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For many of us, the word “outbreak” has taken a more personal meaning this year.For the people of Austin, Indiana, it’s not the first time they’ve dealt with an outbreak.“We’re an itty-bitty town, but we got big city problems,” said Austin resident Ethan Howard.By 2015, the opioid crisis had ravaged Howard’s hometown for years. People became hooked on painkillers and often used needles to take them. The same syringes would be passed from person to person.Dr. William Cooke arrived in Austin in 2004. Back then, he was the town’s only doctor. In fact, he was the town’s first doctor in a generation. He says he saw several issues in the southern Indiana community, including people’s health to poverty.As the opioid crisis started to wrap its grip across parts of the country, Dr. Cooke says he started to see another health issue spread in the community, starting around 2010.“What we saw was a really quick in dramatic rise in Hepatitis C around that time,” Dr. Cooke said. “Any community that has a high Hepatitis C rate is at high risk for an HIV outbreak.”By 2015, the opioid crisis had ravaged the city for years.“Opiates were my devil,” Howard recalled.Howard says his mom convinced him one day to go get tested, after he says he had shared a needle with his cousin.His test revealed he was positive for HIV.“I thought I was dead. I thought it was a death sentence,” Howard said.He wasn’t alone with testing positive for HIV in Austin.“In that first year, we had almost 200 cases,” Dr. Cooke said. “It was almost a quarter of the HIV cases in the state and this is a town of 4,200 people.”Austin had become home to one of the largest HIV outbreaks in rural America ever.Dr. Cooke helped convince then-Indiana Gov. Mike Pence to change his stance on needle exchanges.“It took a few months, but eventually, he signed the executive order allowing us to operate syringe service programs here,” Cooke said.That program, access to addiction recovery services and powerful HIV medicine has led to a dramatic drop in new cases.In 2015, Scott County, Indiana had 157 new HIV cases. In 2019, the county had only five, according to the Indiana Department of Health."The medications today are powerful enough and well tolerated enough that you should not spread the disease to anyone else and you should never worry about dying from HIV,” Dr. Cooke said.Dr. Cooke says Austin is still working to overcome some of the social challenges he found when he first arrived in the community in 2004.It’s been five years after the largest HIV outbreak in Indiana history. Like many communities across the world, this one is now dealing with the impacts of COVID-19.Nurse Jessica Howard is a proud native of Austin. She’s seen the challenges her community has faced over the years. She also sees the good in Austin, pointing to a local church pantry providing food and clothes to those in need.Jessica Howard in charge of coronavirus testing at Dr. Cooke’s office. She grew up in Austin and knows many of the patients that come through the door.As of early July, Scott County has not seen a large amount of coronavirus cases like other parts of the country, but the nurse worries about her patients that struggle with addiction who are now in quarantine and could relapse."These are people these are our people and we have to take care of them and protect them,” she said.Austin has come a long way from where it was in 2015, when HIV spread through a large part of the community.Last year, Dr. Cooke was named by American Academy of Family Physicians the AAFP 2019 Family Physician of the Year for his efforts to help stop the 2015 HIV outbreak.As for Howard, he says medication has made it so HIV is no longer detectable in his blood.He now travels as a musician and points to music as a source of strength that helped him through the darkest of times.“I fought and clawed my way out of a dark place,” Howard said.His fighting spirit is one this small Indiana city has used to battle through crisis before.“We’ve been through a healthcare disaster before,” Dr. Cooke said. “And there is a light on at the end of a tunnel.”It’s a mindset Dr. Cooke says we need now, as we all fight this new crisis of a coronavirus pandemic. 4221

Former President George H.W. Bush was taken to a hospital in Maine on Sunday after experiencing low blood pressure and fatigue.Bush's spokesman, Jim McGrath, said in a tweet Sunday afternoon that the President, who is 93 years old, will likely remain at a Southern Maine Health Care facility "for a few days for observation.""The former president is awake and alert, and not in any discomfort," McGrath continued.Bush was previously admitted to a Houston hospital last month after contracting an infection that spread to his blood the day after a funeral was held for his wife, Barbara Bush. He was discharged from the hospital on May 4. 660

Forget about drones and armies of people driving Amazon trucks. One big Wall Street firm thinks Amazon's plan to build up its air freight delivery service may be what really winds up hurting UPS and FedEx.Morgan Stanley analyst Ravi Shanker said in a report Tuesday that both delivery giants could lose 10% of their revenue to Amazon Air by 2025. Shanker cut his price targets on UPS (UPS) and FedEx (FDX) and both stocks plunged more than 6% as a result.It was a particularly gruesome day for transportation stocks due to worries about the broader economy and confusion about the status of US-China trade talks.The Dow Jones Transportation Average, which includes FedEx and UPS as well as leading airlines, truckers and railroads, fell 4.4% -- its worst drop since June 2016.But Shanker paints a picture that should be extremely worrisome to UPS and FedEx.He notes that Amazon (AMZN), which currently is leasing 40 cargo jets, could eventually have 100 planes running and estimates that the planned Amazon Air routes could overlap with more than two-thirds of the volume flown by UPS and FedEx.That's bad news for both companies since Shanker said that UPS and FedEx each generate nearly 20% of their overall revenue from US air deliveries.Amazon has made big investments to bulk up Amazon Air. In the past few years, it has bought stakes in two freight delivery airlines -- Air Transport Services Group (ATSG) and Atlas Air Worldwide Holdings (AAWW).It also announced plans to invest .5 billion in order to build an Amazon Air hub on more than 900 acres of land that it is leasing near the Cincinnati/Northern Kentucky International Airport. Amazon bought an additional 210 acres earlier this year.There's a simple reason why Amazon will want to handle more of its own air deliveries. According to Shanker, Amazon could save between billion and billion next year. That works out to about 3% to 6% of its global shipping costs.But on a day when the broader market was tanking, investors didn't seem too enthusiastic about Shanker's thoughts on Amazon either. Shares of Amazon fell nearly 6%. 2113

For these 3,000 teens, there's no such thing as going back to normal.On Wednesday, they'll return to the same school where 17 of their classmates and teachers were gunned down. But instead of math and history lessons, their minds will be occupied by the trauma of gunfire and grief."I don't think I'll ever recover from this," said Daniel Bishop, a sophomore at Marjory Stoneman Douglas High School. "How am I supposed to (go back to) a place where 17 of my peers were slaughtered?"  496

For the first time, we are hearing from the accused Antioch church shooter. Emanuel Samson is charged with killing one and injuring six others.He's locked up, but makes calls from his cell and all of them are recorded. Nashville-based WTVF obtained an exclusive copy of those recorded calls.They provide a first look at the mindset of an accused murderer.The 25-year-old Samson is being held in the Davidson County Jail. He's said very little to police, but Samson does plenty of talking by phone."This honestly reminds me of our childhood, you know. You're locked in a room or a house. You're locked in a room. You're locked in your house," said Samson in one call, describing jail life.Samson's now spent the past month in the county jail – held without bond – and in this call he seems to be settling in."You know it's about meditating on the fact that I literally can't afford not to be strong. Period. By any means necessary," said Samson.He's made more than 140 calls in the past month, mostly collect to friends and family. It seems he's been warned by his attorney not to talk about his case, though he may at times, speaking in what sounds like his native Sudanese language.However, we did not hear Samson discuss the murder of Melanie Crow Smith or the other felony charges to come. In conversations – especially with a girlfriend – both she and Samson seem oblivious to the seriousness of the charges against him."Please dream about me baby. I dream about you every night," she said. "Aw, baby, we had so many plans for our future. You know?""And we still do. So many plans. Don't say we did because we still do," Samson told her. "I'm trying to keep my mind positive."There were reports that Samson was suicidal in the months before the shooting at Burnette Chapel Church of Christ.In one call, Samson talked about the gunshot wound he suffered to the leg during a scuffle with the church usher. There was a lot of blood. He thought he might die."When that happened? Did you think 'this is it… that I'm leaving,'" asked his girlfriend."Yeah," said Samson."Did it feel good," she asked. "Leaving?""I just think that you… yeah? Um, in a sense. In a way. In terms of pain," said Samson.Investigators have pointed to Samson's troubled past. Samson himself talked about something he called vibrating energies – referring to a depressing childhood."That's how we have these low vibrating energies within us now. The sad. The sorrow. Because we grew up in a very low vibrating household. Always drama," said Samson.Samson also talked about everything from his favorite video games to how a friend was doing in school. Not once do you hear him tell his family or friends he did not commit the crime.The case against Samson is in the hands of the Grand Jury. Federal prosecutors are also still investigating whether this is a hate crime. 2858