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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 end of an incredibly contentious and the heated 2020 election season ends, new research suggests that Americans are more susceptible to falling prey to disinformation depending on which state they call home.For months, Bhaskar Chakravorti and his team at the Global Business School at Tufts University have been analyzing how misinformation has been spreading during this election cycle. Where a person lives often makes them a higher target to everything from fake Facebook accounts to fake Twitter accounts and even fake headlines."We are in extremely more dangerous territory now than we were two years ago," Chakravorti explained.Bad actors, the analysis found, are more likely to target people in states that are either facing hotly contested Presidential or Senate races. Chakravorti says in places like Florida, South Carolina, Kentucky, Montana and Arkansas, voters are more vulnerable to being hit with misinformation. In places like Georgia, Illinois, New Jersey and Minnesota, residents are less likely to be bombarded by false or misleading posts and stories.A person's age, education level and media consumption all weigh into the findings.Chakravorti also says that misinformation is more likely to spread and gain traction on social media."The misinformation is asymmetric in its power,” he explained. “It travels further and faster than truth and facts."Most troublesome right now, the amount of misinformation spreading about voting, from fake stories claiming people can vote after Nov. 3 to false information about mail-in ballot deadlines. Experts also say the spread of misinformation will likely continue long after Election Day.The non-profit Common Cause has also been studying the issue closely."It can result in more uncertainty when there’s already a decrease in the institutional trust and authority that many people feel with their government," said Jesse Littlewood, who works with the group.So, what's the best way to combat misinformation?Do it on the local level. People are more likely to trust information that comes directly from their city or state officials, especially about voting."It’s a real challenge for voters to stay abreast with all that changing information," Littlewood said. 2239

As new wildfires force tens of thousands of people out of their homes, reports are emerging of flaws in emergency alert systems throughout the west."Where I think the false sense of security was, if something really bad is going to happen, we'll get alerted well beforehand," said Vacaville resident, Will Carlson.Carlson and several of his neighbors say they received no warnings as the Hennessey Fire inched closer to their homes. At around midnight, Carlson saw the flames moving quickly down a hill in the distance. Carlson was one of the last to leave, working frantically to help save animals on the property."What I remember is this sinking feeling in my stomach, and this helplessness that this barn is going to go up in flames, and the horses will be burned alive," said Carlson.After making it out safely, Carlson was left wondering how this could have happened. "Every neighbor that we talked to it was the same story, we knew there was a fire in the area, we thought that we would get alerted, and nothing was said to us," said Carlson. Le'Ron Cummings, public information officer for the Solano County Sheriff's Office, says alerts went out to these areas. However, they cannot guarantee the targeted population will get the message if cell service, internet, or landline signals are impacted. He says it was determined that cellular services and power were affected by the fire.Solano County uses the Everbridge platform to alert residents via the AlertSolano program, delivering Amber Alert-style messages. Cummings says during an evacuation, the Solano County Sheriff's Office and allied law agencies do door-to-door notifications in addition to AlertSolano messaging. The Sheriff's office also uses the High-Low Siren system familiar in Europe to advise residents to evacuate immediately.Carlson says he is frustrated with the response because he believes he had full cellular service throughout the night, texting and posting to social media as he evacuated. "So I think that's where the frustration came in from that night. How many animals could have been saved? Could there have been less loss of life? And could structures have been defended better if we had more warning?" said Carlson. Carlson says two people in his neighborhood died in the fire; however, county officials say they have no reason to believe the alert system was associated with fire-related deaths.Napa County also experienced some kinks with its alert system, when a coding error prevented an alert from going out. Emergency officials say it was an error on the part of its vendor and that the message was not urgent. Staff realized the problem, and they were able to use a different platform to send out the alert. "It happens over and over again," said Art Botterell, who is now retired from the State of California's Office of Emergency Services.Botterell led the effort to develop the Common Alerting Protocol, which he says led to the creation of the FEMA Integrated Public Warning System and some products from the National Weather Service."We've got a pretty good penetration of cellphones, sirens, and telephone dialer systems, that's not usually what breaks down. What usually breaks down is that alert is not sent in time or not sent at all," said Botterell. He says during a 2017 wildfire in Sonoma County, that would prove deadly and destructive, officials failed to send an alert, fearing it would cause panic and clog roadways. Botterell says another reason alerts are often not sent is because officials believe they don't have enough information."It is fair to say that in a lot of cases, we have not given our public safety people the tools to issue public safety warnings effectively," said Botterell. Botterell says more training is needed and believes state and federal governments should provide more guidance to ensure effective responses.With the vulnerabilities in cellular towers and alert systems as a whole, Botterell says counties must utilize several tools to try and reach everyone."We've got a lot of technology. Now we need to get good at using it." 4083

AUSTIN, Texas (AP) — Texas Lt. Gov Dan Patrick says he's offering up to million in defense of President Donald Trump’s unsupported claims of irregularities in the U.S. presidential election. The Republican said Tuesday he would pay out rewards for information that leads to voter fraud arrests and convictions. A former chief Texas ethics regulator suggested that paying reward money, which would come from Patrick’s political campaign, could run afoul of federal campaign finance laws. There's no evidence of widespread fraud in the 2020 election. 559

Ashland University in Ohio is offering a new ,000 scholarship to talented Fortnite players."Fortnite Battle Royale" will be offered in fall 2018 as part of the university's esports program.The AU esports team will be the first known program in the country to add the game to its official offerings. Head Coach Josh Buchanan is excited to add the popular game to the college's gaming titles."Fortnite appeals to both the core and casual gaming audience," said Buchanan in a news release. "We're excited to provide this platform for gamers who want to showcase their skills in a more competitive space."The team at Ashland will arrange four-player teams that practice regularly and compete together.Scholarships will be awarded to players based on skill level and academic requirements.The university plans to conduct open tryouts for Fortnite players next school year. Ashland already offers League of Legends, Overwatch, Counter-Strike: Global Offensive and Rocket League in their esports program. The coach hopes eventually other schools will for programs to set up collegiate leagues for the team to compete against.  1184