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  • For migrant farmworkers, internet access lags

    For migrant farmworkers, internet access lags


    By Clarissa Donnelly-DeRoven

    From tight living quarters to high rates of chronic illnesses to no sick leave protections, immigrant farm workers have found themselves in particularly vulnerable positions as the COVID-19 pandemic spread throughout North Carolina. 

    During the summer of 2020, hundreds of farm workers fell ill at more than 30 farms as COVID ripped through the greater community. Farmworker advocates issued numerous calls to Gov. Roy Cooper, demanding he and other state officials implement policies to better protect workers. Cooper seemed likely to meet the demands, though eventually he changed course.

    The state’s Department of Health and Human Services does not track COVID-19 infections by profession. At the start, the department tracked farmworker housing with outbreaks, as it does with other congregate living settings such as nursing homes and adult care facilities. But by summer 2020, the department changed its record keeping. 

    It moved migrant farmworker housing to the more general “other” category, which also includes homeless shelters. Instead of the name of the farm, only the cross streets are listed. 

    NCDHHS said the change was made to be more precise.  

    “In the former display, a business/farm was named even though the outbreak might have occurred at a housing site several miles away,” said NCDHHS spokesperson Catie Armstrong, adding that the precise address of the outbreak was removed “as an acknowledgement that marginalized populations reside in both settings and those settings/residents are at-risk for acts of discrimination and harassment.”

    General infection data do show that since March 2020, 17 percent of COVID cases in North Carolina have been among Hispanic residents, despite the group accounting for 10 percent of the population (about 94 percent of farmworkers speak Spanish as their native language). 

    To put it mildly, the pandemic has been rough for immigrant farm laborers. As vaccines have rolled out, though, many have finally found some relief and protection.

    As of mid-December 2021, health care workers had administered 28,702 vaccine doses to farmworkers at centralized vaccination sites targeting the population, according to NCDHHS.

    The total population of migrant and seasonal farm laborers in North Carolina is estimated to be around 150,000, including undocumented workers, those in the U.S. on H-2A temporary agricultural worker visas, along with U.S. citizens and permanent residents.

    The number of vaccine doses given to the group is almost definitely an undercount since these workers — like everyone else — can get their vaccine at any location that administers them. If a farmworker went to a nearby pharmacy for a vaccine, rather than waiting for the vaccine pop-up at the labor camp, they wouldn’t be counted in the number of vaccines administered to farmworkers specifically. 

    AMEXCAN, a Latino advocacy group based in Greenville, recently conducted a survey of nearly 100 immigrant farmworkers to gauge their knowledge about COVID-19 and the vaccine. 

    Among the findings: more than 80 percent of the immigrant farmworkers surveyed said they knew where they could go to get a COVID-19 vaccine, a significant feat considering the language and transportation barriers the community often faces. Survey respondents primarily lived in Nash, Wilson and Harnett counties, rural areas in the eastern and central parts of the state. 

    AMEXCAN surveyed migrant farmworkers about their access to the vaccine for COVID-19. The researchers asked migrants if they knew where they could find the closest vaccine center to them. More than 80 percent said yes. Credit: AMEXCAN

    Gaps to more general support remain for immigrant farmworkers. In the survey, workers said they needed help accessing other types of medical care, including mental health care. They also expressed needing clothes, masks, other personal protective equipment and food. 

    Perhaps most significantly, workers said they needed access to the internet. 

    “At this day in time, this is the way that we can communicate with our own communities,” said AMEXCAN’s executive director Juvencio Rocha-Peralta. “These communities or these individuals, they really live in a very remote area, so there’s some room in there for us to advocate more for connectivity, for access to services.”

    Internet unreliable 

    State agencies have also taken note of this critical need. Natalie Rivera coordinates the Farmworker Health Internet Connectivity Project within the N.C. Farmworker Health Program, an organization that acts as a liaison between clinics and farmworkers. 

    “We look for areas in North Carolina where there’s a large density of farmworkers, but maybe not a lot of health services,” Rivera said. “Outreach workers go out into the community, go into farms, visit farmworkers where they’re living and do health outreach to better connect them with the clinic services that are available to them.”

    When COVID arrived, the organization considered switching to a virtual model to better protect farmworkers, community health workers, and to limit physical appointments with doctors. But, they immediately ran into a problem: internet and cell service at most migrant housing ranges from poor to nonexistent. 

    “I knew that this issue existed,” Rivera said. She used to be an outreach worker, and she remembers having to go out to farms to deliver health information — a blood test came back, an appointment had to be rescheduled, etc. — which could have been relayed over a phone call or an email, had those services reliably existed.

    “Hidden” housing

    Part of the challenge in getting internet to migrant farm labor camps stems from how isolated their housing often is. 

    Nearly 40 percent of migrant camps are “hidden,” according to a 2015 study by researchers at Wake Forest School of Medicine, meaning they’re far off the road, or tucked behind other structures. The distance between the road and migrant housing makes it more likely trees or other physical barriers will need to be removed, which can lead to rising costs when laying the fibers and cables. 

    “The other part about migrant housing is, in many cases, it’s congregate housing,” Rivera said. “So that also creates a challenge with bandwidth and data.”

    Researcher from Wake Forest School of Medicine analyzed the “structural vulnerability” that hidden migrant labor camps places farmworkers in. Among the housing units analyzed, researchers found that more than ⅓ were hidden. Here, they map their findings. Credit: American Public Health Association, National Institutes of Health

    Much migrant housing is also built from metal or concrete, which can impede getting internet access inside. Rivera said she’s heard from many growers who’ve gotten quotes from internet service providers saying that it will cost tens of thousands of dollars to wire up such buildings. 

    Housing being “hidden” can also contribute to health problems beyond a lack of internet access.

    “Crowding, lack of access to sufficient bathing facilities, pest infestation, and structural damage are common to dwellings in farmworker labor camps,” the authors of the 2015 study wrote. “Employer-provided farmworker housing seldom meets the requirements of state and federal regulations.”

    While improved internet access wouldn’t address those problems, those in the field have seen how expanded access has helped immigrant laborers in other capacities.

    “We’ve learned that the internet is not only beneficial for health access, but also just for emotional well-being,” Rivera said. 

    Despite the benefits of internet access, and the increasing dependence on web-based services during the pandemic, neither North Carolina nor federal migrant housing regulations require internet access be available to workers living in migrant housing. 

    Wi-Fi v. broadband

    As the virus spread, members of the farmworker health program began speaking with people at the North Carolina Broadband Infrastructure Office to strategize the easiest and quickest way to get internet access to farmworkers. They decided on Wi-Fi hotspots. 

    Hotspots use cellular networks, such as Verizon and AT&T, to deliver internet access. They’re small, essentially the size of a cell phone, and portable. But their size poses some problems.

    “They can easily get lost,” Rivera said. They also don’t work especially well if multiple people are trying to do simultaneous things that require a lot of bandwidth, like watching YouTube or video chatting with family, not to mention a child trying to participate in video classes.

    Since the start of the program, the Farmworker Internet Connectivity Project has distributed more than 200 hotspots to labor camps throughout the state. Credit: North Carolina Department of Health and Human Services

    The organization distributes hotspots to farms through the health partners with whom they already worked. Some nonprofits and other community-based organizations that have existing relationships with farmworkers also participate. 

    Blue Ridge Health, a federally qualified health center that works with migrant farmers in western North Carolina, participated in distribution. 

    Kenett Melgar, the vulnerable populations manager at BRH, said the hotspots were critical. They enabled many migrant workers, who didn’t previously have internet access, to participate in telehealth appointments, and to speak with their families using WhatsApp.

    “The need for the migrant population parallels the needs of the community as a whole,” Melgar said. “Internet access — especially in remote mountainous areas, such as the ones that we have around here — can sometimes be spotty, and a lot of people just don’t have good internet. Which, in today’s world, is kind of a need.”

    As of August 2021, the most recent data available, the group had distributed 258 hotspots, enabling over 2,000 farmworkers to gain access to the internet. They did not have documents available showing the geographic distribution of the hotspots.

    An emergency stop gap 

    The Wi-Fi hotspots were always designed to be a short-term response, generated by the pandemic. There’s only funding for the service through the end of 2022, according to Rivera. 

    Alongside the hotspot program, the agency also partnered with the N.C. Institute of Agromedicine to come up with a more permanent solution.

    Broadband infrastructure takes time to build out and it can be very expensive. It’s an issue rural communities across the state and the country have reckoned with, especially during the pandemic when so much of life has moved online. 

    “Wired internet… like fiber or cable, really needs to be sort of buried underground. It costs a lot more money” Rivera said, “but it ends up being more permanent and more cost efficient once it’s available to you.”

    In addition to the WiFi hotspot program, the internet connectivity project is also working with the N.C. Agromedicine Institute to reimburse expenses for installing more permanent internet access. Credit: North Carolina AgroMedicine Institute

    The agencies designed a program whereby farm owners and growers who want to install more permanent internet at their locations can do so and get reimbursed by the Agromedicine institute for up to $1,000 per migrant housing unit. 

    The reimbursement, though, is also temporary. 

    To achieve digital equity, Rivera said, it’s critical that migrant farmworkers have access to the internet. The question is, who is financially responsible for making that happen?

    “The challenging part has been what would happen afterward,” she said. “Do we pay for it? Or do they pay for it? And I think we were trying to go through this to learn and see.”

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    by Clarissa Donnelly-DeRoven, North Carolina Health News
    January 10, 2022

    1

  • Tired of seeing barriers disrupt mental health support for students, this district redesigned its process

    Tired of seeing barriers disrupt mental health support for students, this district redesigned its process


    By Rupen Fofaria, EdNC

    Lauren Cappola knew she was sounding repetitive, but she felt compelled to ask the same question of her colleagues everywhere she went across the state: How are you connecting children with the mental health services they need?

    As director of counseling services for Harnett County Schools, and a former counselor herself, she saw that the need for mental health services was clear — but so, too, were many barriers. Services outside the schools aren’t widely available in her area, and many school families lack transportation or insurance.

    “I kept hearing the same thing,” she said. “We found a lot of people contracted outside services, which is a roadblock for us because there’s not a lot of agencies to contract with, and then you have to stay in a certain catchment area.”

    Contracting with outside providers has worked in other places, such as Transylvania County. But Harnett is larger, with businesses and residences spread out. The school system didn’t have a lot of success with this model, Cappola said.

    One day, she spoke with a colleague from neighboring Lee County, which had built a system-wide team within its central office that could provide those outside services inside school buildings. 

    “She was so excited,” said Jermaine White, the district’s assistant superintendent for student services, “and I thought, why can’t we try it. It just took an idea, we put some action behind it, and this is where we are now.”

    The result is a five-person mental health support team that works directly with students in schools to provide mental health services that just two years ago lay outside their grasp. Student referrals, student treatment, and teacher knowledge have all gone up, White said, and the district continues to improve on this idea — most recently adding an art therapist to the mix.

    First step: Navigating funding and personnel issues

    The program began with the 2019-20 school year — just before the COVID-19 pandemic. At that time, the most visible roadblocks involved staffing and getting students to their referrals.

    “There would be so many mental health needs of our students, but then there wouldn’t be enough therapists or any appropriate referrals for them,” said Jessalyn Pedone, the first mental health support specialist on the team. “So there were a ton of kids that just weren’t getting the service they needed.”

    Some exhibited behavior issues at school. Others started isolating. Some stopped showing up for school at all.

    “We were all working overtime trying to really help them and support them as best we could,” Pedone said. “But I think that, unfortunately, there was only so much we [could] do.”

    When the district decided to build an in-house team, two issues arose: finding the personnel and paying for them.

    White had to get creative with the budget. He didn’t want to build a new team with grant money because he worried about sustaining it. Instead, he found vacancies the district didn’t need to fill, and he reallocated those dollars for the mental health support team.

    When the district asked Pedone to join the team for the 2019-20 school year, she jumped at the chance. As a social worker, she was trained and licensed to offer one-on-one therapy and trauma support. But ethics rules prevent school social workers from offering all their capabilities to students.

    Following the model from Lee County, though, when Harnett County Schools established the team it restructured Pedone’s social worker role as mental health specialist, allowing her to provide all of the services for which she is certified.

    Finding talent outside the county

    As Pedone and a former district staffer began the project, Cappola and White worked on expanding the team.

    Statewide, public schools are below national recommended ratios for social workers, counselors, and psychologists in schools. Part of the problem, historically, is lack of funding. Another part, White said, is finding local talent.

    The district hired Christi Lowe from a district in Virginia and Jenae Cox from a mental health agency that served Orange County Schools. Initially, the district hired Lowe and Cox as social workers. Neither knew about the program when they were hired. 

    But Lowe was already feeling hamstrung by the ethics rules, and Cox was feeling sick over the number of students she was signing up at her outside agency who still weren’t receiving treatment.

    “You see the need every day, and for me, I’m like, I know I can do it — but I can’t,” Lowe said. “So this was just so exciting to be able to join the team, and be able to do it.”

    Cox added: “I was one of those outsourced therapists that was school-based, so our goal was more getting bodies rather than actually helping. Having the clients and making sure you have that huge caseload, but being unable to actually be effective, I just needed something different. They gave me a chance here. Thank God.”

    Last year, Lowe and Cox joined Pedone to form the specialists team, with Heather Baumhauer providing mental health support, and Amanda Sambets serving as a facilitator. They’re all stationed at different base schools, with the three specialists splitting the county into thirds and the others floating. Each specialist serves seven to nine schools.

    What services look like

    Social workers and counselors identify students who may need services, making referrals to the mental health support team once a parent consents to treatment. Then the team, which includes the behavioral support lead, decides at its Friday meeting whether it will take the case. 

    Approval criteria for the program include such things as access and capability. If students, for example, have insurance to cover treatment and transportation to get to it, they might be good candidates to refer out. The district also refers out students whose needs fall outside the team’s scope of practice.

    “But if a student isn’t approved for the process, that doesn’t mean we’re just going to kind of let them go to the wayside,” Pedone said. “We are very comprehensive, and so we want to make sure that we’re giving them whatever referrals are needed, helping them get to where they need to go.”

    When the team decides to take a case, the specialists find appropriate times — outside of core courses — to meet with the student at school or via video conferencing. It simplifies things for families.

    “Some parents would take off half days or whole days to make it work right, and so kids are missing a lot of instruction if they went to a weekly therapy appointment,” Cappola said. “Now we can provide that, and then they get right back to class.”

    Teachers also get more interaction with specialists, helping build relationships. That rapport has helped create buy-in when specialists offer training, White said.

    “I think when you sit around and listen to every one of our people talk, there’s a passion behind it which makes the difference,” he said. “You can’t not have the passion and do this right, because it’s going to become mundane and you’re not really going to put the effort into it.”

    Adding art therapy, and who knows what next

    White hired Sambets before the school year, getting her from the Wake County Public School System, where she taught exceptional children. Before moving to North Carolina, though, Sambets lived in New York, where she became licensed as an art therapist.

    You hear a lot about art as therapy, or music as therapy. “Art therapy” is something different. It’s a clinical evaluation and treatment of students through art projects. Sambets connects with kids while they draw, putting color and shapes on a canvas while pulling stories and thoughts and feelings from their heads.

    he support team says art therapy has been an added layer of support and, particularly for younger students who may not have the language for what’s happening to them, has provided a unique service.

    Sambets watches carefully as a student draws, noting things like the sharpness of peaks in the triangular shapes and the overuse of straight edges. All of it tells her something about what’s going on in the child’s mind.

    “And then from there, I can come up with a treatment plan,” she said. “Things will come out and I can say, OK, this is what we need to work on.”

    Sambets also leads group activities. Last month, for instance, she partnered with one of the family engagement specialists to lead a grief group activity for students at one of the district’s dual language immersion schools during Hispanic Heritage Month. She helped students create an el duende painting. El duende means a heightened state of emotion, and the process usually means layering paint on a single canvas over a six-week period. These students worked on the art for two weeks.

    North Carolina doesn’t yet recognize art therapy as a licensed profession, but the mental health support team has found ways to use Sambets’ skills in multiple ways to help students.

    “So [the specialists] created a partnership where a student might be referred and then they go through a process where we staff [the student],” Cappola said. “We talk about their needs and their interests and things that may work for them, and then she works with one of these three ladies to integrate the therapeutic art services.”

    Changing attitudes toward mental health support

    White likes to talk about the many layers to the new project, but one he keeps coming back to is the foundational piece of weaving mental health supports into everything the district does.

    “Sometimes people, left to their own devices, think that if they give a worksheet or give a talk about it, that that’s enough to address mental health,” he said. “Well, there are so many different things that we can do as a school system to improve people’s attitudes towards getting [students and teachers] assistance that they need. And that was missing here.”

    Now, with outside service capabilities brought in-house, layered on top of what social workers and counselors provide, more students are actually receiving services, Cappola said. Plus, teachers are getting consistent consultation and training on best practices. 

    “I think the beautiful part about it is, as we’ve gone through this process and people are kind of catching on to this being a component of our school district, they’re less fearful to ask questions when they don’t know,” White said. “What’s been outstanding about this is that I start hearing people use more of that technical terminology and it’s clearly because they’ve been communicating with the people who do this, and they’re getting an understanding and want to know more about how to help these kids.”

    The program’s success has White and Cappola thinking growth — again.

    “Our vision is for us to have three times as many of our mental health support specialists to serve our district,” Cappola said. “We want to grow this. We want this to be desirable for qualified clinicians to reach out and say, ‘Hey, I want to come and I want to work here and I want to be part of this because it is amazing.’”

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    by Education NC, North Carolina Health News
    January 9, 2022

    1

    January 9, 2022
  • Hospitals Recruit International Nurses to Fill Pandemic Shortages

    Hospitals Recruit International Nurses to Fill Pandemic Shortages

    Nick Ehli

    BILLINGS, Mont. — Just before Mary Venus was offered a nursing position at a clinic in this article, she’d never listened to of Billings or visited the United States. A indigenous of the Philippines, she investigated her future go by means of the world wide web, set aside her angst about the cold Montana winters and took the job, sight unseen.

    Venus has been in Billings since mid-November, doing the job in a surgical restoration device at Billings Clinic, Montana’s greatest medical center in its most populous metropolis. She and her partner moved into an apartment, acquired a car or truck and are settling in. They just lately celebrated their first wedding anniversary. Possibly, she mused, this could be a “forever house.”

    “I am hoping to remain here,” Venus explained. “So far, so excellent. It is not uncomplicated, even though. For me, it’s like residing on an additional earth.”

    Directors at Billings Clinic hope she stays, way too. The clinic has contracts with two dozen nurses from the Philippines, Thailand, Kenya, Ghana and Nigeria, all established to get there in Montana by summer season. Extra nurses from far-off locations are likely.

    Billings Clinic is just a person of the scores of hospitals throughout the U.S. seeking abroad to ease a scarcity of nurses worsened by the pandemic. The nationwide demand is so good that it is designed a backlog of well being care experts awaiting clearance to do the job in the U.S. More than 5,000 international nurses are awaiting remaining visa approval, the American Association of Worldwide Health care Recruitment described in September.

    “We are seeing an complete growth in requests for international nurses,” claimed Lesley Hamilton-Powers, a board member of AAIHR and a vice president for Avant Healthcare Specialists in Florida.

    Avant recruits nurses from other countries and then performs to put them in U.S. hospitals, together with Billings Clinic. Right before the pandemic, Avant would usually have orders from hospitals for 800 nurses. It currently has additional than 4,000 such requests, Hamilton-Powers reported.

    “And that’s just us, a single organization,” included Hamilton-Powers. “Hospitals all around the state are stretched and searching for choices to fill nursing vacancies.”

    International-born employees make up about a sixth of the U.S. nursing workforce, and the need is increasing, nursing associations and staffing agencies report, as nurses more and more go away the career. Nursing schools have found an enhance in enrollment considering the fact that the pandemic, but that staffing pipeline has done minimal to offset today’s desire.

    In actuality, the American Nurses Affiliation in September urged the U.S. Office of Health and Human Solutions to declare the shortage of nurses a national disaster.

    CGFNS International, which certifies the credentials of overseas-born health treatment employees to get the job done in The us, is the only such corporation authorized by the federal government. Its president, Dr. Franklin Shaffer, said extra hospitals are on the lookout overseas to fill their staffing voids.

    “We have a massive desire, a massive lack,” he mentioned.

    Billings Clinic would retain the services of 120 a lot more nurses right now if it could, hospital officials stated. The staffing scarcity was substantial before the pandemic. The included needs and tension of covid have manufactured it untenable.

    Greg Titensor, a registered nurse and the vice president of operations at Billings Clinic, noted that a few of the hospital’s most skilled nurses, all in the intense care device with at the very least 20 a long time of practical experience, a short while ago declared their retirements.

    “They are acquiring tired, and they are leaving,” Titensor stated.

    Last fall’s surge of covid situations resulted in Montana owning the highest price in the country for a time, and Billings Clinics’ ICU was bursting with individuals. Republican Gov. Greg Gianforte sent the Countrywide Guard to Billings Clinic and other Montana hospitals the federal government despatched pharmacists and a naval medical crew.

    While the surge in Montana has subsided, lively case numbers in Yellowstone County — property to the healthcare facility — are among the the state’s highest. The Billings Clinic ICU nonetheless overflows, largely with covid clients, and indications nevertheless alert readers that “aggressive behavior will not be tolerated,” a reminder of the danger of violence and abuse health and fitness treatment employees endure as the pandemic grinds on.

    Like most hospitals, Billings Clinic has sought to abate its staffing lack with traveling nurses — agreement workers who normally go wherever the pandemic calls for. The clinic has compensated up to $200 an hour for their services, and, at very last fall’s peak, experienced as quite a few as 200 traveling nurses as element of its workforce.

    The shortage of nurses nationally has driven those steep payments, prompting users of Congress to check with the Biden administration to look into documented gouging by unscrupulous staffing organizations.

    Whichever the cause, satisfying the hospital’s staff shortage with touring nurses is not sustainable, stated Priscilla Needham, Billings Clinic’s chief economical officer. Medicare, she famous, doesn’t spend the hospital a lot more if it wants to retain the services of a lot more high-priced nurses, nor does it shell out enough when a covid affected person desires to stay in the medical center lengthier than a normal covid affected person.

    From July to October, the hospital’s nursing expenses increased by $6 million, Needham explained. Funds from the Federal Unexpected emergency Management Company and the CARES Act has helped, but she anticipated November and December would further more generate up costs.

    Dozens of agencies put intercontinental nurses in U.S. hospitals. The company that Billings Clinic chose, Avant, to start with places the nurses by means of instruction in Florida in hopes of easing their changeover to the U.S., reported Brian Hudson, a organization senior vice president.

    Venus, with 9 yrs of knowledge as a nurse, claimed her stateside education included clearing cultural hurdles like how to do her taxes and acquire auto insurance.

    “Nursing is the same all above the world,” Venus said, “but the society is very unique.”

    Shaffer, of CGFNS Worldwide, mentioned foreign-born nurses are intrigued in the U.S. for a selection of causes, like the chance to advance their schooling and professions, earn additional money or most likely get married. For some, mentioned Avant’s Hudson, the plan of living “the American dream” predominates.

    The hitch so considerably has been having the nurses into the region quick sufficient. Soon after employment are provided and approved, foreign-born nurses involve a remaining job interview to acquire a visa from the Condition Office, and there is a backlog for all those interviews. Powers explained that, mainly because of the pandemic, numerous of the U.S. embassies wherever people interviews get location stay shut or are working for less several hours than normal.

    Even though the backlog has receded in current weeks, Powers explained the delays as challenging. The nurses ready in their property nations, she stressed, have handed all their necessary tests to get the job done in the U.S.

    “It’s been very frustrating to have nurses poised to arrive, and we just just cannot bring them in,” Powers said.

    Once they arrive, the intercontinental nurses in Billings will keep on being staff members of Avant, even though immediately after 3 a long time the clinic can present them permanent positions. Clinic directors stressed that the nurses are compensated the same as its neighborhood nurses with equal knowledge. On prime of that, the medical center pays a payment to Avant.

    A lot more than 90{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of Avant’s global nurses opt for to keep in their new communities, Hudson reported, but Billings Clinic hopes to improved that mark. Welcoming them to the town will be crucial, claimed Sara Agostinelli, the clinic’s director of diversity, fairness, inclusion and belonging. She has even offered winter season driving lessons.

    The additional diversity will advantage the town, Agostinelli claimed. Some nurses will deliver their spouses some will deliver their kids.

    “We will help inspire what Billings appears like and who Billings is,” she stated.

    Pae Junthanam, a nurse from Thailand, reported he was initially concerned about coming to Billings following finding out that Montana’s populace is nearly 90{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} white and much less than 1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} Asian. The prospect to progress his vocation, on the other hand, outweighed the fears of shifting. He also hopes his companion of 10 many years will soon be capable to sign up for him.

    Since his arrival in November, Junthanam reported, his neighbors have greeted him warmly, and one shop operator, soon after studying he was a nurse recently arrived from Thailand, thanked him for his provider.

    “I am much from house, but I truly feel like this is like yet another household for me,” he said.

    KHN (Kaiser Well being News) is a countrywide newsroom that creates in-depth journalism about well being issues. Together with Coverage Examination and Polling, KHN is a person of the a few major running systems at KFF (Kaiser Spouse and children Basis). KFF is an endowed nonprofit firm offering information and facts on health and fitness difficulties to the nation.

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  • Training teens to take COVID vaccine messages to their communities

    Training teens to take COVID vaccine messages to their communities


    By Anne Blythe

    Gabrielle Maradiaga Panayotti is a Duke pediatrician who readily acknowledges that she can encourage teens to get vaccinated and give them all the reasons why she thinks they should, but the reality is that their peers are likely to have more influence.

    That’s why LATIN-19, an organization that Maradiaga Panayotti and other Duke health care workers founded at the start of the pandemic, is raising money to start a program through which teens can become vaccine ambassadors in Durham communities and get paid for it. 

    The organization is partnering with ISLA, a Triangle-based organization that works to build youth leadership with Spanish language and cultural immersion programs.

    “These Latinx youth ambassadors will communicate directly with families in their own communities through social media and other events on why it is so important to stop the spread of COVID-19,” Maradiaga Panayotti said.

    The idea builds on the kinds of community health worker programs that are widely used throughout Latin America. Trained workers go out into neighborhoods, to homes, workplaces and places outside traditional health care settings to provide public health information.

    With bilingual skills and a cultural understanding of the communities, the teens will be trained to empower their peers and Hispanic families to make informed decisions about COVID-19 vaccines.

    “We immediately jumped in,” said Natalia Rivadeneyra, policy research and advocacy manager at ISLA. “A goal is to see public health provided by real agents of change.”

    Changing the trajectory

    One in three pediatric deaths from COVID-19 in this country have been Latino children, according to LATIN-19. In North Carolina, one in six, or nearly 400,000 children, are Hispanic.

    From the start of the pandemic, LATIN-19 has worked to get accurate information to Latinos in Durham and elsewhere throughout the state. During the weekly Zoom sessions that have occurred since March 18, 2020, Maradiaga Panayotti and others discuss timely public health issues and develop strategies to attack problems.

    A year ago in December, the group was talking about the promise of the COVID vaccines and how they could get Hispanic communities to embrace them as a necessary protection in the pandemic.

    With the help of LATIN-19, teams of community health workers, the efforts of public health officials and more, Latino residents went from being one of the least vaccinated populations in the spring of 2021 to having one of the highest vaccination rates by the fall.

    Fifty-four percent of the Hispanic population has had at least one shot compared to 52 percent of non-Hispanic residents, according to the DHHS vaccination dashboard.

    Maradiaga Panayotti uses soccer, her favorite sport, to help teens and others understand what’s needed to attack the pandemic.

    “Sometimes playing our best game means thinking about changing our approach,” Maradiaga Panayotti says in a DHHS public service announcement. “When you’re playing a new team and you use a new move against them you score. But once the rival team sees your moves, they can prepare against you in the future. That’s how viruses like the coronavirus work, which means as new variants pop up, we have to adapt to defend ourselves.”

    Dr. Maradiaga Panayotti explains how vaccines protect you against COVID-19 Youtube from NCDHHS on Vimeo.

    COVID vaccines, the pediatrician says, help bodies recognize COVID-19 and its variants and mount a defense against the virus.

    “Don’t wait to vaccinate,” she says, repeating a phrase that public health officials often use.

    Vaccinating the children

    The North Carolina vaccination rates are nowhere near as high as public health officials would like to see, especially as the Omicron variant adds a new layer of worry to the pandemic.

    Gov. Roy Cooper and Mandy Cohen, secretary of the state Department of Health and Human Services until the end of last month, have tried different tactics to lead more adults to COVID vaccines. Recently they have been encouraging parents of children as young as 5 to get them the kid-size vaccines.

    Pfizer’s vaccine for children ages 5 to 11 was given emergency use authorization by the Food and Drug Administration and Centers for Disease Control and Prevention in November. 

    When Pfizer vaccines were approved for teens and pre-teens, ages 12 to 17 in the spring, there was an initial wave of eager parents getting their children vaccinated followed by a lull, according to a poll by the Kaiser Family Foundation Vaccine Monitor Poll. By Dec. 9, a survey of parents with children ages 5 to 11 before reports of the Omicron variant in the United States found even less enthusiasm for COVID vaccines. 

    Sixteen percent of the parents at that time reported that their child in that age group had at least one dose of the vaccine. Thirteen percent said they would get their child vaccinated “right away,” according to the Kaiser Family Foundation, while three in 10 parents of teens and younger children responded that they would “definitely not” get their child vaccinated for COVID-19.

    In North Carolina, only 21 percent of the children ages 5 to 11 had at least one dose of the vaccine, according to the DHHS vaccine dashboard.

    In Hispanic and Latino families, it’s often the teens and children who are able to bridge the worlds between their home countries and North Carolina, where they are, to make the best arguments for the families.

    Maradiaga Panayotti said some of her teenage pediatric patients go home and share information with their parents about how vaccines can help the older generations in their family stave off serious illness caused by COVID-19. They might persuade their loved ones to get vaccinated so they can protect an aging grandmother or grandfather.

    Often children who speak English and Spanish become leaders in the family because of their language skills and cultural understanding that build bridges between different worlds, said Rivadeneyra. In many immigrant families, children become de facto interpreters for non-English speaking parents and grandparents.

    Through the Spark Hope: Latinx Youth Ambassadors program, teens will deliver messages through TikTok and other social media platforms, at events, in schools and homes. The goal is to give the young ambassadors enough information and training so they can deliver direct, simple and consistent messaging with a sense that they are part of the solution.

    “As a pediatrician, I often see how children are left out of the conversations, or an afterthought,” Maradiaga Panayotti said. “I really love the idea in the youth ambassador program that they are getting a voice.”

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    by Anne Blythe, North Carolina Health News
    January 7, 2022

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  • Study: COVID Vaccination Not Tied to Preterm Birth | Healthiest Communities Health News

    Study: COVID Vaccination Not Tied to Preterm Birth | Healthiest Communities Health News

    New evidence supports recommendations by health officials to get vaccinated against COVID-19 during pregnancy, with researchers finding that the shot is not associated with an increased risk of two adverse birth outcomes.

    An analysis published Tuesday by the Centers for Disease Control and Prevention found COVID-19 vaccination during pregnancy was not associated with a higher risk of preterm birth – defined as giving birth before 37 weeks’ gestation – nor with smaller-than-usual babies when compared against births among unvaccinated women.

    Researchers examined data from more than 40,000 women ages 16 to 49 who became pregnant in 2020 and gave birth in California, Colorado, Minnesota, Oregon, Washington and Wisconsin. Among that group, about 10,000 women received at least one COVID-19 vaccine dose between Dec. 15, 2020 and July 22, 2021.The vast majority received either the Pfizer or Moderna mRNA vaccines, while about 4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} received the Johnson & Johnson vaccine.

    Overall, the rate of preterm birth among all the women was 6.6 events for every 100 live births. Among pregnant women who had received any type of COVID vaccine, the rate of preterm birth was 4.9 for every 100 live births, compared with 7 per 100 among unvaccinated women.

    The rate of babies who were born small-for-gestational age at birth – defined as having a birthweight below the 10th percentile for their gestational age – remained constant at 8.2 per 100 live births among pregnant women overall and among both vaccinated and unvaccinated pregnant women.

    Researchers also assessed rates for both outcomes based on how many doses of the Moderna or Pfizer vaccines a woman had received and whether they’d received their first or only vaccine dose in either the second or third trimester. Though rates fluctuated, they still found no significant association between the shot and a higher risk of the two outcomes.

    The study’s findings support CDC recommendations for pregnant people to get vaccinated due to an increased risk of severe illness tied to COVID-19 compared with people who are not pregnant, even as the agency says the overall risks are low. People who are pregnant and have COVID-19 face increased risks of preterm birth and stillbirth, according to the CDC.

    Researchers in the CDC-published study acknowledged, however, that the timing in which the COVID-19 vaccine became available and the timing of births among women in their cohort may have contributed to the fact that only 1.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of women who got vaccinated did so during their first trimester.

    “Risks associated with vaccination during the first trimester should be evaluated in future studies that include vaccines administered throughout pregnancy,” the study says.

    The findings of the new study may help dispel concerns over vaccine safety among a group that’s had a low vaccination rate despite increased risks. Overall, only about 22{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the more than 40,000 women in the study had received at least one dose of a COVID-19 vaccine between mid-December of 2020 and late July of the next year. In late September of last year, CDC Director Dr. Rochelle Walensky said only about 30{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of women currently pregnant had been vaccinated.

    “The findings from this retrospective, multisite cohort of a large and diverse population with comprehensive data on vaccination, comorbidities, and birth outcomes add to the evidence supporting the safety of COVID-19 vaccination during pregnancy,” the study authors concluded.

  • Coronavirus Today – Jan 4

    Coronavirus Today – Jan 4


    By Anne Blythe

    As public health officials predicted in late December, North Carolina is seeing the Omicron variant of COVID-19 bring record-high cases counts and putting strains on systems across the state.

    Finding COVID-19 tests has become difficult again. Rapid tests are in short supply. Many testing sites have long lines and time-consuming waits.

    On Tuesday, during his first briefing with reporters as the new secretary of the Department of Health and Human Services, Kody Kinsley acknowledged the aggravation that many are experiencing while sometimes waiting for more than an hour to get swabbed and tested for COVID-19.

    “Last week, we set a single-day record for COVID-19 cases. The next day we broke it, and the next day we broke it again, topping out at 19,620,” Kinsley said at the briefing with Gov. Roy Cooper and Susan Kansagra, the DHHS acting senior deputy director of public health. “We are not alone. The highly contagious Omicron variant of COVID-19 is setting record case numbers across the country, putting a strain on testing services and creating concern about hospital capacity.”

    North Carolina’s daily case count had a downward tick this week after last week’s record highs. There were 10,276 new cases of lab-confirmed COVID-19 on Tuesday, according to the DHHS dashboard, but even that number was one of the ten highest daily case counts since the beginning of the pandemic. 

    There were 3,008 people in the hospital with disease related to COVID-19, 603 of those were in intensive care unit beds, taking up 80 percent of the state’s hospital beds and 83 percent of the ICU beds, Kinsley said.

    “Most people in the hospital are unvaccinated,” Kinsley said. “More than 80 percent of the people in the ICU are unvaccinated.” 

    North Carolina has lost 19,494 people to COVID deaths, a sober reminder of the deadly scourge of the coronavirus pandemic.

    Kinsley, Cooper and Kasangra urged North Carolinians to get vaccinated and boosted when eligible to help slow the spread of Omicron and any other COVID-19 variants that might come along.

    “Vaccines are our way out of this,” Kinsley said. “They provide the best protection against severe illness, hospitalization and death. Boosters are critical. Early evidence shows that boosters provide a significant level of protection against Omicron.”

    “You can still decide to get vaccinated and help us save lives, protect hospital capacity and keep kids in school,” Kinsley added.

    DHHS is taking steps to make sure hospitals do not become overwhelmed by the surge in COVID cases, and Kinsley said he is in frequent contact with hospital administrators, keeping track of what they’re seeing and planning ahead for any shifts in resources that are needed.

    The hospital systems still have capacity according to Kinsley and Cooper, but that could change quickly if the case counts continue to soar.

    Each of North Carolina’s 100 counties has a high level of community COVID-19 transmission, according to the Centers for Disease Control and Prevention COVID tracking map, putting the state back in the red zone.

    “As the new year unfolds before us, I have so many reasons to be hopeful about our state’s progress in dealing with this pandemic, educating our children and growing our state’s economy, all at the same time,” Cooper said. “But we have to do what works, and I know we will.”

    Talks with the White House

    One thing Cooper plans to do is to require state employees who are subject to his executive order requiring vaccination or routine testing if they want to continue their employment to also get boosted once the CDC updates the definition of full vaccination to include a booster shot.

    “We want to make sure that our state employees are vaccinated and that they are protected,” Cooper said. “One of the things we are seeing more and more is that really keeping up with your vaccination is making sure you get boosted because more and more with this Omicron variant we are seeing so much more protection because the booster ramps up the immune system.”

    While working to get more North Carolinians vaccinated and boosted across the state, Kinsley and Cooper have been talking with the Biden administration and vendors about how they can increase testing supplies during the Omicron surge.

    “We’ve had a record number of tests over the holidays and that’s a positive thing,” Cooper said. North Carolinians are doing the right thing, he added, by getting tested before gathering with families or going back to school or work.

    The positivity rate for those tests is nearly 30 percent, according to Kinsley, nearly six times as high as the 5 percent mark that DHHS sets as a goal to be at or below.

    Cooper said he was on the phone with the White House this week trying to find out how his administration could get more tests distributed to counties and sites during this time of high demand. This was going on as complaints came from across the state that testing sites were having to close because they ran out of supplies.

    The Food and Drug Administration recently authorized two more rapid tests for emergency use so that some 15 brands of antigen tests will soon be available for distribution in the U.S. market. One test is manufactured by SD Biosensor and distributed by Roche, according to a Health and Human Services press release. The other is manufactured by Siemens.

    “That will help put millions more tests on the market for people,” said Cooper.

    Additionally, the Biden administration plans to get half a billion tests out to states in the next couple of weeks, further increasing the supply.

    In the meantime, the state, which provides only 10 percent of the testing, according to Kinsley, has been using its resources to open additional testing sites and thousands of appointments each day.

    Before the holidays, DHHS distributed about 500,000 test kits across the state, Kinsley said, and stands ready to fill other requests.

    “We are taking several steps guided by our laser focus on saving lives, ensuring that hospitals can provide care to people who need it and keeping kids in the classroom,” Kinsley said. “The first thing on everyone’s mind is testing. We set records there as well. On New Year’s Eve, more than 91,000 tests were reported to the state. I know many people felt the frustration of this increase and had to endure long lines.”

    Kinsley said he expects the demand for tests to remain high throughout the coming weeks.

    ‘Test-to-stay’ in school

    The surge in cases comes as millions of children and college students return to classrooms after a winter break.

    The ABC Science Collaborative, a Duke group that pairs physicians and scientists with school and community leaders to help them understand current and relevant COVID data, recently shared the results of a study with DHHS about a “test-to-stay” program that allows children to stay in the classroom even after exposure to the virus.

    The children and school staff would have to be tested for COVID-19 at specified intervals, continue to wear masks properly, not have any symptoms and remain negative on the rapid antigen tests.

    Kinsley said DHHS plans to talk with state school board members and others toward the end of this week to discuss whether this is something North Carolina schools should and could do.

    Such a program would mean children no longer would have to quarantine after being exposed to someone who tested positive for COVID, easing child care issues for many working parents and offering students an option to be in the classroom instead of isolated from their classmates.

    Prison cases start to tick up

    In just the past day, the number of inmates in the North Carolina prison system with COVID rose sharply, according to the dashboard, going from 84 on Monday to 116 on Tuesday. 

    Researchers who have tracked what’s happened in prisons around the country say the Omicron variant is likely to rip through prison populations, who live in close contact and who often have pre-existing conditions. 

    Tim Moose, the Department of Public Safety Director of Adult Corrections, said at the briefing with the governor and others that 74 percent of inmates throughout the system currently are vaccinated with two shots. Of that number, a third have chosen to get boosters, according to Moose.

    Inmates should be able to request boosters through their case managers or during medical appointments, Moose added, but he could provide no further details during the briefing about which facilities had more boosted inmates. 

    According to the DPS spokesman, John Bull, the department does not perform genetic sequencing on the positive tests from inmates.

    That makes it difficult to track Omicron, which is fast-moving. While Omicron appears to result in milder disease, it still can land an unvaccinated person in a hospital bed or worse.

    Coronavirus by the numbers

    According to NCDHHS data, as of Tuesday afternoon:

    • 19,457 people total in North Carolina have died of coronavirus.
    • 1,742,844 have been diagnosed with the disease. Of those, 3,008 are in the hospital, an 84 percent increase since Dec. 20, 2021, more than half of the admissions are of people between the ages of 50 and 79. The hospitalization figure is a snapshot of people hospitalized with COVID-19 infections on a given day. The hardest hit areas are the Charlotte Metropolitan area, with 813 patients, and the Triad area, with 764 patients. 
    • As of Tuesday, 603 COVID-19 patients were in intensive care units across the state. 
    • North Carolina tracked COVID-19 re-infections in the case counts from March 1, 2021 through Sept. 20, 2021. All told, North Carolina tracked 10,812 reinfections, 200 of those were in people who were previously vaccinated. Ninety-four people who were reinfected with COVID-19 have died. 
    • As of Dec. 20, 2021, 1,538,231 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious. Nor does it reflect the number of so-called “long-COVID” survivors who continue to feel the effects of the disease beyond the defined “recovery” period.
    • To date, 22,067,976 tests have been completed in North Carolina. As of July 2020, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the COVID-19 tests performed in the state. Most recently, 29.7 percent of those testing were testing positive. That doesn’t include home-based antigen tests that are reading as positives.
    • People ages 25-49 make up the largest group of cases (39 percent). While 12 percent of the positive diagnoses were in people ages 65 and older, seniors make up 74 percent of coronavirus deaths in the state. 
    • 338 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
    • As of Dec. 20, 6,607,890 North Carolinians have received at least one dose of a coronavirus vaccine. Ninety-two percent of people over the age of 65 have been completely vaccinated, while 59 percent of the total population is fully vaccinated. 2,542,000 boosters have been administered.
    • Children between the ages of 5 and 11 became eligible for vaccination during November. A total of 186,226 first doses have been given to those children, a total of 21 percent of that population.

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    by Anne Blythe, North Carolina Health News
    January 4, 2022

    1