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When the Trump administration required nursing homes to report their COVID-19 cases, it also promised to make the data available to residents, families and the public in a user-friendly way.But some facilities that have had coronavirus cases and deaths turn up as having none on Medicare’s COVID-19 nursing home website. Those data may be incomplete because the reporting requirements don’t reach back to the start of the pandemic. Numbers don’t necessarily portray the full picture.“The biggest thing that needs to be taken away ... is in its current form, it is really leaving consumers in the dark,” Sam Brooks, project manager for Consumer Voice, said of Medicare’s data website. Consumer Voice is a national advocacy group for improved quality in long-term care.Nursing homes are only required to provide the government with data on coronavirus cases and deaths among residents and staff as of May 8, or more than two months after the first outbreak in a U.S. facility was reported. Nursing homes have the option of full disclosure, but not all have taken it, and there is no penalty for withholding older data that may reflect poorly.The missing information from early in the pandemic leads to some puzzling results on the website.For example, a nursing home that had one of the first major reported outbreaks in the country — Life Care Center of Kirkland, Washington — shows no confirmed COVID cases and no deaths on the CMS data page.A spokesman for Life Care Centers of America, a major chain, said the company is providing the information the government requested.“We are reporting what CMS is asking us to report to them,” said Tim Killian. “We are not evading them in any way.“The Kirkland facility is now COVID-free and it has been for some time,” Killian added. The data showing no cases “is a snapshot of what is currently in the facility.”The company said its cumulative count shows 100 residents tested positive, and 34 died. “You can ask us directly and we’ll give you the exact numbers,” said Killian.But consumer advocate Brooks said that information should be on the CMS site.As it stands, the site “doesn’t tell the whole picture,” he said. “You are not going to be able to look at a home and make an informed decision.”The federal Centers for Medicare and Medicaid Services, which sets standards for nursing homes, said protecting nursing home residents is a top priority, and “transparency and information sharing has proven to be one of the keys to the battle against this pandemic.”But CMS said it lacked the legal authority to require nursing homes to disclose COVID information from before the effective date of its reporting rule in May.On Capitol Hill, there is pressure for more information.Sen. Chuck Grassley, R-Iowa, recently introduced legislation that would require nursing homes to report coronavirus cases and deaths going back to Jan. 1, a push that has bipartisan support.The estimated 1.4 million people living in some 15,500 nursing homes represent a tiny share of the U.S. population, but they have borne a disproportionate share of coronavirus deaths. Nursing homes are only now starting to emerge from a national lockdown that took effect in mid-March.According to the latest CMS figures, more than 33,000 nursing home residents have died in the pandemic. A running tally by The Associated Press, which also includes other long-term care facilities and staff as well as residents, shows more than 55,000 deaths.Depending on the total count, that translates from about one-fourth of the deaths to more than 40%, strikingly high proportions in either case.Coronavirus data for nursing homes do not appear directly on Medicare’s NursingHomeCompare website, the main portal for consumers trying to research a facility on behalf of a family member or friend. Instead, a link takes users to a different COVID-19 site that features statistics and a national nursing home locator map.Finding information on individual nursing homes via the data website can be confusing.If users type in a ZIP code or the name of a nursing home, the website’s locator map will display some small red dots near a larger marker icon, which also has a big dot in the middle.Instructions say click on one of the dots. But which one?The data is under the small red dots, not the larger locator, which instinctively draws the user’s eye.“I would click on the big dot,” said policy attorney Toby Edelman of the Center for Medicare Advocacy, which represents enrollees. “Why would I look for this thing that I can barely see?”CMS said it has received no reports related to search problems although more than 100,000 individuals accessed the site in June.The agency says it will continue to evaluate the usability of the website to ensure it meets consumer needs. 4782

What began with a quick grab-and-go theft Saturday at the San Antonio Aquarium -- the suspect leaving a trail of water drops as he hurried away with his dripping prize of a small but very much alive shark -- ended Monday with the safe return of "Miss Helen" to her tank at the aquarium.The 16-inch female horn shark was taken during a heist that aquarium officials said was no spur-of-the-moment, let's-steal-a-shark thing."The suspects staked out the pool for more than an hour" to wait for the right moment, the aquarium said in a statement.The search for the young female shark, known to aquarium staff as Miss Helen, led police Monday to the home of a man who maintains an extensive collection of marine life, according to the police chief of the San Antonio suburb where the aquarium is located. 808

WEST PALM BEACH, Fla. — There were plenty of Palm Beach County residents opposed to a mask mandate. Now some of them are suing to stop it.A lawsuit filed Tuesday in Palm Beach County court seeks injunctive relief to overturn the county's order.Attorneys representing Palm Beach County residents Rachel Eade, Carl Holme, Josie Machovic and Robert Spreitzer claim the new order requiring that masks be worn in public places infringes upon the constitutional rights of the plaintiffs.The 37-page lawsuit, filed by the Coconut Creek-based Florida Civil Rights Coalition, argues that the plaintiffs and other residents are having their "well-settled constitutionally protected freedoms" violated, including their "constitutional and human right to privacy and bodily autonomy."The lawsuit goes on to say that the county, having no authority to do so under Florida law, "has recklessly required countless American citizens and Florida residents," including the plaintiffs, "to submit to dangerous medical treatments with well-known risks and potential for serious injuries and death, including being forced to wear harmful medical devices like masks."Palm Beach County commissioners unanimously voted last week in favor of the mask mandate to help prevent the spread of the coronavirus amid a recent surge in cases throughout the county and state.The lawsuit takes aim at the "ridiculously vague" language of the order, which attorneys for the plaintiffs claim forces residents and visitors "to guess at the meanings and be subjected to punishment and criminal consequence."It also chastises the order's exemptions "because it arbitrarily and absurdly discriminates against anyone over the age of 2 years old, and countless citizens" who don't meet the "unlawful order's vague and ambiguous exceptions."The lawsuit berates county leaders for not clearly defining terms like "businesses or establishments" and "persons" as it is written in the order."Are non-citizens included?" attorneys wrote. "One is only left to guess, which is why the unlawful order is void for vagueness."Attorneys for the plaintiffs argue that a permanent injunction "will serve the public interest.""Millions of Palm Beach County residents and visitors are burdened by the over-reach of their local government in a fashion not before seen in the history of Florida," they wrote, adding that residents are "unduly burdened" by this violation of their rights. "The public has a strong interest in protecting their rights and ability to control their own bodies in the workplace and in public."Palm Beach County State Attorney Dave Aronberg said during a news conference Friday that commissioners do, in fact, have the constitutional authority to mandate masks."Obviously, those individuals who claim that they know the First Amendment have obviously never read the First Amendment," Aronberg said. "Because it is within the authority of the County Commission to put forward a mask ordinance. They have the authority under state law. They have the authority under the Constitution."The lawsuit seeks expedited consideration because the order is currently in effect. A written response by the county is required within 20 days of the filing.Several studies show that a mask or facial covering limits the wearer from spreading airborne droplets when speaking, sneezing or coughing. The coronavirus can live outside the body in these droplets for several hours and, in turn, infect other people — even before the person who spread the droplets has exhibited symptoms of COVID-19.Earlier this year, the Centers for Disease Control and Prevention (CDC) issued guidance that strongly recommended all Americans over the age of 2 wear masks in public, particularly in situations that would make social distancing impossible.This story was originally published by Peter Burke on WPTV in Palm Beach, Florida. 3872

Who gets to be first in line for a COVID-19 vaccine? U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr. Francis Collins, director of the National Institutes of Health, recently told one of the advisory groups the government asked to help decide. “There will be many people who feel that they should have been at the top of the list.”Traditionally, first in line for a scarce vaccine are health workers and the people most vulnerable to the targeted infection.But Collins tossed new ideas into the mix: Consider geography and give priority to people where an outbreak is hitting hardest.And don’t forget volunteers in the final stage of vaccine testing who get dummy shots, the comparison group needed to tell if the real shots truly work.“We owe them ... some special priority,” Collins said.Huge studies this summer aim to prove which of several experimental COVID-19 vaccines are safe and effective. Moderna Inc. and Pfizer Inc. began tests last week that eventually will include 30,000 volunteers each; in the next few months, equally large calls for volunteers will go out to test shots made by AstraZeneca, Johnson & Johnson and Novavax. And some vaccines made in China are in smaller late-stage studies in other countries.For all the promises of the U.S. stockpiling millions of doses, the hard truth: Even if a vaccine is declared safe and effective by year’s end, there won’t be enough for everyone who wants it right away -- especially as most potential vaccines require two doses.It’s a global dilemma. The World Health Organization is grappling with the same who-goes-first question as it tries to ensure vaccines are fairly distributed to poor countries -- decisions made even harder as wealthy nations corner the market for the first doses.In the U.S., the Advisory Committee on Immunization Practices, a group established by the Centers for Disease Control and Prevention, is supposed to recommend who to vaccinate and when -- advice that the government almost always follows.But a COVID-19 vaccine decision is so tricky that this time around, ethicists and vaccine experts from the National Academy of Medicine, chartered by Congress to advise the government, are being asked to weigh in, too.Setting priorities will require “creative, moral common sense,” said Bill Foege, who devised the vaccination strategy that led to global eradication of smallpox. Foege is co-leading the academy’s deliberations, calling it “both this opportunity and this burden.”With vaccine misinformation abounding and fears that politics might intrude, CDC Director Robert Redfield said the public must see vaccine allocation as “equitable, fair and transparent.”How to decide? The CDC’s opening suggestion: First vaccinate 12 million of the most critical health, national security and other essential workers. Next would be 110 million people at high risk from the coronavirus -- those over 65 who live in long-term care facilities, or those of any age who are in poor health -- or who also are deemed essential workers. The general population would come later.CDC’s vaccine advisers wanted to know who’s really essential. “I wouldn’t consider myself a critical health care worker,” admitted Dr. Peter Szilagyi, a pediatrician at the University of California, Los Angeles.Indeed, the risks for health workers today are far different than in the pandemic’s early days. Now, health workers in COVID-19 treatment units often are the best protected; others may be more at risk, committee members noted.Beyond the health and security fields, does “essential” mean poultry plant workers or schoolteachers? And what if the vaccine doesn’t work as well among vulnerable populations as among younger, healthier people? It’s a real worry, given that older people’s immune systems don’t rev up as well to flu vaccine.With Black, Latino and Native American populations disproportionately hit by the coronavirus, failing to address that diversity means “whatever comes out of our group will be looked at very suspiciously,” said ACIP chairman Dr. Jose Romero, Arkansas’ interim health secretary.Consider the urban poor who live in crowded conditions, have less access to health care and can’t work from home like more privileged Americans, added Dr. Sharon Frey of St. Louis University.And it may be worth vaccinating entire families rather than trying to single out just one high-risk person in a household, said Dr. Henry Bernstein of Northwell Health.Whoever gets to go first, a mass vaccination campaign while people are supposed to be keeping their distance is a tall order. During the 2009 swine flu pandemic, families waited in long lines in parking lots and at health departments when their turn came up, crowding that authorities know they must avoid this time around.Operation Warp Speed, the Trump administration’s effort to speed vaccine manufacturing and distribution, is working out how to rapidly transport the right number of doses to wherever vaccinations are set to occur.Drive-through vaccinations, pop-up clinics and other innovative ideas are all on the table, said CDC’s Dr. Nancy Messonnier.As soon as a vaccine is declared effective, “we want to be able the next day, frankly, to start these programs,” Messonnier said. “It’s a long road.”___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. 5581

When it comes to car sales in California, the Golden State is looking to get a little greener.“Most of our shoppers are looking for a hybrid,” said Chris Wesney, general manager of McCarthy’s, an independent car dealership in San Luis Obispo, California.Wesney says his team sells about 75 vehicles a month with electric vehicles making up 20% of those sales.“That increases every year, year over year,” he said adding he expects that number to increase even more after California Governor Gavin Newsom’s recent executive order, which would ban the sale of gas-powered vehicles by 2035.“There’s a lot to learn when it comes to buying electric cars,” Wesney said. “The problem that I foresee for some vehicles dealers is the repair facilities.”The state’s mandate has industry leaders shifting gears, and it’s raised questions inside Cuesta College’s automotive technology department.“To just simply say, ‘yes, we’re going to do this’ without looking at all other implications kind of makes me a little nervous,” said John Stokes, division chair of engineering and technology at Cuesta College.Stokes says he supports this decision to move away from fossil fuels in theory, but in reality, he’s questioning everything from how to replace gas taxes to adding enough related infrastructure.“There are so many things that are still question marks on how to be able to do this,” he said. “Do we have the production to satisfy the electricity? Do we have the production for the battery capacity?”Other auto industry leaders are also speaking out about this proposed change.“I certainly understand big, bold ideas but only when they’re affordable,” said Cathy Reheis-Boyd, president of Western States Petroleum Association.Reheis-Boyd says right now there are 736,000 electric vehicles in California compared to 36 million cars and trucks that run on gas and diesel. She believes that taking drivers’ choices away in 15 years could cost many Americans their jobs.“I hope we can change our mindsets that’s to collaborate and bring these brilliant minds so California does have a path,” she said.A path that leads drivers back to the car lot where dealers like Wesney are preparing for the fuel of the future.“It will just be interesting to see how the powergrade and everybody adjusts to the increase demand for electricity,” he said. 2334