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Their island getaways went bad in ways that sound similar: crippling stomach cramps, explosive diarrhea and malaise that lasted after they returned home.But in some ways, they consider themselves lucky. They survived their trips to the Dominican Republic.As reports of American tourists dying in the country continue to grab headlines, some travelers who fell violently ill tell CNN they wonder whether they may have escaped a worse fate.More than a dozen reached out to Kaylynn Knull and Tom Schwander, a Colorado couple who were the focus of a CNN story this month, to share their accounts of being sickened. CNN interviewed most of them. Their experiences ranged from what they felt was most likely food poisoning or a virus to what seemed to be dire reactions to chemical contaminants.Like the Colorado couple, several travelers said they smelled a strange, intense chemical odor in their hotel rooms before getting sick. Knull and Schwander said they were nauseous, drooling uncontrollably, sweating, teary-eyed and experiencing stomach cramps. Their sickness continued for days after they returned home. Their US doctors suspected possible poisoning by a compound found in insecticide, and the couple are now suing the owners of the resort.Of course, travelers get sick all the time, and it's still not clear whether the deaths or sicknesses are connected. The FBI is assisting with toxicology testing in at least three of the recent American deaths. The bureau is analyzing samples from at least one deceased couple's minibar, according to a Dominican Republic Ministry of Health spokesman.Dominican officials have called the deaths isolated and have stressed that the country is safe.'You're not going to die,' he told herTina Hammell, from northeastern Ontario, said she was in tears as she read about Knull and her boyfriend.Hammell, 49, and her husband, John, said they went to a resort in the Grand Bahia chain, Grand Bahia Principe Punta Cana, in 2016. They were looking forward to the trip -- a celebration of a successful sales season at a Yamaha dealership they run. On the second day of their trip, they retired to their room for a nap. Tina said she woke under the air conditioning unit in their room. "My throat and nose were on fire," she recalled. "It smelled like paint.""She jumped up and ran outside, coughing and hacking," John said. He was also overwhelmed. "It stung bad."They called the front desk and a worker showed up to their room, they said, and sprayed what seemed to be a disinfectant. The Hammells demanded another room and there got a decent night's sleep. The next morning, Tina was in bad shape. She was nauseated and covered in sweat, had lost her voice and was increasingly struggling to breathe. The couple tried to take a walk, but she couldn't muster the strength. Chest pains set in.John and Tina went to the medical office on the property. It was closed, they said. They tried to eat and get some sleep. The following day, Tina was worse. John called for help from their room, demanding that management find a way to take them to another section of the sprawling resort where there was another medical facility.John broke down as he remembered watching helplessly as his wife's body began convulsing. She buckled into a fetal position and her hands twisted with muscle spasms."She kept passing out while I was trying to hold her," he said. "I said, 'You're not going to die. You're not going to die.'"At the medical center, a doctor managed to revive Tina, John Hammell said, at one point using a defibrillator.She was transferred to a hospital where she stayed for at least four days and doctors found lesions on her lungs, medical records show. They checked out only because they couldn't miss their flight home, John Hammell said.Back in Ontario, the couple said, Tina saw doctors who told her that the Dominican Republic physician might have saved her life. But they couldn't figure out what caused her symptoms."'You've been poisoned,'" John Hammell recalled physicians saying to his wife, "'but we don't know from what.'"Three years later, the couple says, doctors are treating her for lung and heart problems she said she did not have before her trip to the Dominican Republic, though doctors haven't been able to say for sure what the cause is."I had no idea there were other people," she told CNN, weeping.Hammell has read news in the past month about some of the US tourists who have died or fallen ill. Those include some who stayed at the same resort, such as 51-year-old Yvette Monique Sport of Pennsylvania, whose sister, Felecia Nieves, told CNN that Sport died at the Punta Cana facility in June 2018.Nieves said her sister had drinks, including a beverage from the minibar, then took a shower and went to bed. Her fiancé found her dead the next day.A year after Sport's death, her sister said the family still has not been given results of a toxicology test.Alba Mingo, the head of trade marketing at Bahia Principe Hotels & Resorts, declined to comment on specific cases, citing the company's cooperation with authorities in the ongoing inquiry into the incidents.Mingo said the chain's health and safety policies include "sanitation and disinfectant efforts, strict quality standards for the food and beverage items we serve to our guests and an action plan to respond to any reported cases of illness. ... We regularly audit all hotels in respect to health and safety and consistently receive high certification scores for hygiene."'I will never go back there'Elsewhere in Punta Cana, Jake Spruill of Virginia told CNN that he and his family had a terrible vacation at the Majestic Elegance resort in 2017. He, too, described an overwhelming chemical smell in his room.He and his wife plus two family members and their spouses went to the Dominican Republic to celebrate Spruill's 40th birthday.When he and his wife opened their room, they were hit by "an incredibly, overpowering smell that I would consider a chemical smell."His throat and nose felt mildly irritated, he said. They complained to management. "The response was 'We cannot move you. I'm sorry, we can't move you,'" Spruill said.The couple left to spend time in the resort. When they returned, it smelled like someone had sprayed air freshener to cover the chemical smell. It didn't work."We decided to avoid the room at all costs," and try to let the air conditioner run, Spruill said. He and his family members "felt a little off." They were drinking, sure, trying to have a good time. But something didn't feel right, he said. His wife started to have gastrointestinal distress. His eyes burned and watered.Spruill's brother-in-law, Richard Brumfield, said when he went to his room he noticed a smell."It was almost like adhesive," he said. "It was extremely noxious."Brumfield said that when he complained about the chemical smell, the hotel staff put scented candles in his room, which did nothing to help.Within three days, Brumfield said, he started to feel "deathly ill." He lost his appetite, had horrible stomach cramps and felt exhausted, symptoms that lasted nearly three weeks.He and Spruill said that they drank a shot of Patron at the resort that did not taste like Patron, and both suspect the alcohol was adulterated.Neither went to the doctor or ever received a diagnosis. When they got home, they didn't communicate with the resort."I will never go back there," Spruill said.In a written response, Ricardo Espinosa, vice president of sales and marketing for Majestic Elegance, told CNN that "all the bottles used in our hotels, both in our bars and our minibars, are genuine and unadulterated."Espinosa did not address the smell the men described, but he stressed Majestic Resorts' emphasize hospitality and noted that the hotel has "a very good reputation and image."Deaths under investigationThose who came back from vacation to weeks of sickness have had new context for their experience since news of American deaths started to emerge a few weeks ago.As of last week, Joseph Allen of New Jersey, 55, became at least the ninth U.S. tourist in a little more than a year to die at a Dominican Republic resort, his family said. The cause of his death is unclear.Leyla Cox, 53, died June 10 in her room at Excellence Resorts in Punta Cana, according to the hotel. A statement from the resort, citing a forensics report, said she suffered a heart attack, but CNN has not independently verified that.Other deaths include Nathaniel Holmes, 63, and Cynthia Day, 49, who were found dead May 30 at Bahia Principe La Romana. Dominican authorities said both suffered internal bleeding, including in their pancreases, and that Holmes had an enlarged heart and cirrhosis of the liver. Day, authorities said, had fluid in her brain. Toxicology reports are pending, and an investigation is underway into the deaths.Days earlier, Miranda Schaup-Werner died at the same resort. She had a drink from the minibar, felt ill and sometime later collapsed and died. A preliminary autopsy cited by the Dominican Republic's Attorney General's Office said she suffered a heart attack, pulmonary edema and respiratory failure. Her death is also under investigation.Overall, a U.S. State Department official said, "We have not seen an uptick in the number of U.S. citizen deaths reported to the Department" in the Dominican Republic. The State Department said it is closely monitoring investigations, and that the FBI has said toxicology testing could take up to 30 days.The department has a standing travel advisory for the Dominican Republic due to crime, but it has not issued an alert related to the resort deaths. 9659

The Senate on Wednesday passed legislation to make it easier for businesses struggling during the coronavirus pandemic to take advantage of a payroll subsidy program that’s been a central part of Washington’s response to the corresponding economic crisis.The Senate passed the bill by voice vote after a handful of GOP opponents gave way. The measure now heads to President Donald Trump for his expected signature.The legislation would give business owners more flexibility to use taxpayer subsidies for other costs and extend the lifespan of the program as the economy continues to struggle through record joblessness and a deep recession.It passed the House overwhelmingly last week on a 417-1 vote, but was briefly held up this week as Republican leaders sought to placate opponents such as Wisconsin GOP Sen. Ron Johnson.The legislation would lower an original requirement that at least 75% of Paycheck Protection Program money be used on payroll costs, reducing that threshold to 60% of the loan. It would also lengthen the period in which PPP money must be used — and still permit businesses to have their loans forgiven — from eight week to 24 weeks.Critics say the pending measure does nothing to ensure that businesses that don’t necessarily need PPP subsidies are ineligible, among other problems.“If we’re going to potentially authorize more spending, that program needs to be reformed,” Johnson told reporters. “My main problem with what the House did — and this is what’s in dispute — it basically reauthorized the program through Dec. 31, setting up a massive new infusion into the program without the reforms I think really need to be placed so that people who don’t need it don’t keep getting it. We don’t have an unlimited checkbook.”But the bill had strong support among both Republicans and Democrats and the backing of powerful business groups, which strengthened the hand of supporters like top Senate Democrat Chuck Schumer, who had failed earlier Wednesday in his own attempt to orchestrate passage. At that time it became clear Johnson’s resolve to block the bill was fading and Schumer and Majority Leader Mitch McConnell, R-Ky., reprised the effort only hours later.“The impact of this crisis is long lasting, and requires lenient terms. We have all heard from small businesses in our states ... that (PPP) needed some changes to make it work for so many small businesses that had been left out or rejected,” Schumer said.All told, Congress has approved 0 billion for the program in two installments. After an initial burst of loans emptied the program in just two weeks, demand for PPP funding has dwindled amid griping from some business sectors that there are too many restrictions in order to qualify to receive loan forgiveness. Businesses receiving PPP must also certify that they need it to keep operating, a requirement that makes some business owners cautious about applying.Johnson said Republicans are hoping to get top lawmakers to sign onto a nonbinding letter to the program’s overseers seeking to clarify some of the rules governing the program. He did not explain exactly what he’s seeking but said Republican lawmakers are close to agreement on the language of the proposed letter.As enacted in late March, the Paycheck Protection Program required businesses to spend their loan money within an eight-week window to get the loans forgiven — and effectively turned into outright grants. It also required that three-fourths of the money be spent on payroll as a means of keeping workers linked to their jobs. But small businesses said the rules were too inflexible, especially as the eight-week window to use the taxpayer subsidies is beginning to close for many businesses, many of which are still struggling to fully reopen.Restaurants in particular were upset that under the law were required to rehire their laid-off workers even though they were either closed or limited to takeout and delivery. Many other business owners feared that they would use up their loan money before being allowed to reopen, and then have to lay off employees again because their business wouldn’t bring in enough revenue to keep paying everyone.The new measure gives business owners 24 weeks to spend the federal aid — instead of eight as originally designed — and extends the program through the end of the year while also lengthening the the maturity date and deferral period of the loans.Republicans such as Small Business Committee Chairman Marco Rubio of Florida complained that the carefully negotiated bill contains a drafting error that could eliminate loan forgiveness entirely for companies who want to use less than 60% of the money for payroll costs. Under the original PPP legislation, passed in March as part of a massive, about trillion CARES Act, loan forgiveness was prorated according to how badly businesses missed the goal of using 75% to maintain payroll. 4918

The US economy added 128,000 jobs in October. The unemployment rate rose slightly to 3.6%.The United States lost 36,000 manufacturing jobs last month, impacted primarily by the GM strike.Overall, the October report was stronger than expected, beating economists' far more dour forecasts. The 40-day GM strike, which took some 50,000 autoworkers out of the workforce, was 383

The United States is ranked number one in the world for pandemic preparedness, according to the Global Health Security Index. Still, hospitals and medical professionals are in dire need of personal protective gear, ventilators and beds as a looming surge in patients draws near. Some hospitals are as ready as possible, but it’s unclear if even the best can handle what’s to come. In the nation’s third largest city, Rush University Medical Center is one hospital tower built to handle disaster.“That includes infectious disease pandemics, like we're experiencing now. So, not just did we build the tower, but we also routinely drill on these different scenarios,” says Paul Casey, Rush’s chief medical officer. Constructed after 9/11, Rush’s CEO, Dr. Omar Lateef, says the facility was designed to handle mass casualty incidents, and now, it could be a model for epidemic response.“Many of the same features of the building make it a building structured to treat highly contagious infections,” says Lateef.The hospital has the ability to quickly ramp up to 130 percent capacity. Intake and extra beds can be added within minutes and are already on deck. “We are essentially extending our emergency department into our ground floor pavilion area,” says capital projects construction manager Angela Tosic.The ambulance bay area has been transformed into a triage area. They are converting spaces into what are known as “negative pressure” units that help to prevent cross-contamination.“We can take entire quadrants of the building flip switches and make them negative pressure,” explains Lateef. “We can take massive areas of the building that when we built them are nice hallways but secretly inside the columns are oxygen dispensers.”The incident command center is at the heart of the operation. “We closely monitor both the activity of coronavirus locally, as well as our testing of coronavirus,” says Casey. “And then, we look at what's the next step that we need to be prepared to take.”Keeping staff safe and preventing the spread of the virus is a top priority. Employees are being asked to self-monitor and check their temperature at home twice a day. Once at work, facial recognition scanners not only confirm their identities but also take real-time temperature readings to ensure they do not have fevers. Should staffer’s exhibit symptoms, a drive through COVID-19 testing area is already up and running.Patients exhibiting COVID-19-like symptoms enter and are housed in a completely separate unit.Rush says it will max out its bed capacity as much as possible but has to balance that with not running out of available staff.“The number we have is when patients stop coming in we'll figure out a way to not turn people away,” says Lateef. 2761

There's new concern about medical costs because of the coronavirus.Before the COVID-19 pandemic, we were already seeing hospital costs rising.Insurance comparison website Quote Wizard looked at a decade of data and it determined the average cost of a hospital visit went up 36% to more than ,300 a day. In some states, the increase was higher.“Why that matters right now during COVID-19 is obviously there is a stress on the healthcare system with people being sick from coronavirus but also significant numbers of people losing their jobs,” said Adam Johnson, a Quote Wizard analyst. “Millions of Americans losing their jobs and when they're losing their jobs, they're losing their employer sponsored health insurance.” Rising hospital costs are due in part to uninsured and underinsured patients that receive care. However, there's another significant contributor that could be easier to correct.“In other countries where health care systems are a little more uniform, the administrative aspect is much lower, 1 to 3% of total healthcare costs, but in the United States, that’s around 8%,” said Johnson. Hospitals did get some emergency relief funding under the CARES Act and other stimulus bills. That will help offset some of the extra COVID-care debt, but only time will tell how the crisis will impact future costs. 1335