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US

US Coronavirus: Some states have fewer than 10% of ICU beds left as health care staffing shortages complicate care

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The other states are: Arizona, Delaware, Georgia, Massachusetts, Mississippi, Missouri, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, Texas and Vermont, according to HHS data.

Nationally, the number of people in US hospitals with Covid-19 has reached a record high — 151,261 as of Wednesday. And as infection spreads, states and health care systems nationwide are handling shortages of available medical workers, who face a greater chance of Covid-19 exposure and must isolate after testing positive.
National Guard personnel and other federal emergency teams have been deployed to hospitals and long-term care facilities in places including New Hampshire to alleviate the burden with medical and non-medical tasks. And a new wave of federally deployed medical teams will head soon to six states — Michigan, New Jersey, New Mexico, New York, Ohio and Rhode Island — to help hospitals combat Covid-19, President Joe Biden is expected to announce Thursday.

“This is part of the winter surge, part of the long haul, which is why we put so many of the mitigation strategies and measures in place early on to help provide some flexibility to hospitals and health care systems,” New Hampshire Gov. Chris Sununu said Wednesday.

Early research indicates the Omicron variant may produce less of a chance of needing hospitalization than prior Covid-19 variants. But Omicron’s increased transmissibility means more people at higher risk for severe disease, such as those who are unvaccinated or immunocompromised, will be infected.

“Omicron continues to burn through the commonwealth, growing at levels we have never seen before. Omicron is significantly more contagious than even the Delta variant,” Kentucky Gov. Andy Beshear said Monday. “If it spreads at the rate we are seeing, it is certainly going to fill up our hospitals.”

While conditions are not as dire as at the start of the pandemic nearly two years ago due to the availability of vaccines and other treatment options, the staffing shortages in hospitals is a real concern during this latest surge, said Dr. Craig Spencer, director of global health in emergency medicine at New York-Presbyterian/Columbia University Medical Center.

“The problem is that right now we have hospitals where there’s not enough nurses to take care of the patients who are coming in, the Covid patients and the non-Covid patients,” Spencer told CNN’s Laura Coates Wednesday.

“That’s exactly why we need to do everything we can to try to limit the number of people that are infected, not just those that are older or unvaccinated or not boosted, but everyone. Because each infection represents a potential to infect more people. We need to do what we can to slow that spread right now and ease the pressure on our hospitals,” Spencer said.

For those who come into emergency rooms for non-Covid reasons yet test positive, hospitals are still having to invoke quarantine protocols for those patients which puts a strain on operations, he said. And that can have an effect on all patients.

“Right now, we’re still seeing sick people that need oxygen, the overwhelming majority of which are unvaccinated. But a lot of the patients that we’re seeing right now have underlying chronic conditions that are being exacerbated,” Spencer said.

Those patients, he said, can include “someone who gets Covid is dehydrated and needs to stay in the hospital, or someone who gets Covid and is too weak and they can’t go home because they’re a fall risk. Those aren’t as bad in one sense as those kind of classic Covid patients we were seeing before. But every single patient that needs to stay in the hospital takes up a bed. And beds and staffing are what’s in short supply right now.”

CDC to update mask guidance

Health experts are reiterating the need to wear quality masks as never-before-seen figures of positive Covid-19 cases strike the country.

The US averaged more than 771,580 new Covid-19 cases daily over the past week, according to Johns Hopkins University data, more than three times that of last winter’s peak average (251,987 on January 11, 2021) and more than 4.5 times the peak from the Delta-driven surge (166,347 on September 1).

The US Centers for Disease Control and Prevention plans to update information about mask-wearing, including the different levels of protection that various masks — such as cloth, surgical or N95 — provide against the spread of Covid-19, CDC Director Dr. Rochelle Walensky said during a White House virtual briefing Wednesday.

Overall, it is important for people to wear any face mask that they have access to, “but Omicron has changed things a bit because it is so transmissible that we know that masks are even more important,” Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, told CNN Wednesday.

“And if you have the chance, if you have the opportunity, if you have access to a better mask, then the recommendation would be to wear it,” she said, adding that N95 and KN95 masks need to be fitted properly to provide the best protection possible.

Vaccines effective with adolescents, study shows

The rate of deaths in the US has remained lower than during last year’s winter surge, which is often credited to around two-thirds of Americans eligible for vaccines being fully inoculated, according to the CDC.

The country has averaged 1,817 Covid-19 deaths a day over the past week, JHU data shows. The peak daily average was 3,402 one year ago on January 13, 2021.

However, the latest CDC ensemble forecast predicts a potential 62,000 new Covid-19 deaths over the next four weeks, meaning preemptive vaccinations are still needed.

The age group of Americans who are the least vaccinated remains those under the age of 18, and a new study of real-world hospital data between July and late October points to the effectiveness of vaccinations even for those who, by being younger, are generally at lesser risk.

The findings, published Wednesday in the New England Journal of Medicine, show that the Pfizer/BioNTech coronavirus vaccine appears to be 94% effective against Covid-19 hospitalization among adolescents ages 12-18 in the US.

“Vaccination averted nearly all life-threatening Covid-19 illness in this age group,” wrote the researchers from the CDC and a collection of hospitals and universities, who found that far more adolescents hospitalized with Covid-19 were unvaccinated compared with those who were hospitalized for other reasons.

Among the hospitalized adolescents with Covid-19, 4% were fully vaccinated, less than 1% were partially vaccinated, and 96% were unvaccinated. In comparison, of those who did not have Covid-19, 36% were fully vaccinated, 7% were partially vaccinated, and 57% were unvaccinated.

CNN’s Jacqueline Howard, Deidre McPhillips, Naomi Thomas, Virginia Langmaid, Jason Hanna, Christina Maxouris, Claudia Dominguez and Andy Rose contributed to this report.

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World

Napa County runs out of ICU hospital beds amid spike in Bay Area virus cases

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The coronavirus has thrown plenty of curveballs at researchers and health officials, but as 2022 begins, some of the Bay Area’s top medical experts are saying the pandemic endgame could be around the corner. Meanwhile, San Francisco is still facing an “undeniable hospital surge” as the omicron variant fuels new COVID cases. Experts say much of California could see cases peak soon, though several variables are in play.

Stanford sees more 146 new infections: Stanford University said 146 students as of Monday are isolating in campus housing due to infection with the coronavirus. Of that number 136 tested positive since Thursday, most upon returning to campus this past weekend from holiday break, and others having stayed on campus over the break, the university said in an online update. “As we had planned and expected, rapid testing is allowing us to quickly identify COVID-positive cases as students return to campus,” the university said. Stanford said its cases and positivity rates are increasing, “but continue to be lower than the overall trends in the county and state.” In all, 70 weeks of surveillance, with 514,000 student tests, has resulted in 593 positive results, Stanford said.

Bay Area restaurants adding booster to entry requirements: Some Bay Area restaurants now are requiring that patrons show proof of a COVID-19 booster shot to dine indoors. The step is driven by the ability of the omicron variant to evade vaccination more readily than earlier variants of the coronavirus. Breakthrough infections have been reported also among some boostered individuals, but booster shots are seen to provide at least some greater protection when administered after the initial vaccination doses. A rapidly growing number of Bay Area restaurants are temporarily shutting down due to staff infections and exposures or preventative concern about omicron spread. Read which restaurants are taking the extra protective step.

Lawmakers urged to work remotely as new cases surge: Citing surging numbers of COVID-19 cases at the Capitol, Congress’ top doctor urged lawmakers on Monday to work remotely. In a letter obtained by the Associated Press, Brian P. Monahan said there has been “an unprecedented number of cases in the Capitol community affecting hundreds of individuals.” He said they are mostly breakthrough infections in people already vaccinated. Monahan asked congressional offices to “reduce in-person meetings and in-office activities to the maximum extent possible,” adding that even mild infections can lead to six to 12 months of long COVID.

Carnival will go on in New Orleans: Revelers in New Orleans will mark the beginning of the annual Carnival season of opulent parades and partying with a ride Thursday night on a historic streetcar despite recent surges in COVID-19 infections. Participants “will be wearing masks covering their mouths as well as their eyes” on the streetcar, according to a Monday announcement from the Phunny Phorty Phellows organization. Festivities that attract thousands to the streets were largely canceled in 2021, following concerns that the 2020 Mardi Gras celebration had been an unintended “super spreader” of coronavirus. Plans this year call for vaccine or testing requirements for float riders and customers of bars, restaurants and other public places. Louisiana’s governor said last week that the state is setting records for new COVID-19 diagnoses.

L.A. Unified students and staff must get tested: Los Angeles Unified students and employees will be required to show proof of a negative COVID-19 test prior to returning to school after the winter break regardless of vaccination status, district officials announced Monday. Schools were scheduled to resume on Jan. 10, but the district has pushed that date back to Jan. 11. Rapid tests will be made available to students at various locations within the county over the weekend.

Children’s COVID cases hit a new pandemic peak in U.S.: There were 325,340 child COVID-19 cases reported for the week ending Thursday, with pediatric infection representing nearly 18% of all reported weekly cases in the United States, according to the latest data report by the American Academy of Pediatrics and the Children’s Hospital Association. That is the most on record since the start of the pandemic and a sharp increase from the 198,551 cases reported a week earlier. The previous high for pediatric cases was reported on Sep. 2, with 251,781. The number is expected to continue to rise sharply as children return to school following the winter break when many families gathered and traveled. Hospitalizations and deaths among children remain low.

Napa County runs out of ICU beds: Napa County officials said Monday that county hospitals now are out of available intensive care beds as the coronavirus once again tightens its hold on the Bay Area. “The current surge is driving more patients to the health care system and it is also impacting staff,” said Leah Greenbaum, the county’s emergency services coordinator. “When staff become infected with COVID-19 they cannot come into work and care for patients, which can cause significant strain on the health care system.” Hospitalizations in the Bay Area, a lagging indicator of pandemic trends, have risen sharply since mid-November with the spread of the omicron variant and the persistence of the delta variant. Read more here.

S.F. cases soar: San Francisco now has the third-highest coronavirus transmission rate in California, with a daily average case rate of about 104 per 100,000 residents. The county recorded a seven-day average of 896 cases per day on Dec. 30, the most recent date with available data. That is more than double the previous peak of 388 cases, a seven-day average recorded on Jan. 12 last year. Read the story here.

Starbucks issues vaccination mandate for employees: Starbucks employees now must be fully vaccinated against COVID-19 by Jan. 10, or undergo weekly coronavirus testing. Chief Operating Officer John Culver sent a letter to the company’s approximately 220,000 employees that the new policy is in compliance with the Biden administration’s vaccine mandate for private businesses. Those choosing not to get vaccinated will have to procure their own federally-approved test kits. “This is an important step we can take to help more partners get vaccinated, limit the spread of COVID-19, and create choices that partners can own based on what’s best for them,” Culver said. “If vaccination rates rise and community spread slows, we will adapt accordingly. But if things get worse, we may have to consider additional measures. For now, my hope is that we will all do our part to protect one another.”

Ontario shuts schools, indoor dining and gyms: All schools in Canada’s most populous province moved to online learning on Monday because of a record number of coronavirus infections fueled by the omicron variant, the Associated Press reports. Premier Doug Ford also announced the closure of indoor dining, gyms and movie theaters as concerns about hospital capacity grow. “I know online learning is not ideal,” Ford said. “The fact is omicron spreads like wildfire.”

Los Angeles County teachers required to upgrade masks: Teachers and staff in the nation’s largest school district are required to wear high-grade masks to control the spread of the coronavirus, according to updated guidance from the LA County Public Health Department. That means surgical grade or better. Masks will also be required for all outdoor activities at schools where physical distancing is not possible. “During this surge, given the spread of a more infectious strain of the virus, lapses can lead to explosive transmission,” Barbara Ferrer, the county’s health director, said in a statement. “Well-fitting and high-quality masks are an essential layer of protection when people are in close contact with others, especially when indoors or in outdoor crowded spaces where distancing is not possible. … The physical barrier tendered by a mask is known to reduce the spread of virus particles.”

More than 100,000 Americans hospitalized with COVID: There were 103,329 patients hospitalized with COVID-19 in the United States as of Monday, according to data from the U.S. Department of Health and Human Services. About 20% of those patients — 18,557 — are in intensive care unit beds, among hospitals reporting to the agency. The country recorded 104,000 hospitalizations in September at the peak of the delta COVID surge.

Hospitalizations spiking in Bay Area: The number of hospital patients infected with COVID-19 is the highest it’s been since late September, and climbing. Data analyzed by The Chronicle shows the Bay Area with 671 patients testing positive as the new year broke, as the numbers have climbed since mid-November with the rise of the omicron variant and the delta variant’s persistence.

FDA says kids 12-15 can get booster 5 months after their last vaccine dose: On the heels of FDA’s approval of Pfizer booster shots against the coronavirus for children as young as 12 on Monday, the Centers for Disease Control and Prevention is expected to rule on the recommendation later this week. The FDA said everyone 12 and older who’s eligible for a Pfizer booster can get one as early as five months after their last dose. Children tend to suffer less serious illness from COVID-19 than adults, but child hospitalizations are rising during the omicron wave — most of them unvaccinated.

FDA expands Pfizer boosters for U.S. kids as young as 12: Amid the rampant spread of the omicron variant, the Food and Drug Administration will allow Pfizer COVID boosters for children as young as 12 years old, the Associated Press reported. Federal public health officials already recommended booster shots for everyone 16 and older.

LA’s coronavirus transmission rate approaching 2020 peaks: Every person infected with the coronavirus in Los Angeles County is transmitting the virus to two additional people on average, according to the Los Angeles Times, which cited state estimates. Assuming those estimates are accurate, that would represent a higher transmission rate than at any point since the beginning of the COVID-19 pandemic. Los Angeles was recording more than 20,000 new cases daily over the weekend.

Israel offers fourth COVID shot to anyone over 60: Israel began offering a fourth COVID-19 shot to anyone over the age of 60 Monday, the Washington Post reported, in an effort to protect the most medically vulnerable people from serious illness or death from a coronavirus infection. Coronavirus cases are surging in Israel, much like in the rest of the world.

San Diego prepares to idle fire crews due to infections: More than 100 San Diego firefighters are in isolation due to the coronavirus, prompting department leaders to put together an emergency brownout plan outlining which fire crews will be idled if staffing shortages demand it, the San Diego Union-Tribune is reporting. The labor union that represents city firefighters, said that as of Sunday, 113 or the department’s more than 900 firefighters had either tested positive for the coronavirus and were in required isolation or had been exposed to the virus and were isolating while awaiting test results. He said the majority of those had tested positive. The department has developed a plan allowing for closure of up to seven engine companies each day in staff-shortage situations, in addition to three specialty crews, the Union-Tribune wrote.

Pentagon chief infected: Defense Secretary Lloyd Austin said Sunday night that he has tested positive for COVID-19 and was experiencing mild symptoms while quarantining at home. Austin said in a statement that he plans to attend key meetings and discussions virtually this week “to the degree possible.” Austin said he last met with President Biden on Dec. 21, more than a week before he began to experience symptoms, and had tested negative the morning of that day. “My staff has begun contact tracing and testing of all those with whom I have come into contact over the last week,” he said. Austin, 68, said he was fully vaccinated and received a booster in October.

NYC considers mandatory booster for city workers: New York City’s brand new mayor, Eric Adams, said he’s looking into requiring city workers to get COVID booster shots. City employees are already required to be vaccinated against the coronavirus, but as case numbers continue to skyrocket, Adams told ABC’s “This Week” on Sunday that the city would “examine the numbers” and decide if a booster mandate is needed for municipal workers, such as teachers and police officers. “If we feel we have to get to the place of making that mandatory, we’re willing to do that, but we’re encouraging them to do that now,” Adams said.

CDC may add negative test for asymptomatic infected people: U.S. health officials are considering adding a negative coronavirus test to the current five-day isolation restrictions for asymptomatic people who contract the virus, Dr. Anthony Fauci said Sunday. Under guidance issued Dec. 27, the isolation period was shortened from 10 days to five for people who are infected but not feeling symptoms or running a fever. But Fauci, the top White House medical adviser, said the Centers for Disease Control got significant “pushback” over the recommendations and is now considering including the negative test as part of its guidance, the Associated Press reported. State guidance in California already specifies that asymptomatic infected people should test negative on Day 5 or later before leaving isolation, and should mask for an additional five days.

Local schools stick with plan for in-person learning: Bay Area students flood back into schools starting Monday after spending two weeks with family and friends or even traveling to other states and countries just as the omicron wave is hitting California. The combination of a huge rise in coronavirus cases and exposure during the holiday break has left families and teachers concerned about the return to in-person learning in the coming days. But pandemic experts, health officials, Gov. Gavin Newsom and President Biden are in lockstep on how to proceed: test, mask and continue teaching in person. But that doesn’t mean the status quo will be easy, with state-promised test kits arriving after school starts and chilly classrooms from windows opened to increase ventilation. Read the full story.



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World

Pompeii archeologists find Ikea-like extendable beds in rare ‘slave room’ discovery

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What happened?  

Mount Vesuvius erupted in the year AD 79, burying the cities of Pompeii, Oplontis, and Stabiae under ashes and rock fragments, and the city of Herculaneum under a mudflow.  

Mount Vesuvius, on the west coast of Italy, is the only active volcano in continental Europe and is thought to be one of the most dangerous volcanoes in the world.  

Every single resident died instantly when the southern Italian town was hit by a 500°C pyroclastic hot surge.

Pyroclastic flows are a dense collection of hot gas and volcanic materials that flow down the side of an erupting volcano at high speed.

They are more dangerous than lava because they travel faster, at speeds of around 450mph (700 km/h), and at temperatures of 1,000°C.

An administrator and poet called Pliny the younger watched the disaster unfold from a distance. 

Letters describing what he saw were found in the 16th century.  

His writing suggests that the eruption caught the residents of Pompeii unaware.

Mount Vesuvius erupted in the year AD 79, burying the cities of Pompeii, Oplontis, and Stabiae under ashes and rock fragments, and the city of Herculaneum under a mudflow

He said that a column of smoke ‘like an umbrella pine’ rose from the volcano and made the towns around it as black as night.

People ran for their lives with torches, screaming and some wept as rain of ash and pumice fell for several hours.  

While the eruption lasted for around 24 hours, the first pyroclastic surges began at midnight, causing the volcano’s column to collapse.

An avalanche of hot ash, rock and poisonous gas rushed down the side of the volcano at 124mph (199kph), burying victims and remnants of everyday life.  

Hundreds of refugees sheltering in the vaulted arcades at the seaside in Herculaneum, clutching their jewelry and money, were killed instantly.

The Orto dei fuggiaschi (The garden of the Fugitives) shows the 13 bodies of victims who were buried by the ashes as they attempted to flee Pompeii during the 79 AD eruption of the Vesuvius volcano

As people fled Pompeii or hid in their homes, their bodies were covered by blankets of the surge.

While Pliny did not estimate how many people died, the event was said to be ‘exceptional’ and the number of deaths is thought to exceed 10,000.

What have they found?

This event ended the life of the cities but at the same time preserved them until rediscovery by archaeologists nearly 1700 years later.

The excavation of Pompeii, the industrial hub of the region and Herculaneum, a small beach resort, has given unparalleled insight into Roman life.

Archaeologists are continually uncovering more from the ash-covered city.

In May archaeologists uncovered an alleyway of grand houses, with balconies left mostly intact and still in their original hues.

A plaster cast of a dog, from the House of Orpheus, Pompeii, AD 79. Around 30,000 people are believed to have died in the chaos, with bodies still being discovered to this day

Some of the balconies even had amphorae – the conical-shaped terra cotta vases that were used to hold wine and oil in ancient Roman times.

The discovery has been hailed as a ‘complete novelty’ – and the Italian Culture Ministry hopes they can be restored and opened to the public.

Upper stores have seldom been found among the ruins of the ancient town, which was destroyed by an eruption of Vesuvius volcano and buried under up to six meters of ash and volcanic rubble.

Around 30,000 people are believed to have died in the chaos, with bodies still being discovered to this day. 

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Health

How hard are we trying to solve Mass. and Cass when every night there are empty detox beds?

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The disconnect between needs and services ― and the tragic consequences of it ― are indicative of a badly fractured system, the institutional failing of a city rich in resources yet starving for true leadership. What does it say about us if we can’t even use what help we already offer to diminish the suffering that has driven so many to live in squalor and despair?

There has been plenty of talk about what’s lacking ― including too few treatment beds, and not enough transitional housing. Maybe what’s lacking most is the political courage on the part of our leaders to tell people they cannot openly shoot up drugs and occupy streets. Harsh as it may sound to some, living in a tent should no longer be considered an option.

Here’s another hard truth: We let people live in tents because it’s easier than coming up with solutions. But the lack of any meaningful action is just making the situation worse. Mass. and Cass has become a destination for the deeply troubled, and as anyone who deals with treating substance abuse will tell you, the worst place for someone trying to get clean is around other people using drugs.

President and CEO Dr. Charles Anderson approached the Dr. Lucy Sewall Center for Acute Treatment Services while touring the Dimock Center in Boston.Craig F. Walker/Globe Staff

Dr. Charles Anderson, chief executive of the Dimock Center, reached out to me because he believes his organization can play a bigger role in helping to solve the humanitarian calamity unfolding at Mass. and Cass. He has visited the area several times, as have his staff members. He has talked with Acting Mayor Kim Janey and others working on the situation.

Dimock, which was founded in 1862 as the New England Hospital for Women and Children, has space on its campus to add beds and expand programs to help people break the cycle of addiction. In addition to drug treatment, Dimock provides primary care and mental health services for about 19,000 people annually.

Anderson has spent a lifetime studying addiction. Three decades ago, he chose to train at the Boston City Hospital (now Boston Medical Center) during the crack epidemic because he wanted to learn more about treating substance abuse. His father, also a doctor, ran a recovery program for decades in upstate New York.

“We want to remind people we are here,” said Anderson. “We’re just trying to understand where we can show up as a real value.”

A few years ago, Dimock spent $16 million expanding its dormitory-style treatment center and added nine beds after Boston closed its Long Island recovery campus because of an unsafe bridge. Long Island had 800 beds for homeless people and recovering drug users, giving them a steady place to stay.

Dimock is one of at least a dozen facilities in Greater Boston with treatment beds that allow people to stay for a couple of weeks to get drugs out of their system. Others have available beds too; in recent days, for example, there have been about a dozen empty beds within 30 miles of Boston, according to a database maintained by the Massachusetts Behavioral Health Access.

Three weeks ago, at the state’s request, Dimock began setting aside five beds nightly for people looking to leave Mass. and Cass. So far, only a handful of people have come in. Cost isn’t a barrier because you don’t have pay to receive services.

After detox, people can transition into longer-term programs at Dimock. The center also has three available beds in its clinical stabilization program, which provides intensive counseling, case management, and after-care planning for up to a month. Beyond that, there are 13 beds in Dimock’s residential recovery unit where people can stay for six to nine months.

Dimock relies on a network of providers and nonprofits with outreach teams to bring in patients. These teams walk the streets daily, tending basic needs, such as food, clothing, and medicine, all while attempting to coax those who might be ready for recovery to get off the streets.

But it can be a tough sell. How do you convince someone who has lost everything to drugs that it’s possible to turn around their life, and that now is the time to do it? When one bleak day bleeds into the next, it’s hard to see a way out.

“For some, the idea of coming to detox can be a daunting experience,” said Maia Betts, Dimock’s chief behavioral health officer, as she gave a tour of the treatment center.

“People have lost so much,” she added, “and having to face all that, it’s a difficult place to be.”

Knowing how hard it is to convince people they need help, Anderson, the Dimock CEO, does not rule out the need for involuntary treatment. That includes considering Suffolk County Sheriff Steve Tompkins’s controversial plan to convert an empty detention center into a treatment center for those with outstanding warrants.

“There is no answer off the shelf for this,” said Anderson. “Pushback can be good. Pushback should be met with, ‘Let’s think it through together.’ “

During my visit to Dimock, I spoke to people in various stages of recovery. They have been on that roller coaster of addiction and homelessness, and are well aware of the deteriorating conditions at Mass. and Cass. All of them were unequivocal in their belief that government intervention is needed because people living on the street are often too strung out and traumatized to make clearheaded decisions for themselves.

Jamie Adario, 39, who has been in a residential recovery program at Dimock for four months, said people on Mass. and Cass should be given choices, but one of them cannot be to remain on the streets.

“Don’t allow the option of staying in a tent . . . . It shouldn’t be an option for our community,” she said. “It’s not just about what’s better for the addict.”

It’s also been painful for Christopher Kelley, 56, two years into his recovery at Dimock, to learn about the conditions at Mass. and Cass. As an alcoholic, he has pitched a tent and lived on the streets of Boston on and off for two decades. The Army veteran found sobriety this go-around because, Kelley said, he didn’t want to just exist ― he wanted to live.

Resident Chris Kelley at the Dimock Center in Boston.Craig F. Walker/Globe Staff

As inhumane as conditions are on Mass. and Cass, he understands why some choose to live that way. His late sister, who also battled addiction, used to tell him: “Recovery is not for those who need it. It’s for those who want it.”

Which brings us back to unlocking the paradox of Boston’s opioid crisis.

Michael Curry, chief executive of the Massachusetts League of Community Health Centers, said the health care community has been focused on fighting COVID-19 and getting vaccines into arms, and perhaps only now are leaders able to turn their attention back to substance abuse.

“There are always breakdowns in the bureaucracy,” he said. “How do we make sure people get to the right place at the right time?”

Shirley Leung is a Business columnist. She can be reached at shirley.leung@globe.com.

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Health

Larimer County reinstates indoors masks as ICU beds reach breaking point

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LARIMER COUNTY, Colo. – Residents in Larimer County will be required to wear face masks in all public indoors spaces once again as hospitals struggle to care for patients coming into the ICU.

The new public health order, released Friday afternoon by the Larimer County Department of Health and Environment (LCDPHE), calls on everyone aged 3 and up to wear face masks in all indoor public spaces starting at 12 p.m. Wednesday, Oct. 20, regardless of vaccination status.

County health officials said Friday local hospital ICUs have been operating at or above 100% capacity for the past month. Currently, 40% of patients in the ICU have COVID-19 and 90% of those are unvaccinated. Their hope is that universal mask wearing will help slow transmission of the highly virulent delta variant until more people get vaccinated.

“Larimer County hospitals are being overburdened and we cannot allow this to continue indefinitely,” said Larimer County Public Health Director Tom Gonzales in a prepared statement. “Our hospitals need relief so they can swiftly and adequately treat all urgent medical needs in our community. Universal mask-wearing is the next best prevention tool we have to reduce the strain on our hospitals.”

Data from the Larimer County COVID-19 dashboard shows 35% of the county has yet to receive their first dose of the COVID-19 vaccine. The data also shows the county reported an average of 250+ cases per 100,000 people over the past month.

LCDPHE officials said the public health order will remain in place until the county has met the following metrics for 21 consecutive days:

1. Less than 65 COVID-19 patients in Larimer County hospitals
2. ICU capacity at less than 90% of usual and customary levels
3. A 7-day case rate of less than 300 cases per 100,000 people.
4. A 7-day positivity rate of less than 10%.

Larimer County will become the fifth Colorado county to reinstate mask mandates as cases of the novel virus continue to increase across the state due to the highly transmissible delta variant.

San Juan County was the first county in Colorado to reinstate a temporary mask mandate on Aug. 13, just shy of three months after Gov. Jared Polis lifted the statewide mandate on May 14. Boulder County reinstated its mask mandate on Sept. 3, followed by Pitkin County, which reinstated theirs on Sept. 16. San Miguel County mandated masks indoors at the beginning of this month.

The LCDPHE’s decision to reinstate masks indoors – regardless of vaccination status – was welcomed news by hospital systems in the area.

“Last year, when we all masked and practiced social distancing, there were far fewer flu and RSV cases, which lessened the burden on hospitals and allowed us to get a handle on the pandemic,” said Margo Karsten, president of Banner Health Western Region. “To put us back in a good position to provide the care everyone needs, we support steps to have community members adopt good health practices and reduce the spread of these respiratory illnesses.”

UCHealth North Region president and CEO Kevin Unger said masking was a measure that helped in the past.

“Hospitals have been overburdened too long with COVID-19 patients and need relief. Universal masking has proven to work by reducing the spread of the virus,” Unger said.

Statewide, Colorado saw a 61% jump in transmission of COVID-19 over the past two weeks and now ranks 14th highest across the U.S. for cases per 100,000 people. At the beginning of October, Colorado ranked 41st when compared to the rest of the country.

On Thursday, the state reported the highest number of hospital beds in use by patients with confirmed cases of COVID-19, the highest patient count so far this year, according to CDPHE’s COVID-19 Incident Commander Scott Bookman.

Most of those beds are being used by people who are not yet vaccinated against the novel virus. Seventy-eight percent of hospitalizations for COVID-19 statewide are among unvaccinated patients.

“We are in a battle with a virus, and the sooner we, again, collectively fight this virus, the sooner masks will be a thing of our past,” Gonzales said.

On Friday, Denver7 spoke with business owners across Larimer County preparing to adjust practices for the upcoming public health order.

“I just started informing my staff that this is what we’re going to start doing, and we’re going to put out signs this weekend to stay ahead of it and let everybody know,” said Chris Mulligan, owner of Obstacle Brewing and Grill. “There’s pre-made signs available through the county website, so we’ll just post those to give people a heads up.”

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Health

US coronavirus: Hospitalization rates are down across the US, but these 8 states still have fewer than 15% of ICU beds available

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Dwindling capacity from Covid-19 has led to many hospitals strained for resources and staffing, often leaving them unable to provide the standard of care they would like, according to health care professionals.

On average over the last week, Covid-19 hospitalizations have declined by more than 1,400 a day, according to data from the US Centers for Disease Control and Prevention.

Whether the change is temporary or the beginning of the end is still not clear, health experts say, and now is not the time to get complacent.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said the vast majority of the US will need to be vaccinated to control the spread, but according to data from the CDC only 56% of the population is fully vaccinated.

“I am worried that we still have some tough days ahead,” said Dr. Ashish Jha, the Dean at Brown University School of Public Health. “Even though we’re doing reasonably well on vaccines, we’ve got to do much better because the Delta variant is very good at finding people who are unvaccinated and infecting them.”

And with children under 12 still not yet eligible to be vaccinated, many experts are concerned about how kids will fare.

An average of 225 kids were admitted to the hospital with Covid-19 every day for the last seven days, according to data from the CDC. The number is down from an average of 263 the previous week.

While pediatric infections have been decreasing, they remain high. Children under 18 make up 22% of the US population but account for 27% of all cases nationwide, according to data published Monday by the American Academy of Pediatrics.

And although those cases are less likely to be severe or result in death, children can end up with long-term symptoms.

Child deaths are an ’embarrassment’

Child deaths from a preventable illness like Covid-19 are the motivation for authorizing a vaccine in children, the US Food and Drug Administration’s top vaccine official said Tuesday.

“In this latest wave of Covid-19, particularly down south, there have been thousands of children hospitalized. And, frankly, it’s an embarrassment in a developed country to have even 100 children, like we’ve had, die of infectious disease that’s preventable,” Center for Biologics Evaluation and Research Director Dr. Peter Marks said in a town hall hosted by the Covid-19 Vaccine Education and Equity Project.

“We didn’t have a vaccine to give them, but I would hate to deprive children of their lives because we don’t decide to vaccinate them, even against the relatively low-risk thing,” Marks said.

According to the CDC, 645 children have died from Covid-19 in the US.

“No parent should have to lose their child to a vaccine-preventable illness if we have a vaccine that can be deployed that is safe and effective. And we will only allow something to be authorized that we find to be safe and effective,” Marks said.

Marks said he didn’t know whether authorization of a vaccine in children ages 5 to 11 would come following a meeting of the FDA’s Vaccines and Related Biological Products Advisory Committee scheduled for October 14 to 15, but he said the FDA would work quickly to go through needed data when it becomes available.

“Many of us of the people who work at FDA have young children or they have grandchildren. And this is clearly one of the most important issues to get done so we’re not going to be wasting any time,” he said.

Johnson & Johnson asks for booster dose authorization

As officials prepare to review vaccines for young children, they are also considering authorizing a booster dose to increase protection for people who got the one-shot Johnson & Johnson vaccine.

J&J said Tuesday it has asked the FDA to authorize booster shots for its vaccine. According to the CDC, about 15 million people in the US have received a J&J shot.

The company said it has made the request, but is leaving the decisions around who should get the boosters and when up to the FDA and CDC.

The FDA’s Vaccine and Related Biological Products Advisory Committee is scheduled to meet October 14 and 15 to consider requests from Moderna and Johnson & Johnson to add booster doses for their Covid-19 vaccines.

Last month, the company released some data from three different studies that showed boosting its vaccine at two months or at six months increased immune protection.

“We announced that the six month data are a very strong, very strong boost, like an amazingly strong boost,” said Dr. Mathai Mammen, head of global research and development for J&J’s vaccine arm, Janssen. “And that two months is a good boost, and the two-month good boost was associated with 94% vaccine efficacy, right across the board, all ages.”

The Pfizer vaccine has already been authorized by the FDA for use as a booster for people 65 and older, people at high risk of severe disease and people whose jobs put them at risk of infection.

CNN’s Virginia Langmaid, Maggie Fox, Jen Christensen, Holly Yan, Susannah Cullinane, Ben Tinker, Jacqueline Howard, Mallory Simon and Theresa Waldrop contributed to this report.

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Health

Short-Staffed Michigan Hospitals Cut Workers, Beds Amid Patient Surge

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Staff shortages have forced two large Michigan hospital systems to cut hundreds of beds.

The action comes as a fourth wave of the CCP (Chinese Communist Party) virus, the pathogen that causes COVID-19, has caused hospitals to be swamped with patients.

The Detroit-based Henry Ford Health Systems announced on Sept. 13 that it was cutting 120 beds from five of its eight hospitals due to a lack of nurses and other staff members to service them. Two days later, Beaumont Health Systems announced that it was temporarily closing 180 beds for lack of staffing.

Henry Ford Health and Beaumont Health, along with most of Michigan’s hospital chains, implemented requirements earlier this year for all of their employees to be vaccinated against the CCP virus. Those who refuse to do so face suspension, firing, or resignation for refusing the shot.

Henry Ford Health System hasn’t disclosed the number of employees it has lost due to noncompliance with its mandate. Data quantifying the nursing shortage in Michigan are hard to come by.

At a Sept. 9 press conference, Brian Peters, CEO of the Michigan Health and Hospital Association, said that no precise figures will be available until a statewide study is completed later this year.

“What I can tell you is … I have never heard a consistent theme from across our entire membership like I have on this staffing issue,” Peters said. “Right now, our staffing is stressed to a level that we have not seen previously.”

In a statement released by Beaumont Health on Sept. 15, CEO John Fox outlined another cause for the flood of patients at the system’s eight hospitals.

“Many people delayed getting tests and treatment for medical issues because of their concerns about the pandemic. Now, more than a year and a half after the pandemic began, those delays in care are resulting in medical emergencies,” Fox said. “Add in a staffing shortage and you have a perfect storm.”

In an interview with The Epoch Times, a former Henry Ford physician, Dr. Mo Talia, who was recently stripped of his hospital privileges for refusing the CCP virus vaccine, questioned the wisdom of “letting go badly needed nurses and other health care workers at a time when they are needed the most.”

Former Henry Ford nurse Katie Kirn, who was also let go for refusing to get vaccinated, told The Epoch Times: “I absolutely think the bed cuts are due to staffing (shortages) because of the mandate.”

Former Henry Ford nurse Kristen Noble, who also lost her job for refusing to be vaccinated, told The Epoch Times that a pandemic was no time for a health care system overwhelmed with patients and already short on staff “to be firing health care personnel.”

“I absolutely believe there is a correlation between the suspension of staff and systems cutting beds,” Noble said.

Henry Ford Health System’s announcement of the bed cuts came on Sept. 13, three days after the system’s Sept. 10 vaccination mandate deadline. Vaccine refusers were given until Oct. 1 to change their minds.

“They do not have enough staff to care for their patient load,” Noble said. “Patient safety takes a big hit with being short-staffed.”

In a Sept. 13 press briefing, Henry Ford’s chief clinical officer, Dr. Adnan Munkarah, said that despite the staff shortages and resultant bed cuts, “our patients continue to receive the highest and safest level of appropriate care from our care teams.”

The Biden administration’s national vaccine mandate, which affects 17 million health care workers, isn’t helping the situation, according to Rick Pollack, president and CEO of the American Hospital Association.

“As a practical matter, this policy may result in exacerbating the severe workforce shortage problems that currently exist … which the American Nurses Association has called a national crisis,” Pollock said in a Sept. 9 statement.

According to the Michigan Annual Nursing Survey for 2020, nearly one in five registered nurses and licensed nurse practitioners have said they plan to leave the profession within the next five years.

The survey of more than 40,000 Michigan nurses found that one in five cited too heavy a workload, stress, safety issues, and not enjoying the profession as some of their main reasons for leaving.

According to the Michigan Hospital Directory, the state has 185 hospitals with 26,632 beds. As of Sept. 20, 30 of the state’s hospitals were at 85 percent or higher occupancy, with the average occupancy rate being 78 percent.

The state of Michigan’s official virus-tracking website shows that on Sept. 20, there were 1,492 adults in hospitals sick with the virus. From Sept. 18 through Sept. 20, there was an average of 2,395 new cases per day.

Since the pandemic struck Michigan in spring 2020, there have been 995,910 confirmed cases of the CCP virus, resulting in 20,700 deaths.

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Steven Kovac is an Epoch Times reporter who covers the state of Michigan. He is a former small businessman, local elected official, and conservative political activist. He is an ordained minister of the Gospel. Steven and his wife of 32 years have two grown daughters.

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Entertainment

Jimmy Kimmel says unvaccinated people shouldn’t get ICU beds in his return to his late-night show

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Jimmy Kimmel returned to his late-night show after a lengthy summer hiatus on Tuesday where he hit the ground running by mocking the unvaccinated. 

Kimmel spent the past few months on vacation while a slew of guest hosts, such as Wanda Sykes, David Spade, Nick Kroll and Julie Bowen, filled in behind his desk. In his first opening monologue since returning, Kimmel lamented the fact that his hopes to see a full audience with no masks were dashed by an increase in coronavirus cases. It didn’t take long before the host began sounding off on those who continue to refuse the vaccination, placing the blame for the ongoing pandemic restrictions squarely on their shoulders. 

“It was not a fun Labor Day weekend COVID-wise,” Kimmel said noting the increase in cases from this time last year. 

JIMMY KIMMEL FACES BACKLASH FOR ‘NON-APOLOGY’ ADDRESSING BLACKFACE CONTROVERSY

Jimmy Kimmel returned from his summer hiatus. 
(ABC/Randy Holmes)

“Dr. Fauci said if hospitals get any more overcrowded they’re going to have to make some very tough choices about who gets an ICU bed,” the host continued. “That choice doesn’t seem so tough to me. ‘Vaccinated person having a heart attack? Yes, come right in, we’ll take care of you. Unvaccinated guy who gobbled horse goo? Rest in peace, wheezy.'” 

VIEWERS REACT TO JIMMY KIMMEL CALLING FLORIDA ‘AMERICA’S NORTH KOREA’: ‘HATEFUL IGNORANCE’

The comedian’s reference to “horse goo” had to do with increased reports of humans using ivermectin as a coronavirus treatment. However, the Food and Drug Administration (FDA) continues to warn people that it is not safe for humans to take and has not been scientifically linked to treating COVID-19 symptoms. It is typically used to treat parasitic worms in animals.

Kimmel also took time to note that Merck, the company behind ivermectin, also released a statement telling people that it is not an effective treatment for COVID-19 and that humans run health risks if they take it outside doctor-prescribed doses.  

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“We’ve still got a lot of pan-dimwits out there,” Kimmel continued. “People are still taking this ivermectin. The poison control center has seen a spike in calls from people taking this livestock medicine to fight the coronavirus, but they won’t take the vaccine. It’s like if you’re a vegan and you’re like, ‘No, I don’t want a hamburger, give me that can of Alpo instead.'”

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Kimmel concluded his return monologue by thanking the slew of guest hosts who filled in for him while he was away, revealing that he was “white-knuckling it” behind the wheel of an RV most of the time with his wife and two kids.

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US

Oregon and Idaho Run Short of I.C.U. Beds as Covid Resurges

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Oregon and Idaho have joined the list of U.S. states that are running out of I.C.U. beds as both confront a significant rise in new coronavirus infections.

Patrick Allen, the director of the Oregon Health Authority, said in an interview on Saturday that only 50 of the state’s 638 I.C.U. beds were still available. Gov. Brad Little of Idaho, a Republican, said in a statement last week that just four of the state’s nearly 400 beds were still open.

The national Delta-driven surge has filled hospitals in many states. Only a handful have more than 30 percent of their overall I.C.U. beds still available, according to data from the Department of Health and Human Services, and many have less.

I.C.U.s are equipped with specialized equipment and trained staff who can treat critically ill patients. Experts say maintaining existing standards of care for the sickest patients may be difficult or impossible at hospitals with more than 95 percent I.C.U. occupancy, and throughout the pandemic, hospitals have been forced to improvise solutions when I.C.U. space and staffing have dwindled.

Mr. Little and Gov. Kate Brown of Oregon, a Democrat, each mobilized members of their state’s National Guard last month to add extra hospital staff.

“We are dangerously close to activating statewide crisis standards of care,” Mr. Little said in his statement. “In essence, someone would have to decide who can be treated and who cannot.”

Mr. Little’s state is grappling with its highest surge in Covid-19 hospitalizations to date. Idaho had a seven-day average of 512 hospitalizations on Friday, a number that has grown rapidly since July, according to a New York Times database.

In a presentation last Wednesday, Mr. Little said that hospitals had had to convert other spaces into I.C.U.s to accommodate more patients, and that “those are filling up, too.” His state’s health care system, he said, was not designed to withstand “an unrestrained global pandemic.”

At the end of the presentation, the governor pleaded with people to get vaccinated — the vast majority of Idahoans in intensive care are unvaccinated, he said — adding, “I wish everyone could have seen what I saw in the I.C.U. last night.”

In Oregon, the seven-day average of hospitalizations hit 1,219 on Friday, almost double the previous high reached in December.

The dire numbers don’t do justice to the mounting crisis that is overwhelming hospitals and health care workers in both states, officials said. Mr. Little said that even as hospitals made room for extra I.C.U. beds, they filled up — fast.

Demand for beds in Oregon is also exceeding supply. Mr. Allen, the Oregon health official, said that 127 patients in the state were waiting in emergency departments for beds to open up, though not every hospital in the state reports that figure. He said hospitals in southern Oregon, where vaccination rates were lowest, were especially hard hit.

“We’re on the edge of what we can manage right now,” he said, looking ahead to next week, when children would be returning to school in the most populous parts of the state. “There is not much room for things to get a lot worse.”

Adeel Hassan and Daniel E. Slotnik contributed reporting.

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Health

There are no ICU beds left at this Sampson County hospital. Every bed is filled with a COVID-19 patient :: WRAL.com

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By Adam Owens, WRAL reporter & Maggie Brown, WRAL multipaltform producer

Clinton, N.C. — The Intensive Care Unit at Sampson Regional Medical Center is 150% full and all of the patients being treated in the unit have coronavirus, health officials said.

“We are putting patients in non-ICU locations that are ICU patients, staffing and caring for them in those locations instead of our normal ICU,” said Shawn Howerton, Chief Medical Officer with Sampson County Regional Medical Center.

In the past two weeks, more than 750 people have tested positive for the virus in Sampson County, data from the state Department of Health and Human Services showed. Statewide, 25% of the nearly 4,000 North Carolinians with COVID-19 are in intensive care units and almost all of them are on a ventilator.

Each COVID-19 patient requires 12 to 14 times more liters per minute of oxygen compared to a regular patient that needs breathing support, Howerton said. Even with that amount of oxygen, patients still say they feel like they are suffocating.

“You are using so much oxygen, that the oxygen tanks start freezing on the outside,” he said.

The fire department had to be called in to spray water on 8-inch thick slabs of ice that accumulated on oxygen tanks outside the hospital. Those tanks used to need to be refilled about once a month, now they need to be refilled once a week.

“At this point, there is no end in sight,” Howerton said.

Experts anticipate that hospitalizations are only going to increase as more people travel this fall. Duke University infectious disease specialist Dr. Cameron Wolfe feels September could bring the worst of the virus that we’ve seen yet.

“You crash your car this weekend, I don’t know that I can find a bed. That’s nuts. We’ve never been in that situation before,” Dr. Wolfe said.

Statewide, only about 20% of hospital beds were available on Friday.

The hospital posted a desperate message on their Facebook page — a 2-minute long video using the voice of a healthcare worker. The nurse said that there were no beds open for people who needed care beyond COVID-19.

“This year, we are physically, emotionally and spiritually exhausted,” said nurse Kassie Johnson, who works in the ICU.

The video is pleading for residents of the county to get vaccinated, for the sake of healthcare workers. Only 40% of Sampson County residents are fully vaccinated, compared to more than 60% of Wake County, state data shows.

“After giving so much last year, we have nothing left to give, and it’s still not enough,” she said.

New York Times data shows that one out of every 6 people in Sampson County have had the virus, and one out of every 529 people have died from it.

“There aren’t many wins anymore. And when there are, you still cry, because finally someone lived,” Johnson said.

Sampson County has had a 48% increase in cases and a 63% increase in hospitalizations over the past two weeks, New York Times data shows. On Friday, nearly 150 people tested positive for the virus in Sampson.

Howerton said that his staff is completely exhausted and in tears as they try and save as many people as possible as the Delta variant of coronavirus rapidly spreads among the unvaccinated.

“I have seen people who have just ended their medical career, where they do not intend to ever practice medicine again, because they are so exhausted,” he said.

Polling from Morning Consult shows that vaccine skepticism has hardly budged even as unvaccinated people are filling up ICUs and hospitals. In North Carolina, 21% of people say they are unwilling to get vaccinated. The main reasons cited for unwillingness to get vaccinated are side effects and mistrust in pharmaceutical companies.

“Wake up people, you’re not invincible, no matter how smart you think you are,” Johnson said in the video.

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