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As hospitals are becoming overwhelmed with COVID-19 patients, North Dakota is permitting coronavirus-positive health care workers to continue assisting patients.The guidance stipulates that the health care workers must remain asymptomatic and take enhanced precautions in order to stay on the job. This comes as travel nurses are stretched thin as dozens of states are reporting record hospitalizations.Given the situation in North Dakota and elsewhere, it is possible more states will have to follow suit and continue using infected staff members in order to provide care. The CDC has spelled out guidance in these situations.The CDC says hospitals must exhaust a number of other guidelines, including adding travel nurses, postponing elective medical procedures, and postpone elective time off, before going into a crisis staffing situation.“If shortages continue despite other mitigation strategies, consider implementing criteria to allow HCP (health care personnel) with suspected or confirmed COVID-19 who are well enough and willing to work but have not met all Return to Work Criteria to work,” the CDC’s guidance states. “If HCP are allowed to work before meeting all criteria, they should be restricted from contact with severely immunocompromised patients (e.g., transplant, hematology-oncology) and facilities should consider prioritizing their duties in the following order:1. If not already done, allow HCP with suspected or confirmed COVID-19 to perform job duties where they do not interact with others (e.g., patients or other HCP), such as in telemedicine services.2. Allow HCP with confirmed COVID-19 to provide direct care only for patients with confirmed COVID-19, preferably in a cohort setting.3. Allow HCP with confirmed COVID-19 to provide direct care for patients with suspected COVID-19.4. As a last resort, allow HCP with confirmed COVID-19 to provide direct care for patients without suspected or confirmed COVID-19.”North Dakota Gov. Doug Burgum spelled out the challenges facing his state.“Our hospitals are under enormous pressure now,” Burgum said. “We can see the future two, three weeks out, and we know that we have severe constraints.”Despite Burgum’s warning, his state is among the ones not to issue an order requiring masks in public places.In update CDC guidance, the agency says that masks can reduce the viral load for the wearer, in addition to prevent the spread of the virus.Steven Weiser, MD, president of Altru Health System in Grand Forks, North Dakota,, wrote in an op-ed about the toll the virus is having on workers. "Your neighbors in healthcare are pleading with you – they are tired, they are covering shifts for their colleagues who cannot work, they are working in new areas and rallying together to ensure that our promise of providing care to our community is upheld," Weiser wrote. "I ask you, on behalf of our team of healthcare workers, to please take the recommendations... very seriously. This is about protecting our at-risk community members and friends. We need your partnership to stop the spread, now. Doing so will save lives." 3105

Americans counting on emergency coronavirus aid from Washington may have to wait until fall. Negotiations over a new coronavirus aid package have all but ended. The White House and Congress are far apart on the size, scope and approach on relief for households, schools and a national strategy to contain the virus. President Donald Trump’s top negotiator, Treasury Secretary Steven Mnuchin, tried to revive stalled talks Wednesday. But House Speaker Nancy Pelosi and Senate Democratic leader Chuck Schumer dismissed what they called an “overture,” saying the Trump administration is still refusing to meet them halfway. Trump said Democrats are “holding the American people hostage.”While the White House said they believe a compromise can be made on some issues, the two sides remain far apart on funding state and local governments. Many states and municipalities are struggling due to decreased revenues and increased costs amid the pandemic.There is also disagreement among the parties, including Senate Republicans, on unemployment supplements as unemployment figures remain over 10%. From April into July, unemployed workers received an additional weekly 0 unemployment supplement on top of standard unemployment benefits. But many Republicans grumbled that the supplement gave incentive for workers to stay home amid the pandemic.On Saturday, Trump announced the signing of an executive order, which in part would extend weekly unemployment supplements, but the order raised many questions. The supplement would provide 0 a week for unemployed Americans through the end of the year and would call on states to chip in 25%, but many cash-strapped states might not be able to provide the additional funds. There are also questions on how Trump can fund the order without Congressional approval. Although there is grumbling over fears employees won't return to work, if an employer calls an employee back to work, they're no longer eligible for unemployment benefits. 1987

April-through-June quarter, and the numbers were ugly. The number of passengers tumbled 93% from a year earlier, revenue plummeted 88%, and the company’s adjusted loss was worse than expected. 1495

As COVID-19 continues to spread throughout the United States, traveling nurses jump from hot spot to hot spot, caring for patients and making sure hospitals are fully staffed. Grover Street is one of those nurses and specializes in trauma and intensive care.“I’ve worked in over 100 hospitals and probably 15 different states,” Street said.Street says just this year alone, he's been in New York, Miami, and California. He hops all over the country, doing four-week assignments for crisis nursing and coronaivurs relief. "Busy" and "intense" barely describe what he's experienced on the front lines.“I like going to the hot zones and really learning about this virus and learning about the different patients and human functionality and the way people think about this whole process because it’s probably never going to happen in my lifetime again,” Street said.While interesting from a scientific standpoint, he admits, it's natural to be afraid of this virus that has taken over our world.“I’ve worked with nurses that their families died, the nurse died,” Street said. “I worked with a physician, he died. This is real and I’ve been on the front lines since it started and its sad that a lot of people aren’t wearing masks and social distancing.”He says he prefers the traveling nurse aspect of his profession. There's more flexibility, and he says, it's better pay. As a former trauma nurse in the military, it's like a deployment. Except this time, he's being sent to a different type of war zone.“New York is starting to pick back up, Florida is starting to pick back up,” Street said. “I’m getting texts and emails everyday, 'Am I ready to go somewhere else as soon as this assignment ends?'”Lauren Pasquale Bartlett is the Senior Vice President of Marketing for Fastaff Travel Nursing, the agency for whom Street works. When asked how her organization fulfills the need, she said, “It's never a matter of how are we going to do it, it's at what scale.”“At this time last year, we had 3,000 nurses on assignment right, now we’ve got 6,000,” Pasquale Bartlett added.Traveling nurses, she says, have been backfilling hospitals for 30 years.“It really came out of the strike business when nurses were unionizing and going on strikes, they needed replacement nurses so the hospital started bringing in travel nurses to replace those striking nurses,” Pasquale Bartlett said.They answer the call when there are hurricanes, fires, intense flu seasons, and the coronavirus. Except, unlike those other short-lived events, there doesn't seem to be an end in sight.“I know everybody (is) tired of what’s going on, ready to get back out there, go shopping, have parties, but we need to control this before you die or before your family member dies and then it’s too late so just stay safe,” Street said.Street says the difference between responses in each state is fascinating. He's looking forward to a bit of rest and relaxation before his next assignment and says his only wish is that everyone does their part, by washing hands, and wearing a mask to help protect medical staff and each other. 3101

ANN ARBOR, Mich. (AP) — Students at the University of Michigan are being ordered to stay in place for two weeks after a surge of coronavirus cases driven by social gatherings on and off-campus.Local health officials said Tuesday that the surge is overwhelming their ability to confront the pandemic. Officials say coronavirus cases related to the university represent 61% of the total in Washtenaw County, compared to just 2% in August.More than 1,000 students have been infected since the start of the fall term despite limits on gatherings and classes that are mostly held online. Undergraduate students can attend in-person classes and also leave their residences for exercise, work, food, medical appointments, voting, and religious services.In response to the order, university President Mark Schlissel says even more undergraduate classes will shift to remote instruction. Students who want to leave campus housing for the balance of the term could receive a refund or credit. 990