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As the coronavirus pandemic surges across the nation and infections and hospitalizations rise, medical administrators are scrambling to find enough nursing help — especially in rural areas and at small hospitals.Nurses are being trained to provide care in fields where they have limited experience. Hospitals are scaling back services to ensure enough staff to handle critically ill patients. And health systems are turning to short-term travel nurses to help fill the gaps.Adding to the strain, experienced nurses are “burned out with this whole (pandemic)” and some are quitting, said Kevin Fitzpatrick, an emergency room nurse at Hurley Medical Center in Flint, Michigan, where several left just in the past month to work in hospice or home care or at outpatient clinics.“And replacing them is not easy,” Fitzpatrick said.As a result, he said, the ER is operating at about five nurses short of its optimal level at any given time, and each one typically cares for four patients as COVID-19 hospitalizations surge anew. Hospital officials did not respond to requests for comment.But the departures are not surprising, according to experts, considering not only the mental toll but the fact that many nurses trained in acute care are over 50 and at increased risk of complications if they contract COVID-19, while younger nurses often have children or other family to worry about.“Who can actually work and who feels safe working are limited by family obligations to protect their own health,” said Karen Donelan, professor of U.S. health policy at Brandeis University’s Heller School for Social Policy and Management. “All of those things have been factors.”Donelan said there is little data so far on how the pandemic, which has killed more than 231,000 people in the country, is affecting nursing overall. But some hospitals had a shortage even before the virus took hold, despite a national rise in the number of nurses over the past decade.With total confirmed coronavirus cases surpassing 9 million in the U.S. and new daily infections rising in 47 states, the need is only increasing.Wausau, Wisconsin-based Aspirus Health Care is offering ,000 signing bonuses for nurses with at least a year of experience and hiring contract nurses through private staffing companies to handle a surge in hospitalizations that prompted the system to almost quadruple the number of beds dedicated to COVID-19 patients.Aspirus, which operates five hospitals in Wisconsin and four in small communities in Michigan’s Upper Peninsula, also is moving nurses around between departments and facilities as hot spots emerge, said Ruth Risley-Gray, senior vice president and chief nursing officer at Aspirus.Outside help still is needed, in part because some nurses have gotten sick from or were exposed to the cornavirus during the current wave, which “came with a vengeance” starting in August, Risley-Gray said. At one point in mid-October, 215 staffers were in isolation after showing symptoms or being exposed to someone who tested positive, and some are just starting to return to work.Aspirus recently was able to hire 18 nurses from outside agencies, and may need more if the surge continues.Because the pandemic is surging just about everywhere in the country, hospitals nationwide are competing for the same pool of nurses, offering pay ranging from ,500 a week to more than ,000, said April Hansen, executive vice president at San Diego-based Aya Healthcare, which recruits and deploys travel nurses.She said demand for their services has more than doubled since early in the pandemic when the greatest need was in hot spots like New York and New Jersey and then moved to southern states. In recent weeks the virus has been spiking across the country, with the new hot spots in places like the rural upper Midwest and southern-border communities such as El Paso, Texas.Now placing nurses where they’re needed is “like a giant game of whack-a-mole,” said Hansen, whose company has about 20,000 openings for contract nurses.In North Dakota, where infection rates are exploding, hospitals may cut back on elective surgeries and seek government aid to hire more nurses if things get worse, North Dakota Hospital Association president Tim Blasl said.In Texas, Gov. Greg Abbott recently announced he was sending 75 nurses and respiratory therapists to El Paso to help handle the city’s surge. Wisconsin Gov. Tony Evers, meanwhile, issued emergency orders making it easier for nurses from elsewhere to practice in his state and for retired nurses to come back.“This has been a challenge, and we’ve been pleading with the community members to protect themselves and others,” by wearing masks and social distancing, said Aspirus’ Risley-Gray, who said the positivity rate among community members tested by Aspirus rose from under 10% in September to 24% last week.To combat the emotional toll and fatigue that comes with caring for COVID-19 patients, including just donning and removing protective equipment all day, Aspirus has been giving nurses microbreaks and quiet places to get away and collect themselves when they feel overwhelmed.Travel nurses say the need at small hospitals tends to be greater than at larger facilities.Robert Gardner, who’s currently assigned to a hospital in a small town about 20 miles west of Atlanta, said he did search and rescue in the Coast Guard during Hurricane Katrina and the pandemic is “a lot worse.”He worked at a large New Jersey hospital when that state was swamped by the virus in the spring, and now worries that flu season could bring further chaos to hospitals. But he’s determined to stick it out, no matter what.“It’s not even a question,” Gardner said. “Nursing is a calling.” 5727

As the coronavirus pandemic continues, doctors are learning more about the damage having Covid-19 can do to the body. Two separate studies published recently indicate the coronavirus can harm other organs in the body, including the heart.One of the studies looked at 100 patients in Germany who recently recovered from Covid-19 and found 60 percent of participants had inflammation in the heart. The study used MRI scans to monitor the inflammation, and was published in JAMA Cardiology.The majority of the patients in this study, 67 of them, recovered from the coronavirus at home with severity ranging from asymptomatic to moderate. It compared the MRIs of coronavirus survivors to scans from healthy volunteers.The data showed there was some sort of heart involvement in those who had coronavirus, whether or not they had preexisting conditions or any heart-related symptoms during recovery.“Our findings reveal that significant cardiac involvement occurs independently of the severity of original presentation and persists beyond the period of acute presentation, with no significant trend toward reduction of imaging or serological findings during the recovery period. Our findings may provide an indication of potentially considerable burden of inflammatory disease in large and growing parts of the population and urgently require confirmation in a larger cohort,” the researchers noted in conclusion.A second study, also published in JAMA Cardiology, found coronavirus could be found in the heart tissue of patients who died.The study looked at data from 39 autopsy cases in Germany in early April. The patients were aged 78 to 89, had tested positive for Covid-19 and there were results of heart tissue analysis in their autopsies.In 16 of the 39 cases, there was a large “virus load” of coronavirus found in the heart tissue, another eight had a coronavirus presence in the tissue.The sample of autopsy cases was small and the "elderly age of the patients might have influenced the results," the researchers wrote. More research is needed whether similar findings would emerge among a younger group of patients."Taken together the studies support that SARS-CoV-2 does not have to cause clinical myocarditis in order to find the virus in large numbers and the inflammatory response in myocardial tissue. In other words, one can have no or mild symptoms of heart involvement in order to actually cause damage," said Dr. Dave Montgomery, who was not involved in the studies, in a statement to CNN.Dr. Clyde Yancy of Northwestern University Feinberg School of Medicine and Dr. Gregg Fonarow of the University of California, Los Angeles, co-authored an editorial that accompanied the two new studies in the journal JAMA Cardiology called ‘Coronavirus Disease 2019 (COVID-19) and the Heart—Is Heart Failure the Next Chapter?”“We see the plot thickening and we are inclined to raise a new and very evident concern that cardiomyopathy and heart failure related to COVID-19 may potentially evolve as the natural history of this infection becomes clearer,” they write. 3076

As the NBA plans to resume action at the end of the month, the bubble the league has implemented in Orlando, Florida, appears to be working.On Monday, the league said that its latest round of tests netted no new confirmed coronavirus cases.The league has implemented a “bubble” for its players, meaning players are being confined to a hotel complex as Florida is grappling with a spike in recent weeks of COVID-19 cases. The complex also contains practice gyms for the players to workout.At the end of June, before players entered the “bubble,” the league found 16 coronavirus cases out of over 300 tested.The NBA is moving forward with a planned relaunch on July 30, with 22 teams of the league’s 30 teams participating in the conclusion of the season and subsequent postseason based at Orlando’s Wide World of Sports. Fans will not be allowed to watch in person.The league suspended play on March 11 when Utah Jazz star Rudy Gobert tested positive for COVID-19 moments before tipoff in a game against the Oklahoma City Thunder. Several games were allowed to conclude that evening, but the NBA has not held a game since. 1129

As some of you may have already found out tonight Lonnie did not make it... he passed away Sunday morning?? but Wanda told me all the love and support he was receiving put a huge smile on his face so I thank every single one of you guys for that!?????? https://t.co/tNvals0FMh— Jamal Hinton (@Jamalhinton12) April 9, 2020 329

ATLANTA — Georgia’s top elections official says his office is investigating potential election law violations by groups working to register voters ahead of January's Senate runoffs. Secretary of State Brad Raffensperger named four groups his office is specifically investigating: America Votes, Vote Forward, The New Georgia Project and Operation New Voter Registration Georgia. He says some groups are allegedly encouraging people outside the state to register to vote in January's Senate run-off election, according to The Hill. “We have opened an investigation into a group called America Votes, who is sending absentee ballot applications to people at addresses where they have not lived since 1994,” Raffensperger said Monday in announcing the investigations. America Votes responded to the accusations in a statement to the Atlanta Journal Constitution, saying they have mailed applications to those on the list of voters maintained by Raffensperger's office. The secretary is also punching back at claims that fraud has tainted the state’s presidential election. Raffensperger said dishonest actors are exploiting the emotions of many Trump supporters with fantastic claims and apparently misleading the president as well. He said during a news conference Monday that his office has 23 investigators probing 250 open cases alleging some kind of election law violation, but none of them cast doubt on the integrity of the state's election results. 1461

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