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Lauren Lewis originally mistook the dry cough for allergies.
In early November 2020, she attended an outdoor concert with her mother and younger daughter in Dallas, a couple of days after begrudgingly attending a mandatory in-person meeting at work.
When I got home I was like, [The cough] is probably because I was around all the plants and being outside. That probably aggravated my sinuses, said Lewis, 33, who lives in Dallas. Didnt think much of it, just went to bed. But the next morning I woke up and I felt like a train hit me.
After being told that some co-workers also felt sick, Lewis decided to get tested for COVID-19 and her results came back positive. But her situation was more complex than most people who have contracted the virus because she was three months pregnant at the time.
Nights were the worst, she said, with the difficulty breathing making it feel like a weight was on your chest. Even getting up to go to the bathroom was a chore that required help from her husband and, at one point, her daily diet mainly consisted of just chicken broth and Pedialyte.
Although Lewis was never hospitalized with COVID-19 and later recovered, the experience still sticks with her, and when the coronavirus vaccine became available to high-risk Texans at the start of the year, Lewis jumped at the chance to get vaccinated. On April 23, she delivered a baby boy, Langston, with no major complications.
Not all pregnant women are as eager as Lewis about getting vaccinated, however.
Pregnant women have one of the lowest vaccination rates in the United States: As of Sept. 4, about 25% of pregnant women ages 18 to 49 have received at least one vaccine dose nationally, according to the Centers for Disease Control and Prevention. Thats significantly less than the most recent national average for that age group, which is about 61%.
The Texas Department of State Health Services currently does not collect vaccination data on pregnant women, said Lara Anton, an agency spokesperson, and also does not track cases, hospitalizations or deaths among this group.
Doctors said theres no single reason for the low vaccination numbers, although vaccine hesitancy and misinformation have played a role.
Recently, pregnant patients with COVID-19 have come in to Texas hospitals at levels not seen earlier in the pandemic, according to some doctors, illustrating the severity and contagiousness of the delta variant amid the states most recent COVID-19 surge.
Were just seeing a lot more of them progress [to serious illness] very quickly, said Dr. Manisha Gandhi, chief of maternal-fetal medicine at Texas Childrens Pavilion for Women and Baylor College of Medicine in Houston.
Last August, more than 15 pregnant women were hospitalized with COVID-19 at Texas Childrens Pavilion for Women. This August, the number nearly doubled, according to Texas Childrens.
This variant is much more aggressive, [and] pregnant women are getting sicker much faster, Gandhi said.
The CDCs recent recommendation that pregnant people get the vaccine has given medical professionals hope that more will do so. But they know it will still be a battle to overcome some of the hesitancy that has set in since the start of the pandemic.
Women want to make the best decision for them and their unborn child, and its a really difficult position when they dont include pregnant or lactating women in the [vaccine clinical] trial, said Dr. Teresa Baker, professor and regional chair of the department of obstetrics and gynecology at the Texas Tech Health Sciences Center in Amarillo.
Pregnant and lactating women have long been excluded from initial clinical trials due to the possibility of putting an unborn fetus at risk, Baker said, so it wasnt a surprise that the same thing happened during the development of COVID-19 vaccines. But with the lack of initial information about how COVID-19 affects pregnant people and mixed guidance by CDC and leading medical organizations, many pregnant people felt left in the dark about the best way to protect themselves.
We just were working with a lot of unknowns for a long time and that made it uncomfortable for everyone, but I think were catching up slowly, Baker said.
A recent study in the American Journal of Obstetrics & Gynecology found that the vaccines offer similar protection for both pregnant and nonpregnant women.
Dr. Jerald Goldstein, founder and medical director of the Fertility Specialists of Texas, said false claims circulating on social media that women will become infertile or sterile from being vaccinated have contributed to some of the hesitancy.
The online misinformation has definitely created a lot of work for doctors in terms of talking to patients who really, really believe that, Goldstein said.
According to a recent study in the American Society for Reproductive Medicine journal, F&S Reports, neither previous illness with COVID-19 nor antibodies produced from vaccination to COVID-19 will cause sterility.
Studies have also shown that receiving the vaccine does not lead to an increased risk of miscarriage or birth defects.
Gandhi, the maternal-fetal specialist at Texas Childrens, said the most important part of her day now is making sure patients realize the benefits of getting vaccinated and how much it reduces the risk of getting sick with COVID-19 and having to be intubated or enduring a premature delivery.
She has also urged people who are pregnant to not wait until they deliver their baby to get vaccinated.
The highest risk time is while theyre pregnant, Gandhi said. ... Getting vaccines [generate] antibodies that can cross the placenta and potentially protect the baby so there's actually a bonus: Youre also adding to the protection of your baby who may get exposed after delivery.
Austin resident Brittany Clay has never really seen herself as an early adopter to much in life. However, things changed once she learned she was pregnant in October 2020.
By then, she had already lost a family member to the virus. In July, her uncle, who had colon cancer, died from complications of COVID-19. Then, in October, her grandfather also died from complications of the virus and her parents landed in the hospital with pneumonia after contracting COVID-19.
We said our goodbyes to my uncle over the phone, we said our goodbyes to my grandfather over the phone, and when I knew things were not going well for my parents was when they stopped answering their phones, said Clay, 33. They couldnt speak on the phone anymore. It was too difficult for them with breathing. And it was like, Wow, were literally saying goodbye to our loved ones, were telling them its OK to go over the phone on speakerphone. It was the most horrible thing.
It was such a scary time for our family, and when you go through circumstances like that, its just not that difficult of a decision to get the vaccine, Clay said.
But the vaccine wasnt available to high-risk people until December, and Clay still wanted to do her homework first. In January, about six months before the CDC recommended pregnant people get the coronavirus vaccine, Clay and her husband started collecting reports and studies about pregnant women and COVID-19.
Clay said she also gravitated to reading about experiences shared on social media by doctors who were pregnant themselves and got the vaccine.
Being pregnant in a pandemic has so many added stressors and so many additional layers of fear and unpredictability, so much of it can be out of your control, Clay said. So then to add this additional unknown of this vaccine that, you know, has been around for nine months is a really scary decision, and I just try to honor and respect the fact that this is a decision that people have to make on their own.
During her research, she also reconnected with Lewis, an old classmate from Texas Christian University, through social media. Clay was curious to hear about Lewis experience with COVID-19 during pregnancy.
Since reconnecting, they have bonded over motherhood and the shared experience of getting vaccinated while pregnant. Clay was fully vaccinated by February and delivered a baby girl named Navy on June 22.
I later went back to [Lauren] after I had Navy, and I was like, You might have saved my life. Thank you so much for sharing your COVID experience with me, Clay said.
For both women, the importance of getting vaccinated was underscored by the news that one of their TCU classmates who was unvaccinated had died from complications of the virus after delivering her baby.
That has felt so haunting and so sad, Clay said. She was just so young and her family is now really trying to get the word out about the vaccines, and I recognize the severity of the cases are just getting more and more severe for pregnant women.
Lewis has made it a personal mission to encourage pregnant women to get vaccinated and posted videos of herself being vaccinated on social media.
If you have any questions, please reach out to me, Lewis said on video in February after receiving her second dose. Im very pregnant, so I have a different perspective because Ive had COVID.
Lewis said she hopes other expectant mothers will heed her advice.
I mean, [COVID-19] really sucked the life out of me, Lewis said. ... Honestly, I'm waiting to go get my third shot. I want to get it because I dont ever want to feel the way I felt with COVID, and I dont want anybody to ever feel that way when they dont have to.
Disclosure: Texas Christian University has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
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Medical professionals pronate a 39-year-old unvaccinated COVID-19 patient last month at St. Luke's Boise Medical Center in Boise, Idaho. Kyle Green/AP hide caption
Medical professionals pronate a 39-year-old unvaccinated COVID-19 patient last month at St. Luke's Boise Medical Center in Boise, Idaho.
BOISE, Idaho (AP) Idaho public health leaders on Thursday expanded health care rationing statewide amid a massive increase in the number of coronavirus patients requiring hospitalization.
The Idaho Department of Health and Welfare made the announcement after St. Luke's Health System, Idaho's largest hospital network, on Wednesday asked state health leaders to allow "crisis standards of care" because the increase in COVID-19 patients has exhausted the state's medical resources.
Idaho is one of the least vaccinated U.S. states, with only about 40% of its residents fully vaccinated against COVID-19. Only Wyoming and West Virginia have lower vaccination rates.
Crisis care standards mean that scarce resources such as ICU beds will be allotted to the patients most likely to survive. Other patients will be treated with less effective methods or, in dire cases, given pain relief and other palliative care.
Thursday's move came a week after Idaho officials started allowing health care rationing at hospitals in northern parts of the state.
"The situation is dire we don't have enough resources to adequately treat the patients in our hospitals, whether you are there for COVID-19 or a heart attack or because of a car accident," Idaho Department of Welfare Director Dave Jeppesen said in statement.
He urged people to get vaccinated and wear masks indoors and in crowded outdoor settings.
"Our hospitals and healthcare systems need our help. The best way to end crisis standards of care is for more people to get vaccinated. It dramatically reduces your chances of having to go to the hospital if you do get sick from COVID-19," Jeppesen said.
One in every 201 Idaho residents tested positive for COVID-19 over the past week, according to a tally by Johns Hopkins University. The mostly rural state ranks 12th in the U.S. for newly confirmed cases per capita. More than 1,300 new coronavirus cases were reported to the state on Wednesday, according to the Idaho Department of Health and Welfare.
Hospitalizations have skyrocketed. On Monday, the most recent data available from the state showed that 678 people were hospitalized statewide with coronavirus.
Meanwhile, the number of COVID-19 patients in intensive care unit beds has stayed mostly flat for the last two weeks at 70 people each day suggesting the state may have reached the limit of its ability to treat ICU patients.
Though all of the state's hospitals can now ration health care resources as needed, some might not need to take that step. Each hospital will decide how to implement the crisis standards of care in its own facility, public health officials said.
Kootenai Health in the city of Coeur d'Alene was the first hospital in the state to officially enter crisis standards of care last week.
At the time, Chief of Staff Dr. Robert Scoggins said some patients were being treated in a conference center that had been converted into a field hospital. Others received treatment in hallways or in converted emergency room lobbies. Urgent and elective surgeries are on hold across much of the state.
On Wednesday, nearly 92% of all of the COVID-19 patients in St. Luke's hospitals were unvaccinated. Sixty one of the hospital's 78 ICU patients had COVID-19. St. Luke's physicians have pleaded with Idaho residents for months to get vaccinated and take steps to slow the spread of coronavirus, warning that hospitals beds were quickly running out.
Public health officials have warned Idaho residents for weeks to take extra care to ensure they don't end up in hospitals. Last week, Jeppesen said residents should take their medications as prescribed, wear seatbelts and reconsider participating in any activities such as cycling that could lead to injuries.
The health care crisis isn't just impacting hospitals primary care physicians and medical equipment suppliers are also struggling to cope with the crush of coronavirus-related demand.
One major medical supplier, Norco Medical, said demand for oxygen tanks and related equipment has increased, sometimes forcing the company to send patients home with fewer cylinders than they would normally provide. The company is also asking people to return unused or unneeded oxygen tanks so they will have enough on hand for the surge.
"There is a limit to everything, my leadership team and I were actually discussing this and we certainly all agreed that the word we'd like to use right now is that things are getting tight," Norco President Elias Margonis told Boise television station KTVB. "The concern is how much tighter will it get."
Primary Health Medical Group, Idaho's largest independent primary care and urgent care system, late last month was forced to shorten operating hours because its waiting rooms were so packed with patients that staffers were staying hours past closing in order to see them all. Meanwhile, the company was dealing with higher-than-normal numbers of staffers out sick because they had been exposed to coronavirus in the community or had symptoms and were awaiting tests. Vaccination provides strong protection against becoming seriously ill with coronavirus, but the highly contagious delta variant can still cause "breakthrough" cases in vaccinated people.
As case numbers continued to increase, some of Primary Health Medical Group's 21 clinics in southwestern Idaho have had to stop operating on weekends or close certain days of the week, said CEO Dr. David Peterman.
Now the medical group is also preparing to monitor its patients who are released earlier than they normally would be from the hospital after emergencies, Peterman said.
"We will see more visits with patients that are avoiding the emergency room and patients who are sicker and need more care," Peterman said. "We are setting up a system right now to make sure over this weekend that we are immediately notified if one of our patients is discharged early from the hospital so we can make sure those patients are OK."
Resources have been exhausted across the medical system, Peterman said.
"This is heart-wrenching. I've practiced medicine in southwest Idaho for 40 years and I have never seen anything like this," he said. "I feel for the doctors and the nurses and the staff in the hospital who are making very difficult decisions."
Maine schools have reported 1,390 cases of COVID-19 and more than 50 outbreaks in the first weeks of classes, according to a new database of coronavirus cases and outbreaks in schools.
In just the past week, the number of active outbreaks in Maine schools has grown from 14 to 52, according to the Department of Education. An outbreak is three or more epidemiologically linked positive cases.
The data released Friday include COVID-19 cases reported by Maine schools over the last 30 days, although most school districts have not been back in session that long.
By comparison, last April COVID-19 cases in Maine schools rose to 968 cases among students and staff over a 30-day period, which at that time was the high point for the pandemic.
The numbers included in the database are based on case reports made to Maine schools and not all have been confirmed by the Maine Center for Disease Control and Prevention.
Case totals include both students and staff. The department does not break down the numbers of cases among children versus adults.
The new data represents a change in the states approach to reporting on COVID in schools as the delta variant has increased the prevalence of the disease. Earlier in the school year the department was posting a weekly list of school outbreaks but was not attaching case numbers to the outbreaks.
Some of the largest outbreak investigations include 25 cases at Piscataquis Elementary School, 35 cases at Caribou High School and34 cases at Hermon High School.
This story will be updated.
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How did a bubble of good fortune get not merely punctured but shattered? Why has the Red Sox outbreak which has necessitated a constant roster shuffle that left the team limping through the final weeks of a push toward the postseason proven so difficult to contain?
Interviews with more than a dozen players, coaches, and Red Sox and league officials have offered approximations of reasons: more lenient testing protocols introduced at a time when the pandemic was waning; a portion of the team that did not embrace vaccination (it has not reached the 85 percent vaccinated mark); and a determination by Major League Baseball to move forward with a full game schedule in the face of a growing list of infections.
In retrospect, it is remarkable that the virus didnt beset the Red Sox clubhouse through four-plus months of the season. Several opponents the Twins in April, the Phillies and Yankees in July, the Rangers in August experienced outbreaks while playing against the Red Sox.
Relief was the prevailing feeling on the team. Could their luck hold?
The answer came in early August: No.
During a short trip from Detroit to Toronto, all Red Sox personnel in the traveling party were required by the Canadian government to be tested for COVID-19.
Bench coach Will Venable, who had been vaccinated, tested positive with an asymptomatic breakthrough infection. While no one else tested positive, first base coach Tom Goodwin who is unvaccinated had to quarantine in Canada for 10 days.
In the wake of Venables positive test, and amid the heightened protocols in place in Canada, the Red Sox significantly ramped up their testing and spent several days masking not just in the clubhouse but also in the dugout. At least temporarily, those around the team witnessed more careful behavior by players and other team personnel.
My positive, I think, was sobering for the whole group, said Venable.
A warning had been sounded.
The Hernndez case
On Aug. 26, during a game against the Twins that concluded a six-game homestand, Hernndez experienced body aches but didnt consider them alarming.
After all, fatigue or dehydration seemed unsurprising given the humid nights in Boston, long games during the homestand, the late stage of the season, and a year in which Hernndezs everyday leadoff role had already yielded a career high in plate appearances.
With the Sox set to start a seven-game trip to Cleveland and Tampa Bay, Hernndez, who is vaccinated, boarded the team bus for the airport around midnight and sat among his teammates for the short flight to Cleveland.
Earlier in the season, Hernndez might not have left Fenway Park. From April through mid-June, when MLB protocols specified that unvaccinated players would be tested every other day and fully vaccinated players would test at least twice a week, the Red Sox medical team tested everyone in a traveling party before every flight.
The testing before each flight wasnt a league thing; that was the Red Sox going above and beyond, said Barnes, who is vaccinated and is also the Red Sox union representative.
That changed on June 16. At a time when infection rates throughout the US had crashed following the broad distribution of vaccines, a memo outlined the new testing protocols to which MLB and the Players Association had agreed, based on CDC guidance about fully vaccinated individuals.
Fully vaccinated individuals would no longer have to test unless they exhibited symptoms or had a known exposure to someone who tested positive. Masks would no longer be required indoors in the clubhouse, for instance for fully vaccinated players.
The memo noted in bold that it was necessary for all individuals to remain hyper vigilant of their symptom status. But Hernndez simply hadnt recognized his fatigue as a potential COVID symptom.
So with the Sox having stopped pre-flight testing for vaccinated players, Hernndez wasnt tested in Boston prior to the flight to Cleveland. When the plane landed around 3 a.m., members of the Sox wouldnt have imagined anything was wrong.
He was chirping and he was all fired up, said hitting coach Tim Hyers. He was doing his Kik stuff, bouncing off the walls while he was grabbing his luggage.
The next morning, however, Hernndez woke up with congestion and worsening body aches. His concern was immediate. He informed the team, and around 10 a.m., he took a rapid test that came back positive.
I guess you can call me Patient Zero on the team, Hernndez said. Whether I was the first one or not, I was the first one that actually tested positive.
I guess you can call me Patient Zero on the team. Whether I was the first one or not, I was the first one that actually tested positive.
Kik Hernndez
Charting the spread
The positive test set in motion a series of protocols for his teammates to follow, starting with contact tracing to determine who needed to be tested.
Not everyone on a team is immediately tested in case of a positive test. Every Tier 1 MLB employee a 100-person group made up of the players and coaching staff with the Red Sox and Triple A Worcester, as well as select front office members who interact regularly with clubhouse personnel is required to carry a Kinexon chip. The white rectangular sensor records close contact with others, meaning 15 minutes within 6 feet of someone who tests positive.
Based on both Kinexon data and interviews (necessary because there are times when Tier 1 individuals might not be carrying their chip), MLB requires any unvaccinated close contacts to enter a seven-day quarantine. Vaccinated close contacts are subjected to heightened testing but are not immediately quarantined.
On the same day Hernndez was placed on the COVID IL, second baseman Christian Arroyo began a close-contact quarantine the protocol for unvaccinated Tier 1 individuals. But on that Friday and Saturday in Cleveland, there were no additional positive tests. The Sox held their breath, hoping that Hernndez might be the only person to test positive.
It proved a false hope. On Sunday morning, Arroyo tested positive. So did strength and conditioning coach Kiyoshi Momose a red flag, given that he works closely with virtually every player.
Im like, [expletive], now Ive definitely been exposed to it. Its only a matter of time before I test positive, Barnes said.
Now, the Sox had to confront the question of how many other players might become infected.
How long are the tentacles of this and where else is it going to extend? wondered assistant general manager Eddie Romero, who was with the team in Cleveland.
That final day in Cleveland became uncomfortable. With a flight to Tampa Bay looming, the entire traveling party not just individuals defined as close contacts was tested. But weather concerns delayed the start of the afternoon game by 3 hours and 10 minutes, bringing the players together in the clubhouse.
Not everybody has [a mask] on, just to be frank, said Barnes. Everybodys sitting around or hanging out with guys or talking, playing cards, doing whatever. That three-hour delay might have just been a breeding ground for [COVID].
The Sox blew an eighth-inning lead and lost, then bused to the airport for a flight to Florida.
That flight, said reliever Adam Ottavino, felt very different from the one to Cleveland three days earlier. A seating chart was employed. The typical card games (permissible for vaccinated players under the leagues protocols) and conversations didnt take place.
Most people just watched movies or went to sleep, said Ottavino. Nobody really wanted to socialize at that point because we pretty much gathered that the initial spread happened on that flight to Cleveland.
The crisis
On Monday, Aug. 30, prior to the start of a four-game series against the Rays, reliever Martn Prez tested positive. The virus had infiltrated the pitching staff and quickly spread. Barnes tested positive later that afternoon, resulting in his immediately being sent to an isolation room in Tropicana Field.
By that point, some members of the Red Sox became alarmed that the team was being asked to continue playing through what had clearly become a widening outbreak. They wondered why their game against the Yankees July 15 had been canceled but at a point where infections were spreading, there was no move to postpone contests against the Rays.
It could have been stopped if we could have possibly not played, like, one of the games in Cleveland and took a day and did the extra testing and kind of figured it out, said outfielder Hunter Renfroe.
The power to postpone is entirely in the hands of MLB commissioner Rob Manfred. His decision about whether or not to play is guided by medical experts and reviews of the contact-tracing process, though the logistical complexity of rescheduling games is also a factor.
Major League Baseball has postponed nine games in 2021 because of COVID factors, but just two since April the aforementioned Sox-Yankees game following six positive tests for players coming back from the All-Star break, and a Nationals-Phillies game July 28 after 12 members of the Washington organization tested positive.
Sudden large numbers of positive tests contributed to the decision to postpone on those occasions. Steady spreads such as a stretch of nine player positives in 12 days experienced by the Brewers in July and August have not led to postponements.
Some Red Sox speculated about whether other factors were in play.
The first game couldnt get banged because it was an ESPN game everybody knows that, said Ottavino. They had to handle their partners.
The evidence is uncertain on Ottavinos point; the Red Sox-Yankees game that was postponed on July 15 was an ESPN game.
MLB decided to keep playing. The Red Sox recognized that theyd have to learn to play through.
I happen to think that playing these games, while frustrating because we dont have our full complement of starters, was the right decision by Major League Baseball, said Red Sox president Sam Kennedy. Would we have liked a two-week break? Thats what we would have needed. Would we have liked that? Of course.
But thats not the reality of what were dealing with. Were part of a larger ecosystem. We have to get these games in for the integrity of the schedule.
A game off, two days off, in hindsight may have helped identify some other cases. But its impossible to know. And to the extent that we have been harmed by playing games, thats on the Boston Red Sox not on [MLB], not on anyone else.
Would we have liked a two-week break? Thats what we would have needed. Would we have liked that? Of course. But thats not the reality of what were dealing with. Were part of a larger ecosystem.
Sam Kennedy
The players, meanwhile, were growing increasingly uncomfortable with their environment a sentiment only heightened when quality control coach Ramn Vzquez tested positive and reliever Josh Taylor was removed mid-game as a close contact. Goodwin was quarantined as an unvaccinated close contact for the second time in August.
We had a player that was taken out of our team and he didnt have COVID; it was just because he was deemed a close contact and unvaccinated, said Ottavino.
I got pretty annoyed with that fact not necessarily individually to the point of having a problem with anybody. I love all my teammates. But I just felt like thats a certain part of the protocol that, like, maybe guys didnt take seriously enough in their decision-making process [about whether to vaccinate].
I just didnt even want to be around anybody. I was going in the weight room by myself and watching the game. The first game, I didnt go out to the bullpen until the eighth inning. I was like, Why do I want to hang out with anybody?
A sense of crisis grew in the wake of a 6-1 loss that Monday, Aug. 30. While the MLB/MLBPA protocols required only unvaccinated players and vaccinated close contacts to test, the Sox decided to start testing everyone in their traveling party daily on Tuesday.
As this progressed, and especially through multiple flights, through a lengthy rain delay, through various situations where the group was together, it became much harder to distinguish between everybody in our traveling party as to who was a potential close contact and who wasnt, said chief baseball officer Chaim Bloom. It expanded to where it made sense to just start testing the whole travel party.
MLB worked with the team to arrange expanded and expedited testing during the Cleveland and Tampa Bay legs of the road trip. From Aug. 26 through Monday, the league had conducted 2,433 tests on behalf of the Red Sox an average of more than 135 per day.
The team also reverted to several practices employed during the 60-game season in 2020, before vaccinations were available.
Players were told to arrive later at ballparks to cut down on their time around each other. Masking increased. Meetings were moved from the clubhouse to the stands. Hitting groups in the batting cage were smaller. Players who were done playing for the day were told to leave the ballpark.
Still, such measures felt at times like patches in a dike that was steadily springing new leaks.
Reliever Hirokazu Sawamura tested positive before Tuesdays game, becoming the fourth Red Sox reliever to be sidelined in two days. Then Cora pulled Bogaerts off the field prior to the bottom of the second inning. The All-Star shortstop, who was asymptomatic, had tested positive.
The Sox looked bewildered. Ahead, 1-0, when Bogaerts walked off, they allowed seven runs in the next two innings in an eventual 8-5 loss their third straight defeat.
A turning point
The next day marked a reckoning. The Red Sox were 2-3 on the road trip, their lead over Oakland for the final wild-card spot down to just one game. Players recognized that they could either get swallowed by their COVID crisis or they could restore their focus to the field.
Yairo Muoz initially brought up to fill in for Hernndez and Arroyo in the middle infield tested positive prior to Wednesdays game, becoming the seventh player to test positive and the eighth to land on the COVID IL. It was clear, six days into the road trip, that the Red Sox would have to live with a roster being reshaped daily by a pandemic.
It felt like a gut punch after gut punch with all the guys, the COVID guys, coming down, said outfielder Alex Verdugo. We were uncertain, like, Are we going to reschedule these games or are we going to play through it? We realized, Hey, were playing through this, were playing every day.
Once we all realized that, it was a mentality, like a switch just kind of flipped.
With Chris Sale on the mound Sept. 1, the impossible-to-foresee middle-infield combination of Jonathan Araz and Jack Lpez (making his big league debut) helped turn three double plays, and the Red Sox scratched out a game-winning run in the ninth inning.
The next day, Sale became a vocal presence in the Red Sox clubhouse, assuring the team it would find a way to keep winning. The team did just that in the final game of the trip, beating the Rays, 4-0, to split the series and return home from a medically terrifying journey with a 4-3 record.
Anxiety about the outbreak prompted some members of the traveling party, including Cora, to stay in a hotel in Boston rather than return home to their families for the first few days after arriving from Florida.
Virtually everyone with the Sox continued to be tested daily, with some players tested multiple times per day. Efforts to keep players spread out and outdoors at the ballpark and away from the park remained in effect. Masks again became constant accessories.
Despite the heightened precautions, infections continued. Outfielder Jarren Duran tested positive on the first day of a six-game homestand, with pitcher Nick Pivetta, who was vaccinated early in the season, and utility player Danny Santana landing on the COVID IL two days later with symptoms.
Pivettas placement proved particularly jarring, as it came on the morning of his scheduled start. That same day, however, Hernndez after 10 days inside his hotel room was released from his quarantine in Cleveland.
I didnt even know where the elevator was, Hernndez said. There was a housekeeper there in the hallway. I think she got a little sketched out about how confused I looked, like, Whats this guy doing?
At the end of the homestand, Sale tested positive on an off day, prior to the teams flight to Chicago for a weekend series against the White Sox.
Identifying Sale as COVID-positive prior to the trip proved inadequate to stop further infections. On Sept. 11, Santana tested positive, as did reliever Phillips Valdez a day later.
Sixteen days removed from the start of Hernndezs quarantine, Valdez became the 12th Red Sox player known to have COVID-19. The majority of those cases, Bloom said, were vaccinated breakthroughs.
The fact that players continued to test positive more than two weeks after Hernndez created an element of mystery about the outbreak. MLB has not ruled out the possibility that the Red Sox are dealing with more than one strain of the virus that a second strain could have entered during the road trip.
It is impossible to say what role the teams vaccination rate low relative to other teams played in the spread of the virus. The Red Sox are one of six teams below MLBs targeted 85 percent vaccination threshold for Tier 1 employees. Their exact vaccination rate has not been made known, though a league source noted that no team is significantly below the 85 percent threshold.
Though the Sox practiced what Bloom described as good COVID hygiene in avoiding earlier infections, the teams vaccination rate increased the risk of transmission once the virus entered the clubhouse.
On the field, since the midpoint of the Tampa Bay series, familiarity with life in the eye of a storm has allowed the Red Sox to spend most of their mental energy on each nights game.
That didnt mean pristine play. The absence of players and resulting reassignment of roles had an effect, whether with a formless bullpen or misplays by those who were not occupying their typical spots on the field, such as the struggles by Verdugo in center field.
Players who hadnt been in the organization at the time Hernndez tested positive Brad Peacock, Taylor Motter, Jos Iglesias suddenly found their names on the lineup cards.
Through it all, the team treaded water, concluding Wednesdays game against the Mariners with a 10-9 record over the 20-day stretch that began with news of the positive test for Hernndez. The Red Sox have 14 games remaining, with a playoff berth still a possibility.
In the coming days, if the Sox avoid further infections, its possible that their COVID IL could be down to a handful of players or fewer. While players have experienced symptoms of varying intensity, none to this point have shown those that suggest longer-term issues.
Hernndez, Taylor, Bogaerts, Pivetta, Sawamura, and Prez have returned. Sale and Barnes were expected back Friday to face the Orioles at Fenway. Arroyo and Duran may be nearing returns.
The Red Sox contention for a postseason opportunity, in the eyes of many of their members, serves as a testament to their doggedness through dizzying circumstances.
Take a step back and realize that this team lost [13 players to the COVID IL] and was able to still maintain a playoff position, said Barnes. I think its a very defining moment and kind of just shows the kind of team that we have.
Julian McWilliams and Peter Abraham of the Globe staff contributed to this story.
Alex Speier can be reached at alex.speier@globe.com. Follow him on Twitter at @alexspeier.
Medical staff tend to COVID-19 patients at the Georges Pompidou European Hospital in Paris in April. Anne-Christine Poujoulat/AFP via Getty Images hide caption
Medical staff tend to COVID-19 patients at the Georges Pompidou European Hospital in Paris in April.
France's health minister has said that thousands of health care workers across the country have been suspended without pay for failing to get a required COVID-19 vaccine.
"Some 3,000 suspensions were notified yesterday to employees at health centers and clinics who have not yet been vaccinated," Olivier Vran, the health minister, told France's RTL radio on Thursday, according to a France 24 translation.
French regulations set a Sept. 15 deadline for health care employees to have at least one dose of a COVID-19 vaccine and show a negative coronavirus test as a condition for working, unless they have an exemption for health reasons or because they've recovered from COVID-19. By Oct. 16, health care workers must show they are fully vaccinated.
Defending the decision to suspend those who did not meet the deadline, Vran said that "the continuity of care, the security of care and the quality of care were assured yesterday in all hospitals and health care facilities" in the country.
Several dozen employees resigned rather than meet the vaccine requirement, he said.
Despite the suspensions, "continued health care is assured," he said, noting that France has some 2.7 million health workers.
Vran said that most of the suspensions were mainly support staff and only "very few nurses." He said most of them were "temporary."
France's main health authority reported that by Sunday, nearly 90% of care workers in nursing homes for the elderly had received at least one dose of a COVID-19 vaccine, according to Euronews.
In recent months, France has seen mass demonstrations turning out thousands of protesters who oppose the government's vaccine policies including a "health pass" system introduced by President Emmanuel Macron which they believe violate the rights of people who refuse to be inoculated.
As many as 200,000 marched one weekend last month, and tens of thousands filled the streets for other weekend marches in some of France's largest cities, including Montpellier along the French Riviera, Bordeaux in the west and Strasbourg near the German border.
Macron's health pass, which began to be introduced in July, would require anyone wanting to enter a restaurant, large shopping mall, theater or long-distance train to show proof of vaccination or a negative coronavirus test.
This story was originally published in the Morning Edition live blog.
FORT MYERS
Lee Health reports 333 COVID-19 patients being treated as of Friday morning, with 23 new admissions Thursday.
Lee Health offers COVID-19 vaccines for anyone 12 and older at its walk-in Community Vaccination Clinic, located inside Gulf Coast Medical Center. Its open Tuesdays, Wednesdays and Fridays from 7 a.m. to 3:30 p.m. for no cost.
RESOURCES:
While the COVID-19 pandemic is surging in other places across the country, cases and deaths in California are declining and the San Francisco Bay Area is doing especially well. But exactly how low are the rates of transmission in the nine-county region?
The well-vaccinated region is generally doing better than the rest of the state. Here's a look at the seven-day positivity rate, seven-day average of cases per 100,000 people and seven-day average of deaths per 100,000, respectively, for California and each of the counties as of Sept. 16 based on the state's dashboard.
California: 3.4% test positivity (seven-day rate), 20.0 cases per 100,000 (seven-day average), 0.2 deaths per 100,000 (seven-day average)Alameda: 2.3% test positivity, 11.1 cases per 100,000, 0.01 deaths per 100,000Contra Costa: 3.2% test positivity, 15.2 cases per 100,000, 0.2 deaths per 100,000Marin: 2.1% test positivity, 8.3 cases per 100,000, 0 deaths per 100,000Napa: 3.8% test positivity, 18.8 cases per 100,000, 0.2 deaths per 100,000San Francisco: 2.0% positivity, 10.1 cases per 100,000, 0.2 deaths per 100,000San Mateo: 1.9% test positivity, 9.5 cases per 100,000, 0.04 deaths per 100,000Santa Clara: 1.7% test positivity, 11.3 cases per 100,000, 0.1 deaths per 100,000Solano: 4.1% test positivity, 19.9 cases per 100,000, 0.4 deaths per 100,000Sonoma: 2.6% test positivity, 13.2 cases per 100,000, 0.1 deaths per 100,000
The numbers are all headed in a downward direction and inching toward where the state and Bay Area were in June, when the pandemic saw a lull just before the state reopened for business and lifted most restrictions June 15. On June 2, the state was recording an average of 2.1 cases per 100,000 and 0.04 deaths per 100,000 across seven days. On June 1, the seven-day positivity rate was 0.8%.
The Bay Area has had some of the tightest COVID restrictions in the country. All counties in the region mandate masks indoors except Solano.
San Francisco and Berkeley require proof of vaccination to enter indoor bars, restaurants, clubs, gyms and large indoor events. Customers under age 12 are exempt. A negative COVID-19 test is not a substitute. Contra Costa County on Tuesday issued a similar mandate for entering indoor restaurants, bars and gyms though both proof of full vaccination or a negative coronavirus test are acceptable.
CDC released this map of the current seven-day case rate for the percent of tests returning positive for COVID-19.
The Centers for Disease Control and Prevention's COVID Data Tracker map also provides an overview of how counties are doing; the map is based on a county's moving seven-day number of new COVID-19 cases and COVID-19 test positivity percentage.
The severity of the pandemic in each county is represented by four tier levels: high, substantial, moderate and low.
CDC released this map of the current seven-day case rate for the percent of tests returning positive for COVID-19.
In the San Francisco Bay Area, Marin, San Francisco, San Mateo, Santa Clara and Alameda are all in the substantial tier as of Sept. 16. Contra Costa, Napa, Solano and Sonoma are in the high. Just to the south of the Bay Area, Monterey and Santa Cruz are substantial.
The rest of the state is mostly a sea of red except for a few counties with low transmission: Lassen, Modoc, Mono and Sierra.While the center of California is a sea of red with the majority of counties seeing a high level of COVID-19 community transmission
The U.S. is behind the curve on rapid tests.
The Biden administration last week committed $2 billion to boost test manufacturing and distribute free rapid tests to some community sites. Retailers are discounting their prices for consumers. But manufacturers are falling short of demand, and prices remain too high to encourage people to use the tests regularly, public-health experts and economists say.
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New Hanover County reports record-high 37 COVID-19 deaths in the past week
NEW HANOVER COUNTY, NC New Hanover County Public Health officials reported 37 deaths from COVID-19 over the past week, bringing the total number of county residents who have died from COVID-19 to 250. Of the 37 reported deaths, individuals varied in health condition and ranged in ages from their 30s to their 80s.
This is the highest number of reported COVID-19 deaths in one week in New Hanover County.Forty-five of the countys total 250 COVID-19 deaths have been reported so far in September, surpassing the 25 total deaths reported over the entire month of August.
Our community has already lost so much to COVID-19, and now we are on track to report the highest number of deaths from COVID-19 in September since the pandemic began, with a majority of those deaths in the unvaccinated population, said Assistant Public Health Director Carla Turner. These deaths are real, they are incredibly sad, and they are being felt by the healthcare workers and the families and friends of the individuals who have died. This is why we care so much about vaccinations and things like wearing a mask and social distancing. Deaths from COVID-19 are a lagging indicator of severe spread, meaning they often come weeks after surges and can continue even when case trends begin to improve. When we saw high reports of deaths from COVID-19 in early 2021, we had protective measures in place, but we didnt have widely available vaccines yet. We must continue to urge our loved ones to get vaccinated. It could literally save a life.
While the past week has shown signs of downward trends in daily reported cases of COVID-19, 14-day percent positivity, and hospitalizations, New Hanover Countys metrics remain high and residents should continue protective measures and seek out a vaccine if unvaccinated. Public Health vaccine clinics hours, locations, and more information can be found atHealth.NHCgov.com.
As of September 16, here is where we are as a community:
NHC schools and university COVID-19 data:
NHC Public Health COVID-19 Vaccine Clinics(no appointment needed):
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