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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 so many massive data breaches have shown, there's no way to completely protect your information from swindlers.But being aware of fraudulent schemes — especially during tax season — can minimize your bad luck. And it can protect you from IRS penalties, interest and in some cases criminal prosecution if you fall for them.Here are 12 of the biggest tax scams the IRS is flagging this year:1. Phone scams: Put simply, anyone who calls or texts you unsolicited and claims to be from the IRS is a fraud. The IRS will never call, text or email you out of the blue. It will never ask you to wire cash or provide bank and credit card numbers. It will never call to threaten you with arrest or deportation.So, if you're contacted, don't give out any information about yourself. Just hang up.2. Phishing: Emails enticing you to click on a link and give up personal information (name, Social Security number, bank account numbers, etc.) are a scourge of daily life.This tax season the IRS is seeing a new twist on phishing: Unexpected deposits of tax refunds in your bank account.Criminals who've stolen your tax and banking information from elsewhere file a fraudulent tax return in your name and have the refund deposited in your account. They then will contact you by phone or email pretending to be from the IRS or a collection agency, claiming a refund was deposited erroneously in your account and ordering you to send it to them.In other email schemes, criminals may pose as your bank or other legitimate institution you know to get you to fork over your passwords, Social Security number and other valuable information.3. Tax return preparer fraud: Most tax preparers may be honest. But there are still many unscrupulous ones.One telltale sign of a fraudster: They base their fee on the size of your refund and encourage you to take tax breaks you're not entitled to or to under-report your income to inflate your refund.Another: They don't insist you give them records and receipts. Or they ask you to sign a blank return.Before giving any information to a new preparer, ask for an IRS Preparer Tax Identification Number. You can also search the IRS directory of credentialed preparers. If he says he's a CPA, check your State Board of Accountancy. Or for attorneys, check with your State Bar Association.Also, make sure he can e-file returns. Preparers who have more than 10 clients have to be able to do that.4. Falsely inflating refunds: Scam artists posing as tax preparers may file false information on your return all for the purpose of inflating your refund.They may report deductions, credits or exemptions you don't qualify for. Or they may try to report your taxable income as zero through the use of bogus forms.5. Falsely inflating income: Some fraudsters try to inflate your income — reporting wages or self-employment income you didn't earn — to qualify you for a refundable credit like the Earned Income Tax Credit.6. Falsely padding deductions: Some tax preparers may encourage you to overstate your deductions, such as charitable contributions, to get a larger refund or reduce what you owe.7. Improperly claiming business credits: If a tax preparer encourages you to take a business credit like the research and development tax credit or the fuel tax credit, make sure you're eligible first.Here's a break down of how to qualify..8. Making frivolous tax arguments: Did you know that the First Amendment lets you refuse to pay taxes on moral or religious grounds?Well, it doesn't.But anyone who tries to snooker you into believing that it does — or tries to sell you on other too-good-to-be-true ideas — is encouraging you to engage in frivolous tax arguments to lower your tax obligations.9. Abusive tax shelters: If someone tries to sell you on the idea of protecting your money from taxes through a complicated scheme, be wary. It could be an illegal tax shelter.The IRS this year is particularly attuned to so-called "micro-captive" insurance structures. While some are legitimate, there are cases where "promoters, accountants, or wealth planners persuade owners of closely-held entities to participate in schemes that lack many of the attributes of genuine insurance," the agency noted.Before signing on to any type of shelter: Ask the person trying to sell you the product whether she's collecting a referral fee from anyone, and get a second opinion about the set-up from a trusted, independent tax adviser.10. Fake charities: Groups asking for money that have names or websites very similar to well-known charities may be scams. To verify whether they're a qualified charity to which contributions are tax deductible, ask for the group's Employer Identification Number and enter it into the IRS Exempt Organizations Select Check.11. Hiding money offshore: There is nothing wrong with having money offshore so long as you report your foreign accounts to the IRS every year, and pay whatever US taxes are owed on them. But if anyone tries to sell you on an account in another country or non-US territory and promises your money will be protected from US taxes and IRS detection, that's likely an offshore tax cheating scheme.12. Identity theft: The good news is reports of tax-related identity theft have gone down. The bad news? It's still a big risk. Thieves armed with your Social Security number or Individual Taxpayer Identification Number can file a return in your name and claim your refund before you do.The best way to protect yourself is to be vigilant about not falling for the most prevalent tax scams listed here.And never give your personal information to untrustworthy sources.  5633

At a White House news conference on Friday, leaders of Operation Warp Speed said that two coronavirus vaccines could receive emergency use authorization from the FDA in the coming weeks.In addition, Dr. Moncef Slaoui, who is the scientific head of Operation Warp Speed, projected that up to 20 million coronavirus vaccines could be shipped by the end of the year."If approved, they could be used for immunization in the U.S. population in the month of December," Slaoui said. "And we plan to have enough vaccine doses available for use in the U.S. population to immunize about 20 million individuals in the month of December, and another 25 to 30 million per month on an ongoing basis thereon."Given that doses of the two vaccines come in two doses, it could take many months and be well into 2021 before the majority of the American population is vaccinated against the coronavirus.The update came as the virus spreads throughout the country at an alarming and uncontrolled rate. At least 100,000 Americans are confirmed to have contracted the virus every day for the last 10 days, culminating in a record-shattering 153,000 cases on Thursday. Hospitalizations linked to the virus have reached all-time highs since the pandemic began, and deaths linked to the virus are beginning to tick up as well.The update also comes days after Pfizer announced that its vaccine candidate has been 90% effective in Phase 3 trials. The company says it is on track to apply for Emergency Use Status by the end of the month, meaning that some Americans could receive the vaccine before the year's end.New York Gov. Andrew Cuomo, who said his state would independently review vaccine candidates before authorizing distribution to the state, was a frequent target during Friday’s news briefing.“Vaccines will be allocated pro rata by population so we ensure fair and equitable across. We need the states who are part of the planning to accept the vaccine,” saidArmy General Gustave F. Perna, who is overseeing logistics and distribution for Operation Warp Speed. “We are working closely along with the CDC, the jurisdictions and states to ensure vaccine can safely and quickly get to those who need it first.”Trump blasted Cuomo for utilizing an independent review process separate from the FDA. "We won't be delivering it to New York until we have authorization to do so," Trump said. "That pains me to say that. This is a very successful, amazing vaccine that 90% or more. The governor, Gov. Cuomo will have to let us know when he's ready for it. Otherwise, we can't be delivering it to a state that won't be giving it to its people immediately. I know the people of New York very well, I know they want it. The governor will let us know when he's ready."Pfizer said it expects to have 50 million doses of its vaccine ready for global distribution by the end of 2020, and 1 billion doses globally by the end of 2021. That's why other vaccines are also being looked in hopes of getting as many Americans vaccinated as soon as possible. Trump and others on Operation Warp Speed confirmed that health care workers and the elderly would be first to receive doses of the vaccine. Dr. Anthony Fauci, the Trump administration's top infectious disease expert, predicted earlier this week that the vaccine would be widely available in April.Previously, Trump had suggested that a vaccine would have been approved in October and widely available by the start of 2021. Project Warp Speed leaders, however, credited the federal government's response to the virus even if the vaccine has not been distributed as quickly as previously suggested.Friday's remarks were Trump's first on-camera comments since Joe Biden was projected as the winner of the presidential election. Trump had not delivered comments to the press on-camera since Nov. 5, when at a press conference in the White House press room he falsely claimed he would win the presidential election on still-baseless claims of widespread voter fraud.Trump has appeared on camera just once in the last week — a Veteran's Day appearance at Arlington National Cemetery at which he did not speak.Trump's extended media blackout is out of step with the first four years of his administration. Trump has rarely shied away from speaking with reporters, as he often makes himself available for on-camera interviews with the White House press pool on the front lawn and has taken to calling friendly media outlets for phone interviews.However, since last Thursday, Trump has only delivered statements through his Twitter account, where he has continued to spread misinformation about the 2020 election. In the past week, Twitter has taken action on about 50 of Trump's tweets or retweets — be it adding a link to more information, adding a fact check or hiding the tweet from timelines completely. 4827

As mixed messages continue regarding face coverings, Mississippi became the first state to lift a statewide mask mandate. Cities and towns can now put their own rules in place.The governor said the facts and data still show masks work, and the state is still requiring them at certain events, including the state fair that starts this week.“I suspect Mississippi will see an increase in cases if people stop wearing face coverings,” said Dr. Amesh Adalja with the Johns Hopkins University Center for Health Security.Infectious disease experts remind people just because an order may be lifted, doesn't mean they should stop wearing masks.“We have to have an effective vaccine to prevent people from getting infected as well as prevent them from getting severe disease, that we had adequate testing capacity so people could know their status and wouldn't go out into public if they were positive,” said Adalja. “I think short of that, masks are going to be one tool that we have to continue to use and many people are going to get accustomed to masks and they're going to realize that masks also likely have some impact on other respiratory viruses, so we may see mask wearing much more common in the United States, similar to what it is in other Asian countries, because of the value people are gaining from them.”New research on homemade cloth masks found they expel invisible cotton fibers into the air. It’s unknown if those fibers can carry infectious viral particles, which drives home the point of washing any cloth facial coverings. Make sure you do that regularly. 1580

At Monday’s NASCAR event at Talladega Superspeedway, drivers and crew members stood in solidarity with Bubba Wallace, a Black NASCAR driver who said he found a noose in his stall on Sunday.The drivers pushed Wallace’s car to the front of the field moments before the race got underway. 293

来源：资阳报