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Which states had the best pandemic response?

For this story, reporters interviewed a wide range of health researchers, public officials and academic experts to ask them which states were standouts in their management of the pandemic. What we heard repeatedly were lessons culled from a handful of states that others could follow.

We’ve distilled their insights into three categories that represent the greatest challenges states are facing: fighting the virus, managing the economic fallout and reopening schools.

FIGHTING THE VIRUS

Leading the way in the rural Northeast

Few states have a record as unblemished as Vermont.

The odds could have been stacked against the state. The virus arrived in Vermont during the first wave sweeping the country. It shares borders with some of the hardest-hit states and has the third-oldest population in the country.

But Vermont swiftly flattened its initial wave and has since gone weeks at a time without any new confirmed infections. Fewer than 60 people have died, giving the state the second-fewest deaths per capita behind Alaska, which has seen surging caseloads in recent weeks. If the country as a whole had the same per capita death rate as Vermont, the nationwide death toll would be 30,000 instead of more than 215,000.

“This should be the model for the country, how you’ve done it,” Anthony Fauci, the nation’s top infectious disease expert, said during a briefing with state leaders in September. “Notwithstanding that this is a small state, it should be the model of how you get to such a low test positivity that you can actually start opening up the economy in a safe and prudent way.”

While health experts say the state has likely benefited from its rural geography, other sparsely populated areas of the country that let their guard down were overwhelmed by the virus this spring and summer. That sense of complacency never took hold in Vermont, where a moderate Republican governor and a Democratic-led Legislature helped defuse partisan tensions that hampered the response elsewhere.

“Any state that’s going to succeed against Covid has got to have the compliance of the population, because every single thing you do is telling people to alter their personal behavior,” Mark Levine, Vermont’s health commissioner, said in an interview.

What works:

— Vermont reopened slowly. The lockdown it put in place in late March is still gradually being lifted, restaurants and bars are still limited to 50 percent indoor capacity and even outdoor gatherings are still subject to a 150-person limit.

— Local governments have authority to set their own stricter rules. Burlington, the state’s most populous city, reduced its outdoor gathering limit to 25 in late August when college students began returning to nearby campuses.

— The state is also strict about visitors, requiring a two-week quarantine for people arriving from places with higher infection rates. And it invested early in testing and contact tracing and implemented a state-wide mask mandate early on.

“They took action early, they let science lead, and they were consistent

Utah officials announce new pandemic strategy, mask mandates

SALT LAKE CITY (AP) — Utah is implementing a new strategy to fight the coronavirus pandemic as the number of confirmed cases and hospitalizations continued to surge, state officials announced Tuesday.

The state will move away from its color-coded health system and instead place counties under restrictions based on their COVID-19 transmission rates, said Gov. Gary Herbert. Each county will be listed as high, moderate or low level transmission areas.

Six counties — Salt Lake, Utah, Cache, Garfield, Juab and Wasatch — have been designated as high transmission areas. Masks will be required in all indoor settings in these counties, and social gatherings must be limited to 10 people or fewer, said Rich Saunders, acting director of the Utah Department of Health.

In moderate transmission areas, gatherings will be limited to 25 or fewer unless masks are worn, said Saunders. Gatherings will be limited to 50 or fewer in low transmission areas if people don’t wear masks.


As a two-week “circuit breaker,” masks must be worn in all moderate transmission counties until Oct. 29, said Saunders.

Utah has been in the midst of a record-setting surge in reported coronavirus cases over the past month. The state ranks fifth in the country for newly confirmed infections per capita, according to data from Johns Hopkins. Utah’s health department reported a seven-day average of 1,182 new positive test per day on Tuesday, just below Saturday’s record of 1,189.

“We are having one of the worst outbreaks in the country, and this is unacceptable,” Herbert said.

There have been over 87,000 reported virus cases in Utah and 522 people have died, according to state data. The number of infections is thought to be far higher because many people have not been tested, and studies suggest people can be infected with the virus without feeling sick.

For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia and death.

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Using the Pandemic as an Opportunity to Lose Weight and Get in Shape

It also helped that she was no longer able to go out for meals and had to cook at home, where she prepared healthy meals for herself, like chicken, fish and salads. Rather than vodka on the rocks, her previous cocktail of choice, she diluted her vodka with mineral water and a splash of cranberry juice. “Quarantine gave me time to be creative with the meals I was eating,” she said.

Another reason many people gained weight is that they stopped planning their meals in advance. Without planning ahead, they would just grab whatever was available.

“Before shelter in place they would prep their meals and sort of had a plan,” said Dr. Rami Bailony, the co-founder and chief executive of Enara Health, a digital membership weight loss clinic. “Once Covid hit they thought they could cook something up that was healthy. But once you’re thinking about eating in the moment you tend to go with what’s expedient.”

When the pandemic started, Mindy Bachrach, 58, a home health occupational therapist in Henderson, Nev., soothed herself with sugary and high fat foods. As an essential worker, she was working pretty much all of her waking hours. “I have a weird job, I eat in my car all the time,” she said. “If I don’t prepare very carefully, I end up getting fast food, which I don’t even like.”

After two weeks, her pants were tighter. As someone who had lost and regained dozens of pounds in her life, she panicked. “I decided I had to do something,” she said. “If I didn’t, things were going to get out of control.”

She went on the Whole 30 plan, which eliminates processed foods, sugar and sugar substitutes, alcohol, grains, dairy and most legumes. She also stopped weighing herself. “I wanted the focus to be on how foods made me feel and not weight loss itself,” she said. Thirty days later, she stepped on the scale and was down 20 pounds.

Randy Garcia, 42, of Dallas, has lost 104 pounds since July, 2019, with the help of Enara, which connects members with a doctor, dietitian and exercise coach and costs $400 a month.

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Biden’s son-in-law advises campaign on pandemic while investing in Covid-19 startups

“StartUp Health is putting the full support of its platform and network behind building a post-Covid world that uses technology and entrepreneurial ingenuity to improve health outcomes,” the firm said at the time.

Krein simultaneously advising the campaign and venturing into Covid investing could pose conflict-of-interest concerns for a Biden administration, or simply create the awkward appearance of Krein profiting off his father-in-law’s policies. Since the start of the coronavirus outbreak, the federal government has directed tens of billions of dollars in coronavirus medical spending in areas like testing and vaccine research to private firms. It is poised to spend billions more next year and possibly beyond.

The potential conflicts are not limited to the coronavirus for Krein, 53, a Philadelphia-based head-and-neck surgeon who got into venture investing not long after he began dating Biden’s daughter, Ashley, in 2010.

Since StartUp Health’s 2011 launch, when Krein came on as its chief medical officer, it has invested in more than 300 health care businesses, according to its website, which prominently features the term “moonshot” to describe its investment goals — language that echoes that of Joe Biden’s own signature Cancer Moonshot initiative. In its early years, the firm enjoyed close ties to the Obama administration and described Krein as a White House adviser.

“I have little doubt that the relationship to Joe Biden, particularly if he becomes president, would attract the interest of some investors,” said Avik Roy, founder of Roy Healthcare Research, an investment research firm, and a former adviser to the presidential campaigns of Sens. Mitt Romney (R-Utah) and Marco Rubio (R-Fla.).

StartUpHealth did not respond to interview requests, and the Biden campaign declined to make Krein or others tied to the company available for interviews. In response to questions, a campaign official said that Krein does not have a formal role with the campaign, but acknowledged that he had participated in calls briefing Biden on coronavirus based on his experience treating patients and coordinating his hospital’s response to the outbreak.

Even informal input or the perception of access can be valuable in health care, a heavily regulated sector that is influenced by federal policy and spending priorities.

“Sometimes the perception is all you need,” said Laura Huang, a professor at Harvard Business School who studies the early-stage investment process. “Signaling is very important for startups and investors alike, and one signal is high-profile individuals who can help provide access.”

Roy said the firm’s Biden ties could also help it land stakes in hot startups that can be choosy about the investors they take money from. “Those companies will take your calls,” he said. “People who are plugged in have an advantage, and that is a common feature of a lot of heavily regulated industries.”

The influence concerns posed by the firm are compounded by its foreign ties. One StartUp Health fund raised $31 million from investors, including the Swiss drugmaker Novartis and the Chinese insurer Ping An, in 2018. The firm’s website also lists the Chinese technology conglomerate

Lenox Hill Hospital Expansion Battle Resumes After Pandemic Pause

UPPER EAST SIDE, NY — The battle over an ambitious expansion plan by Lenox Hill Hospital is showing signs of coming back to life after going dormant for several months while the hospital responded to the coronavirus pandemic.

In a community meeting last month, Lenox Hill officials revealed changes to the multibillion dollar expansion project, which notably scrapped a controversial, 490-foot-tall residential tower on Park Avenue that would have helped fund the expansion.

The hospital will present a revised plan Tuesday, during a meeting convened by Manhattan Borough President Gale Brewer between local leaders and hospital representatives.

Starting last year, neighbors rose up in fierce opposition to the project by owner Northwell Health, which was also slated to include a 516-foot hospital tower on Lexington Avenue.

Community Board 8 voted overwhelmingly last October to oppose the plan, and a preservation-oriented group called Committee to Protect Our Lenox Hill Neighborhood sprung up to fight the project, citing its “unacceptable” size and the environmental hazards brought on by a decade-long construction project.

This spring, the committee went on an abrupt hiatus, as the group acknowledged the poor optics of fighting a hospital’s expansion while its workers served on the front lines of a global pandemic.

“We want to explicitly thank Northwell Lenox Hill and all of the other New York City hospitals, especially the doctors, nurses and staff for the incredibly brave and selfless work they are doing to protect us all,” a message on the group’s website reads.

Now, the activity has resumed — on Sept. 15, Brewer’s task force between hospital and community leaders held its first meeting in months, where hospital leaders announced the removal of the apartment tower.

An initial rendering of Lenox Hill Hospital's planned expansion at Lexington Avenue and East 76th Street, presented to Community Board 8 in March 2019. (Northwell Health)
An initial rendering of Lenox Hill Hospital’s planned expansion at Lexington Avenue and East 76th Street, presented to Community Board 8 in March 2019. (Northwell Health)

“We will conclude meetings this month and we look forward to seeing Northwell’s proposal enter the public review process,” Brewer spokesperson Aries Dela Cruz said Monday.

Meanwhile, expansion opponents are pursuing a new angle of attack, rolling out statements from health care advocates questioning the project from an equity perspective.

Mark Hannay, director of the advocacy group Metro New York Health Care for All, suggested that Lenox Hill should focus its resources in the outer boroughs, which have been hard-hit by COVID-19, rather than expanding its presence on the hospital-rich Upper East Side.

“If the COVID-19 pandemic crisis has shown anything, it is that access to hospital care across our city is grossly unequal, and beds are much more needed in Lower Manhattan and the outer boroughs,” Hannay said in a statement. “Our public officials need to urge Northwell to rethink their entire plan for Lenox Hill and their larger role across our city.”

Anthony Feliciano, director of the Commission on the Public’s Health System, another community-based health advocacy group, suggested that the expansion was driven by financial concerns, rather than public health.

“This is about profit, not healthcare equity — and

Riskiest behaviors to avoid during coronavirus pandemic, according to an expert

Despite the fact that some may be experiencing so-called “caution fatigue,” the coronavirus pandemic is still raging, with certain areas across the country — namely the Midwest — seeing a surge in cases and hospitalizations. 

And with autumn officially here, bringing with it flu season, experts are urging the public to remain diligent in taking precautions to protect against both the seasonal illness and the novel virus. 

“Wearing a mask the wrong way. I've seen so many people not cover their nose, or letting it slide up their chin. I'm glad you are wearing a mask but when you wear it wrong, the effectiveness drops dramatically,” Dr. John Whyte said. (iStock)

“Wearing a mask the wrong way. I’ve seen so many people not cover their nose, or letting it slide up their chin. I’m glad you are wearing a mask but when you wear it wrong, the effectiveness drops dramatically,” Dr. John Whyte said. (iStock)

“I know everyone is tired of COVID but now is not the time to give up or go easy on the safeguards,” Dr. John Whyte, the chief medical officer of the health care website WebMD, told Fox News. 

Read on for a look at the worst things to do amid the pandemic, according to Whyte. 

DO YOU HAVE CORONAVIRUS ‘CAUTION FATIGUE’?

Gong to work when you feel unwell 

“Do not be around people —  whether at work or socially — when you aren’t feeling well,” said Whyte. “You could be infectious with COVID even before you test positive so listen to your body.  If you feel lousy, stay home and rest in bed. Don’t go out infecting others.”

Wearing your face mask incorrectly 

“Wearing a mask the wrong way. I’ve seen so many people not cover their nose, or letting it slide up their chin. I’m glad you are wearing a mask but when you wear it wrong, the effectiveness drops dramatically,” he said. 

 Avoid the buffet line 

“Sampling the buffet line” should be avoided, warned Whyte. “You often have to wait until it’s your turn. People are touching the same utensils. I’d wait a while until I’d hit the salad bar.”

THE NOVEL CORONAVIRUS MAY INADVERTENTLY FUNCTION AS A PAIN RELIEVER, STUDY SUGGESTS

Going to large events — especially indoors 

“Going to an event of 50 or more people inside, not socially distanced, without masks” is a dangerous game to play, said Whyte. “I know everyone is tired of COVID but now is not the time to give up or go easy on the safeguards.”

Assuming a cure is ‘around the corner’

“Thinking there’s a cure around the corner. Although we have made progress in treatments and various vaccines are in development, you don’t want to let down your guard,” said Whyte. 

CLICK FOR COMPLETE CORONAVIRUS COVERAGE 

Bonus: Avoid this popular Halloween activity

Thrill-seekers should avoid at least one popular Halloween activity this year, said Whyte: haunted houses. 

“It’s dark, crowded, and people are screaming. The chances of getting COVID-19 just aren’t worth it this year,” he said. 

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EU nations set to adopt common travel rules amid pandemic

European Union countries are set to adopt a common traffic light system to coordinate traveling across the 27-nation bloc

BRUSSELS — European Union countries are getting ready to adopt a common traffic light system to coordinate traveling across the 27-nation bloc, but a return to a full freedom of movement in the midst of the COVID-19 pandemic remains far from reach.

When the virus struck in March, several EU countries decided to close their borders to non-citizens without talking to their neighbors, creating huge traffic jams and slowing down the delivery of much-needed medical equipment.

The cacophony, which also played havoc with millions of tourists caught off guard by the virus, prompted the EU’s executive arm to push for a more unified approach. The EU commission last month came up with proposals that have been discussed and amended before their scheduled approval by EU nations on Tuesday.

“This new system will make things easier for citizens. I am glad that we found this solution together,” EU Commission President Ursula von der Leyen said.

The key measure is a common map of infections drawn up by the European Centre for Disease Prevention and Control. It will sort European regions into green, orange and red zones according to the severity of coronavirus outbreaks, taking into account new confirmed cases per 100,000 people and the percentage of positive tests.

Under the latest proposal, red zones should be areas where COVID-19 cases are more than 50 per 100,000 people during a 14-day period and the percentage of positive tests reaches at least 4%. Regions with a lower positive rate but where the total number of cases is more than 150 per 100,000 will also be classified red.

In light of the very high level of infections across the continent, it means that most of the bloc should be classified as red or orange.

The harmonization stops short of providing common rules for the EU’s orange and red zones. Travelers from green areas won’t face limits on their journeys, but national EU governments will continue to set their own restrictions such as quarantines or mandatory testing upon arrival for people coming from orange or red zones.

EU countries have yet to come up with a unified length of self-isolation following an exposure to the virus, but they did agree to mutually recognize test results in all

Westwood BOH Offers Tips For Halloween During Pandemic

WESTWOOD, MA —Westwood’s Board of Health is offering tips to keep trick-or-treaters safe from the coronavirus while allowing them to enjoy Halloween.

In a statement to the community, the board warned residents that trick-or-treating may increase their risk of contracting COVID-19 and that Westwood is deemed a “moderate risk” for the virus, according to the state Department of Public Health. The moderate risk designation means the town has an average COVID-19 case count of between 4-8 per 100,000 people and a percent positive test rate around 1.0.

Westwood has reported 176 COVID-19 cases as of Oct. 7.

“Being that case counts fluctuate, it is difficult to look forward and predict what our case count or percent positivity rate will be at the end of October 2020. With that in mind, at this time we can only advise residents to participate in activities designated as “Lower risk” by the Center for Disease Control and Prevention (CDC) in their Fall Holiday Celebrations Guidance,” the Board of Health said.

Among the tips the board offered were wearing face masks, aside from Halloween costume masks, frequently washing your hands and trick-or-treating only within your immediate family, rather than forming groups.

For those planning on giving out candy, the board recommends placing treats at the end of your walkway or driveway instead of handing them to trick-or-treaters.

“As a final reminder, if you are going to be out at dusk on Halloween or any evening until the first frost you should use an approved insect repellent to protect your selves from mosquito bites,” the board said.

This article originally appeared on the Westwood Patch

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Coronavirus pandemic to cost Americans $16 trillion, study finds

The coronavirus pandemic will end up costing Americans $16 trillion, far more than anyone predicted when the virus first emerged in the U.S. back in March, according to a new study released on Monday.

The study, published in the Journal of the American Medical Association, was co-authored by former Treasury Secretary Lawrence Summers and Harvard University economist David Cutler. Summers was also a top economic adviser to Presidents Barack Obama and Bill Clinton and is a former president of Harvard.

Their estimated cost includes a theoretical estimate for the value of a human life, and is spread out over the next decade. It also relies on an estimate that the eventual U.S. death toll from the pandemic will more than triple by the end of next year.

But $16 trillion is still an eye-popping number, and underscores the long-term impacts of the novel coronavirus and the U.S.’s inconsistent attempts to contain it. The study is listed in the medical publication as a viewpoint, and does not appear to have been peer-reviewed.

The coronavirus is “the greatest threat to prosperity and well-being the U.S. has encountered since the Great Depression,” the authors write.

If the study is correct, the coronavirus’ eventual impact could be four times the size of the damage done by the 2008 housing bust and subsequent Great Recession. The total cost of the pandemic — including more than 10 weeks of near total lockdown across most of the country, which caused the GDP in second quarter to drop by more than a third — will eclipse the money the U.S. has spent on every war since September 11, 2001, including those in Afghanistan, Iraq and Syria, the study says.


Winners and losers in COVID economy

09:03

About half of the price tag, $8.6 trillion, is driven by the long-term health implications and costs for those who contract COVID-19, as well as statistical estimate for the loss of life.

Based on the current death rate, the coronavirus pandemic is likely to lead to a total of 625,000 premature deaths in the United States, the study estimates. It pegs the total cost to society of each death at $7 million, citing a review from earlier this year of statistical and health policy research on the matter.

The study also estimates $2.6 trillion in long-term additional costs from people who survive COVID-19 but have resulting long-term health damage. Mental health costs because of the pandemic will rise by $1.6 trillion, the authors estimate.

10 years of GDP growth thrown off track 

The rest of the coronavirus’ economic toll comes in the form of reduced economic output, which the authors peg at $7.6 trillion, relying on previous estimate from the Congressional Budget Office. The drop in GDP is the cumulative impact of how much lower the GDP will be 10 years from now, versus where it would have been if the coronavirus had never spread.

The paper does not estimate the impact of the Coronavirus Aid, Relief and Economic Security Act (CARES)

As a pandemic presses on, waves of grief follow its path

In a strong voice tinged with her Irish homeland, Fiona Prine talks hauntingly about loss. From her COVID-19 infection and isolation — self-imposed in hopes of sparing her husband, folk-country legend John Prine — to his own devastating illness and death, she’s had more than her share in this year like no other.

Illness and death are the pandemic’s most feared consequences, but a collective sense of loss is perhaps its most pervasive. Around the world, the pandemic has spread grief by degrees.

While less than 1% of the global population is known to have been infected, few on Earth have been spared some form of loss since the coronavirus took hold. With nearly 1 million deaths worldwide, full-blown bereavement is the most recognizable.

But even smaller losses can leave people feeling empty and unsettled.


Layoffs. Canceled visits with Grandpa. Shuttered restaurants. Closed gyms. These are losses that don’t fit neatly into a “Hallmark category.’’ But they are not insignificant — especially when anxiety is already heightened, says psychologist and grief specialist Robert Neimeyer of the Portland Institute for Loss and Transition.

Activities that are part of usual routines, that bring pleasure or purpose, give people a sense of control over their lives. Losing them can result in psychological distress and unease, he says.

In normal times, people look to families, friends, communities for support in coping with loss. But in the pandemic, “We don’t have as much capacity as a human community to meet the needs. Nearly everyone has been affected,’’ he says.

“If you were to approach anyone on the street and ask them 10 times, `What have you lost?’, you would hear some remarkable stories.’’

___

By the time John and Fiona Prine returned home from a trip to Ireland in late February, the pandemic was spreading. Soon after, Prine had hip replacement surgery, and they hunkered down in their Nashville home for his recovery.

They’d been careful overseas and came home feeling healthy but cautious. Coronavirus tests were almost an afterthought.

“We were doing fine. Happy to be home. John was already up on his feet with a cane,’’ Fiona Prine says.

Prine was 73, a cancer survivor with chronic lung disease, but still performing regularly. His wife and manager, 15 years younger, was protective. She often watched from backstage.

“I knew this would not be a safe virus for John,’’ she says.

When the call came with results showing she’d tested positive, “You might as well have told me I was pregnant,” Fiona Prine says. Hoping to keep her husband healthy, “I literally bolted for the bedroom and locked myself in practically.”

His test results were “indeterminate.” But he seemed OK.

Her quarantine was tough on both of them. They missed each other, and FaceTimed every evening. “He didn’t like to be away from me,’’ she says. Both news junkies, they followed pandemic developments.

“God, there are so many things I wish were different,” she said in a selfie video while confined to that bedroom