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ents in the Health Officer Order and are the tools we have to protect each other, our families and those most vulnerable in our communities.”L.A. Mayor Eric Garcetti said Monday that gatherings with people other than those you live with remain prohibited in the city.“Getting together with family, friends, coworkers, is how the virus spreads,” said Garcetti. “When we get exhausted, it gets strong. When we get lazy, it thrives. It only takes one infected person to spread COVID-19 through your network.”The mayor also said that his office has enacted a “hard pause” in the reopening of more businesses in the city, including theaters, bowling alleys, and amusement parks. 2406

Medical offices around the country are opening back up for routine health checks and they're facing a huge problem; there's still a shortage of protective gear. Now, many are spending huge amounts of money restructuring the way they operate to keep themselves and their patients safe.On a window ledge at ENT and Allergy Associates in White Plains, New York, sits a number of brown paper bags. Inside, face masks labeled for each physician.“We have paper bags on our window sills with a bunch of masks. In there, we have 3-4-5 masks we’re rotating through. Those have to be kept covered to protect them from splatter or anything because once they get dirty, then they have to be thrown out,” Dr. Daniel Gold said. “We circulate gowns as well.”Gold is an E.N.T., which is the medical and surgical choice for anything having to do with the ears, nose or throat. It's a profession that is very much in your face, so protective gear is of utmost importance.“After wearing them for 5-10 minutes, you get short of breath and you’re like this is really hard,” he said.Doctors like Gold are having a hard time getting more gear. In fact, Dr. Gold often uses shields that are designed for sheet metal work because medical grade equipment is back ordered, or entirely unavailable. A surgical mask which once cost 30 or 40 cents now costs to .50.They've also found that knockoffs are being sold.“Not made of same material, not sealing against the face, and some had seam lines and then when you really looked, you’d realize there were holes through the seam lines that’s not blocking 95%,” Gold said. “You’re better wearing a t-shirt mask.”Dr. Gold is far from alone on this issue. It's a statewide and nationwide problem. Dr.Bonnie Litvack is the president of the Medical Society, State of New York.“That is an absolute mess because we can’t deliver the care if we don’t have the resources and the mask is ground zero for that,” Said Dr. Bonnie Livtack, the president of the Medical Society of the State of New York.When asked about whether they were able to negotiate for price on PPE, Litvack said, “With the various companies they either have it or they don’t, or you pay the prices or you don’t.”Dr. Litvack joined other state medical societies in the country by sending a letter to the Senate. They're asking the government to step in."We urge Congress to prioritize the production, distribution, and availability of PPE and testing, and accelerate efforts to conduct contact tracing,” the letter read. “All of these are essential to the safe reopening of medical practices and the economy and must be prioritized for all health care workers."They're also asking for financial help as their costs to operate, while seeing half the patient volume, are mounting.“These additional precautions and equipment is running us about per patient,” Dr. Gold said. “It’s about a million in extra overhead a month just in these extra masks, and gowns, and gloves and wipes. All these other things, which nobody could have thought to budget in because who would have thought we’d have to consider every patient highly infectious.”It's a new way of operating, as everyone is learning how to function in our new, post-pandemic world. 3229

Mass shootings and acts of terrorism may dominate headlines, but it's the homicides and, to a lesser extent, the suicides that happen out of the spotlight that make up the bulk of firearm-related deaths around the world, according to a study published Tuesday in the journal JAMA. More gun deaths happened outside of war than in it during the years researchers examined (1990 through 2016) in 195 countries and territories.Worldwide, an estimated 251,000 people died by gun in 2016. In 1990, there were 209,000 firearm-related deaths. Accounting for population growth, that's an annualized rate decrease of 0.9 percent.Gun deaths are predominantly concentrated in six countries that make up less than 10 percent of the world's population. The United States, Brazil, Mexico, Colombia, Venezuela and Guatemala together account for more than half of the gun-related deaths worldwide.In 2016, the majority of global firearm deaths -- an estimated 64 percent -- were homicides. Suicides accounted for 27 percent of the gun deaths. A small fraction, about 9 percent of gun deaths, were accidental.If you were to look on a map, the highest numbers of gun-related homicides are concentrated in a belt that stretches from Mexico through the Caribbean to Brazil. Many of these homicides involve drug cartels, the authors suggest, and there's a problem with organized crime and the illegal gun trade.El Salvador saw the greatest concentration of gun-related homicides in 2016, with 38.9 per 100,000 people. By comparison, Singapore, the country that had the fewest, had 0.1 gun-related homicides per 100,000."The sheer magnitude of these deaths and the range in firearm-related deaths is extraordinary," said the study's senior author, Chris Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.The most vulnerable demographic to gun violence was men between 20 and 24 years old. Men were also the biggest perpetrators of gun violence.Suicide-by-gun rates declined globally between 1990 and 2016. Some countries, though, struggled with this public health crisis. In 2016, Greenland had the highest number of firearm suicides, with 22 deaths per 100,000 people. The US had the second-highest number, with 6.4 deaths per 100,000 in 2016."The US really has quite marked rates around suicide," Murray said. "That was a surprise to me."For perspective, the United States has 4.3 percent of the world's population, but suicide by gun there represented 35.3 percent of all firearm suicides in the world in 2016. By comparison, there were twice as many firearm suicides as gun-related homicides in 2016 in the US.Americans also own more guns per capita than residents of any other country, with about four in 10 Americans saying they either own a gun or live in a home with guns, according to a 2017 Pew Center study.Americans have been killing themselves more with guns over the past decade, but homicide numbers have been relatively flat. The US ranks 30th in the world for total number of homicides, according to the study.The highest increase in gun-related suicide rates in this time period was in Jamaica, and Singapore had the fewest gun-related suicide deaths. These numbers, Murray said, are an important reminder about how widespread this public health problem is.There is no one single trend behind gun violence. Drugs, alcohol, a lack of mental health services and domestic violence are often to blame, as is poverty, the study suggests."Places with high rates of firearm mortality that are getting worse tend to be places with weak government institutions, especially in the criminal justice system or social upheaval," Daniel Webster, who has written extensively about gun violence as director of the Johns Hopkins Center for Gun Policy and Research, wrote in an email. Other things that stood out from these numbers, he said, is that while the "measures aren't great," he said, "there is a connection: more guns, more gun-related deaths."Webster, who was not involved in the new research, added that the general downward trend in firearm mortality is something that stands out because "we tend to think of our current rates of gun violence as the worst ever, but there has been great progress" toward stemming some of this violence.Laws that seem to limit gun violence include ones that strengthen background checks and require permits for ownership, the study authors said. More restrictions on guns in Brazil and South Africa seem to suggest a link between a reduced access to gun ownership and a lower number of gun-related suicides and homicides. 4601

Marc Short, the chief of staff for Vice President Mike Pence, has contracted COVID-19, according to The New York Times and Bloomberg.Pence's staff says the Vice President tested negative for the virus on Saturday.According to the Times, Pence's office released a statement Saturday night saying that even though Pence had close contact with Short in recent days, he "will maintain his schedule in accordance with the CDC guidelines for essential personnel.”The announcement came shortly after Bloomberg reported Saturday night that another one of Pence's top aides, Marty Obst, had also tested positive for the virus."Today, Marc Short, Chief of Staff to the Vice President, tested positive for COVID-19, began quarantine and assisting in the contact tracing process," a statement from Pence press secretary Devin O'Malley read, according to Axios. "Vice President Pence and Mrs. Pence both tested negative for COVID-19 today, and remain in good health. While Vice President Pence is considered a close contact with Mr. Short, in consultation with the White House Medical Unit, the Vice President will maintain his schedule in accordance with the CDC guidelines for essential personnel."Short and Obst are just the latest high-ranking White House officials to contract COVID-19. Earlier this month, President Donald Trump, first lady Melania Trump and their son, Barron, all announced that they had contracted COVID-19. Other top aides like press secretary Kayleigh McEnany, adviser Stephen Miller and former adviser Kellyanne Conway also tested positive for the virus. Most were in attendance at a White House event for the nomination of Judge Amy Coney Barrett, where many guests were pictured indoors without masks.The outbreak in Pence's office comes as COVID-19 cases spike across the country. On Friday, the U.S. recorded a single-day record of new cases of the virus with nearly 84,000. 1901

Many Americans have been working from home for months now and students have also been attending class from home.Your make-shift office or classroom may not be that comfortable.Some common complaints may include pain in the neck, shoulders, wrist, forearm, lower back, hips and legs.Physical therapists say if the family is sharing one workspace, it's important it can be adjusted.“You’d like to have a chair that matches the size of the person,” said Michelle Despres, a physical therapy expert. “It should have some adjustability. It should have some variability in what the chair can do. It should provide support for the lower back. It should have support for your legs. You should be able to put your feet flat on the floor and your thighs should be parallel to the floor.”If you're not looking to buy a desk or chair, you can still adjust by using books as a footrest.It's also important your computer setup is comfortable. If you can, try to use a monitor, or an external keyboard and mouse pad.If you are going to buy one thing for your workspace, Despres says a chair is a great investment.“Maybe, if you make one purchase, then probably the chair is the best purchase,” said Despres. “That's something that you can raise and lower. That's something that can adjust the back. You can go to the stores and sit in the chairs, try them out, adjust the arms.”You should be stretching as often as you can. If you're constantly sitting, make sure to stand often. Try to walk around. stretch your wrists or heel raises to get your blood moving.While you're sitting, make sure your shoulders are relaxed and not shrugging. 1630

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