北京类风湿关节炎针灸治疗(北京治疗类风湿性关节炎极佳的方法) (今日更新中)

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 U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr.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

With Congress debating the next economic relief package, American workers are set to lose additional unemployment money at the end of the week.The crisis has affected all sorts of workers, but one particular group is less likely to be able to recover – the older workforce.AARP found 30% of older workers lost jobs or income because of COVID-19.Research from the Great Recession found it takes older Americans twice as long to get back into the workforce. If they do, they almost always never end up making the money they used to.AARP is also concerned businesses might be reluctant to hire older workers because of the increased risk to the virus.“There’s now five generations for the first time ever in the workforce, so having that diverse age will actually help in bringing products and services to the market that appeal to a wide range of age of people,” said Susan Weinstock, VP of Financial Resilience at AARP.Prior to the pandemic, businesses were looking to recruit older workers because of their unique soft skills: being empathetic, calm under pressure, and a good listener.Multigenerational workforces tend to be more efficient, productive and have fewer errors and absenteeism.“Think about something that happened at work when you are 25 and then when you are 55 and something similar happens you have some perspective you can bring,” said Weinstock.AARP has resources specific for older workers affected by the pandemic, including a jobs board with a lot of remote work for those concerned about going to work in person. 1543

When Tim Frye retired from his job as a project manager in 2017, he envisioned traveling the U.S. in an RV with his fiancée. But not long after spending about a quarter of a million dollars on a luxurious, 39-foot 2014 Forest River Berkshire motorhome, his fiancée left him — and he was left with a very expensive vehicle in his yard.“I could sell it, but I’d lose a ton of money because I had just bought it and wouldn’t be able to get the full value back,” Frye said. “Or I could rent it out.”Frye, who lives in Flower Mound, Texas, opted for the latter, posting his motorhome on online RV rental marketplace Outdoorsy, which is essentially Airbnb for motorhomes and campervans. Owners coordinate with renters on a meetup spot and handle the vehicle maintenance and cleaning. Outdoorsy handles the booking requests, transactions and RV insurance.In his first two years renting his RV on the site, business already was good for Frye. But everything changed when coronavirus hit. And for Frye’s RV business, things changed for the better.“This is the king of side hustles for me,” Frye said.The coronavirus impact on RV rentingPortland-based Adam Clayton has two 2017 Winnebago Travato campervans available for rent on Outdoorsy. Before the pandemic, Clayton said both RVs were booked solid through October 2020. Given his location about 15 minutes from Portland International Airport, Clayton frequently catered to international visitors looking to road trip through the Pacific Northwest.But when the pandemic hit, all his out-of-towners immediately cancelled their reservations. With Oregon state parks closed, business was slow in March and April. But as parks reopened, Clayton saw a quick uptick in locals. Eager travelers converted from cruising to camping. They ignored international travel in favor of national parks. And that meant a sudden uptick in people looking to rent or buy RVs.It was a similar situation for Andrew Carson, who rents his RVs out of his home in Fredericksburg, Virginia.“As of early March, we had 11 reservations set up throughout the summer, yet once COVID hit, every single one canceled,” he said. “We panicked, thinking, ‘what have we gotten ourselves into?’ But once things started opening back up — around April — RVing became the hottest thing in America.”By May, he had already been booked for 120 days straight. Frye was especially lucky; he never even saw an initial dip.“People came to me because they had trips planned, but suddenly their hotels had canceled on them,” he said. “People were scrambling to find places to stay.”Frye says his bookings are up an average of 70% year-over-year. But while business is up, most RV owners agree that the type of business has massively shifted. It’s a lot of first-timers (Carson estimates about 70% of rentals this year were to first-timers), which means owners have to spend more time with renters during the initial walkthrough, and there’s higher odds of renters running into issues simply for being novices.With the usual RV-friendly spots off the list as music festivals remain canceled and many ski resorts are still closed, people are also shifting where they’re headed.“I’ve already booked two customers who are driving my RV to their parents’ houses,” Clayton said. “Rather than stay inside the parents’ house, they’re going to park in the driveway.”How much money can you make renting out an RV?RV rental marketplace RVshare estimates that owners of Class A RVs (those are the largest, most luxurious of the motorized RVs), can earn as much as ,000 per year through their site.There are also some costs involved, however:Commission fees: Online RV rental marketplaces typically charge a commission. Outdoorsy takes a 20% cut of the total reservation cost. RVshare is less transparent about fees since the commission rate correlates with revenue, but owners say it’s typically a 25% cut.Monthly payments, insurance and maintenance: If you’re financing your RV, you’ll have to make monthly loan payments, which likely also means interest and fees. Plus, factor in expenses like maintenance and RV insurance.Storage: RV storage can also be pricey if you don’t have your own garage to store it in. Expect to pay at least ,500 a year — and even more if you’re in a high-cost-of-living area or have an especially large vehicle.But still, it’s a lucrative side hustle. Frye said after accounting for all those costs, he still pockets ,000 annually on his single RV.Virginia-based Carson owns two Class C motorhomes (those are often referred to as mini-motorhomes). Between insurance and monthly payments on his two RVs, he pays about ,400 a month in RV-business related expenses — which easily pay for themselves. Carson said that this summer he grossed ,500 per month between both RVs.Considerations when getting into an RV-renting side hustleHigher-end vehicles typically work out to be better long-termFrye’s RV is a Class A motorhome, which is essentially a full house on wheels that’s big enough to stand up straight inside, has a full kitchen and bathroom, and sleeps multiple people.While they’re more expensive, Frye said he believes Class A motorhomes more easily retain their value versus a cheaper RV, like a campervan. He also said that since the RV is more expensive for renters, it attracts clientele who are more likely to take care of it.It’s good income, but it’s not passive incomeOwning an RV requires regular work. There’s annual maintenance, but there’s also work to be done with every rental. Between doing laundry, power washing the outside and wiping down the inside, Carson estimates he spends three to six hours cleaning the RV after every trip. He also spends about 30 minutes on the pre-rental walkthrough (and sometimes more if the renter is a newbie). Plus, he spends hours each week scheduling and communicating with renters online.Accept that they won’t be returned in perfect conditionWith strangers driving your RV, it’s bound to get dinged up, especially with more first-time RV renters. Even though RV experts will usually tell you they’re not as hard to drive as you might think, they’re still much tougher to navigate than your average small sedan.“You can’t be too emotionally attached,” Frye said.While sites like Outdoorsy do provide insurance, Frye still acknowledged that putting your RV up for rent is not for you if you’ll be flustered by every little scratch.“If they’re seriously damaged, Outdoorsy insurance pays for it,” Clayton said. “But if it’s something smaller — like a faucet breaks — I just fix it. It’s a business, so treat it like a business. If something gets scratched, don’t freak out.”Location mattersFrye attributes his Texas location as a big factor in maintaining consistent bookings year round, as opposed to owners up north who experience a dip in bookings once it gets colder.And specific locations within that area make a difference too. Carson lives just off of Interstate 95, the main highway along the East Coast, which means easy access for road trippers headed up to Maine or down to Florida.Getting into the RV business nowWith road trips surging in popularity, it’s a lucrative time to adopt RV renting as a side hustle. But if you don’t yet actually have an RV to rent out, good luck.Just before COVID-19 was part of the lexicon, Clayton had run the numbers and was committed to buying a third RV to build his small business sometime in 2020. But just as the rental business is booming under COVID-19, so is the business of owning one.“Every Class B RV — even if it does go on Craigslist — is now exorbitantly priced,” he said. “My only regret prior to all this is that I hadn’t purchased four RVs.”Frye is in a similar boat as Clayton; three years after buying his RV with a fiancée who has since left him, his only regret about buying one RV is not buying more RVs.“The RV market is so hot right now,” he said. “I’m trying to find another one to buy, but suddenly since the coronavirus hit, everyone wants to buy an RV.”And Frye has one more personal reason to add more RVs to his collection: He’s since met someone new — and she and her daughter both love RV camping with him.More From NerdWalletRenting Hotels for Big Events Is Dirt-Cheap … for NowAsk a Points Nerd: How Can I Celebrate the Holidays Without Travel?4 Benefits You Need From Your Travel Credit Card in 2021Sally French is a writer at NerdWallet. Email: sfrench@nerdwallet.com. Twitter: @SAFmedia. 8451

When President-Elect Joe Biden and Vice President-Elect Kamala Harris take office in January, they will face a list of extraordinary challenges. The coronavirus pandemic and America's response to it will loom large. The same week our country voted for president, there were record numbers of new COVID-19 cases and hospitalizations and deaths continue to rise. Vaccines are being developed and could be ready for widespread distribution next year. There is also the financial and jobs concerns in the wake of the pandemic. Many are hoping conversations about economic relief can start up again now that results of the election are becoming clear. The jobs report from October shows unemployment is at 6.9 percent. However, this is still historically high and there are concerns it does not include people who have given up looking for work during a pandemic for various reasons.Racism and social justice issues divided the country earlier this year, leading to large demonstrations in dozens of cities. Strong emotions from both sides motivated some voters. Biden has said he also wants to focus on rejoining international organizations, including the World Health Organization, NATO, and the Paris Climate Accord. Biden has also signaled other top priorities in his first few months; including sending a bill to Congress to repeal liability protections for gun manufacturers and closing background-check loopholes, sending an immigration bill to Congress creating a pathway to citizenship for 11 million undocumented immigrants and retaining rights for “dreamers” who were brought to the United States illegally as children, and move to eliminate tax cuts passed under Trump in 2017, according to the Washington Post. In speeches, Biden has also said he wants to address systemic racism, homelessness, and restore transgender students' access to sports, bathrooms and locker rooms. 1891

Widespread flash flooding along small streams, urban areas, and roadways is expected to begin this afternoon into Thursday from far eastern Texas, across Louisiana and Arkansas. This will also lead to minor to isolated moderate freshwater river flooding. #Laura pic.twitter.com/z71y3icU29— National Hurricane Center (@NHC_Atlantic) August 26, 2020 356

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