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The forensic pathology industry is facing a workforce shortage. These are the men and women who determine how and why a death happens. They are being overwhelmed, and the pandemic has only made things worse.“What you’re seeing now is part of our autopsy examination room,” said Francisco Diaz as he walked around the Office of the Chief Medical Examiner in Washington D.C. He is the deputy chief medical examiner.“The purpose of the medical examiner is to do two things, to determine why people die and to classify the manor of death,” he said.Diaz and his team have their hands full. Here, bodies are brought in, x-rayed, and analyzed every day. Most of them are bodies of those who have died of unnatural causes, like homicide, suicide, and certain accidents.They’re brought here, where seven forensic pathologists work.“As medical examiners and forensic pathologists you are dealing with death and tragedy every single day,” he said.This year the volume has been higher than usual, in large part because of the COVID-19 outbreak. “The peak of our pandemic was April, May. At that time we had that emergency morgue off campus,” Diaz explained. “We handled approximately 400 descendants or dead bodies.”The increase in autopsies needed is not only due to COVID-19 directly, but other ripple effects.“What I see as a consequence of the pandemic is a lot of people are dying at home because they choose not to seek medical attention because they may have concerns that they may get contaminated at hospitals,” Diaz said.If they die at home, they’re sent straight to D.C.’s Medical Examiner’s Office. Most people who die in a hospital are handled by the hospital, except for in certain jurisdictions like D.C. where they will help out with the hospital's cases as well.Regardless of where the cases are coming from, jurisdictions are strapped for resources. It’s a problem across the industry right now -- one that’s been facing a workforce shortage for years.“A lot of the policy makers think that it's a waste of money. You're just spending money on the dead, but everything we do is for the living,” said Victor Weedn, Forensic Science Professor at George Washington University. He’s an expert in the forensic pathology industry.“We are terribly undermanned, under served these days. It is thought we have 500 to 600 board certified forensic pathologists working in the field across the United States and that's simply not enough. It’s estimated we really ought to have 1,200 to 1,500 forensic pathologists.”The lack of workers has become more evident due to the pandemic, and also a growing epidemic. “And then the opioid crisis hit. That immediately caused 10% to 30% more cases because of all the overdose deaths,” Weedn said. “On top of that you have the COVID pandemic. The overdose cases have not declined, in fact they've continued to increase. And now we’re seeing a wave of homicides increasing our caseload still further. We are facing a true workforce shortage.”Weedn also talked about how some of their investigations on COVID-19 patients who passed helped answer some questions we had early on in the pandemic.Increasing a workers caseload is not a great option, according to Weedn. The National Association of Medical Examiners has accreditation standards.“A forensic pathologist really isn't supposed to do more than 250 autopsies a year. If you have more than that it’s considered an infraction of the standard,” he said. “When you start doing more than that, things get lost. Details get lost.”This puts many offices in a bind. “In the face of such a severe workforce shortage you find that people have changed the criteria for what deaths they will investigate and that means there are certain deaths that will go uninvestigated. A murderer could get away with murder. That’s certainly a possibility,” Weedn explained.As the workload remains heavy for many jurisdictions, Diaz said education and exposure for the industry might be their best bet in getting more interest.“I think every crisis brings an opportunity. And I think this is an opportunity for forensic pathology to be on the forefront and let the public at large know what we do, how we do it, and to encourage young people to pursue a career in forensic pathology,” Diaz said. 4266

The FBI held an unforeseen news conference on Wednesday to say that Iran and Russia have been leading a misinformation campaign ahead of this year’s election.Although the sudden nature of Wednesday’s news conference made the announcement seem urgent, intelligence community officials have been warning of interference by Iran, China and Russia for months.Director of National Intelligence John Ratcliffe said that the countries obtained voter registration information, and then used that data to direct misinformation toward voters. Ratcliffe, along with FBI Director Christopher Wray, would not take any questions.Voter registration information is generally public information. Information like voters’ names, addresses and voting history are generally available nationwide. It is unclear if Iran and Russia received information that is publicly available."We have already seen Iran sending spoofed emails designed to intimidate voters,” Ratcliffe said.Ratcliffe claimed that the emails worked to hurt Trump's campaign, but House Democrat Ted Lieu, a member of the Intelligence Committee, questioned how the emails were intended to hurt Trump's campaign. 1164

The Food and Drug Administration is investigating an outbreak of Listeria that has killed at least one person.The FDA, CDC and public health officials are looking into ten cases of Listeria monocytogenes infections reported in Florida, Massachusetts and New York. One person has died, the only available information is that the person lived in Florida.Genome sequencing of the Listeria bacteria isolated from those infected shows the ten people in this outbreak are more likely to share a common source of infection, according to the FDA. Samples were taken from patients between August 6 and October 3.In interviews with nine of the infected people, they all reported eating Italian-style meats recently, like salami, mortadella, or prosciutto, according to the FDA.Public health investigators have not found a common type of deli meat or common supplier among the patients at this time.The patients in this outbreak range in age from 40-to-89 years old, and all of them needed to be hospitalized.Listeria can cause different symptoms, depending on the person and part of the body affected, according to the Centers for Disease Control and Prevention. Symptoms include headache, stiff neck, confusion, loss of balance, fever and muscle aches. 1251

The country is heading into a COVID-19 winter without fully deploying widespread testing of sewage for traces of coronavirus, a Newsy investigation has found.Wastewater surveillance is one of the few proven tools able to track community spread of the disease, with the potential to help monitor immunity rates from new vaccines."It is frustrating," said David Larsen, an associate professor of public health at Syracuse University's Falk College. "We're going to see a huge amount of sadness over the next few months. And it's not too late to scale up wastewater surveillance at this time to help us with that."Early on, scientists realized infected people shed the virus in stool.The federal government began a big effort for analyzing the concentration of the virus in community wastewater."It's something I think from a national level we need to pursue," Assistant Secretary for Health ADM Dr. Brett Giroir said during a July webinar.Months later, the government has left it to state and local authorities to launch their own programs.For some, that's been a challenge.Newsy learned New York State, for example, suspended its sewage surveillance pilot after a month in part because of an equipment shortage.As a result, testing stopped in four places including Albany and Erie County, home of Buffalo.The University of Buffalo helped lead the project."UB is in the process of acquiring enough materials to continue the monitoring effort moving forward," university spokesman Cory Nealon said in an emailed statement.As with PPE, there is a global shortage of supplies needed to test sewage for COVID.Other places are struggling with how to pay for sewage analysis, with coronavirus aid from Washington running dry."The biggest factor, the limiting factor, is finances," Larsen said.The result is a patchwork of places examining wastewater across the country, mainly big cities and college campuses."It's not really a unified strategy, unfortunately," said Colleen Naughton, an assistant professor of civil and environmental engineering at the University of California Merced.She and her team plot testing sites on a map."When you zoom out of course the bubbles are big, so it looks like all U.S. is covered," Naughton said. "But when you zoom in you see it's a bit more spread out."Three states, Iowa, Rhode Island and South Dakota, don't have any surveillance sites at all, she said.Biobot Analytics looks for COVID in wastewater for about 200 cities and counties but has the capacity to do much more, said company president and cofounder Newsha Ghaeli."We're at the beginning, let's say that," Ghaeli said. "There hasn't really been a strong coming together yet around a specific approach or even standards."The CDC is still putting together a national wastewater surveillance system, building out a database not available to the public yet."It is, I think, valuable for the public to see that data and take action as a deciding factor for what activities and what risks am I going to take?" Naughton said. 3019

The CDC is changing their recommendations for travelers, urging them to pay attention to local and state recommendations, and dropping their 14-day quarantine for international or out-of-state travelers.The Centers for Disease Control and Prevention updated their travel requirements Friday, according to multiple media reports. They now advise travelers to "follow state, territorial, tribal and local recommendations or requirements after travel." Previously, the agency recommended a 14-day quarantine for those returning from international destinations or any area with a high concentration of coronavirus cases.The guidelines still urge travelers to limit their risk of infecting others by social distancing and wearing a mask. “You may feel well and not have any symptoms, but you can still spread COVID-19 to others," the CDC states on their website.There are still international travelers who are not allowed to enter the U.S. based on presidential proclamations. Foreign nationals who have spent time in these countries in the last 14 days before travel cannot enter the U.S.: China, Iran, United Kingdom, Ireland, Brazil, and most of Europe. U.S. citizens who travel to these countries can return to the U.S. through 15 airports according to the CDC. 1268