Author: Linda Rider

  • Rodgers sought treatments instead of COVID-19 vaccine

    Rodgers sought treatments instead of COVID-19 vaccine

    Green Bay Packers quarterback Aaron Rodgers said Friday he sought alternative treatments instead of the NFL-endorsed COVID-19 vaccinations because he is allergic to an ingredient in two of the FDA-approved shots.

    Speaking on “The Pat McAfee Show on YouTube and SiriusXM,” Rodgers said: “I’m not an anti-vax, flat-earther. I have an allergy to an ingredient that’s in the mRNA vaccines. I found a long-term immunization protocol to protect myself and I’m very proud of the research that went into that.”

    Rodgers, who turns 38 on Dec. 2, did not say what ingredient he was allergic to, or how he knows he is allergic.

    Rodgers, who has been tested daily as part of NFL protocols for the unvaccinated, found out he contracted COVID-19 on Wednesday. The reigning NFL MVP said he didn’t feel well on Thursday but was much better on Friday.

    Rodgers can’t rejoin the Packers for 10 days, missing Sunday’s game at Kansas City. He must have a negative test to return to the team on Nov. 13.

    During the interview with McAfee, Rodgers misquoted the CDC website and offered his explanation for why hasn’t taken the Johnson & Johnson vaccine.

    Rodgers said the CDC’s website says “should you have an allergy to any of the ingredients, you should not get one of the mRNA vaccines. So those two (Moderna and Pfizer) were out already.”

    Instead the CDC site says, “If you have had a severe allergic reaction or an immediate allergic reaction — even if it was not severe — to any ingredient in an mRNA COVID-19 vaccine, you should not get either of the currently available mRNA COVID-19 vaccines.”

    Rodgers did not say he had an allergic reaction.

    He said with some of the public issues involving the Johnson & Johnson vaccine — clotting issues and his “hearing of multiple people who had had adverse events around getting the J&J … the J&J shot was not even an option at that point.”

    The COVID-19 vaccines authorized for use in the U.S. were tested in tens of thousands of people and proven to be both safe and effective at dramatically reducing the risk of serious disease and death. The vaccines now have been given to more than 200 million Americans and that real-world use plus extra government safety tracking have made clear that serious side effects are extremely rare — and that any risk is far lower than the risks posed by COVID-19.

    Rodgers’ research led him to a treatment he did not detail, and he said the NFL was aware of the treatment protocol he was using, which took “multiple months.”

    “The league was fully aware of it upon my return to the Packers (in August),” Rodgers said. “It was at that point that I petitioned them to accept my immunization under their vaccination protocol.”

    A member of the Packers’ medical staff inquired to the NFL Players Association’s medical director on behalf of an anonymous player who asked if an alternative homeopathic treatment could render him as “fully vaccinated” under the protocols. That player was Rodgers.

    The NFLPA’s medical director, Dr. Thom Mayer, shared an email from the team and related materials from Rodgers with Dr. Allen Sills, the league’s medical chief, and with an independent infectious disease expert, who were asked for an opinion.

    The expert, hired jointly by the league and union, said he could not find in his research that the treatment offers reliable and robust COVID-19 protection — that the treatment was not the equivalent of receiving one of the three endorsed vaccines. There was a lack of scientific data demonstrating whether and how well the treatments Rodgers wanted approved would work.

    The union and the doctors were never contacted again by Rodgers after his petition and a subsequent appeal were denied.

    “And I also said, how come there’s no exemption for medical exemptions, religious exemptions, pre-existing conditions?” Rodgers added. “And they basically said those are all basically exempted but you would be put in the non-vaccinated category.”

    Rodgers also told McAfee he has concerns about potential fertility issues had he taken one of the vaccinations.

    Many scientists, including three doctors who specialize in reproductive health, have vouched for the safety of vaccinations for couples who want to have a baby and urged people to seek out their doctors or nurse practitioners with any questions. The Centers for Disease Control and Prevention and obstetrician groups also recommend COVID-19 vaccines for pregnant individuals.

    Dr. Stephanie Broadwell of Sanford Health Fargo, Dr. Stephanie Foughty of Altru Health Devils Lake and Dr. Ana Tobiaz of Sanford Health Bismarck said at a virtual North Dakota town hall in July to get the vaccine.

    “I can understand that people are scared, people are nervous,” Broadwell said. “I think sometimes there can be information that can be helpful and some that can be somewhat misleading. I think it’s just really hard to digest all the information that is out there and stories that are filtering through that maybe even come from trusted sources.”

    Rodgers strongly questioned the NFL’s protocols, along with any organization forcing health requirements on individuals.

    “I believe strongly in bodily autonomy and the ability to make choices for your body, not to have to acquiesce to some woke culture or crazed group of individuals who say you have to do something,” he said. “Health is not a one size fits all for everybody, and for me it involved a lot of study in the offseason.”

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    More AP NFL coverage: https://apnews.com/hub/nfl and https://twitter.com/AP_NFL

  • Four things millennial men should know about reproductive health

    Four things millennial men should know about reproductive health

    Modern lifestyles — which are riddled with stress — require modern interventions so as to ensure health. When it comes to men’s reproductive health, there is a lot of stigma attached to it, which can lead to misconceptions.

    Dr Kshitiz Murdia, CEO and co-founder Indira IVF says while there is no one particular cause, doctors — over the years — have narrowed it down to a few harmful ones that millennial men need to keep in mind due to ensure sound reproductive health:

    – Consumption of substances like alcohol and tobacco
    – Sedentary lifestyle
    – Unhealthy diet
    – Sexual diseases such as STDs or STIs
    – Coming in contact with chemicals and harmful toxins
    – Extreme levels of stress, emotional or mental distress
    – Accidents or physical injury

    “These causes can not only hamper reproductive health, but can also impact one’s fertility. The conditions that lead to male infertility broadly include infections, hormonal imbalance, obesity, erectile dysfunction, retrograde ejaculation, and exposure to radiation or heavy metals, chemicals and drugs among others,” the doctor explains.

    He lists a few things for millennial men to keep in mind to ensure sound reproductive health; read on.

    1. Reproductive health challenges
    It is important to educate about reproductive challenges like low sperm count, low testosterone, impotence, STIs etc. can cause complications at later stages in life. There should be awareness about STIs and reproductive infections such as human immunodeficiency virus (HIV), syphilis, hepatitis B, chlamydia, gonorrhoea, herpes, and human papillomavirus (HPV) to take necessary precautions or seek medical help.

    2. Having an active lifestyle
    Work from home has induced a new era of being constantly surrounded by computers, while daily physical activity has reduced. Swimming, jogging, cycling and other sports can help in building immunity, remaining active, maintaining hormone levels, especially in the case of diabetes and heart-related diseases. These simple lifestyle changes will help in reducing stress and other hormones that affect sperm production.

    3. Consumption of a healthy diet
    Consumption of fruits, vegetables and plenty of water is important for a nutritious diet. Junk food and processed food can prove to be harmful in the longer run and hamper hormone levels in the body. A nutritional diet would help in ensuring not just a strong reproductive health but also overall health.

    4. Personal hygiene
    Male genital region is located outside the body to provide cooler temperature for the production of sperms. Personal hygiene — such as washing hands after using the toilet, keeping the genital region clean, wearing washed and breathable underwear, avoiding any chemical or synthetic soaps and ensuring general cleanliness — is essential.

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  • Virtual therapy may help, but isn’t for everyone

    Virtual therapy may help, but isn’t for everyone


    Story by Heidi Perez-Moreno, UNC Media Hub

    Video story by Sierra Sanders

    Graphics by Stephanie Mayer

    Maddie Ellis was crying in her bedroom. Last fall, she was juggling her responsibilities as a fulltime UNC student and as the university editor for the Daily Tar Heel. It was too much.

    “I just was really stressed all the time and super burnt out,” Ellis said. “I really struggled to find joy in each day. I was really just not doing well.”

    Many days, she was terrified of the idea of making a mistake and she felt as if she were a failure. The stress was dragging down her personality and her health. She was finding it harder to control her negative emotions. She grew lethargic, which is not her style.

    A friend Facetimed her when she was crying. At one point, the friend said, “I’ve never been more worried about someone than I am about you.”

    Ellis’ mother said something similar, leading Ellis to seek professional help. 

    “Maybe if my mom is saying it, maybe it’s time,” she said. 

    Ellis raised the volume on the television and climbed into her empty bathtub, a place most isolated from her two roommates. She dialed the UNC-Chapel Hill’s Counseling and Psychological Services’ 24/7 hotline and made an appointment for a Zoom therapy session.

    “I’m seeking professional help for something that I’ve always covered up and buried, and never really sought help for,” Ellis said. 

    Seeking help behind a screen

    Since the start of the pandemic, more and more students have used virtual therapy as a way to seek mental health and wellness care. 

    The university’s CAPS program — a popular resource for UNC students — shifted to exclusively provide virtual counseling services after concerns of COVID-19 transmission last year. 

    Transitioning services from in-person to Zoom served as a way to continue offering services to UNC students at a time when many were exhausted and burned out from the stress of a remote semester. Around the same time, classes shifted to remote and most would stay like that for another year or so. 

    “Our number one priority at CAPS is the mental health and overall wellbeing of our students,” CAPS Associate and Clinical Director Avery Cook said. “We serve as a possible first step in helping students identify the level of care they need. We then guide them through the process of getting that care, whether it’s within CAPS or through an outside provider.”

    The virtual services aren’t the same as in-person counseling. Ellis didn’t feel comfortable during her sessions of virtual therapy because the in-person human connection was missing.

    “I feel like you miss some of the body language cues and you miss so much of that human interaction,” she said. 

    From the start of the pandemic up until early November, CAPS has served 6,571 students, and has provided more than 10,000 virtual appointments. The clinic also provided virtual group sessions and continued to refer students to local organizations if needed. 

    Those virtual services became more necessary during the pandemic. 

    Symptoms of moderate to severe depression among first-year students increased from 21.5 percent prior to COVID-19 to 31.7 percent four months into the pandemic, according to research from the Carolina Population Center and the UNC School of Medicine. Within the same time, the prevalence of moderate to severe anxiety went from 18.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to 25.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} within the same timespan. 

    Black students, in addition to those from gender and sexual minorities, were hit hardest by the pandemic, the research showed. 

    Matthew Mills, a licensed clinical social worker and professor at UNC-Charlotte, isn’t a fan of virtual therapy services. 

    “If I had to choose between the two, I would definitely choose an in-person setting,” Mills said. “I think the vibe from most clinicians is trying to figure out how we do our work in a virtual setting effectively when some of us don’t operate in our best fields — how do we adapt.” 

    But he understands some of the benefits of virtual therapy, including being more accessible to those who can’t find transportation to see a counselor in-person or have a busy schedule. In addition, many of his colleagues are immuno-comproised, and so virtual therapy is the safest route to doing their jobs. 

    “It’s here to stay — I don’t see it going anywhere,” Mills said. “I think it definitely opens a new door.”

    Nadia Charguia, medical director of UNC Psychiatry Outpatient Services, said the department is slowly transitioning to in-person services, but the vast majority of patients are being treated through tele-health services. 

    “It’s hard to take time off work, It’s hard to find time between classes,” she said. “We are definitely seeing a lot of folks gravitate towards virtual services because of how accessible they are.”

    Talking behind a computer screen

    Rachel Gora, currently a sophomore at UNC, has faced mental health struggles since the eighth grade.

    By her senior year of high school in April 2020, she was increasingly depressed. Gore realized she wasn’t in touch with many of her friends and was missing out on a high school experience. She sought out virtual therapy, but there were constant technical issues during the appointments. Her counselor would often call her when Zoom wasn’t working at all or somebody’s WIFI was acting up as well. Sometimes, her audio would cut out at random moments. 

    That, coupled with her ADHD diagnoses, made it harder to consistently attend sessions. She often missed several sessions in a row, and she hasn’t been to a session in months. It was hard to repeatedly spend time on a task that didn’t seem as though it was worth her time. 

    “I think it was harder to connect online virtually rather than in-person because there’s just an aspect of connection that is missing,” Gore said. “It’s hard to put your finger down on why virtual is different but I definitely think it is.”

    Taking steps to get help

    Ellis’ struggles with mental health arose once she started at the DTH’s university desk. She immediately transitioned from a summer internship to the position. 

    Once the semester officially started, she spent most of her time at the DTH. It was rare to find a moment to herself. It also became harder to deal with her own emotions. At her first session with a CAPS specialist last November, Ellis found it difficult to put her thoughts into words, so she didn’t. She just sobbed. 

    Her therapist said she has a tendency to catastrophize and assume the worst will happen. 

    “These are some things that I did take away from it and like to think about in my life now,” Ellis said. 

    Between her second and third session, she did something that had rarely happened that semester – take a break. During Thanksgiving weekend, she visited the Outer Banks with friends for several days. She was finally able to read and hang out with friends. 

    When she returned to see her CAPS counselor for the third session, she had nothing but good things to tell her. 

    “It sounds like you don’t really need to talk today,” the therapist told her. 

    The answer immediately made her feel bad. Like her feelings weren’t valid. As though she was merely being dramatic about her issues over the course of the other two sessions. 

    So, she didn’t return. 

    Ellis emphasized the importance of being able to advocate for yourself during therapy. She accepted the therapist’s response without mentioning that she wanted to continue seeing a counselor to reflect on why the fall semester had been so tough. 

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  • Covid News: New Zealand Will Reopen to Foreign Tourists Within Months

    Covid News: New Zealand Will Reopen to Foreign Tourists Within Months

    ImageNew Zealand has announced it will reopen to the world in coming months.
    Credit…Hannah Peters/Getty Images

    New Zealand plans to allow most fully vaccinated travelers into the country by the end of April without a mandatory hotel quarantine, as it slowly emerges from what has been one of the world’s longest lockdowns.

    But those entering the country next year will face significant restrictions, with a mandatory seven-day home isolation period, as well as tests on departure and arrival. The border will open in stages to different countries, with fully vaccinated New Zealanders and visa holders able to travel from Australia from Jan. 16 and from elsewhere in the world starting Feb. 13. Foreign nationals will follow from April 30.

    Experts have for weeks questioned the need for requiring new arrivals to quarantine when the virus is already in the community, and experts say international arrivals seem to pose no additional risk. No fully vaccinated travelers from Australia, for example, have tested positive in New Zealand’s hotel quarantine system since Aug. 23.

    Some 84 percent of people in New Zealand age 12 and up are fully vaccinated against the coronavirus. And representatives from the country’s tourism industry, which has struggled to contend with the long absence of foreign visitors, decried the seven-day isolation requirement.

    New Zealand has been on edge since August, when an outbreak of the Delta variant erupted in Auckland and put an end to the country’s “zero Covid” approach.

    “It’s very encouraging that we as a country are now in a position to move towards greater normality,” Chris Hipkins, the minister responsible for New Zealand’s pandemic response, said at a news conference on Wednesday. “I do want to emphasize, though, that travel in 2022 won’t necessarily be exactly the same as it was in pre-2020 travel.”

    For over a year, New Zealand has operated a lottery system for citizens and permanent residents who want to return, locking people out of the country and creating a large backlog. The system has faced legal challenges from people desperate to return home from overseas and be reunited with their families.

    New Zealand is waiting until April to fully open to permit time for airlines to plan, he said, as well as to allow a transition to the country’s new “traffic light” pandemic management system that starts Dec. 2. That system will end lockdowns and place significant restrictions on the unvaccinated, Prime Minister Jacinda Ardern announced at a news conference on Monday.

    On Dec. 15, Auckland — where the country’s outbreak is concentrated — will open its border to the rest of the country.

    Before the pandemic, tourism was a big part of the New Zealand economy, employing nearly 230,000 people and contributing 41.9 billion New Zealand dollars ($30.2 billion) a year. About 3.8 million foreign tourists visited between 2018 and 2019, with the majority coming from Australia. Though domestic tourism has surged while borders have been closed, the industry has struggled to make up its losses, as international tourists spend about three times as much per person as their domestic peers.

    Defending New Zealand’s caution, Mr. Hipkins pointed to the new virus wave that is crashing through Europe. “As we move into 2022, we know that the pandemic is not over,” he said. “It’s not going to suddenly end, and we only need to look at Europe to know that the path out of the pandemic is not a straightforward one.”

    Credit…Hannah Beier/Reuters

    In the largest revision of state vaccination numbers to date, the Centers for Disease Control and Prevention updated those for Pennsylvania, which had counted about 1.2 million more doses than had actually been administered.

    The C.D.C. said the data, updated almost every day on its website, had been corrected. As of Tuesday evening, about 81 percent of people in Pennsylvania had received at least one shot of a vaccine, according to C.D.C. data, whereas on Monday the data indicated that about 84 percent of people in the state had gotten a shot.

    The agency has been periodically revising vaccination numbers in states since July 14. Altogether, the C.D.C. and the states have reduced the number of reported doses in the U.S. by about 2 million.

    The C.D.C. has posted on its website that the revisions are part of a collaboration with states to gather their most “complete and accurate” data. Sometimes the revisions result in more shots being added to a state’s tally. Other times they result in a drop. Illinois, for example, revised its data to add about 316,000 doses in late October only to subtract about 214,000 doses a few weeks later.

    Barry Ciccocioppo, communications director for Pennsylvania’s Department of Health, said that the department “continues to update and refine our vaccination data throughout the commonwealth to ensure duplicate vaccination records are removed and dose classification is correct.” He said that the C.D.C. had now begun to “rectify” the data.

    “This is not a practice specific to Pennsylvania and the C.D.C. is going through a similar process with other states across the country,” he said.

    Cindy Prins, a professor of epidemiology at the University of Florida, said she feared that people might jump to the conclusion that there were deliberate errors in the initial reporting, but she did not believe that was the case. “I think it’s just a process of cleaning up and making sure what is in there is accurate to the best of our ability to know that,” Dr. Prins said.

    Still, without fully accurate and up-to-date vaccination rates, it is difficult for counties to make informed health recommendations, she said. If vaccination rates are overreported, that could give counties a false sense of confidence that more people are vaccinated than actually are.

    More than 230 million people across the United States have received at least one shot of a coronavirus vaccine, according to the C.D.C. Last week, the agency authorized booster shots for all adults. Across the U.S., Covid-19 infections have been rising, with more than 90,000 cases reported on average each day.

    Credit…Kenny Holston for The New York Times

    This was supposed to be the year vaccines brought the pandemic under control. Instead, more people in the United States have died from Covid-19 this year than died last year, before vaccines were available.

    As of Tuesday, the Centers for Disease Control and Prevention had recorded 386,233 deaths involving Covid-19 in 2021, compared with 385,343 in 2020. The final number for this year will be higher, not only because there is more than a month left but because it takes time for local agencies to report deaths to the C.D.C.

    Covid-19 has also accounted for a higher percentage of U.S. deaths this year than it did last year: about 13 percent compared with 11 percent.

    Experts say the higher death toll is a result of a confluence of factors: most crucially lower-than-needed vaccination rates, but also the relaxation of everyday precautions, like masks and social distancing, and the rise of the highly contagious Delta variant.

    Essentially, public health experts said, many Americans are behaving as though Covid-19 is now a manageable, endemic disease rather than a crisis — a transition that will happen eventually but has not happened yet.

    Yet many are also refusing to get vaccinated in the numbers required to make that transition to what scientists call “endemicity,” which would mean the virus would still circulate at a lower level with periodic increases and decreases, but not spike in the devastating cycles that have characterized the pandemic. Just 59 percent of Americans are fully vaccinated, the lowest rate of any Group of 7 nation.

    “We have the very unfortunate situation of not a high level of vaccine coverage and basically, in most places, a return to normal behaviors that put people at greater risk of coming in contact with the virus,” said Jennifer Nuzzo, an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security. “If you take no protections whatsoever, you have a virus that is capable of moving faster and you have dangerous gaps in immunity, that adds up to, unfortunately, a lot of continued serious illness and deaths.”

    Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center, estimated that roughly 15 percent of the U.S. population might have immunity from prior infection, which is not as strong or durable as immunity from vaccines.

    Many of those people have also been vaccinated, but even assuming the two groups didn’t overlap and so 74 percent of Americans had some level of immunity, that still would not be enough to end the pandemic, said Dr. Gounder. It would probably take an 85 to 90 percent vaccination rate to make the coronavirus endemic, she said.

    “When vaccines rolled out, people in their minds said, ‘Covid is over,’” Dr. Gounder said. “And so even if not enough people are vaccinated, their behavior returned — at least for some people — to more normal, and with that changing behavior you have an increase in transmission.”

    Some news outlets reported last week that confirmed 2021 deaths had surpassed 2020 deaths. Those reports stemmed from counts of deaths based on when the deaths were reported, not when they happened — meaning some deaths from late 2020 were counted in early 2021. The C.D.C. counts, which did not show that mark being reached until this week, are more accurate because they are based on the dates on death certificates.

    Credit…Libby March for The New York Times

    With daily coronavirus case rates reaching record numbers and area hospitals more than 90 percent full, local officials in the Buffalo area reinstituted a mask mandate for all indoor public spaces that went into effect on Tuesday.

    “We really need to keep the hospitals from being inundated,” Mark Poloncarz, the Erie County executive, said on Monday in a news conference announcing the new policy. “These numbers are not good.”

    The mask mandate applies to all staff and patrons at stores, restaurants, bars, salons, and other public indoor spaces in the county, regardless of their vaccination status. It is the first phase of what Mr. Poloncarz warned would be increasing restrictions if virus numbers do not begin to stabilize.

    Erie County, which encompasses the city of Buffalo, is the first New York county to impose a blanket mask mandate for public indoor spaces since May, when the Centers for Disease Control and Prevention recommended that vaccinated people could safely take off their masks in most settings.

    Federal officials eventually reversed that recommendation as the Delta variant spiked, but New York did not reinstitute a statewide mask mandate. Currently, most of the state, including New York City, only requires masks in specific locations such as in schools, on public transportation, and in medical settings.

    Western New York, a bustling five-county region of some 1.4 million people along the Canadian border and the Great Lakes, has seen cases spike dramatically in recent weeks. In Erie County, cases have doubled in the last month. Hospitalizations are up 50 percent in the last two weeks.

    Vaccination rates have not been high enough to head off the surge, even though about 75 percent of adults in Erie County have received at least one dose. County officials said that local case numbers now are actually higher than they were at this time last year. Rates among children and staff in schools are also at the highest levels since the start of the pandemic, Mr. Poloncarz said.

    “Until we can get through this, masking is necessary,” he said.

    Erie County decided to institute a mask mandate instead of requiring people to show proof of vaccination for entering most indoor public places, after hearing concerns from local business leaders that requiring masks would be less harmful to trade.

    But if the mask rule fails to curb virus rates, the county will require vaccination for indoor dining and entertainment, as New York City has. If that fails to work, it will bring back capacity restrictions in restaurants and other indoor public settings. And if that also fails, shutdowns will occur, Mr. Poloncarz said.

    Local officials said they were most closely watching the load in hospitals, which are already strained because of staff shortages. The wait time at emergency rooms for people who are not critically ill has risen to eight hours or more, officials said. And seasonal flu has yet to hit hard in New York State, according to the latest data from the Centers for Disease Control and Prevention.

    “Our hospitals are in dire straits,” the Erie County health commissioner, Dr. Gale Burstein, said.

    Credit…Christopher Lee for The New York Times

    The Department of Health and Human Services has begun distributing billions of dollars to rural health care providers to ease the financial pressures brought by the coronavirus pandemic and to help hospitals stay open.

    The agency said on Tuesday that it had started doling out $7.5 billion to more than 40,000 health care providers in every state and six U.S. territories through the American Rescue Plan, a sprawling relief bill that Congress passed in March. The infusion of funds will help offset increased expenses and revenue losses among rural physicians during the pandemic, the agency said.

    Xavier Becerra, the health and human services secretary, said that the coronavirus pandemic had made clear the importance of having timely access to quality medical care, especially in rural America.

    “When it comes to a rural provider, there are a number of costs that are incurred, that sometimes are different from what you see with urban providers or suburban providers,” Mr. Becerra said. “And oftentimes, they’re unique only to rural providers.”

    Rural physicians serve a disproportionate number of patients covered by Medicaid, Medicare or the Children’s Health Insurance Program, which often have more complex medical needs. Many rural hospitals were already struggling before the pandemic; 21 have closed since 2020, according to data from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina.

    Under the program, every eligible provider that serves at least one Medicare, Medicaid, or C.H.I.P. beneficiary in a rural part of the country will receive at least $500. Payments will range up to $43 million, with an average of $170,700; the size is based on how many claims a provider submitted for rural patients covered by these programs from January 2019 through September 2020.

    Rural America is home to some of the country’s oldest and sickest patients, many of whom were affected by the pandemic.

    The new funding is supposed to help rural hospitals stay open in the long run and improve the care they provide, building on efforts the Biden administration has already made to help improve access to health care in rural communities, which it considers crucial to its goal of addressing inequities in access to care.

    The money can be put toward salaries, recruitment, or retention; supplies such as N95 or surgical masks; equipment like ventilators or improved filtration systems; capital investments; information technology and other expenses related to preventing, preparing for or responding to the pandemic.

    The administration has also allocated billions of dollars through the American Rescue Plan for coronavirus testing for the uninsured, increased reimbursement for Covid vaccine administration, improving access to telehealth services in rural areas, and a grant program for health care providers that serve Medicare patients.

    On Monday, Vice President Kamala Harris said that the administration would be investing $1.5 billion to address the shortage of health care workers in underserved tribal, rural and urban communities. The funds — which will provide scholarships and pay off loans for clinicians who commit to jobs in underserved areas — come on the heels of a report from the White House’s Covid Health Equity Task Force that made recommendations on how inequalities in the health care system could be fixed.

    Credit…Oded Balilty/Associated Press

    JERUSALEM — Israel began a campaign to vaccinate 5- to 11-year-olds against the coronavirus on Tuesday ahead of expected gatherings over next week’s Hanukkah holiday, but the initial response from parents appeared to be slow.

    By Monday night, parents had made appointments for only a little over 2 percent of children in that age group, according to figures published by the country’s main health services. Health officials said they were trying to persuade parents of the benefits of vaccinating their children without applying pressure or any form of coercion.

    In a bid to reassure the public, Prime Minister Naftali Bennett accompanied his son David, 9, to a vaccination center of the Clalit Health Services in the seaside town of Herzliya, north of Tel Aviv.

    “I call on all Israeli parents to come and have their children vaccinated,” Mr. Bennett said. “It is safe and it safeguards our children.” In a video posted on the prime minister’s official Twitter account, David said he had agreed to be filmed to encourage other children to get vaccinated. He said he was a little afraid at first but assured other children that “it really didn’t hurt.”

    Earlier this month, the United States also began vaccinating 5- to 11-year-old children. A number of countries have approved vaccinations for children starting at 12 years old, but few aside from China, Israel and the United States are vaccinating younger children.

    Israel has emerged in recent weeks from a fourth wave of the virus, with new daily cases dropping to several hundred from a peak of 11,000 in mid-September. Israeli officials attribute the sharp decrease in cases to a booster shot campaign, suppressing a wave driven by a combination of waning immunity five or six months after the second injection, together with the spread of the highly infectious Delta strain.

    At least 80 percent of Israelis ages 16 and older have been vaccinated against the virus, but the numbers are lower in the younger age groups. More than four million Israelis have received a booster shot since August, out of a total population of nine million.

    In the Palestinian-administered territories, after a late start and some early hesitancy, about three million doses have been administered, enough to cover about a third of the population with two doses.

    Credit…Evgeniy Maloletka/Associated Press

    Europe’s death toll from Covid will exceed two million people by next spring, the World Health Organization projected on Tuesday, adding that the continent remained “firmly in the grip of the Covid-19 pandemic.”

    Covid is now the leading cause of death in Europe, the W.H.O. said in a statement, with almost 4,200 new deaths a day, double the number at the end of September. To date, Europe, including the United Kingdom and Russia, has reported 1.5 million deaths. Between now and spring, hospital beds in 25 countries and intensive care units in 49 countries are predicted to experience “high or extreme stress,” the W.H.O. said.

    Dr. Hans Kluge, a regional director for the W.H.O., said Europe faces a challenging winter. “In order to live with this virus and continue our daily lives, we need to take a ‘vaccine plus’ approach,” he said.

    That means getting vaccinations or booster shots if offered and taking other preventive measures to avoid the reimposing of lockdowns, like calling on the public to wear masks and maintain physical distance, he said.

    Over one billion vaccine doses have been administered in Europe; about 53 percent of the population is fully vaccinated. But countries have gaping disparities in vaccination rates, the organization said, and it was essential to drive the lagging rates up, the officials said.

    In recent days, European countries have imposed restrictions to try to curb the highest surge of new cases in the region since the pandemic began. Austria on Monday began its fourth lockdown and Germany is pressuring its citizens to get vaccinated. Slovakia, Liechtenstein and the Czech Republic have the world’s highest rates of new cases compared to their populations.

    The W.H.O. considers Europe to include not only the countries of the European Union, but also the United Kingdom, Iceland, Norway, Switzerland, Turkey, Israel, Russia, Ukraine, and several countries in the Balkans and Central Asia.

    Credit…Emily Elconin for The New York Times

    Coronavirus cases in children in the United States have risen by 32 percent from about two weeks ago, a spike that comes as the country rushes to inoculate children ahead of the winter holiday season, pediatricians said.

    More than 140,000 children tested positive for the coronavirus between Nov. 11 and Nov. 18, up from 107,000 in the week ending Nov. 4, according to a statement on Monday from the American Academy of Pediatrics and the Children’s Hospital Association.

    These cases accounted for about a quarter of the country’s caseload for the week, the statement said. Children under 18 make up about 22 percent of the U.S. population.

    “Is there cause for concern? Absolutely,” Dr. Sean O’Leary, the vice chair of the academy’s infectious diseases committee, said in an interview on Monday night. “What’s driving the increase in kids is there is an increase in cases overall.”

    Children have accounted for a greater percentage of overall cases since the vaccines became widely available to adults, said Dr. O’Leary, who is also a professor of pediatrics at the University of Colorado School of Medicine and Children’s Hospital Colorado.

    Though children are less likely to develop severe illness from Covid than adults, they are still at risk, and can also spread the virus to adults. Experts have warned that children should be vaccinated to protect against possible long-Covid symptoms, Multi-system Inflammatory Syndrome and hospitalization.

    At the end of October, about 8,300 American children ages 5 to 11 have been hospitalized with Covid and at least 172 have died, out of more than 3.2 million hospitalizations and 740,000 deaths overall, according to the Centers for Disease Control and Prevention.

    At a news conference on Friday, Dr. Janet Woodcock, the acting commissioner of the Food and Drug Administration, said hospitalizations and deaths among 5- to 11-year-olds were “really startling.”

    Dr. O’Leary said it did not help that many schools had softened their safety protocols in the last few months.

    “So any protection that might be happening in schools is not there,” he said.

    Vaccinations of younger children are likely to help keep schools open. Virus outbreaks forced about 2,300 schools to close between early August and October, affecting more than 1.2 million students, according to data presented at a C.D.C. meeting on Nov. 2.

    Dr. O’Leary said that he was especially concerned about case increases in children during the holiday season.

    With the pace of inoculations stagnating among U.S. adults, states are rushing to encourage vaccinations for children 5 through 11, who became eligible earlier this month after the C.D.C. authorized the Pfizer-BioNTech vaccine for that age group. In May, the federal government recommended making the Pfizer-BioNTech vaccine available to children ages 12 to 15. Teenagers 16 and older became eligible in most states a month earlier.

    The White House estimated on Nov. 10 that nearly a million young children had gotten vaccinated; 28 million are eligible. They receive one-third of the adult dose, with two injections three weeks apart.

    All of the data so far indicates that the vaccines are far safer than a bout of Covid, even for children.

    Still, about three in 10 parents say they will definitely not get the vaccine for their 5- to 11-year-old child, according to a recent poll by the Kaiser Family Foundation. Only about three in 10 parents said they would immunize their child “right away.”

    Credit…Alisha Jucevic for The New York Times

    The Biden administration has asked a federal appeals court to let the government proceed with a federal mandate that all large employers require their workers to get vaccinated against the coronavirus or submit to weekly testing starting in January.

    In a 52-page motion filed on Tuesday, the Justice Department urged the U.S. Court of Appeals for the Sixth Circuit, in Cincinnati, to lift a judicial stay on proceeding with the rule while it is being challenged in court, saying the requirement would “save thousands of lives and prevent hundreds of thousands of hospitalizations.”

    The Occupational Safety and Health Administration, or OSHA, issued the “emergency” rule earlier this month at the direction of President Biden as one of several vaccine mandates he announced in September. The OSHA rule applies to employers with at least 100 workers, although it exempts those who work at home or exclusively outdoors.

    The rule was immediately challenged by employers around the country and several Republican-controlled states. In court papers, they argued that the rule exceeded the agency’s authority under law to issue regulations to protect workers from toxic hazards at work, arguing the law was meant to address dangerous substances like asbestos but not exposure to the virus.

    Earlier this month, a three-judge panel on the Court of Appeals for the Fifth Circuit, in New Orleans, agreed with the plaintiffs in several of those cases and temporarily blocked the government from proceeding with the rule. But since then, those cases and many others from around the country have been reassigned to the Sixth Circuit in order to consolidate the litigation.

    “The Fifth Circuit’s stay should be lifted immediately,” the Justice Department said in its filing. “That court’s principal rationale was that OSHA allegedly lacked statutory authority to address the grave danger of COVID-19 in the workplace on the ground that COVID-19 is caused by a virus and also exists outside the workplace. That rationale has no basis in the statutory text.”

    Credit…Brett Gundlock for The New York Times

    As the pandemic heads into a third year, a global battle for the young and able has begun. With fast-track visas and promises of permanent residency, many of the wealthy nations that drive the global economy are sending a message to skilled immigrants all over the world: Help wanted. Now.

    In Germany, where officials recently warned that the country needs 400,000 new immigrants a year to fill jobs in fields ranging from academia to air-conditioning, a new Immigration Act offers accelerated work visas and six months to visit and find a job.

    Canada plans to give residency to 1.2 million new immigrants by 2023. Israel recently finalized a deal to bring health care workers from Nepal. And in Australia, where mines, hospitals and pubs are all short-handed after nearly two years with a closed border, the government intends to roughly double the number of immigrants it allows into the country over the next year.

    The global drive to attract foreigners with skills, especially those that fall somewhere between physical labor and a physics Ph.D., aims to smooth out a bumpy recovery from the pandemic.

    Covid’s disruptions have pushed many people to retire, resign or just not return to work. But its effects run deeper. By keeping so many people in place, the pandemic has made humanity’s demographic imbalance more obvious — rapidly aging rich nations produce too few new workers, while countries with a surplus of young people often lack work for all.

    New approaches to that mismatch could influence the worldwide debate over immigration. European governments remain divided on how to handle new waves of asylum seekers. In the United States, immigration policy remains mostly stuck in place, with a focus on the Mexican border, where migrant detentions have reached a record high.

    Still, many developed nations are building more generous, efficient and sophisticated programs to bring in foreigners and help them become a permanent part of their societies.

    “Covid is an accelerator of change,” said Jean-Christophe Dumont, the head of international migration research for the Organization for Economic Cooperation and Development, or O.E.C.D. “Countries have had to realize the importance of migration and immigrants.”

    Credit…Brendan Mcdermid/Reuters

    Seeking to increase the supplies of coronavirus vaccines, treatments and diagnostic tests needed to quell the pandemic around the globe, 15 human rights groups have asked President Biden to apply maximum pressure on the World Trade Organization to grant an intellectual property exemption for the vaccines.

    The exemption would mean that any country or company that has the ability to produce a vaccine could do so without having to worry about running afoul of the world economic body’s property right protections. Some public health experts see a W.T.O. exemption as key to bolstering the production of vaccine in developing countries, allowing drugmakers around the world access to closely guarded trade secrets on how viable vaccines have been made.

    “The stakes could not be higher,” the groups wrote in a letter to the White House dated Nov. 19. “Failure to enact a waiver will prolong the pandemic leading to more death, illness, economic hardship, and social and political disruption.”

    Only 5 percent of people in low-income countries have received at least one dose of a coronavirus vaccine, according to the Our World in Data project at the University of Oxford, a figure that is dwarfed by rates in wealthier countries.

    Public Citizen, Oxfam, Amnesty International, Human Rights Watch, Doctors Without Borders and Partners in Health are among the organizations listed on the two-page letter.

    “There are people talking about whether or not we should take boosters,” Dr. Joia Mukherjee, chief medical officer of Partners In Health, a global public health nonprofit, said at a news conference on Tuesday. “This, to me, is even a false argument because that plays into the narrative that this is a scarce commodity.”

    “It is only a scarce commodity because Pharma wants it to be a scarce commodity so that they can maximize profit,” she said, using shorthand for the pharmaceutical industry. “And we just need to say enough is enough. This is the time for us to show leadership.”

    The increase in pressure on the Biden administration comes one week before hundreds of officials converge on Geneva for the W.T.O.’s major ministerial conference on Nov. 30.

    In May, the White House said that it supported waiving intellectual property protections for coronavirus vaccines, as it sought to bolster production amid concerns about vaccine access in developing nations.

    But the rights groups said in their letter that they were disappointed that the administration had since “been unwilling to take further leadership.” They noted that more than 100 W.T.O. member nations supported a waiver.

    Six times as many booster shots of coronavirus vaccine are being administered in wealthy countries around the world each day than primary doses are being given in low-income countries, according to the World Health Organization. The group’s director general, Dr. Tedros Adhanom Ghebreyesus, has called that disparity “a scandal that must stop now.”

    The Biden administration said last week that it planned to spend billions of dollars to expand vaccine manufacturing capacity, with the goal of producing at least one billion additional doses a year beginning in the second half of 2022.

    Most public health experts agree that it’s OK to make holiday plans with your favorite people, as long as you’re taking precautions. Answering a few simple questions can help you make safer decisions.

    You can take the quiz by clicking below, or keep reading for an overview.

    Will everyone be vaccinated?

    If yes — or if the only unvaccinated people are young children — that will make the party safer for everyone, though if you want to reduce the risk even further, you may want to encourage every adult to get a booster shot. If unvaccinated adults will be there, on-the-spot rapid tests are a great way to lower risk. You can also improve ventilation by opening windows, using exhaust fans, adding portable air cleaners or moving the event outdoors if weather allows.

    Are any guests at higher risk from Covid?

    If everyone is at relatively low risk, you may decide that being vaccinated is enough, and that additional precautions aren’t needed. But if any of your guests are older or have underlying conditions that put them at higher risk, it’s important to plan the event around the most vulnerable person. That could mean using rapid tests and improving ventilation, or having the party at their home so they don’t have to travel.

    Are you traveling?

    Staying local is the lowest-risk option, and if you’re traveling farther, driving is safer in terms of Covid risk than taking public transportation.

    If you have to fly or take a bus or train, you should take extra precautions. A high-quality medical mask like an N95, KN95 or KF94 can keep you safer; if those aren’t available, double mask with a surgical mask and quality cloth mask. If possible, you should keep it on the whole time. At airports and train or bus terminals, try to avoid crowds, keep your distance in screening lines and use hand sanitizer often.

    What’s the Covid situation where you’re celebrating?

    Check local Covid conditions like you would the weather, looking at vaccination rates, case counts and hospitalizations. If you’re headed to a Covid hot spot, it’s best to wear a mask in public spaces, and you may want to avoid indoor dining, especially if someone in your group is at high risk.

    What’s it like where you live?

    If you live in a Covid hot spot, the chance of bringing the virus with you when you travel is higher. Be vigilant about masking and avoid crowds in the days before you leave. Using rapid tests can also reassure everyone that you’re not infectious.

    How big is the gathering?

    When you limit a gathering to two households, it’s easier to keep track of risky behaviors and potential exposures. This doesn’t mean large families shouldn’t gather, but you may want to take extra precautions if more than two households will be present. Those precautions could include opening windows, turning on exhaust fans and using portable air cleaners. And the bigger the party, the more useful it is to have rapid tests on hand for everyone.

    How long until your event?

    Risk is cumulative. The choices you make before the party can help lower the risk for everyone. If you’ve been invited to other gatherings before you leave, consider skipping them, and be vigilant about reducing your exposures during travel.

  • 5 Easy-To-Follow Fitness Tips For Successful Results

    5 Easy-To-Follow Fitness Tips For Successful Results

    PHOTO: Evolve MMA

    PHOTO: Evolve MMA

    Fitness is both an end goal and the process that gets you there. It is a lifestyle that you need to build, block by block. These building blocks take the form of small decisions that you need to make regularly.

    This article will explore a few helpful tips that help you to achieve good results that stay with you for the long haul.

    Doable fitness goals that are worth pursuing

    Taking on a fitness journey is a lifestyle change that quickly improves your physical and emotional health. Regular and consistent exercise also sculpts the body, but only in the medium to long term. For many, the lack of immediate results in the weight loss and muscle departments can be demotivating.

    For this reason, you should start your fitness journey with very realistic, gradual milestones. Your fitness journey will be a marathon, after all, not a sprint. The strategies below will help you make enduring changes that will pay off for a long time to come.

    Starting over

    This section is for anyone who is looking to take up fitness after an extended hiatus. The mere thought of starting a new fitness journey can be intimidating. Your mind may trick you into thinking that you need to clear some impossible hurdles even before starting. There’s only one way to get through this: Start small.

    If the idea of going to the gym seems like too much, start with five or ten minutes of exercise right in your home. Make it a point to make this small, daily effort towards exercise. This will rewire your brain to accept that you are capable of setting a goal and working on it. Here is how to rewire your brain to make yourself more consistent.

    1) Forming a habit and sticking with it

    You’ve overcome the mental block of starting your fitness journey, and now you have to find the motivation to keep going. So there you are, faithfully showing up for every one of your workouts, until one day you just don’t feel like it.

    Maybe you didn’t have the energy to wake up early one morning, or a hard day’s work had you running on empty. Missing one morning or evening session can lead to erratic workout patterns, snowballing into another long hiatus. Here’s how to avoid this:

    Build a habit by starting small

    Diet and exercise are habits you form mentally, even as you form them physically. Your mind can override your body after a long day, and it can wake you up when you would rather sleep in. Here is how to turn the mind into your very own fitness trainer:

    • Start with short, easy sessions that are a walkover and stick with the ‘easy’ setting for a week or two.

    • Proceed to turn it up a notch to give your body and mind something new to work with. Take care not to discourage yourself by pushing too hard; this is about forming a habit more than anything else.

    • Slot your workouts for a time when you have the energy and concentration to get through a few minutes of exercise.

    It will take a couple of weeks for your mind to adopt exercise as part of your lifestyle. There are no shortcuts to forming a habit, except for time and repetition. The good news is that it is easy to remain consistent throughout your fitness journey once the habit forms. For motivation, you can change up your workouts whenever you start to get bored.

    2) Build muscle to burn fat

    PHOTO: Evolve MMA

    PHOTO: Evolve MMA

    This applies to anyone, no matter their fitness goals. If you want to lose weight, you need to build muscle and burn fat. If you want sculpted abs, you need to build muscle and burn fat.

    You do this by incorporating high-intensity exercise and strength training into your cardio workout. This prevents the loss of muscle while stimulating the formation of new muscle tissue. Muscle burns more calories than other tissue types, which helps you reach your fitness goals that much faster.

    3) Some foods will help while others will hurt

    You still need fuel to exercise even if weight loss is your ultimate fitness goal. You can take in small amounts of complex carbohydrates before your workouts. This measure becomes even more important as you increase the intensity of your workouts.

    Avoid fatty foods before exercise since they can make you sluggish. Also, remember to hydrate before, during, and after your workout sessions. Lastly, reward yourself with a healthy snack a short while after your workouts, preferably a protein-rich one.

    4) Find exercises and activities that suit you

    Don’t take up jogging if you despise jogging. Stay away from gym settings if you hate the gym. Instead, take up the kinds of activities that you enjoy. If it helps to watch TV as you ride an exercise bike, do that. Maybe competitive sports are more your speed, so find people who like the same sport as you.

    Better still, take up martial arts like Muay Thai, which can help you burn up to 1000 calories per hour. There’s a whole world of sporting activities to choose from. Pick one that works with your schedule and your preferences.

    5) Find a way to stay accountable

    We all need a little help to maintain our enthusiasm as we turn a fitness journey into a healthy lifestyle. Find a friend or support group that will either work out with you or check on you periodically. Having someone to answer to may provide a timely dose of motivation on days when you feel like you just don’t have it in you.

    Put your best foot forward

    Setting a fitness goal and reaching that goal is an investment that pays off in a big way. We appreciate that you’re already putting your energy into doing something good for yourself just by reading this. Martial arts training provides a fun activity that can burn up to 1000 calories per hour, bringing you closer to your fitness goals.

    This article, “5 Easy-To-Follow Fitness Tips For Successful Results”, originally appeared on Evolve MMA, Asia’s No. 1 martial arts organisation.

  • Mental Health Tips for Fall and Winter

    Mental Health Tips for Fall and Winter

    Newswise — Fall and winter can be challenging for many from a mental health perspective, and for the second year in a row, the holiday season will be impacted by the COVID-19 pandemic. Here are some tips on ways to maintain good mental health in the months ahead from Allison Johnsen, LCPC, BCC, behavioral health specialist at Northwestern Medicine Delnor Hospital.

    Focus on the meaning of the holidays
    Ask yourself what the holidays mean to you personally. What do you cherish: the feast, the family camaraderie, viewing the lights and decorations? Identify what is most important and meaningful for you, and be flexible with the rest. Then identify specific ways to make the holidays special for you this year.

    Beware ‘post-pandemic flux syndrome’
    Coined in a Washington Post article by Riley Cuddy on August 11, 2021, this is not a clinical term, but it is something you may have noticed affecting you during the long months of the pandemic. Many people are feeling rather numb, or trending up and down with anxiety and depression, as hopes of a return to “normal” wax and wane. You may also find yourself wanting to make a big change, like moving to a different state; changing jobs; buying an RV, a new car or a new house; or working remotely from another location (perhaps in your new RV). But make sure you vet such decisions carefully and understand where they are coming from. You do not want to make a long-term decision like blowing your budget, depleting your savings, or walking away from your significant other in response to the pandemic.

    Stay active
    Put exercise, movement, outdoor and social activities into your schedule as must-do’s, just like meetings or appointments. It may be safe to return to the gym, especially if you are vaccinated. Walking is always an option with weather-appropriate clothing. You can also try Pilates, yoga and other video-streaming exercise options at home.

    Cultivate a positive mindset
    Take a look at your thought process and adjust if needed. Observe your own thinking and ask yourself: Is it negative, worried or angry? If so, that’s how you will feel. So keep your thoughts as positive as possible and curb that inner negativity with these ideas:

    • Keep a gratitude journal.
    • Reading or listen to uplifting music, podcasts or audio books.
    • Remind yourself that winter is temporary and spring light will come again. Here in the Northern Hemisphere, every day after December 21 gets longer.
    • Each week, schedule activities you enjoy and look forward to:
      o Visits with friends and family
      o Special dinners
      o Reading a great book
      o Watching a TV series that does not depress you
      o Taking up a project or hobby and keeping at it (productivity is great for mental health)
    • Reach out to someone you trust if you find your thoughts are trending towards the negative or irrational. Ask for help to return to a positive mindset.

    Protect your health this winter
    Implement these practices to boost your immune system and your mental health:

    • Make sleep a priority. Get seven to eight hours on most nights. This will improve your mood and your productivity.
    • Keep hand-washing, mask-wearing and physical distancing if you are indoors with people who may not be vaccinated or outdoors in crowded situations. The Centers for Disease Control and Prevention website at cdc.gov has excellent guidelines to protect yourself and those you love.
    • Take vitamins.
    • Avoid bingeing on food and alcohol.
    • Keep exercising.
    • Use lotion, as skin dries out in low humidity and heated environments.
    • Monitor your thought patterns and work on increasing positive thinking.

    If you find you cannot do at least some of these healthy things on your own, then seek a mental health counselor or talk to your primary care physician.