adrienne Publicover: So, I haven't seen any lawsuits about vaccine mandates, per se. I think that the issues with the pandemic have created an additional stress on the health care systems, which has the potential to pervade every area of dispute possible and the ADR that comes out of that.

[00:03:59] Moderator: Chris, what kind of effect do you think that the pandemic has had on some of these internal disputes?

[00:04:04] Chris Keele: We can't overstate the significance that the pandemic has had on changes in the health care industry and health care systems. I think we're seeing staffing shortages, obviously, which again implicate employment issues. Vaccine mandates, gosh, what a political football and uncertain area. But I think we're going to see disputes arise internally between employees on the one hand or the groups that represent employees and management on the other hand, concerning vaccine mandates.

Even though, courts have recently struck down the Biden administration requirement for vaccines, I think that we're going to see further court action in that area. Also, we have to recognize that private businesses can still require vaccination and if they do, and I think health care systems will take that step seriously, then we're going to see increased disputes over the mandates.

I also think that with the uptick in private equity investment in, especially in, physician or provider groups, plus an increased activity in mergers and acquisitions and other health care combinations that will also give rise to disputes between the function of the clinician or the professional care on the one hand and the business management on the other.

So, I think that's going to be an area where internal disagreement and non-alignment will increase. The other area that I think we're seeing or will see in terms of internal disputes is with the increased use of telehealth and telemedicine, I think there will be disputes internally over the delivery of health care services using that technology and who controls what internally. I also think it will implicate provider or physician compensation issues.

[00:06:06] Moderator: Can you talk a little bit more about physician employment agreements and the host of potential conflicts they present?

[00:06:12] Chris Keele: Physician employment agreements are an interesting animal, if you will, because physicians are the heart and soul of health systems and the product or service that health systems provide.

There are regulatory restrictions on how physicians and other professional providers can be compensated or what concerns they need to be sensitive to in providing health care. So, for instance, the stark law in a kickback statute, prohibit referrals and sort of a referral based upon personal and financial relationships.

So how do physicians get compensated? They get compensated by basically three things. One is the quantity of care that's provided. Two is the quality of care provided. Three is the type of care provided or the specialty services. It's a complex model to compensate physicians under services, agreements, or employment agreements that take into account various factors in all three of those areas. It constantly changes with the dynamic part of health care.

So, for instance, when the pandemic started in 2020, the volume of patients, the number of patients decreased. With that, there should have been a decrease in physician compensation, but health systems decided that with that they would lose the quality care that the patients needed because physicians would either try to find a different place to provide services or quit altogether.

So, they adjusted the model and had to incorporate that into the compensation system, enhance into the employment agreement process. Specialty groups pose a different problem because they usually operate in mass within a health system and can add a unique value to the systems practice. So, it's like negotiating an agreement with, on a constant basis, a valued system or valued component of the clinical system within the entire organization.

So, physician compensation, physician agreements, add a complexity that is at the heart of the health system. If there is some tension between the business side of things and the clinical side of things, that can portend possible jeopardy to critical parts of the practice and critical parts of the system.

[00:09:20] Moderator: Adrienne, health care whistleblower claims can raise the blood pressure of a lot of folks inside health systems. Have you seen an uptake of those and what kind of issues they give rise to?

[00:09:32] Adrienne Publicover: Yes, there has definitely been an uptick and I think that these types of actions have the potential to strain what is already a taxed system. They are expensive to litigate. They are disruptive to the business practices of the hospital system.

One of the ancillary issues that comes up in these cases is insurance coverage. There are a lot of reasons why the health care systems would want to explore ADR for these types of claims and to ensure that they're engaging neutrals that have that experience on the insurance coverage aspect of it as well.

[00:10:12] Moderator: Chris, can you talk a little bit about the common themes that underlie these conflicts within health systems?

[00:10:18] Chris Keele: There is tension on a micro level between business and management interests on the one hand and clinician professional quality of care interests on the other. The magic of health care systems is how do those interests join and align to one, make money, which is the business interest and continue to allow a smooth productive operation from an organizational standpoint and give quality care on a timely basis, regardless of what that care is.

It could be acute care, or it could be long-term care. It could be medications, it could be emergency care, but it's that merging in a smooth and productive way that's the magic.

What happens is there is always some stakeholder on the business side that will push back against the professional clinician on the other side saying, Oh, no, that's not efficient or, Oh no, you're undermining our ability to recover and recoup reimbursement from health plans and payers, et cetera.

Then on the clinician side, they're going, Oh wait, you're interfering with our ability -- you're impeding our ability to deliver quality care because you only have your business interests in mind. So that's on the micro level. The macro level is when you start getting private equity, SPACs and major investors involved who want immediate quick gains from their investment in health care systems.

But that then undermines the long-term goal of the provider side of building a sound quality practice to provide high quality health care. So, there's that macro tension. So, when I refer to this tension, that's what I'm referring to and we see it. Adrienne, when you referred to the disputes between providers on the one hand and plans and payors on the other concerning either unpaid or underpaid reimbursements, there's a tension there because business management wants one thing (i.e., just settle the darn thing and get as much as you can).

The provider side however goes, Well, wait, it's because of some uncertain term or some disagreement over a term in these contracts, these services agreements, that's giving rise to these disputes. Why can't we resolve that so that we don't keep having to fight each other and really resolve this at the foundational level?

But business management goes and contracting, and revenue cycle folks go, Yeah, just get rid of it. We need to just resolve this and move forward.

[00:13:25] Adrienne Publicover: I would say just from an ADR perspective, I think Chris has keen insights into the internal workings of this. But I think from an ADR perspective, just following up on what Chris just said about the plan versus the hospital, when these cases come into arbitration, sometimes they deal with issues of medical necessity and where I think that the hospital system is in the situation where they feel the plan is second guessing the services that were provided.

Then the other part of those disputes has to deal with exactly what Chris talked about, which are the contract interpretation disputes. When you have arguable ambiguities, how are those ambiguities resolved? Then what does that ultimately mean for the hospital system in terms of the payments?

[00:14:30] Moderator: The hospital systems have been under financial pressure during this pandemic. What kind of impact do you think that's had on dispute resolution?

[00:14:38] Adrienne Publicover: I think it's had a huge impact and twofold. I think we're seeing fewer cases in the arbitration sphere settle, because number one, exactly what you just mentioned. The hospitals have been under incredible financial strain as a result of the pandemic. Number two, with virtual ADR, I think it's easier to, and more efficient and more economical, to actually arbitrate these cases in the new virtual world.

[00:15:11] Moderator: I suppose another question. Chris, just knowing we have these disputes, what can parties do to get ahead of them? To minimize and mitigate them in the future? If they're seeing disputes of the same kind repeat over and over?

[00:15:25] Chris Keele: The thing that systems can do to mitigate the disputes isn't so much how do they minimize the disputes the disputes are going to arise, and this is really a function of their business organization collaborating with the professional or clinical side of things with the guidance of legal compliance, finance, et cetera. So, the disputes will be there. It's what can we do as neutrals to help that?

I think the thing that we can do is to step in when the health systems acknowledge and recognize that there's a problem, that there is a dispute or disagreement, or not necessarily a conflict, but that the interests or objectives are not entirely aligned when they can acknowledge that call on a neutral to come in, to step in and develop with their collaboration, a structure and process to resolve those disputes as quickly and efficiently as possible. I wanted to recommend to our listeners a recent article actually just published in JAMS ADR Insights on December 8th, authored by Richard Burke, who is a JAMS vice president and an executive director of the JAMS Institute. Where Rich sets out sort of in not great detail as Adrienne I've talked about and not the same focus, but what a mediator or arbitrator can do to help structure a process to tackle these disputes.

[00:17:13] Moderator: Adrienne, do you agree that structuring disputes is where neutrals can really have an impact?

[00:17:17] Adrienne Publicover: I think that is absolutely one impact they can have. I think that neutrals can also be used to help strengthen relationships between the hospital systems and the payors. Certainly, through the mediation process, I've been involved in contract negotiations and helping parties see the limitations with their contracts, the ambiguities in the contracts and see where contracts can be improved.

So, I think that the neutrals can play several different roles.

[00:17:49] Moderator: So looking forward, what do you expect to see in this space?

[00:17:52] Adrienne Publicover: Virtual ADR has created a paradigm for the plans and the payers to more efficiently and economically resolve their disputes, which might mean less settlements and more arbitrations.

But I do notice that, even for years to come, no one seems to be in a rush to return to a live arbitration setting. Maybe there'll be hybrid, but virtual will definitely at least play a part in the resolution of some of those disputes.

[00:18:27] Chris Keele: I think that in 2022, we are going to see hopefully the pandemic subside and life, including health care, begin to level out for lack of a better term.

Having said that, I think we're going to see the same issues that we've identified before, internally, employment and staffing. Those issues are going to remain. I think we're going to see health systems suffer the consequences of staffing shortages. I think vaccine mandates are going to continue to be an urgent and pervasive topic internally.

I think that, again, telehealth, telemedicine and the provision of health care services through that mode is here to stay and we're going to see systems deal with the issues that arise out of increased use of telemedicine, including data breach issues and data security issues, who controls and who is responsible, for what part of telemedicine internally, including delivery of health care services, as opposed to maintaining and implementing the technology behind telehealth. I think it's also going to continue to affect the issue of provider compensation.

[00:19:57] Moderator: We'll definitely keep our eye out. I want to thank you, Chris and Adrienne. Thank you so much for a great conversation. I really appreciate it.

[00:20:04] Chris Keele: Its been a pleasure. Thank you.

[00:20:06] Adrienne Publicover: Thank you very much.

[00:20:08] Moderator: You've been listening to a podcast from JAMS, the world's largest private alternative dispute resolution provider. Our guests have been Adrienne Publicover and Chris Keele.

For more information about JAMS solutions for health systems, please visit http://www.jamsadr.com/healthsystems. Thank you for listening to this podcast from JAMS.

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[PODCAST] The Pandemic and Beyond: Navigating Disputes Within Health Care Systems - JD Supra

US hospitals recruit foreign nurses to ease health care worker shortage : Shots – Health News – NPR

Mary Venus, a nurse from the Philippines, on duty at Billings Clinic in Billings, Mont. Nick Ehli/Kaiser Health News hide caption

Mary Venus, a nurse from the Philippines, on duty at Billings Clinic in Billings, Mont.

Before Mary Venus was offered a nursing job at a hospital in Billings, Mont., she'd never heard of Billings or visited the United States. A native of the Philippines, she researched her prospective move via the internet, set aside her angst about the cold Montana winters and took the job, sight unseen.

Venus has been in Billings since mid-November, working in a surgical recovery unit at Billings Clinic, Montana's largest hospital in its most populous city. She and her husband moved into an apartment, bought a car and are settling in. They recently celebrated their first wedding anniversary. Maybe, she mused, this could be a "forever home."

"I am hoping to stay here," Venus says. "So far, so good. It's not easy, though. For me, it's like living on another planet."

Administrators at Billings Clinic hope she stays, too. The hospital has contracts with two dozen nurses from the Philippines, Thailand, Kenya, Ghana and Nigeria, all set to arrive in Montana by summer. More nurses from far-off places are likely.

Billings Clinic is just one of scores of hospitals across the U.S. looking abroad to ease a shortage of nurses worsened by the coronavirus pandemic. The national demand is so great that it has created a backlog of health care professionals awaiting clearance to work in the U.S. More than 5,000 international nurses are awaiting final visa approval, the American Association of International Healthcare Recruitment reported in September.

"We are seeing an absolute boom in requests for international nurses," says Lesley Hamilton-Powers, a board member of AAIHR and a vice president for Avant Healthcare Professionals in Florida.

Avant recruits nurses from other countries and then works to place them in U.S. hospitals, including Billings Clinic. Before the pandemic, Avant would typically have orders from hospitals for 800 nurses. It currently has more than 4,000 such requests, Hamilton-Powers said.

"And that's just us, a single organization," adds Hamilton-Powers. "Hospitals all over the country are stretched and looking for alternatives to fill nursing vacancies."

Foreign-born workers make up about a sixth of the U.S. nursing workforce, and the need is increasing, nursing associations and staffing agencies report, as nurses increasingly leave the profession. Nursing schools have seen an increase in enrollment since the pandemic, but that staffing pipeline has done little to offset today's demand.

In fact, the American Nurses Association in September urged the U.S. Department of Health and Human Services to declare the shortage of nurses a national crisis.

CGFNS International, which certifies the credentials of foreign-born health care workers to work in America, is the only such organization authorized by the federal government. Its president, Franklin Shaffer, says more hospitals are looking abroad to fill their staffing voids.

Mary Venus, a nurse from the Philippines, and Pae Junthanam, a nurse from Thailand, talk during their shift at Billings Clinic in Billings, Mont. Nick Ehli/Kaiser Health News hide caption

Mary Venus, a nurse from the Philippines, and Pae Junthanam, a nurse from Thailand, talk during their shift at Billings Clinic in Billings, Mont.

"We have a huge demand, a huge shortage," he says.

Billings Clinic would hire 120 more nurses today if it could, hospital officials say. The staffing shortage was significant before the pandemic. The added demands and stress of COVID-19 have made it untenable.

Greg Titensor, a registered nurse and the vice president of operations at Billings Clinic, notes that three of the hospital's most experienced nurses, all in the intensive care unit with at least 20 years of experience, recently announced their retirements.

"They are getting tired, and they are leaving," Titensor says.

Last fall's surge of COVID-19 cases resulted in Montana having the highest rate in the nation for a time, and Billings Clinic's ICU was bursting with patients. Republican Gov. Greg Gianforte sent the National Guard to Billings Clinic and other Montana hospitals; the federal government sent pharmacists and a naval medical team.

While the surge in Montana has subsided, active case numbers in Yellowstone County home to the hospital remain the state's highest. The Billings Clinic ICU still overflows, mostly with COVID-19 patients, and signs still warn visitors that "aggressive behavior will not be tolerated," a reminder of the threat of violence and abuse health care workers endure as the pandemic grinds on.

Like most hospitals, Billings Clinic has sought to abate its staffing shortage with traveling nurses contract workers who typically go where the pandemic demands. The clinic has paid up to $200 an hour for their services, and, at last fall's peak, had as many as 200 traveling nurses as part of its workforce.

The scarcity of nurses nationally has driven those steep payments, prompting members of Congress to ask the Biden administration to investigate reported gouging by unscrupulous staffing agencies.

Whatever the cause, satisfying the hospital's personnel shortage with traveling nurses is not sustainable, says Priscilla Needham, Billings Clinic's chief financial officer. Medicare, she notes, doesn't pay the hospital more if it needs to hire more expensive nurses, nor does it pay enough when a COVID patient needs to stay in the hospital longer than a typical COVID patient.

From July to October, the hospital's nursing costs increased by $6 million, Needham says. Money from the Federal Emergency Management Agency and the CARES Act has helped, but she anticipated November and December would further drive up costs.

Dozens of agencies place international nurses in U.S. hospitals. The firm that Billings Clinic chose, Avant, first puts the nurses through instruction in Florida in hopes of easing their transition to the U.S., says Brian Hudson, a company senior vice president.

Venus, with nine years of experience as a nurse, says her stateside training included clearing cultural hurdles like how to do her taxes and obtain car insurance.

Mary Venus, a nurse from the Philippines, checks on a patient inside the in-patient surgical recovery unit at Billings Clinic in Billings, Mont. Nick Ehli/Kaiser Health News hide caption

Mary Venus, a nurse from the Philippines, checks on a patient inside the in-patient surgical recovery unit at Billings Clinic in Billings, Mont.

"Nursing is the same all over the world," Venus says, "but the culture is very different."

Shaffer, of CGFNS International, says foreign-born nurses are interested in the U.S. for a variety of reasons, including the opportunity to advance their education and careers, earn more money or perhaps get married. For some, says Avant's Hudson, the idea of living "the American dream" predominates.

The hitch so far has been getting the nurses into the country fast enough. After jobs are offered and accepted, foreign-born nurses require a final interview to obtain a visa from the State Department, and there is a backlog for those interviews. Powers explains that, because of the pandemic, many of the U.S. embassies where those interviews take place remain closed or are operating for fewer hours than usual.

While the backlog has receded in recent weeks, Powers describes the delays as challenging. The nurses waiting in their home countries, she stresses, have passed all their necessary exams to work in the U.S.

"It's been very frustrating to have nurses poised to arrive, and we just can't bring them in," Powers says.

Once they arrive, the international nurses in Billings will remain employees of Avant, although after three years the clinic can offer them permanent positions. Clinic administrators stressed that the nurses are paid the same as its local nurses with equivalent experience. On top of that, the hospital pays a fee to Avant.

More than 90% of Avant's international nurses choose to stay in their new communities, Hudson says, but Billings Clinic hopes to better that mark.

Welcoming them to the city will be critical, says Sara Agostinelli, the clinic's director of diversity, equity, inclusion and belonging. She has even offered winter driving lessons.

The added diversity will benefit the city, Agostinelli says. Some nurses will bring their spouses; some will bring their children.

"We will help encourage what Billings looks like and who Billings is," she says.

Pae Junthanam, a nurse from Thailand, grabs supplies from a closet in the intensive care unit at Billings Clinic. Nick Ehli/Kaiser Health News hide caption

Pae Junthanam, a nurse from Thailand, grabs supplies from a closet in the intensive care unit at Billings Clinic.

Pae Junthanam, a nurse from Thailand, says he was initially worried about coming to Billings after learning that Montana's population is nearly 90% white and less than 1% Asian. The chance to advance his career, however, outweighed the concerns of moving. He also hopes his partner of 10 years will soon be able to join him.

Since his arrival in November, Junthanam says, his neighbors have greeted him warmly, and one shop owner, after learning he was a nurse newly arrived from Thailand, thanked him for his service.

"I am far from home, but I feel like this is like another home for me," he says.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues.

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US hospitals recruit foreign nurses to ease health care worker shortage : Shots - Health News - NPR

We’re buying more of this high-quality health-care stock amid the market sell-off – CNBC

Jim Cramer

Scott Mlyn | CNBC

(This article was sent first to members of the CNBC Investing Club with Jim Cramer. To get the real-time updates in your inbox, subscribe here.)

After you receive this email, we will be buying 50 shares ofDanaher (DHR) at roughly $295.79. Following the trade, the Charitable Trust will own 300 shares of Danaher. This buy will increase DHR's weight in the portfolio from about 1.78% to roughly 2.13%.

Markets are kicking off the trading week on a sharply lower note, with many technology and other high-multiple stocks extending their recent declines. Once again, the rise in the 10-Year Treasury yield is causing investors to rotate out of high-multiple and riskier names and into lower-multiple and cyclically oriented areas like financials and energy. Separately, many names in retail are taking it on the chin after Lululemon (LULU) provided a weaker-than-expected revenue and earnings guidance for its holiday quarter.

With that in mind, we want scan for high-quality stocks that are caught up in the broader action despite no deterioration in the underlying fundamentals, with multiples that may have contracted but are approaching levels at which support can come in (think something that has dropped to a more attractive price-to-earnings multiple, not a 20x price-to-sales stock that has contracted to 15x sales). Again, the focus this year is on companies that "do stuff and make things," not "story stocks" with hopes of turning a profit at some undetermined point in the future.

Danaher fits this profile perfectly, as it's a multi-industry growth company with real earnings, headed by a management team with a proven track record of delivering operations improvements across the portfolio. Moreover, the company's revenue is 75% recurring in nature, which adds an additional layer of support to the stock's valuation. Remember, investors tend to reward durable, recurring revenues with higher relative multiples.

As for valuation, with shares now falling to just below 29x forward earnings estimates, we believe support will start to come in. This is because, although Danaher's multiple is above market, the stock hashistorically traded in the mid-to-upper 20s multiple region. Combine that with a the recent move that has brought shares to just over 10% below all-time highs, and we believe buyers will be circling at or near current levels and indeed, they appear to have swooped in at the open to take advantage of the opening sell-off.

We thereforewant to use this opportunity to further build our position and reduce our overall cost basis, despite shares being up at the time of this alert and our preference to buy stocks are down.

The CNBC Investing Club is now the official home to my Charitable Trust. It's the place where you can see every move we make for the portfolio and get my market insight before anyone else. The Charitable Trust and my writings are no longer affiliated with Action Alerts Plus in any way.

As a subscriber to the CNBC Investing Club with Jim Cramer, you will receive a trade alert before Jim makes a trade. Jim waits 45 minutes after sending a trade alert before buying or selling a stock in his charitable trust's portfolio. If Jim has talked about a stock on CNBC TV, he waits 72 hours after issuing the trade alert before executing the trade. See here for the investing disclaimer.

(Jim Cramer's Charitable Trust is long DHR.)

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We're buying more of this high-quality health-care stock amid the market sell-off - CNBC

Gourmet Cookie owner sharing the love with health care workers by donating treats for each dozen cookies sold – WATE 6 On Your Side

KNOXVILLE, Tenn. (WATE) Heres your chance to help a local business and thank a healthcare hero.

Valentines Day is almost here, but one cookie company is sharing the cookie love all month long.

They are delightful, delectable, edible works of art.

I would describe them as delicious pieces of cookie love, The Gourmet Cookie Knoxville owner Ashley Martinez said.

Ashley turned her love of creating the beautiful cookies into a business four years ago.

Now, shes giving back that cookie love.

Throughout the month of February, when you buy a dozen cookies at http://www.thegourmetcookietn.com, Ashley will send a dozen of the fancy treats to hardworking heroes at area hospitals.

Weve been lining them up, Ashley said. We have UT Medical Center, Parkwest Hospital, also were trying to get East Tennessee Childrens Hospital.

Thanks, Ashley, for creating these scrumptious cookies for all to enjoy.

I just thought what can we do to put a sweet smile on their faces, she said.

There is also a thank you dinner giveaway for one local area healthcare worker. Check the Thank a Health Care Worker section on The Gourmet Cookie Knoxville website to nominate a health care hero in your life.


Gourmet Cookie owner sharing the love with health care workers by donating treats for each dozen cookies sold - WATE 6 On Your Side

Health care heroes honored | News, Sports, Jobs – Youngstown Vindicator

Staff photo / Bob CouplandBishop David Bonnar of the Diocese of Youngstown, left, speaks with Dr. John Popovec and Alberta Popovec of Boardman after the White Mass on Sunday at St. Columba Cathedral in Youngstown to recognize those in the health care field, who have been affected most by the COVID-19 pandemic.

YOUNGSTOWN The past year has been a challenge for many people because of the coronavirus pandemic, but those in the health care field especially have faced difficulties on the front line and were recognized for what they do at the 25th annual White Mass hosted by the Diocese of Youngstown.

Led by Bishop David Bonnar on Sunday at St. Columba Cathedral, the special Mass praised the work of doctors, nurses, aides, support staff and other health care and mental health professionals.

The power was out for most of the Mass after a car hit a nearby telephone pole, but Bonnar said the lit candles in the sanctuary and the sunlight streaming through the stained-glass windows provided a sense of peace.

How dark it has been for many this past year during the pandemic, but we have reached for the light to guide us, Bonnar said.

The theme of his homily was dont despair, which he said is a loss of hope. He started his homily with a joke about a nun giving a homeless man outside the convent a $100 bill with a note wrapped around it that said dont despair. The man returned several days later with stacks of $100 bills that he won after betting on a horse named Dont Despair at the racetrack. The congregation, which included about 50 health care professionals, chuckled at the punchline.

Bonnar, however, quickly turned serious, drawing parallels between the COVID-19 pandemic and two of the readings at Mass that were about people with leprosy, who had to isolate themselves because they were unclean.

During the pandemic, it has been very tempting to despair. We pray fervently for all our sick brothers and sisters and also for the doctors, nurses and other health care staff who care for the sick. Health care workers take many risks to help the sick and suffering. This year stands out as a significant one that has stretched beyond belief every health care worker who has been on the front lines. They do this because they care, Bonnar said.

Bonnar said Jesus does not want anyone to despair or to be in isolation despite their status.

Jesus wants us to touch the untouchable, love the unloveable and forgive the unforgiveable, he said.

Those in the health care profession were asked to stand in their pews for applause and recognition.

Deanna Ford of Poland, director of missions for Mercy Health, said, I work for Mercy Health so this is extremely appreciated. We talk about hope all the time. We thank the Diocese for the recognition, especially for this past year.

We all needed this blessing he gave us for what we have faced. It was nice with all the candles being lit even when the power went out. What would we do if we did not have doctors and nurses? Maureen Fogarty of Youngstown, a speech pathologist, said.

Dr. John Popovec and Alberta Popovec of Boardman said it has been a challenging year.

John said in his 41 years in medicine, he has never seen a year like this.

Coming together and realizing how hard everyone has worked and made sacrifices is important. People have put in so much time and energy during the pandemic, Alberta said.

Dr. James Kravec, chief clinical officer for Mercy Health of Youngstown, said the fact the Diocese continues to have this Mass each year shows how much it cares for the many health care workers in the community.

This year is even more important than ever given the fact health care workers are working harder and taking care of more and more patients. It has been a challenging year, and these many heroes are out there doing wonderful work for the patients and taking care of those in their communities. It is wonderful the Diocese is celebrating them at this special Mass, Kravec said.

Kravec said he has attended the White Mass for many years, including while he was in medical school.

He said it is encouraging so many people are getting vaccines as well as continuing to social distance and wear masks.

I am hopeful we will be able to get back to some form of normalcy this year, Kravec said.

He is a member of St. Christine Parish in Youngstown and was there with his wife, Dr. Cynthia Kravec, who did the readings, and their four children.

David Schmidt, director of the Diocesan Office of Pro-Life, Marriage and Family Life, said normally, a reception takes place in the parish hall after the Mass, but it was canceled because of the pandemic.

This is the Dioceses way of honoring health care professionals and celebrating the work that they do. Anyone in the health care professions needs an extra blessing for the work they have done and challenges thay faced this past year, Schmidt said.

He said usually, many retired health care professionals come to the Mass, but they were unable to do so because of the pandemic. They would have watched a livestream of the service, but the power outage just before Mass changed that.

Metro editor Marly Reichert contributed to this report.


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Health care heroes honored | News, Sports, Jobs - Youngstown Vindicator

Black community leaders to discuss vaccines and repairing trust in health care – wcia.com

SPRINGFIELD, Ill. (NEXSTAR) The local Black Lives Matter chapter will host a discussion on the disparities Black people routinely face in the health care system in regards to the COVID-19 vaccination.

The virtual event is open to the public and will take place on Wednesday, February 17th, at 6:30 pm on the groups Facebook page. The discussion will be led by four panelists and a moderator who are all leaders of the Black community, including Illinois Department of Public Health Director Dr. Ngozi Ezike.

Sunshine Clemons, president of the Springfield Black Lives Matter chapter, says while the event is during Black History Month, it is open to everyone regardless of their race or age. Clemons believes that more people are traditionally inclined to learning about Black history during this time. She hopes the event helps to educate people on the long standing history of distrust within the Black community toward the health care system due to some horrendous acts that were previously performed and neglected care.

This is a serious issue that needs to be addressed, Clemons said. Its not solely on Black people to correct this..So it is open to everyone and you cant really work to rectify an issue if you dont know whats causing the issue. So this will give some historical context and background as to what some of the problems are and how we can all work together to correct this.

Following the discussion, attendees will be able to voice any questions or concerns.

Clemons says she hopes the event will help build comfort for those who are reluctant about receiving the Coronavirus vaccine.

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Black community leaders to discuss vaccines and repairing trust in health care - wcia.com

Funding for Health Care Providers During the Pandemic: An Update – Kaiser Family Foundation

From the early days of the pandemic, Congress and the Administration adopted a number of policies to ease financial pressure on hospitals and other health care providers. The infusion of funds responded to concerns about the potential fiscal impact of revenue loss due to fewer admissions and other services, coupled with higher costs associated with COVID-19. Nearly one year later, this brief describes the main sources of federal funds for health care providers and how those funds have been allocated. It also reviews what is known about the economic impact of COVID-19 on providers.

The $178 billion provider relief fund originally created by the Coronavirus Aid, Relief, and Economic Security (CARES) Act has been a major source of financial assistance for hospitals and other health care providers. Through this fund, virtually all health care providers have now qualified for a general grant that amounted to at least 2% of their previous annual patient revenue. This approach used one formula to distribute funds across a diverse set of providers in a relatively short period of time, but it did favor some providers over others. As previous KFF analysis shows, hospitals with a larger share of revenue from privately insured patients received a disproportionately large share of these grants because private insurers tend to reimburse at higher rates than Medicare and Medicaid. Certain hospitalssafety net hospitals, childrens hospitals or hospitals that treated a large number of COVID-19 patients early in the pandemiclater qualified for additional grants totaling $37 billion (Figure 1). Rural providers also qualified for $11.3 billion in extra grants. In addition, $9.4 billion was allocated for skilled nursing facilities, which account for a disproportionate share of COVID-19 deaths.

As of February 10, 2021, about $26 billion remains in the fund. The Consolidated Appropriations Act, 2021 requires that 85% of remaining funds be made available to providers to help cover revenue losses or additional expenses due to COVID-19. This same law also changed the rules regarding how the provider relief funds can be used, making it easier for providers to keep their grants even if they were more profitable in 2020 than in previous years.

In addition to the Provider Relief Fund, the federal government has provided financial support to health care providers in response to the pandemic through other programs and policies.

Together, these programs and policies were adopted early in the COVID-19 pandemic in response to the dramatic drop in health care consumption and revenues. Recent studies show that health care spending has since rebounded and overall health spending was up slightly in the third quarter of 2020, as compared to 2019. Year-to-date health services spending was down by 2.4% as of the third quarter of 2020 (relative to year-to-date spending as of third quarter in 2019). Changes in year-to-date spending varied by type of service, with physician office revenue down 4.0% and hospital revenue down 1.7%.

The federal financial assistance for providers has helped them cope with the financial impact of the pandemic. With year-to-date hospital revenue down by 1.7% by the third quarter of 2020, the CARES ACT grants, based on a minimum of 2% of patient revenue, would offset revenue losses for the average hospital. Reports in the press and earnings statements for hospitals suggest that some hospitals have done well and were profitable in 2020. Analysis from the Medicare Payment Advisory Commission found that new federal funds made available to skilled nursing facilities and health professionals likely offset a majority of their financial losses caused by COVID-19.

When hospitals and other health care providers experienced steep drops in revenue early in the pandemic, Congress stepped in with an infusion of funds to bolster these providers. Health care spending has now largely stabilized, though health care providers may still be facing increased expenses to respond to the pandemic and remain a sympathetic constituency. However, many other parts of the economy continue to suffer, and COVID-19 is still negatively impacting the labor market. This suggests that it may be time to shift more resources to help individuals weather the COVID-19 pandemic, creating significant resource needs elsewhere as well.

This work was supported in part by Arnold Ventures. We value our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.

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Funding for Health Care Providers During the Pandemic: An Update - Kaiser Family Foundation

City adds disabled residents, home health care providers to list of groups eligible for vaccinations | City of Detroit – City of Detroit

Residents of Detroit with documented intellectual or developmental disabilities are now eligible to be vaccinated at TCF Center, Mayor Mike Duggan announced today. The city also is adding to the eligibility list home health care providers who live in Detroit.

The announcement is the latest move by the city to reach its most vulnerable populations. Earlier this week, the Mayor announced Senior Saturdays, as series of weekend vaccination events for Detroiters age 65+ starting this Saturday, as well as a program to provide $2 rides to TCF center for Detroit residents who may not have their own transportation. That program includes wheelchair accessible vehicles for individuals with physical disabilities.

As a city, we recognize that individuals with certain conditions are more vulnerable to COVID-19 due to a weakened immune system or being unable to properly socially distance, said Mayor Duggan. Only four states in the country have specifically opened access to disabled residents and in Detroit we are making them among our highest priority.

Disabled residents wishing to make an appointment at TCF can do so starting today by calling 313-230-0505. Wheelchair accessible transportation can be arranged after your vaccination appointment is scheduled by calling 313-208-7364. Among the conditions covered by the Mayors directive are:

When they arrive for their appointment at TCF, the patient will be asked to show evidence of their condition, such as a health provider note, insurance record, prescription bottle or any other document that verifies their condition.

The Mayor also added home health care providers living in Detroit to care for their patient to the eligibility list. Part time care providers and those working at congregate settings have been eligible since January 28th in Detroit.

It is required that the home health care provider make his or her appointment at the same time as their patient and that they arrive at TCF in the same vehicle.

The City recently partnered with the Detroit Wayne Integrated Health Network to begin delivering vaccines on site at adult foster care homes and other group settings with highly vulnerable populations.

At his briefing today, Mayor Duggan introduced his new Director of Disability Affairs, Chris Samp. Samp, who is deaf, will be leading the citys efforts to ensure that Detroits disabled community is considered across the spectrum of city services to recommend, develop and implement new policies and practices to support them. The Office of Disability Affairs is a division of the Department of Civil Right, Inclusion & Opportunity, led by Charity Dean.

The opening of the office of disability affairs is a major milestone for the City of Detroit. Together, we will strengthen accessibility, employment and housing opportunities and make pedestrian routes safer, Samp said. Mayor Duggans expansion of equitable access to vaccinations for individuals with disabilities is a huge step in the right direction. The disability community is not expendible and they are a valued part of our community."

Starting this weekend, the Detroit Health Department will be partnering with two of the citys largest churches to hold weekly vaccination fairs exclusively for Detroit residents ages 65 and older. Fellowship Chapel will hold its first fair this Saturday, February 13, from 9 AM to 1 PM and Second Ebenezer will hold its event the same day from 1 -5 PM

The events at both churches will repeat each Saturday on February 20th & 27th and March 6th. Up to 500 vaccinations will be scheduled at each location, each day. Eligible residents can call 313-230-0505 to schedule their appointment at either church.

Vaccinations will be administered by appointment only. Workers and residents will not be vaccinated without having first made an appointment. Individuals must call 313-230-0505 to schedule.

Grocery store and security guard employees scheduling appointments will be required to provide their name, residence address and age. For greater efficiency and convenience, the city is recommending that when possible, eligible members of the same family or neighbors schedule jointly and arrive in the same vehicle. Group B essential workers will be required to provide the name of their employer and their most recent pay stub to verify their eligibility.

Second vaccination requiredWhen they schedule their appointment, individuals will be provided TWO appointment dates, one for the first dose and another for the required second dose. Call center staff will contact each scheduled person prior to their second appointment to remind them. Individuals also will be provided specific instructions on when and where to arrive to the TCF Center, where they will be required to fill out a basic consent form.

After receiving their vaccination, individuals will be required to remain in their vehicles inside the TCF garage for a period of approximately 15 minutes to make sure they are not experiencing any side effects. Medical staff will be on hand to assist any who may experience any side effects. Appointments should last approximately one hour once the person enters the TCF garage.

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City adds disabled residents, home health care providers to list of groups eligible for vaccinations | City of Detroit - City of Detroit

Vaccine rollout wont be equitable unless health care reckons with racism – The Verge

The pandemic has been anything but the great equalizer that some people called it when it started more than a year ago. Here in the US, COVID-19 has sickened and killed a disproportionate number of Black, Native American, and Latinx people. Vaccine rollout is proving to be inequitable, too. Black and Latinx elders in Los Angeles, for example, have been vaccinated at a lower rate than their white and Asian American counterparts.

Distrust in vaccines has been a challenge across the board. But Black Americans were less inclined than other racial and ethnic groups to want to get vaccinated, according to a Pew Research Center survey from December. To fix a system that isnt fully serving Black Americans and other people of color, There really needs to be some healing, says Melva Thompson-Robinson, executive director of the Center for Health Disparities Research at the University of Nevada, Las Vegas.

The Verge spoke with Thompson-Robinson about the roots of that distrust and how to heal.

This interview has been lightly edited for length and clarity.

How does distrust for vaccines in communities of color differ from white celebrities or conspiracy theorists who are anti-vaxxers?

Its not just a simple matter of, Oh, I dont believe that something works because this is what I heard. This is about that deep-rooted, historical trauma that has been carried down through generations. That distrust comes out of the racism that they experience. When youre talking about African Americans, in particular, youre talking about a group of people who are descendants of slaves.

And so its a different kind of thing. Its not I believe that these vaccines arent effective because I heard thats what somebody said. This is Im not trusting because of the experience that my family has had under slavery.

A big thing now is people are looking at whos in charge. Whos running the vaccine trials? Whos participating in the trials? They say, Well, I dont see people who look like me. Or I do see people who look like me. And all of that is huge. We need to see people who look like us who are involved.

What are some of those historical traumas that have led to distrust of vaccines among some people of color?

When you start to talk particularly about slaves, one of the men who is credited as being the founder of gynecology actually did surgery on Black women because they were considered property. He was doing gynecological surgery with no anesthesia because part of the thought was Well, they dont experience pain.

Thats not true. All people experience pain.

You can jump the Tuskegee syphilis study. You could also even look at the story of Henrietta Lacks, who had cervical cancer. And they harvested her cells at Johns Hopkins and still to this day still use her cells for research.

So people are saying, Well, you need to trust the health care system. But health care systems, health care facilities, and health care providers need to act in a trustful manner. You cant just expect people to say, Oh yeah, Ill now trust you after centuries of mistrust.

How do we see inequities playing out today when it comes to vaccine rollout in the US?

The challenge has been with some of the vaccines that you have to have very specialized storage capabilities, which then has limited where some of these can be distributed. Communities of color dont always have access to those storage facilities.

For people working in grocery stores or other retail and food outlets, its not as simple for them to take time off to go to an appointment. If they dont have sick leave or they have a limited amount of leave, they cant go and stand in line for hours at a time.

Another challenge is the messaging thats going out to people. You already know that you have populations that are concerned about getting the vaccine. So the messaging for that population needs to be different.

Theres no one size fits all prescription for how to reach out to different communities of color. But what should solutions or outreach strategies look like?

Here in Clark County where Las Vegas is located, the governor just came out last week with an equity initiative. Because if you look at the data, where the cases are versus where people are who are getting the vaccine its two different places within the same city. Its not the same group of people. Were seeing this inequitable distribution of resources. Were in this perfect storm, and in order to survive it, I think there has to be some relinquishing of power.

There really needs to be some healing and some stepping back. Not rushing, but stepping back and saying: You know what, we hear what youre saying. We understand where weve done wrong, and we want to do better.

Heres what else is happening this week.

The fast-spreading coronavirus variant is turning up in US sewersSome researchers are tracking coronavirus variants through US sewer systems. For more on sewers and COVID-19, check out Verge Sciences video from last year. (Antonio Regalado / MIT Tech Review)

Doctors and lawmakers call on FDA to address racial disparities in pulse oximetersPulse oximeters can measure the amount of oxygen in peoples blood through their skin, but they arent as accurate in people of color. Some experts are calling on the FDA to review these devices effectiveness. (Erin Brodwin and Nicholas St.Fleur / STAT)

Childhood Colds Do Not Prevent Coronavirus Infection, Study FindsFor a while, some people thought that children might be less vulnerable to the coronavirus that causes COVID-19 because they had been exposed to other coronaviruses that cause colds. This is not the case. A study found that those other coronaviruses didnt produce antibodies that were effective against the new coronavirus. (Apoorva Mandavilli / The New York Times)

How Merck, a Vaccine Titan, Lost the Covid RaceA look at why a pharmaceutical giant dropped out of the vaccine race and where they might go from here. (Katie Thomas / The New York Times)

AstraZenecas COVID-19 vaccine has been confusing from the startEarlier this week, South Africa decided to pause the rollout of the AstraZeneca vaccine after it performed poorly against a widespread variant in a small trial. Later this week, the WHO recommended that the vaccine should still be used. (Nicole Wetsman / The Verge)

Covid-19 vaccination rates follow the money in states with the biggest wealth gaps, analysis showsStates with large wealth gaps, like Connecticut, are seeing huge disparities in vaccination rates. In Connecticut, theres a 65 percent difference in vaccination rates between the wealthiest and poorest communities. (Olivia Goldhill / STAT)

I do my shift, wash my face, change my clothes and then get on the app.

Emergency room doctor Daniel Fagbuyi tells Bloomberg about his voluntary second shift: countering vaccine misinformation on social media app Clubhouse.

To the more than 108,030,043 people worldwide who have tested positive, may your road to recovery be smooth.

To the families and friends of the 2,377,268 people who have died worldwide 479,458 of those in the US your loved ones are not forgotten.

Stay safe, everyone.

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Vaccine rollout wont be equitable unless health care reckons with racism - The Verge

New help to quit smoking; how to get the health care you need – The Union Leader

Q: You talk about this a lot, but I just bombed out one more time on my stop-smoking attempt. I have tried patches, group support, daily mantras, exercising. But I always go back. Any new ideas? --Phil Y., Dunedin, Fla.

A: Your dedication is terrific and the key to success. Dont give up! Its important to realize that doctors and researchers see tobacco use as a chronic, relapsing substance-use disorder. Getting free takes time. Around 55% of Americans who smoke tried to quit in the previous year, but only 7.5% succeeded. Most people try to quit five to seven times before they do it for good. The new news is that there are some breakthroughs in understanding whats most effective.

Incentive: Its more important than ever to quit, since a new study in Thorax found people who smoke and test positive for COVID-19 are 200% more likely to end up in the hospital and 50% more likely to report over 10 COVID-19-related symptoms, including loss of smell, skipping meals, diarrhea, fatigue, confusion or muscle pain. More symptoms indicate a more severe case of COVID-19.

A plan: A recent study in JAMA says using varenicline is more effective than a nicotine patch or bupropion and using varenicline and a patch is even more powerful, although there is a slight increase in side effects.

Varenicline is a drug that reduces cravings for and the pleasurable effects of tobacco. You can take it before you quit to help you get there and after you quit to help you stay the course. The researchers recommend that varenicline be used for 12 weeks or longer. The problem: You cant drive or operate heavy machinery while taking it, so start while youre working from home!

The study also stresses that behavioral therapy should be part of a quit plan. Check out the Centers for Disease Control and Preventions 800-QUIT-NOW for info and coaching help. You can do it!

Q: Every time I have to interact with my health insurance, a doctors office or a hospital, I end up with the nagging feeling that Im not getting the best care I could be. Why does the U.S. health care system seem like such a mess?

Jess H., Lincoln, Neb.

A: It breaks our heart, but according to a well-done new study in JAMA Internal Medicine, the U.S. spends more than $3.5 trillion per year on healthcare, 25% more per capita than the next-highest-spending country. However ... compared with countries tracked by the Commonwealth Fund, the U.S. ranks behind every country on causes of preventable mortality that could have been addressed by health system interventions.

Where does that leave you? With a lot of work to make sure you stay healthy and a lot of work to make sure youre getting the best care you can. Fortunately, you can accomplish those things if you follow some pretty straightforward advice. In his upcoming book The Great Age Reboot, Dr. Mike predicts that scientific breakthroughs in aging research will help you live 30 years longer and younger. But you need to adopt a great lifestyle to benefit fully from these scientific breakthroughs. So here are four steps to help you regain control of your wellbeing day-to-day and when interacting with the health care system.

1. Follow the lifesaving nutritional advice in Dr. Mikes book What to Eat When and look at OzTube on doctoroz.com (search for exercise) for a complete rundown of activity choices.

2. Stay up to date with your regular checkups and vaccinations dont put it off.

3. Go to your doctor with written-out questions; take a family member or friend with you so they can ask questions too. Insist on being heard. Never hesitate to go for a second opinion.

4. If you go into the hospital, arrange to have the patient ombudsman talk to you so you know your rights, have an advocate and get answers to questions especially if family cannot be at your bedside.

Mehmet Oz, M.D. is host of The Dr. Oz Show, and Mike Roizen, M.D. is Chief Wellness Officer Emeritus at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily@sharecare.com.

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New help to quit smoking; how to get the health care you need - The Union Leader

Delawareans Will Have New Opportunity to Gain Health Insurance Through HealthCare.Gov from Feb. 15 to May 15 – State of Delaware News -…

NEW CASTLE (Feb. 9, 2021) Delawareans looking for affordable health insurance will have an additional opportunity to sign up for coverage including tax credits for eligible enrollees that help to reduce monthly premiums significantly from Feb. 15 to May 15 on HealthCare.gov, the federal online Health Insurance Marketplace created by the Affordable Care Act (ACA).

In light of the exceptional challenges and uncertainty caused by the coronavirus pandemic, President Joe Biden signed an executive order Jan. 28 that created a three-month special enrollment period (SEP) to give Americans greater access to health insurance, including those who lost their job or their coverage as part of the fallout from the pandemic.

Access to affordable health care remains a critical need for all Delawareans as we continue to fight the spread of the coronavirus. I am grateful to President Biden for giving state residents this additional opportunity to get the coverage they need, said Delaware Gov. John Carney. I encourage everyone to spread the word about the benefits of enrolling in coverage through HealthCare.gov during this three-month sign-up period.

This special enrollment period provides a great opportunity for Delawareans who are looking for high-quality, affordable health insurance, especially those impacted by the pandemic, said DHSS Secretary Molly Magarik. Despite the success of the Health Insurance Marketplace since it opened eight years ago, many state residents still lack insurance, and some might remain unaware that they can access comprehensive care and, in many cases, get financial help to afford it through HealthCare.gov.

The marketplaces annual open enrollment period for 2021 coverage ended Dec. 15, and since then individuals could get coverage only if they experienced a life event that qualified them to apply for a special enrollment period. The new three-month enrollment period is open to all eligible applicants who want to apply for coverage or change their existing coverage for any reason; applicants wont be required to provide documentation of a qualifying event (e.g., loss of a job or birth of a child).

Individuals currently covered under a marketplace plan will be able to change to any plan available in Delaware without being restricted to the same level of coverage as their current plan. Current enrollees will need to go through their existing application and make any necessary changes then submit their application in order to receive an updated eligibility result.

Eligible individuals who enroll under the special enrollment period will have 30 days after they submit their application to choose a plan. Note that even after the special enrollment period ends May 15, individuals who experience qualifying life-changing events will be eligible to enroll for marketplace coverage. (It is also worth noting that proof of insurance is not required to receive the COVID-19 vaccine, once your group becomes eligible.)

Delaware is one of 36 states that use HealthCare.gov for eligible residents to sign up for coverage. More than 25,000 Delawareans signed up for 2021 coverage during the recent open enrollment period.

The special enrollment period is available to all marketplace-eligible individuals who are submitting a new application or updating an existing application. You can enroll in marketplace coverage at http://www.HealthCare.gov or http://www.CuidadodeSalud.gov or by calling 1 (800) 318-2596 (TTY: 1 855 889-4325).

Applicants will need to provide the following when applying for coverage:

About 6.6 percent of Delawareans remain uninsured, according to the 2020 Americas Health Rankings. Thats down significantly from the nearly 10 percent who lacked insurance in 2010 before the ACA and the Health Insurance Marketplace existed.

For nearly a year, we have hoped that the Health Insurance Marketplace would allow for greater enrollment opportunities in response to the pandemic and economic conditions. President Biden has made it happen, said Insurance Commissioner Trinidad Navarro. This Special Enrollment Period will help ensure Delaware residents have access to comprehensive health insurance that protects pre-existing conditions. And, because weve reduced rates by more than 19% over the past two years, these plans are more affordable for residents.

Support from Congressional delegation

Delawares U.S. senators and representative urged uninsured or underinsured Delawareans, especially those who may have lost their jobs because of the pandemic, to find out whats available for them on the marketplace during the three-month enrollment period.

President Biden understands that it is critical for Americans to be able to access the care and coverage they need during an unprecedented pandemic. Thats why hes beginning a new open enrollment period so that Delawareans, and families across this country, have another chance to enroll in a health insurance plan and get covered this year, said U.S. Sen. Tom Carper, who helped pen the Affordable Care Act that created the marketplaces. Dont leave your familys well-being to chance. Enroll in an affordable, high-quality health insurance plan today that meets your needs and your budget.

I commend the Biden administration for reopening the federal online Health Insurance Marketplace, which will allow Delawareans, particularly those impacted by COVID-19, another opportunity to sign up for the health insurance coverage that best meets their needs, said U.S. Sen. Chris Coons. Ensuring that Delawareans have access to quality, affordable health care is critical, even more so during a pandemic. I urge all Delawareans who need health coverage to assess their options during this three-month special enrollment period.

As we continue to face the COVID-19 pandemic, and Americans are in need of affordable and accessible care, it is crucial that comprehensive health coverage is available to all those that need it, said U.S. Rep. Lisa Blunt Rochester. A special enrollment period is critical for allowing Delawareans in need of health insurance to sign up. Im grateful to President Biden for reopening the Health Insurance Marketplace and ensuring that everyone who needs coverage has access.

Whats covered

All plans on the marketplace offer essential health benefits such as coverage of pre-existing medical conditions, outpatient care (including telehealth services), emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, and pediatric services.

Marketplace plans cant terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19. The rules in marketplace plans for treatment of COVID-19 are the same as for any other viral infection; enrollees are encouraged to check their particular plan for complete information about benefits.

Highmark Blue Cross Blue Shield Delaware is the sole health insurer offering plans on Delawares Health Insurance Marketplace for 2021. Highmark offers 12 plans for individuals and families. Two dental insurers Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. offer a collective 11 stand-alone dental plans on the marketplace.


About 86 percent of marketplace enrollees in Delaware in 2020 were eligible for federal tax credits, which help reduce the cost of the monthly premium.

Tax credits are available for those whose household income is between 138 percent and 400 percent of the Federal Poverty Level. For 2021 coverage, thats between $17,609 and $51,040 for an individual, or between $36,156 and $104,800 for a family of four.

According to the most recent figures from the U.S. Department of Health and Human Services, the overall average monthly premium in Delaware in 2020 was $668, with the average premium reduced to $192 per month after tax credit. For the 86 percent of Delawareans who received financial assistance, the average premium after tax credit was $110 per month.

Plans on the marketplace are spread among metal-level categories bronze, silver, gold and platinum and are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need care. In a silver plan, the insurer pays about 70 percent of medical costs and the consumer pays about 30 percent. For any marketplace plan in 2021, individual consumers cant pay more than $8,550 in out-of-pocket medical costs and families cant pay more than $17,100.

Catastrophic plans are also available to some people. Catastrophic plans have low monthly premiums and very high deductibles. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself.

Consumers who pick silver health care plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 29 percent of current enrollees qualify for cost-sharing reductions.

Where to find help

Delawareans who want help enrolling in coverage will have access to free assistance from trained specialists at Westside Family Healthcare. Virtual and phone appointments are encouraged; in-person appointments are limited and must be made in advance. Because of the pandemic, walk-ins are not permitted. Assistance is available in any language and for all Delaware residents. Call 302-472-8655 in New Castle County, 302-678-2205 in Kent/Sussex counties or email enrollment@westsidehealth.org.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge. See a list at ChooseHealthDE.com.


President Bidens executive order also called for states to reexamine policies, such as work requirements, that restrict access to coverage through Medicaid, which pays medical bills for eligible low-income families and others whose income is insufficient to meet the cost of necessary medical services. This part of the presidents order does not affect Delaware, which under the ACA expanded access to Medicaid starting in 2014. More than 10,000 Delawareans have received coverage under the states Medicaid expansion. To be screened for eligibility or to apply for Medicaid benefits year-round, go to Delaware ASSIST.

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Delawareans Will Have New Opportunity to Gain Health Insurance Through HealthCare.Gov from Feb. 15 to May 15 - State of Delaware News -...

Health Care Workers Hit Hard by the Coronavirus Pandemic – The New York Times

Dr. Sheetal Khedkar Rao, 42, an internist in suburban Chicago, cant pinpoint the exact moment when she decided to hang up her stethoscope for the last time. There were the chaos and confusion of the spring, when a nationwide shortage of N95 masks forced her to examine patients with a surgical mask, the fears she might take the coronavirus home to her family and the exasperating public disregard for mask-wearing and social distancing that was amplified by the White House.

Among the final blows, though, were a 30 percent pay cut to compensate for a drop in patients seeking primary care, and the realization that she needed to spend more time at home after her children, 10 and 11, switched to remote learning.

Everyone says doctors are heroes and they put us on a pedestal, but we also have kids and aging parents to worry about, said Dr. Rao, who left her practice in October. After awhile, the emotional burden and moral injury become too much to bear.

Doctors, paramedics and nurses aides have been hailed as Americas frontline Covid warriors, but gone are the days when people applauded workers outside hospitals and on city streets.

Now, a year into the pandemic, with emergency rooms packed again, vaccines in short supply and more contagious variants of the virus threatening to unleash a fresh wave of infections, the nations medical workers are feeling burned out and unappreciated.

Over the last year, there have been the psychological trauma of overworked intensive care doctors forced to ration care, the crushing sense of guilt for nurses who unknowingly infected patients or family members, and the struggles of medical personnel who survived Covid-19 but are still hobbled by the fatigue and brain fog that hamper their ability to work.

Researchers say the pandemics toll on the nations health care work force will play out long after the coronavirus is tamed. The impact, for now, can be measured in part by a surge of early retirements and the desperation of community hospitals struggling to hire enough workers to keep their emergency rooms running.

Everyone wants to talk about vaccines, vaccines, vaccines, but for our members, all they want to talk about is work force, work force, work force, said Alan Morgan, chief executive of the National Rural Health Association. Right now our hospitals and our workers are just getting crushed.

Some health care experts are calling for a national effort to track the psychological well-being of medical professionals, much like the federal health program that monitors workers who responded to the 9/11 terrorist attacks.

We have a great obligation to people who put their lives on the line for the nation, said Dr. Victor J. Dzau, president of the National Academy of Medicine.

Celia Nieto, 44, an intensive care nurse in Las Vegas, said many Americans had scant appreciation for the tribulations that she and her colleagues face day after day. There is the physical exhaustion of lifting and turning patients on their bellies so they might breathe easier, the never-ending scramble to adjust ventilators and pain medication, and the mental anguish of telling relatives she doesnt have the time to help them FaceTime with their loved ones.

It feels like were failing, when in actuality were working with what weve got and we dont have enough, she said. We feel quite helpless, and its a real injury to our psyches.

Dr. Donald Pathman, a researcher at the University of North Carolina at Chapel Hill, said he was struck by the early results of a study he has been conducting on the pandemics effect on clinicians who serve in poor communities. Many of the 2,000 medical, dental and mental health professionals who have participated in the survey so far say they are disillusioned.

There is a lot of personal trauma, Dr. Pathman said. Many people have been scarred by their experiences during the pandemic, and they will look to leave their practices.

In interviews, doctors who have recently left the field or are considering early retirement said the pandemic had exacerbated frustrations spurred by shifts in the business of medical care that often required them to work longer hours without increased compensation.

In a survey released in September by the online site Medscape, two-thirds of American doctors said they had grappled with intense burnout during the pandemic, with a similar percentage reporting a drop in income. A quarter of respondents said their experiences with Covid had led them to exit the medical field.

Another survey, by the Physicians Foundation, found that 8 percent of doctors in the United States had closed their offices during the pandemic, translating to 16,000 fewer private practices.

Feb. 14, 2021, 8:48 p.m. ET

Dr. Erica Bial, a pain specialist from suburban Boston who barely survived Covid-19 last spring, said she felt increasingly drained.

We put on our masks and come to work every day because we dont have the luxury of working from home in our pajamas, but the apathy and ennui thats taken hold of society just makes our job feel thankless, said Dr. Bial, who works full time despite struggling with the lingering effects of her illness. Its so demoralizing.

Staffing shortages have been especially acute at nursing homes and long-term care facilities. They were already struggling to retain employees before the pandemic, but many are now facing an existential shortage of skilled workers. According to a study released last week by the nonpartisan U.S. PIRG Education Fund, more than 20 percent of the nations 15,000 nursing homes reported severe shortages of nursing aides in December, up from 17 percent in May, a significant jump over such a short period.

As more and more medical staff members fall ill or quit, those who remain on the job have to work harder, and the quality of care invariably suffers, said Dr. Michael L. Barnett, assistant professor at the Harvard T.H. Chan School of Public Health who served as a consultant to the study.

Its a recipe for a collapse in the work force, he said.

So far, the federal government has shown little interest in addressing what Dr. Dzau, of the National Academy of Medicine, writing in The New England Journal of Medicine, described as a parallel pandemic of psychological trauma among health workers.

He and other experts say the government should start by making a concerted effort to accurately count medical worker infections and fatalities.

There is no comprehensive federal government count of worker deaths. But according to a tally by Kaiser Health News and the Guardian, more than 3,300 nurses, doctors, social workers and physical therapists have died from Covid-19 since March.

Experts say the death toll is most likely far higher. The Centers for Disease Control and Prevention counts 1,332 deaths among medical personnel, which is striking given that its sister agency, the Centers for Medicare and Medicaid Services, lists roughly the same number of deaths just among nursing home workers a small portion of those employed by the nations hospitals, health clinics and private practices.

A number of studies suggest that medical professionals made up 10 percent to 20 percent of all coronavirus cases in the early months of the pandemic though they comprise roughly 4 percent of the population.

Christopher R. Friese, a researcher at University of Michigan, said the governments failure to track health care workers had most likely contributed to many unnecessary deaths. Without detailed, comprehensive data, he said, federal health authorities have been hamstrung in their ability to identify patterns and come up with interventions.

The number of health care worker deaths in this country are staggering, but as shocking and horrifying as they are, we cant be surprised because some very basic tools to address the crisis were left on the shelf, said Dr. Friese, who directs the schools Center for Improving Patient and Population Health.

Jasmine Reed, a spokeswoman for the C.D.C., acknowledged the limitations of its coronavirus case data, noting that the agency relies on reporting from state health departments and that can vary according to the state. At least a dozen states do not even participate in the C.D.C.s reporting process, she said.

Many medical workers who have survived Covid-19 face more immediate challenges. Dr. Bial, the pain specialist from Boston, is still plagued by fatigue and impaired lung function.

The day before I got sick, I could comfortably run eight to 10 miles, said Dr. Bial, 45, who started a Facebook group memorializing doctors lost to Covid. Now I go out for a brisk walk and my heart is pounding. Im starting to wonder whether these effects could be permanent.

Dr. Andrew T. Chan, a professor at Harvard Medical School and a gastroenterologist at Massachusetts General Hospital who has been studying the pandemics disproportionate toll on health care workers, said his preliminary research suggested that long haulers in the medical field suffer greater health challenges than the overall population. That is in part because they are often exposed to increased levels of virus, which can lead to more severe illness.

Another factor, he said, is that the worsening staffing shortages in much of the country lead many Covid survivors to return to work before they have fully recovered.

Health care workers are likely to experience a greater risk of long-term complications, Dr. Chan said. Covid could impact our health care system for years to come by not only depleting our work force but by impairing the ability of survivors to do their jobs.

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Health Care Workers Hit Hard by the Coronavirus Pandemic - The New York Times

What Health Care Providers and Facilities Should Know About the PREP Act’s "Covered Countermeasures" – JD Supra

As many businesses and those in the health care industry wonder what protections, if any, they have against COVID-19-related litigation claims, Jackson Walker's Healthcare practice chair, Virginia Mimmack, and healthcare litigator Brad Nitschke discuss the patchwork laws and regulations of federal, state, and local governments. While the PREP Act allows for certain "covered countermeasures" for litigation claims, the expansion of telehealth services beyond traditional state borders raises questions about what protections are provided Seemore+

As many businesses and those in the health care industry wonder what protections, if any, they have against COVID-19-related litigation claims, Jackson Walker's Healthcare practice chair, Virginia Mimmack, and healthcare litigator Brad Nitschke discuss the patchwork laws and regulations of federal, state, and local governments. While the PREP Act allows for certain "covered countermeasures" for litigation claims, the expansion of telehealth services beyond traditional state borders raises questions about what protections are provided for COVID-19-related activities performed by telehealth workers. Seeless-

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What Health Care Providers and Facilities Should Know About the PREP Act's "Covered Countermeasures" - JD Supra

These Are The States Attempting to Pass Anti-Trans Health Care Bills – Human Rights Campaign

Now, theyre targeting our communitys health care.

This legislative session, states across the country are trying to prevent transgender youth from receiving gender-affirming healthcare.

Right now, theres at least 15 bills targeting the trans community and our ability to seek medical care. Heres a running list of some of the bills were tracking, and what you can do to help:


This anti-trans medical bill in Alabama (HB 1/SB 10) is called Vulnerable Child Compassion and Protection Act. Despite its name, this bill has nothing to do with compassion or protection - and seeks to harm trans youth, not protect them. This bill would impose criminal penalties on medical professionals and parents who provide best practice gender-affirming care to trans youth.

This is an appalling overreach. Alabaman legislators are trying to tell parents how to care for their trans kids -- and theyre dead wrong.

Fight back now. If you live in Alabama, you can help us.

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These Are The States Attempting to Pass Anti-Trans Health Care Bills - Human Rights Campaign

Many health care workers turned down their COVID vaccine. Here’s why – KGW.com

Data show about 62% of nursing home workers nationwide have not gotten vaccinated for COVID-19. Many Portland hospital employees have also declined the vaccine.

PORTLAND, Ore. While thousands of people are still waiting to get the vaccine, there is a large group not getting it when offered.

According to a report from the Centers for Disease Control and Prevention (CDC), about 62% of nursing home workers across the country have not gotten the vaccine.

The CDC looked at more than 11,000 senior living facilities that held one vaccination clinic between mid-December and mid-January. While 78% of residents got the shot, only 37.5% of staff members did.

Melissa Unger, executive director for SEIO 503, which represents 73,000 nursing and home health care aides across Oregon, said there are several reasons why she believes workers declined the shot.

Unger said this is a young workforce with a distrust of government. Many nursing home workers have low wages and a difficult relationship with their employer.

Unger also said a large percentage of nursing home workers are people of color, who are historically vaccine hesitant.

"There are a lot of reasons. These are some of the first people to get it, lots of these people have had COVID because there's been massive outbreaks, so they question, do they need it? So, there's just a lot of factors that I think are really coming into play, said Unger, who believes most nursing home workers will eventually get the shot.

Its not just nursing home workers. Some hospital employees are also declining or refusing the COVID vaccine.

KGW Investigates checked with the major hospital systems in the Portland and found:

A spokesperson for OHSU said they dont have a number of who refused of declined the vaccine. Kaiser and Legacy Health officials told KGW they don't keep track of how many employees declined the vaccine.

Some workers have cited side effect concerns or wanting to give the shot to someone more vulnerable as reasons why they waited.

Its not a great idea for the people that are bathed in COVID like we are to refuse to get it because they themselves can be spreaders, said Dr. Mauricio Heilbronn, vice chief of staff at St. Mary Medical Center in Long Beach, California.

Dr. Heilbronn urges people in health care and everyone else to get it for themselves, for their families and to achieve the long-awaited herd immunity across the country.

This has been like a nightmare science fiction, horror movie for the last two months, three months. Anything we can do to keep people out of the hospital, we'll do that. And the vaccine will do that.

Originally posted here:

Many health care workers turned down their COVID vaccine. Here's why - KGW.com

Healthcare equity and Alzheimers is the focus of March 3 virtual town hall – cleveland.com

CLEVELAND, Ohio -- The Alzheimers Association will host a virtual town hall examining the relationship between access to health care and the deadly disease from 5 to 6:30 p.m. March 3.

Those interested in the free event should register online here.

The impacts of the coronavirus pandemic continue to expose disparities in healthcare access that overwhelmingly affect communities of color. And underserved populations contend with elevated rates of Alzheimers and other dementias as well as COVID-19.

According to the Alzheimers Association, Black populations are twice as likely as whites to develop Alzheimers or another dementia. Hispanics are 1.5 times more likely.

Complicating the picture, particularly for caregivers, CDC data confirms that minorities are at greater risk of contracting COVID-19.

Case Western Reserve University researchers recently released a study indicating that Black Americans with dementia are nearly three times as likely to become infected with COVID-19 as their white counterparts.

In general, Black Americans are also more prone to factors associated with vascular disease, including diabetes, high blood pressure and high cholesterol, that may put them at risk for Alzheimers and stroke-related dementia.

The town hall -- named for distinguished University of Michigan social psychologist James S. Jackson, who explored links between racial disparities and minority health -- will be hosted by Carl V. Hill, chief diversity, equity and inclusion officer for the Alzheimers Association, and Peter Lichtenberg, president of the Gerontological Society of America.

Speakers from The Ohio State University, the University of Michigan, Michigan State University, West Virginia University, the Michigan Alzheimers Disease Research Center and the Rockefeller Neuroscience Institute will provide valuable insights.

According to Hill, it is important to examine disparities in health care because the research highlights contextual factors for Alzheimers and other dementia risk.

For example, he explained, cardiovascular health and stress may be part of the pathways to Alzheimers and other dementia for disproportionately affected communities.

Eric VanVlymen, Ohio regional leader of the Alzheimers Association, said the organization remains committed to funding national research initiatives that target minorities.

Such initiatives include the new IDEAS study, which aims to enroll 4,000 African-American and Latino participants to determine whether amyloid PET scans improve diagnosis and treatment of Alzheimers.

The association also continues to work with partners in Ohio and nationwide to improve outreach and ensure that all communities have equal access to opportunities for early detection and diagnosis of the fatal illness.

Being there in the community and working within the community is so critically important, said Hill. Its an unparalleled opportunity to translate research findings and engage all communities using community-based participatory strategies.

Hill hopes that all who attend the town hall will walk away with a stronger commitment to health equity and inclusion as part of the overall effort to defeat Alzheimers and other forms of dementia.

The Alzheimers Association is the leading voluntary health organization involved with Alzheimers care, support and research. The associations 24/7 help line can be reached at 800-272-3900.

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Healthcare equity and Alzheimers is the focus of March 3 virtual town hall - cleveland.com

‘It happened so quickly’: Health-care workers lose everything in house fire – 9News.com KUSA

Mike and Tara Wiesner have spent a year on the frontlines helping people dealing with devastation, only to now deal with their own.

ERIE, Colo. A bag of dog food thudded as Allison Frary pushed it away with her foot. Donated jackets and pants were piled on her couches, and shoes covered her floor. She looked around and laughed at how cluttered the front room of her home had become.

"I dont like to look over there," she said as she stared at the charred home across the street. "But this happened because of that, so its nice to remember whats going on."

It was about 1 a.m. Wednesday when Frary ran out of her home in Erie to see the orange glow of a fire coming from her neighbor's house.

"It was my daughter," Frary said. "She heard Tara screaming for help and frantically started screaming for help for us to wake up because our neighbor's house was on fire."

The neighbors, Mike and Tara Wiesner, made it out safely along with their kids and dogs. A puppy and a guinea pig couldn't be saved. Mountain View Fire said the cause of the fire at the home on Parkdale Circle has not been released yet, but they didn't think it was suspicious.

"It happened so quickly that if our son hadn't woken us up, that would have been it," Mike Wiesner said.

"I just kept counting the children, just making sure all the kids were out," Tara Wiesner said.

Mike is a respiratory therapist, and Tara is a nurse case manager. Their year has been spent on the frontlines, helping people deal with devastation, only to come home to their own.

"My husband and I are no strangers to seeing people in peril and seeing people that were devastated by fire," Tara said. "Weve seen a lot go on this past year."

While the couple knows all too well how quickly anguish can spread, so can a little kindness, especially when it comes from just across the street.

"I asked them their sizes when they were here the night of the fire," Frary said as she folded a T-shirt. "Every member of the family has their own wardrobe now."

Frary said she couldn't sit around and replay those screams in her head. She needed to do something. She put the call out for donations the morning after the fire. Within hours, her living room was packed with clothes, toiletries, food and school supplies. She created a GoFundMe as well, and it raised more than $37,000 in a couple of days.

"It was just pretty much an instinct," she said. "I knew that they pretty much lost everything, their whole life that they have been working for. If they were in my shoes, I would just hope that they would do that same."

While houses may make up a neighborhood, they don't create a community. The Wiesner family realized it's compassion that really makes a neighborhood whole and believes theirs is worth rebuilding for.

"It's amazing the kindness that people can show you when something happens," Tara said. "Why would you ever want to leave that type of environment?"

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'It happened so quickly': Health-care workers lose everything in house fire - 9News.com KUSA