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Category Archives: Covid-19

Are Gyms Safe Right Now? What To Know About COVID-19 Risk While Working Out : Shots – Health News – NPR

Posted: July 5, 2020 at 10:50 am

Peet Sapsin directs clients inside custom built "Gainz Pods", during his HIIT class, (high intensity interval training), at Sapsins Inspire South Bay Fitness, Redondo Beach, California, Wednesday, June 17, 2020. Jay L. Clendenin/Los Angeles Times via Getty Images hide caption

Peet Sapsin directs clients inside custom built "Gainz Pods", during his HIIT class, (high intensity interval training), at Sapsins Inspire South Bay Fitness, Redondo Beach, California, Wednesday, June 17, 2020.

Exercise is good for physical and mental health, but with coronavirus cases surging across the country, exercising indoors with other people could increase your chance of infection. So, as gyms reopen across the country, here are some things to consider before heading for your workout.

Assess your own risk

It starts with you, says Dr. Saadia Griffith-Howard, an infectious disease specialist with Kaiser Permanente.

"You have to make your own assessment of how risky it is based on knowing your medical situation and whether you are someone who's at high risk for an infection," Griffith-Howard says.

People 65 years and older are at higher risk for getting a severe case of COVID-19, according to the Centers for Disease Control and Prevention. So are people with certain underlying health conditions, like diabetes, heart or lung disease, or those who are immunosuppressed.

So if you fall in a high risk category, Griffith-Howard says it may not be worth the risk.

"If it was someone in my family [who was high risk] I would suggest that they not go to a gym," she says.

Consider alternatives for working out

If you want to exercise indoors, it's safer to do it at home, says Doug Reed, an immunologist and aerobiologist at the University of Pittsburgh.

"That's what I'm doing now," he says. "When the weather's nice, I'm jogging outside, but when it's not, I'm doing some weights and stretches and exercise indoors."

Exercise outdoors is a great low-risk alternative, agrees Dr. Nikita Desai, a pulmonologist with the Cleveland Clinic. When you are outside it's easier to control how close you get to other people.

"I would be less worried about the jogger who is running past you for a split second and more worried about the person who's working out next to you without a mask for half an hour," she says.

And the risk of transmission is lower outside than inside, says Joshua Santarpia, a microbiologist who studies biological aerosols at the University of Nebraska Medical Center.

"Outdoors you have sunlight which has been shown to quickly inactivate the virus," he says. And outside airflow and humidity help dilute it.

If you do go: Assess your gym's safety measures

There are things gyms can do to help mitigate the risk of infection, so Griffith-Howard suggests making a checklist before you go.

"Are they taking your temperature?" she asks. "Are you seeing them regularly clean equipment? And are staff and other clients in the gym wearing a mask?"

Official guidance for how gyms should proceed varies state by state. Gyms are not open yet in some states, or open with restrictions in others find your state's restrictions here. Most guidelines suggest limiting capacity to keep the gym from getting crowded, routine disinfection of all equipment including machines and weights before and after use, posting signs to reinforce hygiene and other policies, and all recommend physical distancing.

In fact, that should be the number one thing on your checklist: Is there at least six feet of physical distance between everyone who is working out? Even more would be better. Another tip: Go during off hours when they'll be fewer people.

Some clubs have constructed exercise pods to ensure physical distancing. Others have gone touchless and are encouraging members to use a mobile app to check-in, says Sami Smith, Communications and Public Relations Assistant for the International Health, Racquet & Sportsclub Association, which has developed guidelines for clubs to use as a reference when planning their reopening.

Stay far apart. Really

This bears repeating stay at least six feet away from other people while you are exercising. And, if people are breathing heavily, "it would be preferable to double that to 12 feet," says Dr. Lou Ann Bruno-Murtha, division chief of infectious diseases at Cambridge Health Alliance in Cambridge, Mass.

That's because we don't know exactly how far virus particles travel when people are breathing heavily," says Doug Reed, an immunologist and aerobiologist at the University of Pittsburgh.

"When you are exercising and exerting yourself, you're going to be breathing out and breathing in more than you normally would, he says.

"And so the potential for being infected or spreading the infection would be that much higher," says Reed.

And if you're thinking about taking a group exercise class, think again, says Griffith-Howard, because it can be very difficult to keep six feet apart when moving around quickly.

"You may be breathing harder, people may be coughing, it may be hard to keep on masks," she says. "I would have some concerns about that."

A small study from South Korea looked at coronavirus spread at 12 different sports facilities. It found that infection spread rapidly among high intensity fitness dance classes with up to 22 students. Whereas yoga and pilates classes, with just seven or eight participants and little moving around, saw no spread.

So if you really want to take a group exercise class make sure it's small and that you can maintain a distance of six to 12 feet away from others.

Pay attention to air flow

Steer clear of small gyms and those with little ventilation, says Desai of the Cleveland Clinic.

"Your best bet is going to be a gym that is larger, able to have windows open or have multiple floors or levels to allow for physical distancing," she says.

That's because more space and more air flow dilute the concentration of the virus in the air and likely reduce the risk of transmission.

"If you're strenuously exercising then you're tending to draw in and exhale more air," says aerobiologist Reed.

This is especially important because there's increasing evidence to suggest "that people who are not symptomatic are, in fact, transmitting the infection," says Reed.

In fact levels of the virus found in the nose or throat of asymptomatic or pre-symptomatic individuals "can be considerable and are equivalent" to the amount of virus found in individuals with symptoms of coronavirus, he says.

So people who feel well enough to exercise may not realize they are infected, and may be on the weight machine next to you.

Should I wear a mask?

Our experts say it's best wear a mask as much as possible in the gym, including at the front desk, in the locker room and the bathroom and even while doing light exercise. But of course, when you're working out hard and breathing heavily it can be difficult to keep a mask on.

"Physical exercise doesn't lend itself well to the idea of wearing a mask," says Reed, because it can make it harder to breathe.

And while many gyms recommend masks, most don't require them.

"If you're doing aerobic type exercises on an aerobic type machine, you probably are not wearing a mask," says Bruno-Murtha of the Cambridge Health Alliance in Cambridge.

And even if people don a mask when they enter the gym, Bruno-Murtha still highly recommends maintaining at least a minimum 6-foot physical distance, "because I suspect at some points people may inadvertently remove their mask," she says which can be risky for others.

"Physical exercise is important for your physical and mental health but you still have to be smart," says Bruno-Murtha. "Wearing a mask is part of being smart, along with physical distancing, disinfecting equipment and vigilant hand washing."

Location, location, location

And, finally consider your geographic location. Exercising indoors in hot spots where cases are surging is more risky than in areas with low infection rates says Bruno-Murtha. So check out this color coded tracker to look up the COVID-19 risk in your county, and nearby counties.

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Are Gyms Safe Right Now? What To Know About COVID-19 Risk While Working Out : Shots - Health News - NPR

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COVID-19 Daily Update 7-3-2020 – 10 AM – West Virginia Department of Health and Human Resources

Posted: at 10:50 am

TheWest Virginia Department of Health and Human Resources (DHHR)reports as of 10:00 a.m., on July 3, 2020, there have been 179,995 totalconfirmatory laboratory results receivedfor COVID-19, with 3,077 total cases and 93 deaths.

In alignment with updated definitions fromthe Centers for Disease Control and Prevention, the dashboard includes probablecases which are individuals that have symptoms and either serologic (antibody)or epidemiologic (e.g., a link to a confirmed case) evidence of disease, but noconfirmatory test.

CASES PER COUNTY (Case confirmed by lab test/Probable case):Barbour(15/0), Berkeley (444/18), Boone (20/0), Braxton (3/0), Brooke (8/1), Cabell(139/6), Calhoun (2/0), Clay (10/0), Fayette (67/0), Gilmer (13/0), Grant(15/1), Greenbrier (60/0), Hampshire (42/0), Hancock (21/3), Hardy (44/1),Harrison (66/0), Jackson (143/0), Jefferson (230/5), Kanawha (323/9), Lewis(19/1), Lincoln (8/0), Logan (26/0), Marion (61/3), Marshall (40/1), Mason (19/0),McDowell (6/0), Mercer (46/0), Mineral (55/2), Mingo (19/3), Monongalia(181/14), Monroe (13/1), Morgan (19/1), Nicholas (12/1), Ohio (100/1),Pendleton (12/1), Pleasants (4/1), Pocahontas (28/1), Preston (68/15), Putnam(59/1), Raleigh (54/1), Randolph (161/1), Ritchie (2/0), Roane (11/0), Summers(2/0), Taylor (16/1), Tucker (6/0), Tyler (4/0), Upshur (20/1), Wayne (114/1),Wetzel (10/0), Wirt (4/0), Wood (102/8), Wyoming (7/0).

As case surveillance continues at thelocal health department level, it may reveal that those tested in a certaincounty may not be a resident of that county, or even the state as an individualin question may have crossed the state border to be tested.Such is the case of Kanawha County in this report.

Please visit thedashboard at http://www.coronavirus.wv.gov for more information.

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COVID-19 Daily Update 7-3-2020 - 10 AM - West Virginia Department of Health and Human Resources

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FDA commissioner refuses to defend Trump claim that 99% of Covid-19 cases are ‘harmless’ – CNN

Posted: at 10:50 am

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CNN's Sarah Westwood reports.","descriptionText":"Kimberly Guilfoyle -- the girlfriend of Donald Trump Jr. and a top fundraiser for the Trump campaign -- has tested positive for coronavirus, according to a top official for the committee she leads. CNN's Sarah Westwood reports."},{"title":"Stelter: Trump's speech won't make sense to most people","duration":"02:08","sourceName":"CNN","sourceLink":"https://www.cnn.com/","videoCMSUrl":"/video/data/3.0/video/politics/2020/07/04/trump-mount-rushmore-stelter-ndwknd-vpx.cnn/index.xml","videoId":"politics/2020/07/04/trump-mount-rushmore-stelter-ndwknd-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200704092042-stelter-trump-speech-vpx-large-169.jpg","videoUrl":"/videos/politics/2020/07/04/trump-mount-rushmore-stelter-ndwknd-vpx.cnn/video/playlists/this-week-in-politics/","description":"President Donald Trump used the backdrop of Mount Rushmore the night before the Fourth of July to deliver a speech to his base. 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CNN's Nic Robertson reports on how the country's virus response is the latest in a long line of President Trump's policies that has reduced America from respected partner to unreliable ally."},{"title":"'On another planet': Tapper reacts to Trump's virus comment","duration":"01:58","sourceName":"CNN","sourceLink":"http://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/politics/2020/07/02/trump-coronavirus-response-jake-tapper-lead-vpx.cnn/index.xml","videoId":"politics/2020/07/02/trump-coronavirus-response-jake-tapper-lead-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200702172445-trump-coronavirus-response-jake-tapper-lead-vpx-00000000-large-169.jpg","videoUrl":"/videos/politics/2020/07/02/trump-coronavirus-response-jake-tapper-lead-vpx.cnn/video/playlists/this-week-in-politics/","description":"President Trump continues to falsely suggest that the coronavirus is under control in the United States. 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"},{"title":"Trump's former adviser says President is trying to avoid responsibility","duration":"01:37","sourceName":"CNN","sourceLink":"www.cnn.com","videoCMSUrl":"/video/data/3.0/video/politics/2020/07/02/bolton-trump-russian-bounty-intel-lead-tapper-sot-vpx.cnn/index.xml","videoId":"politics/2020/07/02/bolton-trump-russian-bounty-intel-lead-tapper-sot-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200702153253-bolton-the-lead-0722020-large-169.jpg","videoUrl":"/videos/politics/2020/07/02/bolton-trump-russian-bounty-intel-lead-tapper-sot-vpx.cnn/video/playlists/this-week-in-politics/","description":"Former national security adviser to President Trump, John Bolton, says that it is hard for him to believe that the President was not informed about intelligence that suggested Russia might be offering bounties to kill US soldiers in Afghanistan. ","descriptionText":"Former national security adviser to President Trump, John Bolton, says that it is hard for him to believe that the President was not informed about intelligence that suggested Russia might be offering bounties to kill US soldiers in Afghanistan. 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","descriptionText":"CNN's Jeff Zeleny speaks to longtime Republicans in Florida who say they will not vote for President Donald Trump in November because of his response to the coronavirus pandemic. "},{"title":"US sets a new single-day record of coronavirus cases","duration":"02:53","sourceName":"CNN","sourceLink":"https://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/politics/2020/07/02/coronavirus-new-single-day-record-trump-masks-boris-sanchez-vpx.cnn/index.xml","videoId":"politics/2020/07/02/coronavirus-new-single-day-record-trump-masks-boris-sanchez-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200702082152-map-0702-large-169.jpg","videoUrl":"/videos/politics/2020/07/02/coronavirus-new-single-day-record-trump-masks-boris-sanchez-vpx.cnn/video/playlists/this-week-in-politics/","description":"CNN's u003ca href="http://www.cnn.com/profiles/boris-sanchez-profile" target="_blank">Boris Sanchezu003c/a> reports on the United States u003ca href="http://www.cnn.com/2020/07/02/us/florida-coronavirus-thursday/index.html" target="_blank">setting a new recordu003c/a> for most Covid-19 cases reported in one day.","descriptionText":"CNN's u003ca href="http://www.cnn.com/profiles/boris-sanchez-profile" target="_blank">Boris Sanchezu003c/a> reports on the United States u003ca href="http://www.cnn.com/2020/07/02/us/florida-coronavirus-thursday/index.html" target="_blank">setting a new recordu003c/a> for most Covid-19 cases reported in one day."},{"title":"Lawmaker: I'm out of words describing this lack of leadership","duration":"01:25","sourceName":"CNN","sourceLink":"http://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/politics/2020/07/02/coronavirus-american-deaths-donald-trump-leadership-inability-shalala-sot-ac360-vpx.cnn/index.xml","videoId":"politics/2020/07/02/coronavirus-american-deaths-donald-trump-leadership-inability-shalala-sot-ac360-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200701203245-coronavirus-american-deaths-donald-trump-leadership-inability-shalala-sot-ac360-vpx-00000301-large-169.jpg","videoUrl":"/videos/politics/2020/07/02/coronavirus-american-deaths-donald-trump-leadership-inability-shalala-sot-ac360-vpx.cnn/video/playlists/this-week-in-politics/","description":"Rep. Donna Shalala (D-FL) tells CNN's u003ca href="http://www.cnn.com/profiles/jim-sciutto" target="_blank">Jim Sciuttou003c/a> she's "running out of words" to describe the "lack of leadership" from the White House as the u003ca href="http://www.cnn.com/2020/07/01/health/us-coronavirus-wednesday/index.html" target="_blank">nation reels from the coronavirus pandemicu003c/a>.","descriptionText":"Rep. Donna Shalala (D-FL) tells CNN's u003ca href="http://www.cnn.com/profiles/jim-sciutto" target="_blank">Jim Sciuttou003c/a> she's "running out of words" to describe the "lack of leadership" from the White House as the u003ca href="http://www.cnn.com/2020/07/01/health/us-coronavirus-wednesday/index.html" target="_blank">nation reels from the coronavirus pandemicu003c/a>."},{"title":"Susan Rice: Trump is derelict in his duty","duration":"02:39","sourceName":"CNN","sourceLink":"http://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/politics/2020/07/02/susan-rice-intel-report-russia-bounty-ac360-vpx.cnn/index.xml","videoId":"politics/2020/07/02/susan-rice-intel-report-russia-bounty-ac360-vpx.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/160515210257-susan-rice-large-169.jpg","videoUrl":"/videos/politics/2020/07/02/susan-rice-intel-report-russia-bounty-ac360-vpx.cnn/video/playlists/this-week-in-politics/","description":"President Obama's former national security adviser Susan Rice discusses President Trump's response to US intelligence reports of potential Russian bounties on US troops.","descriptionText":"President Obama's former national security adviser Susan Rice discusses President Trump's response to US intelligence reports of potential Russian bounties on US troops."},{"title":"Mayor received racist texts after mandating masks","duration":"02:11","sourceName":"CNN","sourceLink":"http://www.cnn.com","videoCMSUrl":"/video/data/3.0/video/politics/2020/07/02/kansas-city-quinton-lucas-mayor-death-threats-masks-sot-vpx-ebof.cnn/index.xml","videoId":"politics/2020/07/02/kansas-city-quinton-lucas-mayor-death-threats-masks-sot-vpx-ebof.cnn","videoImage":"//cdn.cnn.com/cnnnext/dam/assets/200701201621-mayor-lucas-large-169.jpg","videoUrl":"/videos/politics/2020/07/02/kansas-city-quinton-lucas-mayor-death-threats-masks-sot-vpx-ebof.cnn/video/playlists/this-week-in-politics/","description":"Kansas City, Missouri, Mayor Quinton Lucas describes receiving a death threat and racist text messages after mandating the use of face coverings while in public. 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FDA commissioner refuses to defend Trump claim that 99% of Covid-19 cases are 'harmless' - CNN

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Alaska reports 16th death tied to COVID-19 and 55 more resident and nonresident cases – Anchorage Daily News

Posted: at 10:50 am

We're making coronavirus coverage available without a subscription as a public service. But we depend on reader support to do this work. Please consider joining others in supporting local journalism in Alaska for just $3.23 a week.

As Alaskans commemorated Independence Day, the state reported another death associated with COVID-19 and 55 more cases among residents and nonresidents.

The 16th reported death of an Alaskan with COVID-19 involved an Anchorage man in his 70s with underlying health conditions, Alaska Department of Health and Social Services spokesman Clinton Bennett said Saturday. The man died in Alaska, though Bennett was not immediately able to clarify when his death occurred.

The state on Friday reported a 15th resident death involving an Anchorage man in his 80s who died in early June. In that case, the virus was listed as a contributing cause of death, the state health department said in a statement.

We are thinking of the loved ones of the person who died, the states chief medical officer, Dr. Anne Zink, said in statement Friday. We are concerned about Alaskas sharp rise in cases and hope everyone takes this as a warning call to limit contacts this weekend, stay six feet apart from non-household members, wear a face mask and wash your hands often.

If you are sick, even with mild COVID-19 symptoms, please isolate yourself and seek testing. We need all Alaskans working together to break infection chains.

Forty-eight residents and seven non-Alaskans newly tested positive for the illness caused by the coronavirus as of Saturday, according to the state health departments COVID-19 dashboard. Since the start of the pandemic, 1,111 Alaskans and 230 nonresidents have tested positive. Of those, 551 resident cases and 174 nonresident cases are active, meaning they are not considered to be recovered from COVID-19.

The new cases reported Saturday continue a surge in daily case counts and active cases since the state lifted most pandemic-related restrictions on businesses and social gatherings in late May. State officials have said they expect coronavirus case numbers to rise as people mix together, but they believed the state had the health care capacity and supply of personal protective equipment to manage an increase in cases.

The influx of new cases has strained the states ability to swiftly conduct contact tracing, however, with new cases now involving dozens or hundreds of contacts as opposed to just a few contacts per case, which was more often the situation earlier in the pandemic. In the states largest city, health officials this week said Anchorage had reached its maximum capacity to conduct contact tracing.

Investigating recent cases and tracking their contacts is a key component in helping limit the spread of the virus.

Three more Alaskans confirmed to be infected with the virus required hospitalization, bringing that total to 72 since the coronavirus was first detected in the state. There were 23 people with suspected or confirmed cases of the illness currently in the hospital, according to state data Saturday, which is down two from the previous day.

Fourth of July celebrations were canceled across the state, prompting Alaskans to celebrate on a smaller scale this weekend and organize their own festivities. Ahead of the holiday, state officials including Gov. Mike Dunleavy urged Alaskans to wear face coverings and maintain a physical distance of 6 feet from other people to avoid spreading the coronavirus.

Southcentral Alaska saw the bulk of new cases reported by the state Saturday. The new cases involve 32 residents of Anchorage, where the city health department confirmed COVID-19 exposure at more than a dozen establishments on specific dates in June. Health officials urged anyone who visited those businesses mostly bars at the specified times to monitor themselves for COVID-19 symptoms and get tested.

Elsewhere in Southcentral, four residents of Wasilla, one in Palmer, two in Willow and one in Soldotna also were confirmed to have COVID-19, according to state data.

The state reported no new cases out of Seward among test results returned Friday, but the city said four new cases emerged there Saturday. (The state reports new virus cases daily based on test results returned the previous day, and the new Seward cases will likely be included in the states count Sunday.) Officials in Seward this week limited gathering sizes, required masks in indoor public spaces and restricted capacity at businesses in an effort to contain an outbreak involving a couple dozen people.

The state on Saturday also reported four cases among residents of Fairbanks, one in Petersburg and one each in smaller communities in the Yukon-Koyukuk Census Area, Bethel Census Area and Bristol Bay plus Lake and Peninsula boroughs. The state doesnt report the name of communities smaller than 1,000 people as a means of privacy protection.

The Bristol Bay Area Health Corp. said in a statement that a Bristol Bay-area resident who developed symptoms of COVID-19 after traveling to Anchorage tested positive Friday. That person is self-isolating and several close contacts of theirs were instructed to remain in strict quarantine, the health corporation said, adding that the City of Dillingham and the affected village have also been notified of this new index case.

New nonresident cases include a seafood industry worker and another person in Anchorage, two seafood industry workers in Valdez, two people in Fairbanks and one individual in Juneau. The vast majority of nonresident cases confirmed in the state involve workers in Alaskas seafood industry, whose employees from out of state are generally required to undergo COVID-19 testing or quarantine before being allowed to work here.

On Friday 2,524 tests were run, out of 122,732 tests processed since the start of the pandemic, according to state data. Testing data reflects individual tests that were run, and not necessarily the number of individuals who have been tested.

Alaska health officials continue to urge Alaskans to maintain a distance of 6 feet from non-household members; frequently wash their hands; wear a mask in places where physical distancing is difficult to maintain; wipe down and sanitize frequently touched surfaces; stay home if they feel sick; and get a COVID-19 test if theyre experiencing symptoms of the illness.

Anchorage Daily News reporter Morgan Krakow contributed.

[Because of a high volume of comments requiring moderation, we are temporarily disabling comments on many of our articles so editors can focus on the coronavirus crisis and other coverage. We invite you to write a letter to the editor or reach out directly if youd like to communicate with us about a particular article. Thanks.]

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Why tick season could be worse in the summer of Covid-19 – CNN

Posted: at 10:50 am

Noting the mild winter on the East Coast, Sapi says, "We do have a bad year for the ticks."

Hikers, campers and anyone else eager for an escape could "just explode into the outdoors. And there may not be the same thoughtful approach" to preventing exposure, explains Dr. Sorana Segal-Maurer, director of the Dr. James J. Rahal, Jr. Division of Infectious Diseases at NewYork-Presbyterian Queens health care system.

"I'm a little nervous that their guard may be down just a slight bit," she adds.

Outdoor crowds were so big around Memorial Day weekend, that parks from southern California to North Carolina had to close early after hitting capacity.

Last year, the Centers for Disease Control and Prevention announced a rise in Lyme and other tick-borne diseases, with seven additional germs identified in the US in the last two decades, while the "lone star tick" expanded its footprint beyond the southeast to northern states and the Midwest.

But ignoring basic steps that reduce the risk of tick and vector-borne illnesses to focus solely on Covid-19 prevention is just one danger. Another is the possibility of confusing the symptoms if you start feeling sick.

Lyme disease and Covid-19: a tale of similar symptoms

Warning signs for tick-borne illnesses are "very similar to the severity that we've seen with Covid-19, which is that fever, the muscle aches, the headaches, the severe fatigue," says Dr. Segal-Maurer.

She believes a unique difference is that breathing problems are common in coronavirus patients, but not with those infected by tick diseases. Yet even that distinction is up for debate.

"Pulmonary involvement, even to a fatal degree, has been documented in a range of tick-borne infections," Dr. Steven Phillips of the Bay Area Lyme Foundation tells CNN. "Although serious pulmonary involvement with vector-borne infections is relatively uncommon, non-specific pulmonary complaints, such as shortness of breath, are extremely common."

Even if you follow the Covid-19 tips, heeding the advice to avoid bites is just as important. Dr. Segal-Maurer describes a "realistic" scenario if you're on a crammed hiking trail: "You're all going to be pushing into the vegetation ... you're going to be just a little bit off the path."

Ticks "hang off the very tip of the blade of grass or the leaf or the vegetation, and they have these little feelers that they ... sort of shake out there. So, the second you brush by, they latch on."

Last month, Pennsylvania Secretary of Health Dr. Rachel Levine announced an increase in emergency room visits over the past several months "related" to tick bites. "Some symptoms of Lyme disease, such as fever, chills and headache, are similar to symptoms of COVID-19," Dr. Levine said in a statement, reiterating what other experts say.

Head outside -- but responsibly

Dr. Segal-Maurer says health care professionals always need to ask patients about their travel and other activities. "You have to cover all your bases... we don't want to be Covid-blinded."

Patients, in turn, should also be asking about both possibilities.

And when it comes to guarding yourself from ticks, she says, "You need to use DEET. It's gotta be 30%. You need to watch where you hike. And then you need to do a body check when you get back inside."

Dr. Phillips prefers Permethrin, which he says is stronger, but "can only be sprayed on clothes, not skin, and should be allowed to dry overnight before wearing."

Other tips include putting on hats, light-colored clothing to make ticks easier to spot, placing socks over your pants and choosing long-sleeved shirts to block ticks from getting near your skin.

That, of course, is in addition to wearing a mask to fight coronavirus spread.

Yet even with the extra hassle for a safer summer getaway, Dr. Segal-Mauer encourages people to head outside this summer because she believes "it's been such a traumatic several months. I think the great outdoors is a very healing place."

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Why Some Young People Fear Social Isolation More Than COVID-19 – NPR

Posted: at 10:50 am

Recent protests in Philadelphia and across the country have drawn young people. But for most of the pandemic, youth have been quarantined and away from their social circles, which could make depression and other mental illness worse. Cory Clark/NurPhoto via Getty Images hide caption

Recent protests in Philadelphia and across the country have drawn young people. But for most of the pandemic, youth have been quarantined and away from their social circles, which could make depression and other mental illness worse.

Audrey just turned 18 and relishes crossing into adulthood: She voted for the first time this year, graduated high school and is college-bound next month. The honors student typically wakes up "a bundle of nerves," she says, which had fueled her work volunteering, playing varsity sports and leading student government.

But for years, she also struggled with anxiety, depression and obsessive compulsive disorder all of which drove her to work harder.

"I was spending so much time on my homework, I felt like I was losing my friends so my thoughts would race over and over again about my friends," says Audrey. "And then I would have the difficult thoughts about suicide and some scarier stuff." (NPR agreed to use only her first name to protect her medical privacy.)

Audrey's psychological struggles landed her in mental health treatment last fall. There, she says, the coping skills she learned gave her perspective on quarantine: "I know all about how seeing friends and seeing people outside and social interaction is vital for survival."

There is a simmering tension between young people's desire to gather socially, and the growing threat from the coronavirus in the United States. The virus is now infecting more people in their teens and 20s than it had earlier in the pandemic, and that's contributing to outbreaks, especially in states in the South and West. As a result, public health officials are imploring young adults to limit social contact and take precautions to help protect their more vulnerable elders. But many young people see continued social isolation as a much greater risk than COVID-19 to their own mental health.

It's not that Audrey isn't worried about the pandemic; in fact, confirmed cases of the coronavirus are spiking in her hometown of Charlotte, N.C. So Audrey wears masks, washes her hands and stays 6 feet from friends. But for her generation, she says, infection isn't the primary threat.

"A lot of people are calling attention to coronavirus because it's right in front of us," she says. "But at the same time, teens' depression rate it's a silent threat."

The health risks of infection differ by generation. For many young adults, life lived at a social distance, with a lack of peer support, comes at a high cost to mental health. The Centers for Disease Control and Prevention says nearly half of people between 18 and 29 report feeling symptoms of anxiety or depression. That's significantly higher that the rate for both their parents and their grandparents. Suicide is the second leading cause of death for people under 35.

Yet somehow, says Audrey, that's not talked about as much.

"We haven't seen the government or adults as passionate about the things we really care about, like mental health and climate issues," she says.

It might be tempting to think that FaceTime and Zoom provide substitutes for in-person social outlets, especially for a generation of digital natives who grew up with smartphones. But, therapists say, talking by small screen offers no replacement for a calming hug and can miss the subtleties of a compassionate expression.

Audrey's complaint is a common refrain among the adolescent and young adult patients whom psychologist Lisa Jacobs counsels. It is not that they aren't concerned about the risks of COVID-19, she says; it's just that their risk calculations differ.

"They are appropriately realizing that isolation is a risk for them as well it's a risk factor for depression, and depression is a risk factor for suicide," Jacobs says. "And 8% of American teens attempt suicide each year."

Jacobs says many of her young patients complain older generations failed to address the young people's fears of school shootings and climate change, for example.

"After not being protected, after not being taken seriously, they were asked to take extreme measures to protect other groups and to put themselves at risk by doing so," Jacobs says.

There is a biological basis for young people's need for socialization. Scientists say bonding isn't a luxury; it's critical for development.

Young brains need social connection to feel secure about their identity and place in the world, says Gregory Lewis, who studies the neurobiology of social interaction at Indiana University.

"We expect as a human being to have other people there to share the stressful times and to be our backup, and when they're not there physically, that in of itself tells our nervous system 'you're in a dangerous environment because you don't have these people here,' " he says.

That is less of an issue among older adults, Lewis says, who have had more time to develop their social networks both at work and around their community and more time to find partners who can help ground them emotionally. By contrast, he says, "younger people are missing a larger percentage of what previously was there to buffer them."

So the societal challenge, he says, is to find ways to help community members of all ages balance the risks of infection against the need to foster those essential social bonds.

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The New Normal For International Air Travel In The COVID-19 Era : Goats and Soda – NPR

Posted: at 10:50 am

Passengers are tested for COVID-19 at Beirut International Airport on July 1. Anwar Amro/AFP via Getty Images hide caption

Passengers are tested for COVID-19 at Beirut International Airport on July 1.

I've been stranded in Kenya since March, trying to get a "repatriation" flight to return home to the United States. I was finally able to book a flight but I'm still not sure I'll be able to board at the scheduled departure time a week from Saturday. Not only are cancellations part of the new normal for international flights, but passengers in some countries need to present evidence they're likely not infected with the novel coronavirus before being allowed to board.

In Kenya, that means going to a private laboratory chain within 72 hours of my scheduled departure time and undergoing a COVID-19 test, which will cost about 8,000 shillings about $80. The lab will provide documentation of my test results which I must present to airline staff at check-in.

As governments worldwide ease lockdown restrictions and lift bans on international travel, travelers will have lots of questions about how to proceed. Whether you are an expatriate hoping to return to your home country, a traveler with an urgent personal or business matter that requires an international trip or a tourist willing to consider a holiday in another country, here is what you need to know.

First: Flight schedules remain uncertain with frequent and last-minute cancellations and changes in departure dates and times, mainly because airlines can't fill enough seats on the plane to make it financially worth it. To make life less painful for passengers in these uncertain times, many airlines have dropped fees for changing flights and are even honoring unused but expired tickets.

Second: Some destinations have only opened their borders to travelers from select countries where there is a low or declining number of new COVID-19 cases. Those in countries such as the U.S., Brazil and Russia, where outbreaks are still surging, will not be permitted to enter any European country that has recently opened its borders, for instance. Cyprus will only allow incoming flights from about 35 mostly European countries, and Thailand will only allow in certain groups of foreigners such as students studying at Thai schools, those with valid work permits or spouses of Thai nationals.

Third: Many airlines and destination countries are now requiring passengers to undergo COVID-19 testing prior to boarding a flight and to provide a variety of paperwork proving they do not have the respiratory illness. Kenyan citizens returning home from India, for instance, are required to provide an electronic note from a physician confirming they have tested negative for the virus before they are allowed to fly. Those flying Kenya Airways have to arrange for a COVID-19 PCR test, which determines if a person is contagious within 72 hours of their flight and present negative test results to airline staff at check-in. Emirates airline has been conducting rapid COVID-19 blood tests at the airport, which take 10 minutes to return a result, for passengers flying through Dubai to destination countries that require documentation that you're COVID-19-free. Other airlines similarly require passengers to be tested between 2 to 7 days before their scheduled departure.

Dr. Lin Chen, an associate professor at Harvard Medical School and president of the International Society of Travel Medicine, says that requiring passengers to show proof of their virus-free status is, overall, a good step to help prevent the transmission of the disease both during the flight and once passengers reach their destination.

However, these new measures are not perfect. Prospective travelers may test negative for COVID-19 days before their flight but can still be exposed to the virus between the time they go for testing and the time they board.

Moreover, COVID-19 testing is not foolproof. Testing may not be done properly and even if it is, there can be false negatives which might allow contagious individuals to board a flight. Another consideration: Depending on your country of residence, it may be difficult to get tested if there is a shortage of testing centers, health-care staff or testing equipment. And in some countries, expats may not be eligible to receive care from public health services while private health insurance policies may not cover the cost of testing if the test is not considered medically necessary.

Apart from logistical challenges, the looming question remains: is it safe to travel?

Scientific studies and outbreak investigations have found that COVID-19 transmission in crowded, indoor spaces such as cruise ships, churches and factories can be explosive.

But according to Chen, transmission of COVID-19 between passengers on airplanes is rare.

On one January flight from China to Canada, a passenger with a symptomatic case of COVID-19 did not infect any of the 350 passengers on board, according to a brief report by Canadian researchers. Similarly, on a flight from New York to Taipei, a passenger with COVID-19 also did not infect anyone else on board, according to Chen.

The U.S. Centers for Disease Control and Prevention also asserts that the risk of getting an infectious disease on a flight is low while the United Nation's International Civil Aviation Organization states on its website that restricting international travel is not an effective means of containing outbreaks.

Yet despite these reassurances, there are documented cases of transmission of COVID-19 on an airplane. On a March 2 flight from London to Vietnam, a woman who was infected with the virus went on to infect at least 13 other passengers, according to Vietnam's Ministry of Health.

The IATA, International Civil Aviation Organization, World Health Organization, and the US Federal Aviation Association have all released guidelines for travel during the pandemic, and many airlines have adapted them and introduced protective measures to keep crew and passengers safe. For example, many airlines have stopped giving passengers reusable items such as blankets, magazines and headphones and have increased layover times and time between flights to allow for more thorough cleaning of the cabins. Most, if not all,airlines have also installed high efficiency particulate air, or HEPA, filtration systems which are better at cleaning the air than most systems used in hospital isolation rooms, Chen says. Airlines provide information about their air filtration systems on their websites.

Chen says that passengers can further protect themselves by following all the anti-virus guidelines they would follow outside of the plane including wearing a mask, washing hands and practicing social distancing as much as possible. In addition, Dr. Chen recommends passengers avoid crowded areas of the airport, carry hand wipes, sanitize or avoid "high-touch" areas and bring their own food.

In addition, says Chen, travelers should research the current COVID-19 situation in their prospective destination country and the country's capacity to test and treat people with the viral illness. She also suggests finding out if the destination country has policies requiring people to wear masks in public or encouraging hand-washing and practicing social distancing while on public transit, grocery stores and other public-gathering places. Prospective travelers can find this information on national and international health agency websites including the World Health Organization and CDC and from health ministries, immigration offices and embassies in destination countries.

And then there are questions, if travel is optional, that only you can answer."For tourism or adventure travel, the individual traveler has to consider their own personal risk and whether they tolerate that potential risk of getting infected and whether they might bring it home to their family or community especially if they have older family members who are more susceptible to severe disease," Chen says.

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Latin America sees half of all new Covid-19 infections as health systems flounder – CNN

Posted: at 10:50 am

Since then, similar scenes have played out across Latin America, which has seen an explosive spread of the coronavirus. In Guayaquil, Ecuador's largest city, coffins were fashioned from cardboard boxes as bodies were left uncollected. In the Chilean capital Santiago, public hospitals were overwhelmed as lockdown was eased too soon.

The head of the Pan American Health Organization (PAHO), Dr. Carissa Etienne, said this week: "The region of the America is clearly the current epicenter of the Covid-19 pandemic."

There are many reasons for Covid-19's outsize impact on Latin America: high levels of inequality, the vast "gray" economy of informal workers, a lack of sanitation in crowded urban slums, as well as slow and uneven responses by governments.

Alejandro Gaviria, a former Colombian health minister, told CNN: "Latin America is very heterogeneous. In some cities, health infrastructure is similar to what you find in developed countries; in rural areas, infrastructure is poor in general. It is like having Europe and Africa in the same continent."

Latin American states have had dramatically different experiences with Covid-19. Uruguay, which has a well-funded public health system, embarked on an aggressive tracking and testing program when the pandemic arrived. Despite a change of government in the middle of the crisis, it has had a consistent policy on lockdown. Nearly 20% of the population downloaded a government app with guidance on the virus.

Paraguay, which is much poorer than Uruguay, appears to have benefited from an early lockdown. It also enforced quarantine measures for people entering the country from Brazil, the epicenter of infections in Latin America.

Crowded living conditions in poorer urban areas, where basic hygiene and social distancing are next to impossible, threaten the region with a growing tide of infections. As Dr. Marcos Espinal, chief of the Department of Communicable Diseases and Health Analysis at PAHO, told CNN: "In the barrios of Lima it's going to be very difficult to do social distancing."

Espinal noted that in some countries only a third of the population have a fridge, meaning people must shop daily.

Low Investment

Gaviria says there are many differences between countries, "but most people have access to some type of care. In Colombia, for example, coverage is close to 100%."

Quality is a different issue, though, he says -- a point echoed by Espinal at PAHO. All but five or six governments fall well short of the WHO target of spending 6% of GDP on health, he says. Peru, for example, spends 3.3%.

Some Amazon towns in Brazil are more than 500 kilometers from the nearest ICU bed. In 2016, there were fewer than three beds per 100,000 inhabitants in some northern states in Brazil, but more than 20 beds per 100,000 in the wealthier south-east. The PAHO has warned that the region won't overcome the virus unless it improves care for marginalized communities, such as indigenous peoples in the Amazon. CNN reported a surge of infections this week among the Xavante people in the north-east of the Brazilian state of Mato Grosso.

Coronavirus is just one of multiple health crises in Latin America. Studies shown that poorer people in the region have higher levels of diabetes, obesity, hypertension and heart disease, all of which make them more vulnerable to Covid-19. This is especially problematic in Mexico and Brazil.

Fabiana Ribeiro, a Brazilian researcher currently at the University of Luxembourg, told CNN that a recent study showed the lowest survival rates were for rural patients of 68 and older, and for patients who were Black, illiterate or had previous conditions such as heart disease and diabetes.

The winter months in the southern hemisphere bring other sicknesses, including flu and pneumonia. Francesco Rocca, president of the International Red Cross, said this week that Latin America's health emergency could worsen "with the arrival of the southern winter, the flu season in South America, and especially the hurricane season in the Caribbean."

Some governments -- Chile for example -- have warned private providers that they may take over beds as public hospitals buckle under the strain. Gaviria notes that in Colombia the government now controls access to ICU beds in both the private and public sectors -- "and decide where each new patient should go. They want to avoid rationing based on type of insurance or financial considerations."

The Pan American Health Organization has said that in the coming months robust testing and tracing programs will be critical. There are a few promising signs -- such as the mobile teams in Costa Rica checking on infections and quarantine. And in much of the region there is already a large network of labs established to test for flu that are being mobilized.

But testing capacity is hugely variable across the region. As of June 29, Chile had done nearly 5,800 tests per 100,000 population, according to the PAHO. Panama had done just under 3,000. But Brazil had done 230 -- and Guatemala 45.

"In Nicaragua, we don't even know how many tests are being done," says Espinal.

The impact of coronavirus in Latin America is likely to leave deep scars. The World Bank believes that more than 50 million people will see their incomes fall below the $5.50 a day poverty line. Some economists fear the economic damage may be on a par with the "lost decade" of the 1980s.

In the midst of a deep recession that may shrink the region's economy by one-tenth this year, the necessary investment in public health may not materialize. Espinal thinks that would be a big mistake. "There's no way," he told CNN, "countries can justify continuing investing at the same level even if the economy suffers."

Alejandro Gaviria, Colombia's former health minister and now rector of the University of the Andes, is apprehensive about what the rest of 2020 will bring. "Three problems overlap," he says, "a growing pandemic, a social devastation and an increasing fatigue with lockdowns. New lockdowns will only be possible with strict and repressive enforcement measures."

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Parents are opting to home-school their children due to COVID-19 pandemic, but experts say it might not be for everyone – NBC News

Posted: at 10:50 am

Haley Campbell was eager for her two older children, ages 11 and 6, to start school in the fall.

She imagined how their first day would go: special outfits, an encouraging pep talk, and kisses goodbye before dropping them off for sixth grade and kindergarten, respectively.

But two weeks ago, after she received a letter from the school outlining its COVID-19 protocols which included isolated lunches, staggered schedules and the possibility that remote learning could return at any moment, Campbell felt it wasnt worth sending her children back to school.

She decided, instead, to home-school her children this upcoming school year and resigned from her full-time job as an insulin pump technician to fully commit to it. She also pulled her 2-year-old son out of day care.

Kids need a safe space to feel comfortable learning and what was being described to me by the school is not good enough for my kids, Campbell, 29, who lives just outside Boise, Idaho, said. They need to be able to focus on learning, and not worry about what they can and cant touch, staying apart, and not being able to play with their best friend.

After being in survival mode with remote learning, she no longer wants to be at the discretion of the school. I know they are doing their best but I cant rely on the school anymore, I need to be in control and have the ball in my court, she said.

While there isnt comprehensive data on how many parents are planning on home schooling come fall, several states, including Texas, Utah and Washington, have reported sharp upticks in interest.

Over the last month, calls and emails from parents inquiring about home schooling have exploded, said J. Allen Weston, executive director of the National Home School Association.

Public schools across the country have started to reveal what a return to classrooms may look like amid the pandemic, but many parents have preemptively opted not to return and are planning to home-school instead, a decision experts say is a huge undertaking that parents should be well prepared for.

A lot of parents were disillusioned with what they saw over the last 120 days, said Luis Huerta, a professor of education and public policy at Teachers College at Columbia University. They felt the level of instruction was not up to par and that schools dropped the ball during the transition. That led many parents to reconsider, at least temporarily, that they need to take control of their children's education.

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Even though parents have every right to that decision, they have to consider the extent to which they are prepared and have the skills to carry it out, he said.

Some families may have the ability to do it well and even better than their local school, but others will struggle, he said.

It will be a mixed bag based on the myriad of diverse experiences that parents experienced over these last few months.

Huerta added that if parents are exploring the idea of shifting to home schooling, they will need to be very aware of the challenges and rigor of executing it well, and need to be able to quickly tap into the many resources that can support them in that transition.

Jessica Bates, a Nashville-based mother of two, has already started preparations with curriculum research based on input from two of her sisters who are public school teachers. Her son will be starting kindergarten in the fall.

I'm very pro-school and very pro-public school and I never thought I would be thinking about home schooling, Bates, a freelance writer, said. But with COVID-19 spreading and my state opening back up as cases are rising, were concerned with my son going to school.

Bates said social interaction was the main reason for sending her son to school, but with the possibility of remote learning still high, she felt it was better to teach him herself.

COVID-19 has helped people to see that there are other education options out there that they had never seriously considered before, said Michael Hansen, senior fellow at the Brookings Institution and the director of the Brown Center on Education Policy. It allowed people to see flexibility and think outside the box about what schooling means and how it works best for their children.

Even though most students who are home-schooled during the pandemic will return to a traditional school setting once the public health crisis passes, 1 or 2 percent of them may end up sticking with it because it worked well, Hansen said.

Lara Miller, who lives with her immunocompromised mother, won't be sending her third grader and fifth grader back to school in the fall and is also researching home schooling options.

Despite the school's precautions, she said she is still not comfortable exposing her children to other kids.

"It was a tough decision, but as a family we decided it was best for me to keep them home and home-school," she said. Miller, who is self-employed, said she will have to take a step back from working and rely solely on her husband's income over the next year.

Parents are trying to decide what is right for them during an unprecedented time of crisis, which is not easy, said Kevin Welner, director of the National Education Policy Center and a professor at the University of Colorado at Boulder School of Education.

But what is important to recognize is that what parents did with remote learning wasnt home schooling but an emergency response that involved trying the school in the home," he said. Home schooling is very different. It is very demanding and requires a lot of hard work, preparation and time.

Parents not only need to have the subject area knowledge but also knowledge of how to teach, and since that often requires a large commitment by at least one parent in order to be successful, it doesnt work with every situation, Welner added.

It's not for everyone and even those who think it might be for them at this point may find out it's not, he said.

But Haley Campbell is optimistic and wants to keep an open mind over the next year.

"No one has parented during this, so I just have to be flexible and adaptable," she said. " Its hard because you are responsible for these little lives, but I feel like I'm doing the right things for my kids."

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A 24-year-old Covid-19 survivor is celebrating a different kind of independence this July Fourth – CNN

Posted: at 10:50 am

Freedom from Covid-19.

"It feels amazing," Avery told CNN. "After knowing what all I've been through, it's still kind of hard to wrap my mind around. But I'm very thankful and grateful that I'm still here."

Avery, who turns 24 on July 4, recently returned home after spending 76 days in a Kansas hospital -- many of them sedated and on a ventilator -- battling the novel coronavirus.

"I'm going to be at home, safe and sound with my family," said Avery, a barber from Kansas City, Missouri, when asked how he would celebrate his birthday and Independence Day. "There will be plenty of other birthdays, I'm sure, down the line where I can make up for this one."

"You're just as at risk as anybody else," Avery said. "You can be the healthiest person on Earth, and you still risk your life every time you carelessly go out here and act like it's not real."

"It's very real," he said. "I was almost taken away from my family."

'It felt like someone was choking me'

By the time Avery arrived at Menorah Medical Center in Overland Park, Kansas, on April 6, he says he had what felt like every Covid-19 symptom, including chills, high fever and body aches. But what worried him most was his shortness of breath.

"Even if I was to take a deep breath it felt like someone was choking me," he said.

"I was definitely thinking that something bad was about to happen," Avery said. "I immediately thought of my son. I immediately thought of my family."

Avery says he remembers very little of what came next. Once he arrived at the hospital, Avery remembers getting out of his car and into a wheelchair. He has a faint memory of being wheeled into the intensive care unit.

"I don't want to say I started to panic," he said, "but I was definitely scared. That's not a normal patient room. That's where you're critically ill."

Before getting sick, Avery had taken precautions to ensure his family's safety amid a lockdown, like making sure there was enough food.

"But I can't say that I took it as serious as I needed to," he said. "I didn't think it was as serious as it is."

'Older people were getting this virus'

"My take on it was that older people were getting this virus and they were more susceptible as far as getting really sick from it," Willetta Avery said.

"To hear my son was going through this was very, very terrifying," she said, adding that things "got real" when she learned her son needed a ventilator.

"And not knowing much about ventilators ... it scared me to know that he was going to have to be on one of those," she said. "That's when the seriousness of his illness just kind of slapped me in the face."

Willetta Avery remembers getting a call from the hospital at 4:30 a.m. on April 11.

"They were basically telling us Shakell was maxed out on ventilation support, that there was not much else they could do," she said.

The hospital finally allowed her to see her son.

"It was as if I would be seeing him for the last time," she said.

Avery's doctors at Menorah Medical Center collaborated with physicians at Research Medical Center in Kansas City -- both are part of the HCA Healthcare system -- to treat him with convalescent plasma.

'I beat Covid-19'

After Shakell came to, he still had trouble fighting the virus.

"Being independent, you're used to doing everything on your own," he said.

But he needed help getting up and going to the bathroom. He couldn't speak or walk. He also struggled with depression in the hospital, particularly when his family would come visit him at a tent the hospital set up outside his window.

"It was a great moment at the time being, but as soon as they left I went right back down," he said. "It was really tough being away from my girlfriend. It was tough being away from my son, my mom, my siblings."

Avery eventually started to improve and he came off the ventilator. He started physical therapy and was sent to a full rehabilitation center, where he was discharged late last month.

Shakell returned to Menorah Medical Center with his family on Tuesday to thank staff for helping him.

"I was more than grateful," Avery said. "I could have said 'thank you' an infinite amount of times, and it wouldn't have matched the intensity of how grateful I was."

Avery has a message for young people, and he says that he wants to be "as blunt as possible."

"Every time you carelessly step out your door -- no mask or no empathy for anyone else's life -- you're counting your days," he said.

"My advice would simply be to try not to be selfish, but as selfless as possible," he said. "Because you're not just hurting yourself."

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