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While officials in Puerto Rico placed the official death toll from last year's Hurricane Maria at 64, researchers from Harvard believe the death toll was actually in the thousands. According to Harvard's study, there were an estimated 4,645 deaths directly or indirectly tied to the hurricane, which struck the island in September. Harvard estimated a mortality rate of 14.3 deaths per 1.000 people from September 20 through December 31, 2017 in Puerto Rico. Harvard said in its study that it believes its estimate is rather conservative due to a "survivor bias."Harvard conducted the study by performing a random survey of 3,299 households in Puerto Rico. "In our survey, interruption of medical care was the primary cause of sustained high mortality rates in the months after the hurricane, a finding consistent with the widely reported disruption of health systems," the study says. "Growing numbers of persons have chronic diseases and use sophisticated pharmaceutical and mechanical support that is dependent on electricity. Chronically ill patients are particularly vulnerable to disruptions in basic utilities, which highlights the need for these patients, their communities, and their providers to have contingency plans during and after disasters."Part of why there the death toll might have been underreported is due to how hurricane-related deaths are counted. In order to have a death counted as storm related, bodies had looked at by a medical examiner, which required a body to be transported to San Juan, or the medical examiner to travel to remote locations. With a lack of electricity and blocked roads, some bodies were likely buried before the government could count fatalities. Maria is considered the third-costliest hurricane in US history.  1816

Will Smith will be back sitting on his throne as the Prince of Bel-Air when HBO Max streams the "Fresh Prince of Bel-Air" cast-reunion special on Thursday, Nov. 19.The trailer shows the former castmembers reminiscing about their time on the hit 1990s NBC comedy series at their time and the cultural impact it has had.There was also a tribute to the late actor James Avery, who played Uncle Phil, who died in 2014 due to open-heart surgery complications. 462

White House chief of staff Mark Meadows told reporters Wednesday that President Donald Trump wants to continue working from the Oval Office despite being infected with COVID-19.According to CNN and CBS, Meadows told reporters that the White House would be taking extra precautions to allow Trump to do so. According to CBS reporter Ben Tracy, any White House staff coming in contact with the president will wear gowns, gloves, masks and eye protection.It's unclear if Trump would also wear personal protective equipment (PPE) while working in the Oval Office.Following Meadows' statement to reporters, Larry Kudlow, the Director of the United States National Economic Council, said during an appearance on CNBC that Trump visited the West Wing with those added precautions on Tuesday.Medical experts say that while PPE greatly reduces the spread of COVID-19, it cannot prevent the spread of the virus entirely. The CDC recommends that anyone who comes within six feet of a person who may have COVID-19 should quarantine for 14 days, excluding those who have had the virus within the last three months.During a press conference on Monday, White House physician Dr. Sean Conley did not specify if Trump would be asked to quarantine in the White House residence while he was infected with COVID-19.This story is breaking and will be updated. 1346

With many teachers opting out of returning to the classroom because of the coronavirus, schools around the U.S. are scrambling to find replacements and in some places lowering certification requirements to help get substitutes in the door.Several states have seen surges in educators filing for retirement or taking leaves of absence. The departures are straining staff in places that were dealing with shortages of teachers and substitutes even before the pandemic created an education crisis.Among those leaving is Kay Orzechowicz, an English teacher at northwest Indiana’s Griffith High School, who at 57 had hoped to teach for a few more years. But she felt her school’s leadership was not fully committed to ensuring proper social distancing and worried that not enough safety equipment would be provided for students and teachers.Add the technology requirements and the pressure to record classes on video, and Orzechowicz said it “just wasn’t what I signed up for when I became a teacher.”“Overall, there was just this utter disrespect for teachers and their lives,” she said. “We’re expected to be going back with so little.” When school leaders said teachers would be “going back in-person, full throttle, that’s when I said, ‘I’m not doing it. No.’”Teachers in at least three states have died after bouts with the coronavirus since the start of the new school year. It’s unclear how many teachers in the U.S. have become ill with COVID-19, but Mississippi alone reported 604 cases among teachers and staff.In cases where teachers are exposed to the virus, they could face pressure to return to the classroom. The Trump administration has declared teachers to be “critical infrastructure workers” in guidance that could give the green light to exempting them from quarantine requirements.Throughout Indiana, more than 600 teacher retirements have been submitted since July, according to state data. Although the state gets most of its teacher retirements during the summer, surveys suggest more retirements than usual could happen as the calendar year progresses, said Trish Whitcomb, executive director of the Indiana Retired Teachers Association.“I’ve gotten more (teachers) calling me back saying, ‘Well, I’m going to go ahead and retire,’” Whitcomb said. “Some still wanted to go back in the classroom, but they didn’t think the risk was worth it. They looked at their grandkids and the life they have, and I think they’re saying, ‘I’m just not going to do it.’”In Salt Lake County, Utah, the state’s most populated metropolitan area, more than 80 teachers have either resigned or retired early because of concerns about COVID-19 in schools. More than half of those happened in one of the county’s five school districts, Granite School District. All of the district’s teachers who left were fined ,000 for failing to give 30 days’ notice.Mike McDonough, president of the Granite Education Association teachers union, said the departures stem from frustration over how the schools have reopened. In Granite, most students will return to in-person instruction for four days a week, and there are few opportunities for teachers to instruct solely online.Some teachers waited until the last minute, hoping that the district would change its reopening plan. But checking out of the classroom was “the only way to keep themselves safe,” he said.“Teachers are still scared and overwhelmed,” McDonough said. “I have heard from teachers that are just heartbroken to leave the classroom, but they didn’t feel safe going back. They don’t want that level of risk, and they have no other choice but to get out.”Education leaders in states including Arizona, Kansas, New Hampshire, Pennsylvania and Texas have said they are bracing for worsening teacher shortages as the pandemic drives away some educators.To try to maintain staffing levels in classrooms, the Missouri Board of Education made it easier to become a substitute teacher under an emergency rule. Instead of the previous requirement — 60 hours of college credit — eligible substitutes now only need to obtain a high school diploma, complete a 20-hour online training course and pass a background check.Iowa responded similarly, relaxing coursework requirements and the minimum working age for newly hired substitutes.In Connecticut, college students have been asked to step in as substitutes. Michele Femc-Bagwell, director of the teacher education program at the University of Connecticut, said the school has been getting requests to use fifth-year graduate students as substitute teachers. Heavy class loads and internship responsibilities, though, limit their availability to one day a week.Many who work as substitutes are retired teachers such as 67-year-old Margaret Henderson, of Phoenix, who said she will not return as she had planned.“I don’t want to get called into a classroom where a teacher has called out because of the virus or to quarantine. ... And we know that’s going to happen more and more,” Henderson said. “There are still uncertainties about the safety of reopening the school buildings. Can you blame (substitutes) for not wanting to go in?”In rural Iowa’s Hinton Community Schools, Hinton High School Principal Phil Goetstouwers said the school is already down to a third of the substitute teachers it had last year. More than half of those are also willing to sub in other districts, he said, making it even more troublesome when teachers are absent.Allen Little, who retired as a math teacher in Sioux City, Iowa, this past spring, said the “complexities” of teaching during the pandemic made him decide to retire three years earlier than he had planned. Although he anticipated returning to work as a part-time substitute this fall, fears about the virus are holding him back. He encouraged his son, who is studying to be a social studies teacher and who considered getting experience as a substitute, to weigh the risks carefully.“We’re thinking about students, our schools, our community with every decision we make,” Little said. “But we also have to think about ourselves and our families. What’s best for us, maybe more and more of us ... is not being inside the classrooms right now.”___Associated Press Writer Pat Eaton-Robb contributed to this report from Hartford, Connecticut.___Casey Smith is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. 6529

With a swipe of a pen Monday, Mississippi Gov. Phil Bryant signed into law a bill that prevents women from getting abortions after 15 weeks of pregnancy. His state, effective immediately, now holds the distinction of having the earliest abortion ban in the nation."As I have repeatedly said, I want Mississippi to be the safest place in America for an unborn child," Bryant tweeted this month in anticipation of the bill's passage. Lt. Gov. Tate Reeves echoed that sentiment Monday, tweeting "It's a great day in Mississippi" along with a picture of the signing.Also known as the Gestational Age Act, Mississippi's new law makes exceptions only for medical emergencies or cases in which there's a "severe fetal abnormality." There are no exceptions for incidents of rape or incest.The law also puts physicians on notice. Doctors who perform abortions after 15 weeks will be required to submit reports detailing the circumstances. If they knowingly violate the law, their medical licenses will be suspended or revoked in Mississippi. If they falsify records, they will face civil penalties or be forced to pay fines of up to 0.The measure is just one in a string of efforts to diminish access to abortions in Mississippi, critics say."Abortion is a safe medical procedure and it is a critical part of the broad spectrum of reproductive health care that a woman may use in her lifetime," said Felicia Brown-Williams, Mississippi state director for Planned Parenthood Southeast Advocates, in a statement. "This ban is not only unconstitutional -- it endangers women's health care across our state. If legislators truly cared about women's health, they would be focused on ways to improve access to health care for women, not restrict it."Access to abortions in Mississippi was already highly restrictive.It is among a small handful of states that has one remaining clinic: in this case, Jackson Women's Health Organization. Although Mississippi is among the states with a 20-week ban, up until the enactment of this latest bill, the cutoff time for abortions at the Jackson clinic was 16 weeks. And since hospitals won't perform abortions, the resulting one-week change brought on by this new law is "arbitrary," based on "capricious whim" and a way to "feed political meat" to a political base, said Dr. Willie Parker, board chairman of Physicians for Reproductive Health.Mississippi is the only state in the country that requires physicians who perform abortions to be board-certified or board-eligible obstetrician-gynecologists, a fact that's being challenged in court as unconstitutional by the Center for Reproductive Rights. Parker, an OB/GYN, explained that he could be trained in a plastic surgical procedure and be free to perform that procedure in Mississippi, even though he's not a board-certified plastic surgeon. But a family physician, a surgeon or an internist trained to perform abortions isn't given the same leeway.Mississippi also requires in-person counseling and a 24-hour waiting period before receiving an abortion, which means women must make repeat trips to the facility -- a fact that's especially burdensome for those living outside Jackson. Health plans under the Affordable Care Act, insurance policies for public employees and public funding for abortions can be applied only in cases of rape, incest, fetal impairment or when a life is endangered, according to the Guttmacher Institute.About 2,000 women a year in Mississippi receive abortions, Parker said. The vast majority, 88%, receive them in the first 12 weeks of pregnancy. So by 15 weeks, he estimates, 200 women in Mississippi who should have access to an abortion no longer will.For women living in poverty who need time to gather resources to pay for an abortion and for those outside Jackson who need to find ways to cover additional expenses associated with travel, House Bill 1510 will close the door to a procedure that's been a legal right for women since the passage of Roe v. Wade in 1973.Proponents of the bill, like Mississippi State Rep. Dan Eubanks, argue that this law will do what's best for women."Beyond the obvious debate of trying to save the lives of innocent babies, there is the often less discussed issues that relates to the health of the mother who receives an abortion," Eubanks wrote in an email. "When did looking out for the life, health and overall wellbeing of a child or its mother start getting labeled as extreme in this country?"Eubanks says that the longer a woman carries a child in her womb, "the greater the potential she will suffer from psychological, emotional, and physical damages as an outcome," though that contention is generally disputed by those who advocate for safe access to abortions.The new Mississippi law is expected to be challenged in court.The Center for Reproductive Rights points out that similar efforts in other states -- Arizona, North Dakota and Arkansas -- were shot down on constitutional grounds. And the advocacy group expects that this bill to ban "pre-viability abortion" will similarly be stopped."Mississippi politicians' flagrant assault on reproductive rights will not go unchallenged," said Lourdes Rivera, senior vice president of US programs at the Center for Reproductive Rights, in a written statement. "This bill is dangerous and unconstitutional. The Center is prepared to answer any attempt to undermine 40 years of Supreme Court precedent with the full force of the law." 5500