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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 coronavirus outbreak has put a hold on many things over the last few months, including some elective surgeries.When Nohely Uriostegui and her husband, Jose Pava, found out they were pregnant with a little boy, they were ecstatic. Then, the unfortunate news: their baby had spina bifida."After that, she said we’re going to do a test. You might be eligible for an in-utero surgery," said Uriostegui.That means surgery while the baby is still in the womb, and it had to be performed before 26 weeks of pregnancy. Everything was set up to go in Chicago until a phone call came from her doctor."He said, 'You know what? Based on COVID, everybody here on the team doesn’t feel like it’s an essential type of surgery,’" recalled Uriostegui.The same situation was unfolding for all types of patients around the country. Those hoping surgery could help their chronic pain were told they’d have to endure it for months longer. Organ transplant candidates were forced to wait as well. For Nohely and Jose, a delay meant they might miss their window to help their baby. But then, hope from three states away in Colorado."For this family, the clock was ticking. She had until she was 26 weeks to have fetal intervention, and that was literally five days, four days away. And they had to get from Chicago to here, be evaluated, have surgery set up to be performed, and so, we were able to do that for them," said Colorado Fetal Care Center surgeon Dr. Ken Liechty.The couple decided to travel to Colorado to have the procedure done."I got there on the 4th; my surgery was set for Monday, April 6, which was the exact same date that I was going to get it done in Chicago, and it was one day before I hit the 26-week mark," said Uriostegui."It’s open fetal surgery on the fetus as the actual patient," said Dr. Liechty. "We excise the cyst, we put the spinal cord back into the spinal canal."Doctors then put the muscle back over to seal it, close the skin over it, and then close the uterus. Without the in-utero surgery, Dr. Liechty says 90 percent of babies with spina bifida have a shunt put in to decompress the brain. However, that likely wouldn’t have been the only surgery he would have needed."These shunts fail, they can get infected, they can have all kinds of problems, they average seven surgeries at least for these shunts in their first few years of their life," said Dr. Liechty.In the time of this pandemic, that could mean more waiting as hospital beds begin to fill back up with coronavirus patients."COVID-19 caused a lot of places around the country to reexamine what cases could be done in their facilities, and a number of fetal centers are actually located in adult centers," said Dr. Liechty.Those places are filling up faster than children's hospitals, causing families like Uriostegui and her husband to almost miss opportunities to help their children before they even enter the world."The neurosurgeon over there actually said to us last time, that if you were to look at him, you would have never guessed that he’s born with spina bifida or that we went through this whole journey," said Uriostegui. 3126

The first day of October might seem like an odd time to talk about summer camp, but one business has found a way to keep its operation running overtime during the COVID-19 pandemic.Camp Sea Gull is located on a remote part of the North Carolina shore. Typically, it accommodates thousands of campers a year. But once COVID-19 hit, that changed and put the camp in a precarious position along with so many other businesses.“It was really difficult,” said camp director Allison Simmons.Simmons said the camp was able to open this summer but only with a fraction of its normal participants. So, to try to attract more people, she had the idea of opening the bunks to families who wanted a change of scenery as they work or learn from home.“To me, this is giving a lot of our parents and students some hope in breaking up the monotony of whenever their school started,” said Simmons.The reservations allow families to stay at Camp Sea Gull for up to seven days, and Simmons, along with other administrators, came up with five different activity programs for families.The camp installed high-speed WiFi throughout its buildings so parents and their kids could access it during working hours, while it worked to offer activities afterward.A normal day might include opportunities to fish, sail, canoe, and play games from 3 p.m. to sundown.“[Before coming to camp] my kids were all sitting in their rooms by themselves for 6 or 8 hours a day in front of a screen, and that’s just not normal for kids,” said Stan Coerr.Coerr says he has been coming to Camp Sea Gull for 40 years--first as a camper, then as a counselor, and now as a dad who wants to plan a getaway with his three sons ages 20, 16, and 14.“I told my boys [the pandemic] won’t be the worst thing you go through but it will probably be the weirdest,” said Coerr. “And as much as I can get them out and doing things as a family, which is kind of rare these days, I will definitely take that opportunity.”Coerr says the four of them stay in the same bunk and have each claimed a portion of it for their work. Since being at camp for a few days now he says he has noticed his sons are more attentive to their schoolwork and bicker less.It has also allowed Simmons’ business to flourish. She says camp can now stay open past August, when it would end during a normal season.She says 75 percent of the people who have signed up are new clients as well. 2412

The coronavirus pandemic is forcing school districts that choose to reopen for in-person learning to do so with precautions.While many school corporations have posed ideas for protocols, not all have decided on a final plan.In the animation above, we imagine what a day at school might look like, using ideas from districts around the United States. 357

The E.W. Scripps Company is a partner with The Associated Press and has been following guidance from their election desk on 2020 race updates.From Wednesday through Saturday, Joe Biden had a projected total of 264 Electoral College votes, six shy of the number needed to become president. As Election Day ground on into “election week,” it became increasingly clear that Biden would oust President Donald Trump from the White House. The question, rather, was where he would win, when it would happen and by how much, as late counted ballots in Nevada, Pennsylvania and Georgia continued to keep Biden in the lead and offered him multiple paths to victory. On Saturday, Biden captured the presidency when The Associated Press declared him the victor in his native Pennsylvania at 11:25 a.m. EST, garnering the state’s 20 electoral votes, which pushed him over the 270 electoral vote threshold needed to win. 914