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Rural hospitals across the country are in a difficult spot right now. COVID-19 is hitting them harder than many metropolitan hospitals as they deal with issues of lower staffing.According to the National Center for Biotechnology Information, about 20% of our nation’s population lives in rural areas, yet less than 9% of our nation’s physicians practice there.Add on the fact that according to CDC data, COVID is killing rural Americans at a rate 3.5 times higher than those living in metropolitan areas, and this issue is affecting staff and patient care.“I’m very worried about rural health care because rural health care is teetering on the brink right now,” said Dr. Kurt Papenfus, an ER doctor at Keefe Memorial Hospital in rural Cheyenne Wells, Colorado. “There’s a darkness in this illness that I can’t say I’ve said about any other illness.In late October, Dr. Papenfus contracted COVID-19 as he was traveling back from the Northeast to visit his daughter.“I was very cognizant and was wearing a mask at all times, social distancing, and washing my hands,” Papenfus said. “But I remember having this thought on the train that this is a super-spreader event.”When he got home, Papenfus got tested and was confirmed positive for COVID-19. The diagnosis put Keefe Memorial in a tailspin as he served as the only ER doctor in the small 25-bed hospital.“We are a trauma level four hospital so keeping that physician on staff 24/7 is what we are required to do,” said Stella Worley, Keefe Memorial’s CEO. “And it is getting to be more of a challenge to have hired physicians out here in rural [America].”Within minutes of learning of Dr. Papenfus’ COVID-positive diagnosis, Worley was on the phone with several different hospitals working to find a replacement. Within a few hours, they had settled on a former ER doctor who moved to another hospital in Texas a few months prior.After she agreed, Keefe Memorial paid the doctor to drive 10 hours from Texas to Colorado and fill in immediately as Papenfus recovered at home for the next two weeks.“Worst-case scenario is you would have to divert patients if there’s no one in the door to care,” said Worley.Populations in rural America tend to be older, poorer, and less insured than the nation at large, according to the National Conference of State Legislatures.Since 2010, hospital closures in rural America have been growing as there have been 118, including 17 last year.The closures only exacerbate a growing lack of health care coverage in rural America, said Dr. Dan Derksen, a rural health care expert and family physician“Once a critical access hospital (25 beds with a 24/7 emergency department and at least 35 miles from another facility) closes, they almost never come back,” he said. 2756

SACRAMENTO, Calif. (AP) — The enthusiasm both parties say exists in the electorate hasn't yet translated into early voting in California, where the percentage of people who have voted so far is similar to this time four years ago.Voters who are Republican, white and older are sending in their ballots early at a higher rate, which is typical in California elections, said Paul Mitchell of Political Data Inc., a firm that collects voter data from the counties.About 570,000 Californians had cast ballots as of early Monday. That's about 100,000 more than voted at this point in the 2014 election. About 12.5 million people received mail-in ballots, compared to 9.2 million four years ago.RELATED: What you need to know about voting this NovemberThe early numbers are just a fraction of the total voters expected to cast ballots by mail. California voters can send in their ballots through Election Day, on Nov. 6, and ballots are counted as long as they are received by the Friday after the election.In 2014 roughly 4.5 million people cast mail ballots."Right now it's hard to tell exactly how much we're measuring enthusiasm and how much we're measuring changes in the mechanics of the elections," Mitchell said.Monday is the deadline to register to vote, although people can register conditionally through Election Day. Their ballots will be treated like provisional ballots that are counted after the voter information is verified.Statewide, Republicans count for just a quarter of registered voters. But they make up 34 percent of early voters.RELATED: See your sample ballot for the November 2018 electionEighty percent of already returned mail ballots are from voters older than 50, even though they make up only about half of the electorate.Democrats need strong turnout to win U.S. House seats in Orange County and the Central Valley that have long been held by Republicans. They're banking on increased enthusiasm among voters angry at President Donald Trump or concerned about issues such as health care and immigration to drive turnout."For Democrats to win these competitive congressional races they need atypical," Mitchell said.Drew Godinich, a spokesman for the Democratic Congressional Campaign Committee, said Latinos and young voters are "outpacing expectations" in key districts and that it's too early to jump to conclusions about turnout."In these tight races, every vote counts — and Democrats have been organizing since last year to turn out our voters in these crucial midterms," he said in a statement.More than 19 million people registered to vote as of early September, a record in a California gubernatorial election.Mitchell predicts a 56 percent voter turnout. That would be higher than the 2014 election but lower than 2010. 2774

ROME (AP) — Cruise ship passengers had temperatures checked and took COVID-19 tests Sunday so they could set sail on what is being billed as the first Mediterranean cruise after Italy's pandemic lockdown. The cruise ship company MSC has made the procedures, for crew as well as passengers, part of its new health and safety protocols. The MSC Grandiosa departed from the port of Genoa on Sunday evening for a seven-night cruise. Earlier this month, the Italian government gave its approval for cruise ships to depart from Italian ports. The cruise around the western Mediterranean was limited to 70% capacity but MSC declined to say how many passengers were on board. 675

Retirees should be spending their time golfing, taking vacations and playing with grandchildren. Instead, one Ohio man is doing the opposite.Robert Blocksom, 87, is looking for a job, and he’s not alone.“It's definitely a trend. The bureau of labor statistics is predicting an increase over the next five years," Lori Long and Entrepreneurship Professor at Baldwin Wallace University said.In the last year, nearly 300,000 Americans 85 and older were working. That number is up 3 percent from the start of the 2006 recession.Industries, like the trucking industry, who years ago might not have given Blocksom a shot, could now do just that.“The shortage of drivers spans the entire country and virtually every trucking company in the United States," Frank Gagyi, President of the Buckeye Interimobile Trucking company in Cleveland said.And that’s where Blocksom is hoping a door will open.“I've always liked driving, so I figured that I'd like to be able to make some money driving," he said.Since his wife's been ill, he's had to sell his home, mobile trailer and other assets to cover expenses. Now he says trucking is a practical solution for income.“That would be the best way to do it," he said.And though it’s something he has to do, he’s pretty optimistic about trying something new."I believe I can do this pretty well, and it would be a nice challenge and it'd be fun,” he said.Blocksom still has to pass his commercial driver's licenses test for him to start working. His classes for that test start next month. He said the ideal shift would be local weekend trips, so he can still care for his wife.  1638

ROCKFORD, Ill. -- As many police departments continue to struggle to reflect the diversity of the cities and municipalities, some are looking to a return to old school policing as a solution. One city grappling with violent crime is embedding officers in the thick of it. It’s a way to have a personal stake in policing their own neighborhood.Eighteen-year police force veteran Patrice Turner knows the streets of Rockford, Illinois, like the back of her hand.“This is my stomping grounds," said Turner. "I used to walk up and down this street. You know when I went to West Middle School here.”She grew up in Rockford, a town about 75 miles northwest of Chicago that has one of the highest crime rates in the country.“I drive through the lot and make sure it's OK. It’s actually been robbed a few times,” said Turner as she patrolled her route near a shopping center.For the last three years, she’s been part of a unique policing program working as a resident officer community keeper or ROCK.“They're actually living in that community,” explained Rockford’s assistant deputy chief, Mike Dalke. “They have a car squad car that they take home that's parked in front of their house and their job really is to build capacity, build trust within that community."Turner lives rent-free, embedded in the community. Her name and number are boldly displayed outside her house.“So yeah, there is there is little sense of anonymity, that's for sure,” said Turner.Police residency requirements fell out of favor in the early 20th century.According to government data, in 75 U.S. cities with the largest police forces, on average 60% of police officers live outside the city limits.Research suggests residency requirements don’t necessarily translate to public confidence in the police.Still, the ROCK program hopes personal interaction will build trust at a time when relations between police and communities of color across the nation are inflamed.Turner knows mending those relationships won’t come until the fractures of the past are dealt with.She says she’s trying to do that as an officer who has a vested stake in the community.“You form stronger bonds, you know people no longer see you as just a police officer. They see you as a human,” she said. “They see the officer as the person behind that uniform.”The department says it plans to hire a third ROCK officer soon and believes the model could work in other cities and municipalities. 2443