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Were celebrating Thanksgiving amid a pandemic. Heres how we did it in 1918 — and what happened next – USA TODAY

Were celebrating Thanksgiving amid a pandemic. Heres how we did it in 1918 — and what happened next - USA TODAY

More than 200,000 dead since March. Cities in lockdown. Vaccine trials underway.

And a holiday message, of sorts: “See that Thanksgiving celebrations are restricted as much as possible so as to prevent another flare-up.”

But it isn’t the message of Thanksgiving 2020. It’s the Thanksgiving Day notice that ran in the Omaha World Herald on Nov. 28, 1918, when Americans found themselves in a similar predicament to the millions now grappling with how to celebrate the holiday season amid the coronavirus pandemic.

“Every time I hear someone say these are unprecedented times, I say no, no they’re not,” said Brittany Hutchinson, assistant curator at the Chicago History Museum. “They did this in 1918.”

On Thanksgiving more than a century ago, many Americans, like today, were living under various phases of quarantines and face mask orders. Millions were mourning loved ones. And health officials in many cities were issuing the same holiday warning: Stay home and stay safe.

Giving thanks for WWI victory, beating pandemic

By late November of 1918, the U.S. – in the midst of the suffrage movement, Jim Crow and the tail end of WWI – was battling the ebbing second wave of the H1N1 influenza epidemic, also known as the Spanish flu.

The first cases were detected in the U.S. in March of that year, growing exponentially by the fall. In October, the virus burned through the nation. Dozens of cities across the U.S. implemented mandatory face mask orders and curfews and locked down for two to three weeks, temporarily closing schools, libraries, theaters, movie houses, dance halls, churches, ice cream parlors and soda shops. The virus killed an estimated 195,000 Americans during October alone.

Red Cross Women sit at long tables making influenza masks in Chicago, Illinois in 1918.

Red Cross Women sit at long tables making influenza masks in Chicago, Illinois in 1918.
Image provided by the Chicago History Museum. Graphic by Karl Gelles, USA TODAY.

As Thanksgiving rolled around, some cities were celebrating the relaxation of flu-related restrictions – partly due to successful opposition campaigns by retailers, theater owners, unions, mass transportation companies and other economically stressed stakeholders. Washington, D.C., Indianapolis, and Oakland had just lifted restrictions days before, and San Francisco was on the brink of lifting its mask mandate.

San Francisco, in particular, had one of the nation’s largest anti-masking campaigns, spearheaded by the Anti-Mask League of San Francisco, according to Howard Markel, a professor of the history of medicine at the University of Michigan and co-editor-in chief of The American Influenza Epidemic of 1918-1919. Many people refused to wear masks and were arrested, and when the “line into the courtroom was so long, they laid off arresting people because the system couldn’t enforce it,” Markel said.

But Nov. 13, the San Francisco Examiner reported that “Thanksgiving Day will be celebrated in San Francisco by the discarding of gauze masks, if the present rate of decrease in influenza continues.”

A week later, San Franciscans ceremoniously removed their masks as a whistle-blow sounded across the city at noon. “San Francisco Joyously Discards Masks In Twinkling; Faces Beam As Gauze Covers Come Off At Time Fixed,” the San Francisco Chronicle wrote on its Nov. 22 front page.

On page 7 of its Nov. 23 edition, the San Francisco Examiner reported "'Flu' Masks To Be Ousted Thanksgiving."

On page 7 of its Nov. 23 edition, the San Francisco Examiner reported “‘Flu’ Masks To Be Ousted Thanksgiving.”
Image provided by Influenza Encyclopedia. Graphic by Karl Gelles, USA TODAY

Resistance to public health measures was not as “vociferous or widespread as today,” but it was there, Markel said. “A lot of these rules and regulations were wrapped up in the patriotism of World War I, and most people followed them. But we don’t have that unifying situation right now. You would think the pandemic would be unifying.”

In some cities, Thanksgiving rituals brought a welcome sense of normalcy. Many Americans returned to religious services, performed charity work and went through with planned football games, parties and performances.

In Portland, a “grand reunion service” was planned for the Sunday following Thanksgiving, “in honor of the reassembling after being debarred from worship on account of the epidemic for the last five weeks.” Members of various congregations were “ready to greet each other after the long absence,” according to the Oregon Daily Journal on Nov. 16.

“The chimes of church bells will once more be heard on Sunday morning throughout the city, beckoning one and all to attend their chosen place of worship, where a double celebration will be held, first over the suppression of autocracy and, second, over the eradication of a frightful plague,” the paper wrote.

Rabbis, priests, pastors and more conveyed a unified message at that time, Hutchinson said – one of “forgiveness and compassion.”

“People are urging to be considerate of one another, to care for one another,” Hutchinson said. “There are messages of putting the smallness of the individual into perspective with the vastness of humanity.”

Other cities, however, were still trending in the opposite direction.

Lockdowns, quarantines on Thanksgiving

By the end of November, cases were rising in cities such as Atlanta, Denver, Louisville, Milwaukee, Omaha, Portland and Richmond. Many health experts attributed the “renewal of the grip epidemic” to festivities on Nov. 11 – later designated as Armistice Day – when thousands flooded the streets to celebrate the end of WWI.

“It is not the lifting of the closure ban that is the cause of spreading of the epidemic but the putting aside of all precautions and restrictions by the people of Denver when they celebrated on Victory Day,” Denver City Manager of Health and Charity Dr. William H. Sharpley told the Denver Post in a Nov. 21 story.

On Nov. 27, the day before Thanksgiving, St. Louis reported its highest new daily case count since the epidemic began, and Buffalo, New York, reported its largest jump in daily cases since the lifting of its pandemic ban weeks earlier. Both cities subsequently cracked down on public gatherings, limited the number of passengers on street cars and ordered those cars to be ventilated and cleaned.

In Salt Lake City, residents were under “quarantine” on Thanksgiving, shops were prohibited from holding sales and celebrations were postponed until Christmas Day. Placards indicating households infected with influenza were placed on the front and rear entrances of 2,000 homes.

“Owing to the influenza quarantine, the day’s festivities . . . had to be postponed till Christmas day. But Thanksgiving services of some sort are being held in nearly every home,” an article on the front page of the Desert Evening News said. “Because the influenza quarantine prevents public gatherings, the day in Utah is being observed quietly and without any spectacular features.”

Officials in Los Angeles were promoting a “Stay at Home Week” over Thanksgiving. The Los Angeles Times issued a call on its front page to “REMEMBER AFFLICTED THANKSGIVING DAY; Influenza Ban Is Felt,” saying that “Thanksgiving Day held many attractions, although in a modified sense.”

“The salvation Army served fifty pounds of turkeys to fifty old men, but dispensed with its usual big dinner to the outcasts at the headquarters, because of the influenza ban,” the Times wrote.

Denver was under a face mask order, had just opened up three emergency hospitals and was issuing an urgent call for nurses. Churches were expected to hold Thanksgiving services, but “extra precautions will be taken to guard against spread of epidemic,” the Rocky Mountain News reported the day before. 

“Special pains have been taken to provide all the ventilation necessary and to make attendance at the services safe in spite of the influenza epidemic. In a number of churches electric fans have been placed in the auditoriums so as to change the air every few minutes,” the article said.

In many cities, traditional Thanksgiving Day pageants were held outside. In Cincinnati, which was seeing a surge in cases among children and firemen, Thanksgiving “exercises” at school were held in auditoriums instead of classrooms to “avoid crowding,” the Cincinnati Enquirer wrote Nov. 28.

A handful of cities began to see a surge in cases on Thanksgiving itself.

Cities see cases rise on Thanksgiving

Cincinnati health officials “requested parents to forego children’s parties and gatherings during the Thanksgiving vacation,” but the number of hospitalized patients rose on the holiday. Schools added an extra day of vacation to the Thanksgiving holiday break to promote “a beneficial result in the influenza situation.”

“We are not in a happy frame of mind tonight,” Dr. Walter List, Superintendent of the city’s General Hospital, told the Cincinnati Enquirer on Thanksgiving. “An institution such as this can stand the strain of an epidemic for five or six weeks, but when it continues for such a long period the situation is complicated.”

Kansas City saw a similar trend. The week of Thanksgiving, the number of flu cases at the city’s General Hospital doubled, and, on Thanksgiving Day, city health officials reinstituted home quarantine for influenza victims and their families. Schools on break for Thanksgiving were closed until further notice.

Public dance halls and restaurants were closed on Thanksgiving in Spokane, Washington, and private parties were prohibited. But, the next day, the city’s emergency hospital received more applications for admission than on any other day during the entire epidemic. On Thanksgiving, “the hospital was filled and death a frequent visitor,” the Spokesman-Review wrote.

Seattle resident Violet Harris recounts Thanksgiving Day in her diary on Nov. 28, 1918.

Seattle resident Violet Harris recounts Thanksgiving Day in her diary on Nov. 28, 1918.
Provided by Elizabeth Weise, USA TODAY

Jefferson, Iowa physician, Dr. C. W. Blake spent much of his Thanksgiving evening making house calls on people ill from influenza, author Thomas Morain wrote in his 1998 book, Prairie Grass Roots. Blake had been attending a Thanksgiving dinner at a farm outside of town and had let the local phone operator know he would be available later in the day. When he received the call about patients in the early evening, the operator had a list of 54 patients who had come down with the flu that day.

“At one farm north of Jefferson a family of four was too sick even to make themselves the most simple meal,” Morain wrote. “While Blake checked each one, (his assistant) made a soup from ingredients on hand and left it for the family.”

Hopes of a vaccine on Thanksgiving

By the fall of 1918, scientists in cities across the country were working on an influenza vaccine, and many were developed and used over the course of the pandemic. Researchers in New York, Boston, Pittsburgh, New Orleans and Seattle developed vaccines, and thousands of people in those cities and many others were inoculated.

Days before Thanksgiving, health officers in Rochester were encouraging people to obtain the vaccine available at a local health bureau. In Salt Lake City, the emergency hospital gave more than 100 vaccinations on Nov. 30. By early December, free inoculation clinics were established across the city, and thousands of residents lined up for their vaccinations.

A barber in a barbershop shaving a man's face wears a mask to protect against influenza in Chicago in 1918.

A barber in a barbershop shaving a man’s face wears a mask to protect against influenza in Chicago in 1918.
Image provided by the Chicago History Museum. Graphic by Karl Gelles, USA TODAY

The problem? Researchers didn’t know influenza was a virus.

“The vaccine that was made was a vaccine against (a bacteria), which they thought was the cause of influenza,” Markel said. “So not only were vaccines of this era crude and not all that effective, the vaccine that they did produce was for the wrong organism.”

Vaccine science was nowhere near the scientifically advanced level of 2020, said Markel, whose mother died from COVID-19 earlier this year. At the time, the study of virology was in its infancy, and researchers didn’t yet have the tools to see viruses. While bacteria are much larger and can be viewed under a light microscope, viruses require an electron microscope, which was not yet invented in 1918, Markel said.

The vaccines that researchers did develop did not stop an impending third wave of the flu.

Third wave of influenza surges after the holidays

Just as cases rose after Armistice Day celebrations, they rose again following Thanksgiving. Dallas, Minneapolis, San Antonio, San Francisco and Seattle saw surges. Omaha relaunched a public health campaign. Parts of Cleveland and its suburbs closed schools and enacted influenza bans in early December.

On Dec. 6, the St. Paul Daily News announced that more than 40 Minneapolis schools were closed due to the flu, below the headline “SANTA CLAUS IS DOWN WITH THE FLU.” Local health officials asked “moving picture show” managers to exclude children, closed Sunday schools and ordered department stores to dispense with “Santa Claus programs.”

On Dec. 6, the St. Paul Daily News announced that "SANTA CLAUS IS DOWN WITH THE FLU."

On Dec. 6, the St. Paul Daily News announced that “SANTA CLAUS IS DOWN WITH THE FLU.”
Image provided by Influenza Encyclopedia. Graphic by Karl Gelles, USA TODAY

On Christmas Eve, state health officials in Nebraska made influenza a mandatory quarantine disease, with fines ranging from $15 to $100 for violations. Approximately 1,000 homes in Omaha were placarded, with their occupants unable to leave for at least four days after the fever had subsided.

In Denver, the Salvation Army cancelled their annual Christmas parties for children, and the Women’s Press Club canceled its New Year’s Eve ball. School Christmas assemblies were cancelled in Fall River, Massachusetts, and families with an influenza patient in their homes were warned not to entertain guests and were barred from borrowing books from the library.

By January, the U.S. was fully engulfed in its third wave of influenza. The virus spread throughout the winter and spring, killing thousands more. It would ultimately infect one-third of the world’s population and kill approximately 675,000 Americans before subsiding in the summer of 1919.

“What did they do wrong? That’s hard to say, but all of these measures are like swiss cheese. They have holes, so you try to use as many layers as possible,” Markel said. “To me, those surges just represented whether there was social distancing or not. Flu didn’t stop circulating, the question was when did people go out and get exposed to it? And that’s what’s going on now.”

A warning for 2020: ‘Stay home and stay safe’

A century later, the nation has recorded more than 11.5 million cases of COVID-19, and more than 250,000 people in the U.S. have died. Dozens of states are re-implementing coronavirus-related restrictions, and health officials are echoing the stay-at-home guidance issued decades ago.

“The risk of not traveling is less than the risk of traveling,” Dr. Anthony Fauci, the nation’s leading infectious disease expert, told USA TODAY Wednesday. “During this interesting period of a lot of infection going on, colder weather, indoors: Do you want to travel and go to a Thanksgiving meal where there may be 12, 15, 20 people?”

Fauci said his three adult daughters won’t be coming home for Thanksgiving this year. Hutchinson, the Chicago-based curator who had COVID-19 in April, said she’s planning to celebrate Thanksgiving at home with her dog and Facetime family members. Markel, in Ann Arbor, said he plans to eat Thanksgiving dinner alone, downsize from a full turkey to a sliced turkey breast, and Zoom with family.

If history tells us anything, Markel said, it’s that “the risk of contracting the virus or spreading the virus by congregating in groups or even traditional holiday parties is right now too great.”

“It is disappointing, but let’s get through this so we can celebrate many, many more Thanksgivings,” he said. “The better part of valor is to stay home and stay safe.”

Want to read more on the pandemic of 1918? Learn about how St. Louis succeeded but Philadelphia failed to limit influenza deaths.

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Photo shows doctor embracing a vulnerable, lonely COVID-19 patient on Thanksgiving – USA TODAY

Photo shows doctor embracing a vulnerable, lonely COVID-19 patient on Thanksgiving - USA TODAY
Dr. Joseph Varon hugs and comforts a patient in the COVID-19 intensive care unit (ICU) during Thanksgiving at the United Memorial Medical Center on November 26 in Houston, Texas.

Photographer Go Nakamura has visited a COVID-19 intensive care unit in Houston about 20 times, but he never gets used to what he sees there.

Taking photos too graphic to share; seeing patients one day who will be gone when he returns later in the week — there’s no getting used to that, he told USA TODAY on Saturday.

But on Thanksgiving, Nakamura captured an image of compassion that has gained national attention as the United States reels under a record number of daily COVID-19 cases and hospitalizations.

The photo shows Dr. Joseph Varon, clad in protective equipment, embracing a patient who has collapsed into his arms. 

In the moments before the photo was taken, the patient was clearly feeling “vulnerable … lonely,” Nakamura said. 

The patient had confused the photographer with a medical professional. Soon, those professionals arrived to help.

Watch:Dad beats virus and has joyful reunion with family

Watch:Illinois governor calls out virus hoax believers

Varon often gets close to patients, in Nakamura’s experience. The doctor is known for offering cheerful words of encouragement. But a hug is something rarely seen.

Nakamura was focused on capturing the moment, so he didn’t hear the soft words spoken after the shutter clicked. But based on his experience at the United Memorial Medical Center, he’s sure they were kind and comforting.

To the public, Varon has offered different words: “America is going to see the darkest days in modern American medical history” if the nation doesn’t “do things right” in coming weeks.

That was his message to CNN on Wednesday, hours before the Thanksgiving image was captured.

He told the network he has worked for more than 250 days straight. He said his hospital is full and is increasing capacity, bracing for an expected surge in cases following the holiday.

Nakamura plans to continue documenting, knowing he will see more of the same: patients on life support; “people suffering and dying.”

But through it all Nakamura pays tribute to those on the front lines: “I am grateful to witness a wonderful moment and I thank all the medical staffs for their hard work even during the holiday season,” he wrote as he shared the photo on social media.

Photo shows doctor embracing a vulnerable, lonely COVID-19 patient on Thanksgiving - USA TODAY

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Its bad. Its really bad: Anchorage nurses under pressure as COVID-19 pushes busy hospitals to the brink – Anchorage Daily News

Its bad. Its really bad: Anchorage nurses under pressure as COVID-19 pushes busy hospitals to the brink - Anchorage Daily News

Nurses at Anchorage’s three big hospitals are working long hours under burnout-inducing pressure as the state’s coronavirus pandemic surges into new territory.

As their colleagues fall ill or quarantine, some nurses here say they are spending more time on patient care with less help, struggling to get tested, and at times overwhelmed by the rigors and emotional strife of treating patients cut off from family due to coronavirus precautions.

They describe levels of burnout and stress far beyond the usual for a job that’s always required resilience but now has the added intensity of treating seriously ill COVID-19 patients.

All three of the large hospitals in Anchorage say they’re working to make sure patient care doesn’t suffer. But the state’s hospital association is reporting major staffing issues and challenges transferring patients from rural Alaska, where new cases are rising at disproportionate levels to the rest of the state.

Unless Alaskans start limiting gatherings and wearing masks, health authorities say, there’s no indication the daily high case counts, rising hospitalizations and deaths are going to slow.

Teanna Hehnlin, a nurse for almost 15 years, has worked with COVID-19 patients at Providence Alaska Medical Center since the pandemic began here in March.

Hehnlin, a 37-year-old from Chugiak, said patients with the virus require more nurses for the same number of patients because of the time it takes to treat them. And the virus is compromising nurse and other staff numbers as people get sick or get exposed to infected patients or people in the community. She sees nurses working a lot of extra shifts, team leaders getting pulled into floor charge shifts or even treating patients.

But Hehnlin says in her experience, the hospital is “being diligent” to make sure nurses have everything they need.

What takes a toll on her psyche, she said, is going from caring for dying COVID-19 patients to a community where some people downplay the risks of a virus known to cause lengthy ICU stays, stroke or irreversible lung damage, and suffering for family and friends mourning those who don’t survive.

Anchorage nurse Teanna Hehnlin (Courtesy Teanna Hehnlin)

“People scoffing at the masking mandates and not wanting to do their equal parts and saying it’s a hoax, that’s doesn’t feel good,” she said. “We’re in here holding the hands of patients as they take their last breaths.”

Even Alaska’s top health officials acknowledge there aren’t enough nurses in the state to staff existing hospital beds, never mind any overflow centers authorities might open if patients max out health care capacity. Limited staffing in Alaska’s “brittle” health care system prompted Anchorage officials to enact a hunker-down order for the month of December.

Nurses say the problem is reaching critical levels.

One Anchorage registered nurse said the staffing crisis hit home when her young child got sick and spiked a fever. She prayed her pediatrician wouldn’t recommend a trip to the ER — at the hospital where she works. She trusts the providers with her life, she said, but they’re overworked and understaffed.

“It’s bad. It’s really bad,” the nurse said. “It’s a lot worse than the hospitals want the public to know.”

She was one of 11 nurses interviewed for this story. Most did not want to be identified because they feared they’d face workplace retribution or lose their jobs.

Longtime RN Donna Phillips, labor representative for the state nurse union, is familiar with most of the nurses interviewed and supports their contention that Anchorage’s hospitals are being bombarded with patients of all kinds right now and they aren’t keeping up.

Administrators should be doing more to increase nurse numbers, given the CARES Act funds they’ve received, Phillips said. They’re also still choosing to perform lucrative elective procedures that tie up resources.

But the public also needs to take responsibility to reverse the ongoing COVID-19 case trends threatening to overwhelm the state health care system by wearing masks and social distancing in public, she said, recalling a nurse on a staff meeting call this week who picked up food at an Anchorage restaurant. It was packed. No one was wearing a mask.

“Obviously the workload is increasing,” Phillips said. “And the frustrations nurses are feeling about what people aren’t doing to protect themselves — it’s tough.”

Like many of their counterparts around the country, nurses here say they’re working amid labor shortages because hospitals are struggling to recruit and keep nurses.

That’s especially true in Alaska, where the isolation further complicates the challenge of employee retention. Travel nurses, often used to supplement regular staff, are hard to lure here especially with winter coming and high COVID-19 demand in the Lower 48, closer to their families. They can make $8,000 in a week on a contract elsewhere, hospital officials say.

The virus itself is having an obvious impact, increasing patient loads while eroding staff numbers.

Alaska’s coronavirus cases are surging, topping 500 most days. By the weekend, the state ranked 15th nationally for the seven-day average of new cases per capita. Hospitals are filling up in response to the new pressure. Nearly a fifth of the adults hospitalized around the state were COVID-positive as of Saturday.

Providence Alaska Medical Center, the state’s largest hospital, recently acquired a refrigerated trailer to use as a temporary morgue if necessary in light of rising case numbers.

The Providence Alaska Medical Center hospital, photographed Tuesday, March 31, 2020. (Loren Holmes / ADN)

The virus cuts into staff numbers as well. An informal poll of health care facility administrators earlier this month revealed more than 530 medical employees were unable to work due either to a positive COVID-19 test, exposure to a positive person or travel-related quarantine.

Nearly 232,500 health care workers across the country have tested positive for the virus and at least 836 have died with it, according to the Centers for Disease Control and Prevention.

Testing nurses for COVID-19 makes sure they aren’t getting sick and also lowers the risk they might infect patients. But, like many of their counterparts in other states, nurses at Providence and Regional are not regularly tested.

And it can take up to seven days to get test results, a long time to stay out of work with symptoms that could be stress, allergies, dehydration — or COVID-19. An exposure can put a nurse out of work for 10 to 14 days.

The bigger problem is the challenge of maintaining staffing levels while navigating protocols for nurses potentially exposed to the virus outside of work, given the soaring case counts in Anchorage, where the state’s largest hospitals are.

“If there’s anything that these nurses want, it’s for the community to wear their masks. Please,” one nurse said. “Because we do not have the capacity.”

A number of the nurses interviewed for this story said they felt their employers ignored concerns about staffing and safety issues. One described a 12-hour shift that was so busy she didn’t have time to fill a water bottle, much less take a lunch break.

“I would definitely feel better if we weren’t so strapped for staffing,” said another nurse who works in critical care and has young children. “We’re frequently getting text messages saying ‘Hey, we’re really desperate for nurses to come in and help.’ I’m a team player … but at the same time I am stretched super super thin trying to keep myself, my family afloat at home.”

Some say the job, which is always stressful, is no longer worth the pay.

“I am as well as others in ICU are burnt out and actively looking for other employment,” another nurse said in an email, expressing frustration over managers ignoring her training recommendations and having unrealistic patient care goals. “(J)ust not seeing an improvement is overwhelming and disrupts my work/life balance.”

Alaska has health care limits that become more critical when needs surge, state health officials acknowledge.

“The hospitals have been trying very hard to stay ahead of this in many, many different ways,” Dr. Anne Zink, the state’s chief medical officer, said during a briefing earlier this month. State health officials hold weekly meetings with hospital CEOs and the state hospital association, Zink said.

Home-monitoring systems and oxymeters can limit the numbers of people coming to the hospital with COVID-19 by allowing patients to stay home unless their condition worsens, she said.

Only one of the city’s three hospitals — Alaska Native Medical Center — is broadly cutting back on elective procedures to ration staff numbers.

Hospitals in Anchorage, where the state’s sickest patients often end up, acknowledge they are at times struggling to staff intensive-care beds now, never mind additional beds that might be needed if surging hospitalizations prompt the need to open alternate care centers at Anchorage’s Alaska Airlines Center or the Carlson Center in Fairbanks.

But for now, they say, they are keeping up with patient loads.

Representatives for the three main hospitals in Anchorage say patient care hasn’t suffered.

“Our staffing ratios are determined by the patient’s needs,” said Shirley Young, a spokeswoman for Alaska Native Medical Center, a nonprofit 173-bed health center that provides medical care for the Alaska Tribal Health System.

“We have maintained the same high level of care,” Young said.

The Alaska Native Medical Center hospital on Friday, March 27, 2020. (Loren Holmes / ADN)

At Providence Alaska Medical Center, staffing ratios are similar to what they were a year ago, “though we have provided additional resources on some units when needed related to additional COVID workload,” said Mikal Canfield, a spokesman for the 400-bed hospital that’s part of a nonprofit Catholic network.

“Patients with COVID and patients who could potentially have COVID are provided care in the same units,” Canfield said in an email. “Within these units, we follow strict infection prevention best practices to keep patients and caregivers safe.”

Alaska Regional Hospital, a 250-bed facility operated by national chain HCA Healthcare, is “looking at creative ways to extend the nursing skill set” and considering alternate care models while still ensuring patient safety, spokeswoman Kjerstin Lastufka said in an email.

Alaska Regional Hospital, photographed on Saturday, March 28, 2020. (Loren Holmes / ADN)

The hospital has “slightly modified” the skill mix by adding nurse assistants to the existing RN pool, Lastufka said.

“It is always dependent upon patient acuity and care needs,” she said.

Several of the nurses interviewed for this story, however, said they have seen staffing ratios change.

“I can see a crunch coming toward us,” one Anchorage medical-surgical nurse wrote in an email.

The ratio on their floor shifted from four patients for every nurse to six patients for every nurse plus one nursing assistant, who can’t administer medications and do other tasks that RNs can, the nurse said. Many patients are bed-bound and supposed to be turned regularly to prevent bedsores but it’s hard to find time or an extra pair of hands to assist.

“So, we can’t turn them every 2 hours and do everything we need to do and do it safely,” the nurse wrote.

Another nurse who works with COVID-19 patients described a ratio of one nurse per three patients, partly because it takes so much time to put on and take off PPE each time. But the last time they worked on that floor, the nurse was responsible for two COVID-19 patients and two non-COVID patients.

“This was concerning to me for several reasons,” the nurse said in an email. “One patient has been battling cancer and would be at a very high risk for mortality from covid. I also did not feel that patients were even aware that covid patients also existed on that floor let alone that I was working with them simultaneously.”

Donna Phillips, who has been an RN in Anchorage for more than 40 years and who also serves as the labor representative for the state nurse union, at her office in Anchorage on Nov. 6, 2020. (Emily Mesner / ADN)

Generally, nurses say, more RNs who can sign off on certain high-risk medications and are dedicated to the ICU are needed in Anchorage hospitals, not just assistants, especially given the new pressure of dealing with COVID-19 patients.

“Hospitals tell you (their) staffing hasn’t changed but the acuity of what we’re doing is higher because of all the PPE required for every single patient,” Phillips said. “It’s fine to say we’re good, we didn’t do anything differently but you’ve got to do something differently. You’ve got to do something better.”

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Tracking COVID-19 in Alaska: 2 deaths and 656 new cases reported Saturday – Anchorage Daily News

Tracking COVID-19 in Alaska: 2 deaths and 656 new cases reported Saturday - Anchorage Daily News
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In total, 120 Alaskans and a nonresident have died with COVID-19 since the pandemic began here in March. The two deaths reported Saturday involved an Anchorage woman in her 70s and an Anchorage woman over 80, according to the state health department.

Saturday’s COVID-19 numbers represent a continuation of high case counts statewide that have grown for weeks alongside a nationwide virus surge. Concern surrounding the state’s strained hospital and health care system continues to grow as daily tallies climb.

And health officials say that daily counts may be underreporting new case numbers as lags in data entry persist. They say looking at trends, such as two-week averages, may give a fuller picture of the state’s current virus situation. Almost every region in the state is now in a high-alert level based on the average number of cases per 100,00 people over the last 14 days, with that number steeply rising in multiple regions over the past week. That means there’s widespread community transmission, frequent outbreaks and many undetected cases across Alaska.

People in Alaska are largely getting the virus from friends, family members and co-workers, according to health officials, and many people who tested positive reported going to social gatherings, community events, church services and social venues while they were contagious but did not yet know they had COVID-19.

Officials recommend that Alaskans stay away from gatherings with people they don’t live with and avoid crowds, and they continue to encourage people to stay 6 feet from others and wear masks around non-household members.

As of Saturday, 141 people were currently hospitalized with COVID-19 and another 12 hospital patients were suspected of being infected with the virus. Close to a fifth of all hospital patients statewide had COVID-19 by the weekend. Hospitalizations are rising and the limited availability of staffing is a significant concern, health officials said this week.

Of the 639 new cases reported by the state Saturday among Alaska residents, 262 were in Anchorage, plus 16 in Chugiak, 13 in Eagle River and one in Girdwood; 91 in Wasilla, 29 in Palmer, two in Big Lake, one in Houston and one in Sutton-Alpine; 16 in Soldotna, 12 in Kenai, four in Sterling, two in Seward, two in Homer, one in Fritz Creek and one in Nikiski; 37 in Fairbanks and seven in North Pole; 11 in Kodiak; 10 in Nome; seven in Utqiagvik; seven in Juneau; seven in Sitka; six in Bethel; three in Delta Junction; three in Kotzebue; two in Dillingham; two in Chevak; one in Ketchikan; one in Petersburg; and one in Unalaska.

Among communities smaller than 1,000 people not named to protect privacy, there were 55 resident cases in the Bethel Census Area; eight in the Kusilvak Census Area; four in the northern Kenai Peninsula Borough; four in the Yukon-Koyukuk Census Area; two in the Northwest Arctic Borough; two in the North Slope Borough; one in the Kodiak Island Borough; one in the Valdez-Cordova Census Area; one in the Denali Borough; one in the Prince of Wales-Hyder Census Area; and one in the Yakutat plus Hoonah-Angoon region.

Seventeen cases were reported among nonresidents: seven in Anchorage, two in Delta Junction, one in Fairbanks, one in Wasilla, one in the Southeast Fairbanks Census Area and five in unidentified regions of the state.

The percentage of positive cases among people arriving in Alaska is five times what it was just weeks ago, at around 5%, officials said in a weekly report. Traveling by air risks exposure in airports, on planes, in taxis or rideshares and after arriving, they said.

While people might get tested more than once, each case reported by the state health department represents only one person.

Among the new cases, it is not reported how many people were showing symptoms when they tested positive. The Centers for Disease Control and Prevention estimates that about a third of people who have the virus are asymptomatic.

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Should you quarantine after Thanksgiving gathering amid rising COVID cases? Yes, expert says – WPVI-TV

Should you quarantine after Thanksgiving gathering amid rising COVID cases? Yes, expert says - WPVI-TV
Thanksgiving is over. Many people celebrated with just their household unit, but many others did not. In fact, up to 50 million Americans are traveling over the Thanksgiving weekend, according to the American Automobile Association, or AAA.

The comings and goings of US travelers belie the fact that the COVID-19 pandemic continues to surge. The US reported 2,046 deaths Wednesday — the highest one-day coronavirus death toll the country has reported since early May, Johns Hopkins University data shows. The country also hit a new daily hospitalization record, with 89,954 people currently hospitalized for COVID-19, according to the COVID Tracking Project. This is the 16th straight day that figure set a record for the pandemic, as previously reported by CNN.

We talked to CNN Medical Analyst Dr. Leana Wen about her recommendations on how to keep safe after people return from holiday festivities.

First and foremost, anyone who traveled to visit with family and friends or hosted guests outside their immediate household unit should quarantine, Wen advised.

Taking action to protect others around you will help mitigate the spread of COVID-19, especially with Hanukkah, Christmas and New Year’s just around the corner.

CNN: Many people took a risk and got together with loved ones for Thanksgiving. Why are you recommending that these people quarantine after they return?

Dr. Leana Wen: Coronavirus is surging all across the country, and there are hotspots in so many areas. Anyone who traveled to another part of the country and got together with other people could be at risk for contracting COVID-19. When they return to their home communities, they could spread it – to people in their households and to friends, colleagues and any other people around them.

We are facing an impending calamity. Many hospitals are already at the brink. ICUs are full. We all need to do our part and flatten the curve again. And that means knowing when we are at risk to others around us. If you’ve traveled, and have seen other people, you could pose a risk to your community.

CNN: How should you go about assessing your risk?

Wen: There are three things you should consider when assessing your own risk exposure. First, consider who you saw over the holidays. How many guests were there and what were their risks? If you visited elderly parents who have been quarantining themselves, that’s very low risk to you. On the other hand, if you were together with three households, some with teenage children who are in school, and they’ve been at work themselves, and these households haven’t been quarantining, the risk is much higher.

Second, what activities did you do with others? If you only saw people outdoors, spaced at least 6 feet apart, the risk is very low. Time spent indoors is high risk, particularly if you are in poorly ventilated spaces for long periods of time, and where people are eating and drinking (and therefore don’t have masks on). If you stayed in someone’s house, the risk could be even higher, because the time of exposure was longer.

Third, what kind of exposure did you have during travel? If you drove, the risk will be lower than if you flew. I’m actually less concerned about your risk exposure during the flight than all the other components, like waiting at the airport and boarding the jetway, where there’s the potential of people crowding together in less well-ventilated spaces. If you wore a three-ply surgical mask the whole time, that further reduces risk. Overall, I’m most concerned about the risks of getting together with people.

CNN: What does a quarantine look like?

Wen: Good question. By quarantine, I mean that you should act as if you’ve been exposed to someone with coronavirus, because you could have. That means you should not be around others as much as possible. Do not go into work. Keep kids out of school. Get groceries delivered. Definitely do not get together with others during this period.

The safest thing to do is to quarantine for 14 days. If you have testing readily available, you could quarantine for at least seven days after the date of return and then get tested.

I recognize that this is asking a lot. For some people, this full protocol may not be necessary, if your risk during travel was truly very low (that is, if you saw elderly parents only who were already quarantined and you drove yourself). But if you got together with others who have risk themselves, know that you are now at risk, too.

Please keep in mind just how contagious COVID-19 is, and that nearly 60% of the spread is by people who don’t have symptoms. I am certain that none of us want to inadvertently infect others and increase the level of community spread where we live.

CNN: The community I’m going back to is a hotspot itself. Should I still quarantine?

Wen: Yes. Just because the area you’re going back to also has a lot of COVID-19 doesn’t mean that you don’t have a responsibility to try to keep the level from getting higher. Having hospitals overwhelmed affects all of us – not just patients with coronavirus but also patients with cancer and heart disease who may not be able to get the care they need.

CNN: What if you have roommates who didn’t travel with you?

Wen: If you normally live at home with other people who didn’t go with you on your travels, you should stay away from them during your quarantine period. Do not spend time in shared spaces. If this can’t be avoided – for example, if you have a shared restroom or kitchen – wear a mask, open the windows and do not use either space at the same time as others. Remember that they could have risk themselves if they traveled too, so please urge them also to follow the same quarantine protocol.

CNN: What should you do if you are staying put, for example, if you’re a college student and school has let out?

Wen: For some students, they were able to quarantine and then get tested prior to returning home. In that case, they are fine to see their family members – though they must continue to be vigilant and not engage in risky behaviors like seeing their friends indoors. For those who couldn’t, they should quarantine once they return home, following the same procedures as above: ideally 14 days and if not, at least seven days and then take a test.

CNN: Will I need to follow all these procedures for Christmas and New Year’s, too?

Wen: Yes. There will almost certainly be an even higher level of coronavirus infection by then, and hospitals will be in an even more dire position. I highly encourage everyone to put off nonessential travel. We are so close to getting a vaccine that will allow us to see one another safely again. Please, let’s get through this winter. Keep up the safeguards that we know to work: Wear a mask. Practice physical distancing. Do not gather indoors. I know it’s very hard, but we can make it through this winter!

The-CNN-Wire ™ & © 2020 Cable News Network, Inc., a WarnerMedia Company. All rights reserved.

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Illinois COVID-19 Updates: Tom Dart Tests Positive, State Reports More Than 7,800 New Cases – NBC Chicago

Illinois COVID-19 Updates: Tom Dart Tests Positive, State Reports More Than 7,800 New Cases - NBC Chicago

Note: Any news conferences from Gov. J.B. Pritzker, Chicago Mayor Lori Lightfoot or other officials will be streamed in the video player above.

Here are the latest coronavirus headlines from around the state of Illinois.

Cook County Sheriff Thomas Dart Tests Positive for COVID-19

Cook County Sheriff Thomas Dart has tested positive for coronavirus and is quarantining at his home, officials announced Saturday.

According to the Cook County Sheriff’s Office, Dart was tested for the virus on Tuesday and received his positive test results on Friday.

The sheriff was last in the office on Nov. 19. He began to feel symptoms of the virus on Friday and immediately self-quarantined.

Illinois Officials Report 7,873 New COVID-19 Cases, 108 Additional Deaths

The Illinois Department of Public Health reported 7,873 confirmed and probable cases of coronavirus on Saturday, along with 108 additional deaths attributed to the virus.

According to the latest figures released by the department, the state has now reported 712,936 total cases of the virus since the pandemic began, along with 12,137 fatalities.

The state performed an additional 79,055 tests over the last 24 hours, giving the state a total of 10,368,278 tests performed during the pandemic.

Deck the Halls? Not at the Illinois Capitol Due to COVID-19

The coronavirus has extinguished some traditional holiday cheer at the Illinois Capitol.

There will be no Christmas tree nor any holiday displays inside or outside the building, The State Journal-Register reported.

The Capitol for months has been closed to all but employees and others with permission. Tours were suspended months ago because of the COVID-19 pandemic.

Lights on the Capitol dome won’t be used for the second consecutive year. Engineers have recommended that an observation deck, which is typically used to anchor the lights, should be fortified.

Saturday’s Ohio State-Illinois Game Postponed Due to Positive COVID-19 Tests

The University of Illinois’ home football game against the Ohio State Buckeyes has been postponed after a series of positive COVID-19 test results within the Ohio State program.

The school made the official announcement Friday night, cancelling the Saturday morning game between the two schools that was set to be played at Champaign’s Memorial Stadium.

The announcement came after a second round of coronavirus testing of the Ohio State roster on Friday. The school said that it had seen an increased number of positive COVID-19 tests earlier Friday, with head coach Ryan Day among those who tested positive for the illness.

Chicagoland Christmas Trees Selling Fast Amid Pandemic Restrictions

The coronavirus pandemic has made Christmas tree hunting a bit different this year, but that hasn’t stopped families from making sure to get their trees in time for the holiday season.

Some Christmas tree farms in Illinois are requiring reservations, due to the pandemic, and as of Friday afternoon, many times were already sold out for the weekend.

The early and high demand for trees comes during an ongoing Christmas tree shortage across the country. According to experts, this shortage has its roots (pun intended) in the 2008 global recession, which led to a slowdown in planting seedlings.

It can take a tree 7 to 20 years to reach the desired height, so business owners can’t flood the market overnight, no matter how high the demand is.

Farmers are now raising their prices on Christmas trees, which could be passed down to the consumer.

Illinois COVID Metrics: A Region-by-Region Look at the State’s Latest Coronavirus Data

All 11 of Illinois’ healthcare regions are currently operating under Tier 3 coronavirus mitigation rules, but some regions are trending in the right direction to have those rules eased in the coming weeks.

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