Former Presidents Barack Obama, George W. Bush, and Bill Clinton announced earlier this month their intentions to get vaccinated against Covid-19 potentially on live television to bolster trust and confidence in the shots among Americans. Following their lead, President-elect Biden said he too would take a vaccine on camera, as did Anthony Fauci, the nations most visible virologist. Ivanka Trump also signaled her willingness to get inoculated publicly.
Celebrities and other influential people leveraging their star power to promote a medical product is nothing new in America, not even for vaccines. Elvis Presley famously rolled up his sleeves to receive the polio vaccine on national television in 1956. The quick needle jab into the King of Rock n Rolls arm was among the most memorable moments from the robust teenager-led vaccine campaign. The crusade against the crippling disease helped immunizations skyrocket across the country, and by 1960, yearly cases of polio plummeted by 90% in the U.S. compared with a decade earlier, according to the University of Cambridge.
Now, as the first Covid-19 vaccine has been authorized for emergency use in the U.S., some polls suggest only about half of Americans are willing to get vaccinated against the scourge that is claiming two lives every minute in this country. The challenges of vaccine hesitancy thrust into the spotlight questions about the role, if any, celebrities should play in boosting public support for Covid-19 vaccines: How much can VIPs sway peoples opinions about getting vaccinated, which celebs would be best to tap, and is it ethical for a big name to jump the line to get a vaccine in exchange for an endorsement?
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I think its going to be harder to have an Elvis Presley moment with Covid, said Timothy Caulfield, a health policy professor at the University of Alberta in Canada.
Pop culture in the U.S. is much more fragmented now than in the 50s, he said, making it tougher to rally the public behind any particular influencer. (Dolly Parton, though, has received wide praise as a sort of Covid-19 vaccine ambassador after it was reported she helped fund the Moderna vaccine.) Caulfield suggested The Rock, Tom Hanks, or Beyonc might make good ambassadors because they are beloved and hold a neutral place in pop culture. He also said a public health campaign that seeks to enlist A-listers should focus on finding celebrities who resonate with particular communities in order to build trust within those groups.
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He added that any vaccine campaign using celebrities should aim to create a memorable, shareable, and engaging message that also explains the science of the vaccine and addresses concerns people hold, like how quickly it was developed. That means developing strategies that connect with people of different age groups that reach them where they are, like on Twitter, Facebook, and TikTok.
For a good chunk of people, they wont get a vaccine and there will be no changing their minds. Some may dabble in conspiracy theories and claim that celebrities purporting to get a vaccine are actually getting placebos and tricking the masses, as some people claimed on social media after the former presidents made their announcement. Caulfield said public health officials should not focus their energy on this subset of people who accounted for 1 in 4 of those polled this month by the Associated Press-NORC Center for Public Affairs Research and instead look towards those who are on the fence about getting vaccinated. Some 27% of Americans fall into the not sure category, the poll found.
Caulfield, who has spent much of his time debunking celebrity vaccine myths, advises public health officials to take a page out of the anti-vaxx movements playbook. Jenny McCarthy, an actress and anti-vaccine advocate, was successful at perpetuating the falsehood that vaccines cause autism, he said, because she was able to center the story around her autistic son and resonate her struggles as a parent with other parents.
They use these powerful anecdotes in order to push misinformation, said Caulfield. Weve got to flip that on its head and start using narratives and creative communication strategies to get across the good stuff.
A celebrity who lost a loved one to the disease and understands the grief that comes with mourning during a pandemic could make for a potent partner in helping the public understand the altruism in getting vaccinated and how it protects their loved ones. Such a message could connect with people on the fence, he said.
Steven Hoffman, a professor of global health, law and political science at York University in Toronto, said if public health officials can partner with a variety of celebrities, such as former politicians, religious leaders, movie stars, singers, and athletes, it could be a powerful way of normalizing and encouraging the use of the Covid-19 vaccine. But he warned that careful vetting is key.
Sometimes it can present a risk, if one chooses the wrong celebrity, he said, or a celebrity who might have a tendency to veer off message or who might be open to mixing gobbledygook with science.
Other experts question whether celebrities acting as ambassadors for the Covid-19 vaccines could budge the needle on alleviating peoples fears. Its one thing for celebrities like Gwyneth Paltrow to promote unproven and potentially harmful health products, but quite another to overcome entrenched ideas about vaccines; in fact, research into the influence of celebrities on creating anti-vaccine sentiment far eclipses research on celebrities promoting vaccine use.
If I say celebrities will help, do I know thats really true? I dont. I think its true, but I dont really know, said Arthur Caplan, a bioethicist at New York University. We spent a ton of money making these vaccines, but we didnt spend anything on the social science about how to persuade people to take them.
A small study in Indonesia published earlier this year offers some support for the idea of using celebrity ambassadors: It recruited actors, pop stars, television personalities, and motivational speakers to tweet or retweet vaccine endorsements as a part of a nationwide Twitter immunization campaign. It found that vaccine tweets celebrities wrote themselves garnered much more attention than tweets written by someone else and posted from the celebritys account. The researchers concluded that celebrities could be effective partners for vaccine campaigns, especially when theyre just acting like themselves.
Other research has shown that celebrities can inspire people to take other actions to prevent illness: In whats become known as the Angelina Jolie effect, many women followed the movie stars lead after she disclosed in a New York Times op-ed in 2013 that she had a double mastectomy after learning she carried a BRCA1 mutation that put her at high risk for cancer. And researchers also documented the Katie Couric effect an increase in the number of people who underwent colonoscopies after the news anchors televised procedure.
Vaccine hesitancy is of great concern in communities of color, especially Black communities that have a long legacy of mistrust of medical research due to historical and present-day racial injustices. Only 24% of Black adults would get a Covid-19 vaccine, and some 37% are not sure, according to the AP-NORC poll.
Malika Fair, senior director of health equity partnerships and programs for the Association of American Medical Colleges, is skeptical celebrity endorsements would appreciably change those numbers. I dont think it matters who is taking the vaccine, she said. I do not think that its going to remove the hesitancy and the mistrust of the medical system, of the public health system, of politicians around the vaccine.
One reason, she said, is that celebrities have access to the greatest medical care in case something goes wrong. People are not just thinking about what happens on day one. Theyre thinking, what happens a month from now? What happens a year from now? And what if I have a horrible reaction and I dont have backup? Fair said. Faith leaders and local physicians would likely have more success in building community confidence in Covid-19 vaccines, she added.
Thomas LaVeist, dean of the Tulane University School of Public Health and Tropical Medicine, echoed those sentiments. But he added that some athletes like Serena Williams and LeBron James, who are seen as trusted voices within many Black communities, are good examples of celebrities that could potentially lend credibility to the Covid-19 vaccines.
I dont think that theres any one messenger, and I dont know who would be the Elvis Presley of today, he said. I think you need Elvi, or multiple Elvises, to reach the population.
There are also ethical considerations that need to be taken into account if celebrities are used to promote the vaccine. Under no circumstances should they jump the priority line to get vaccinated, said Lawrence Gostin, professor of global health law at Georgetown University. That would mean that during the early months of the vaccine rollout, any PR campaign should not attempt to televise athletes and young, healthy celebrities getting a vaccine out of turn. Instead, they should set their sights on partnering with celebrities who fall into those groups designated as high-risk. Obama and spokespersons for Bush and Clinton have said the former presidents would receive their vaccinations only within their priority groups, according to CNN.
President Trump, who will be a former president for much of the vaccine rollout, will play a pivotal role in whether or not the vaccination efforts are successful, said LaVeist.
Doses of the Pfizer-BioNTech vaccine will be offered to Trump and other White House officials beginning Monday, according to Reuters. Though it is unclear whether he will try to have an Elvis moment and get vaccinated on live television when he does get the shot, according to People Magazine, Trump could be a useful vaccine ambassador if he stressed to his supporters to get vaccinated, said LaVeist.
There are a lot of people that have followed him down the path of not wearing masks, not taking this pandemic seriously, and putting themselves and their communities at risk, said LaVeist. I think a lot of those people, he can turn around. He can reach people who I dont know could be reached by anyone else.
Every day, COVID-19, which has taken more than 300,000 American lives, exposes the great divide between the powerful and powerless. The poor and people of color suffer the most from the disease, while small businesses continue to take a big economic hit. To control the spread of the virus, states mandate assorted business lockdowns. But the NBA can still create a bubble so basketball can be played. In California, a restaurant owner must shut down an outdoor patio, while next door, a television production crew dines under tents. In Massachusetts, gyms must cut back service, but casinos can still operate.
The pandemic also reveals Americas willingness to accept the basic unfairness that is baked into our health care system. Medical ethics begins with the assumption that all people are equal, that every life has value, Charles E. Binkley, a surgeon and director of bioethics at the Markkula Center for Applied Ethics at Santa Clara University, said in an interview. But in real life, theres plenty of wiggle room. Anybody can get COVID-19, but not everyone gets access to the same treatment. Some people, because of what they do to keep society moving, get priority, said Binkley. Who these special people are is a judgment call. A president and his cabinet members? A president-elect and his incoming staff? And whats the difference between jumping the line and instilling confidence by taking the vaccine publicly, as former presidents Bill Clinton, George W. Bush, and Barack Obama plan to do?
When it comes to national vaccine distribution, the Centers for Disease Control and Prevention has designated front-line health workers and people in nursing homes as the first recipients. But its also a given that some people who fall outside those categories are going to use their power and privilege to game the system and try to get what others cant, said Binkley. Can such gaming be stopped? Only by the conscience of the individual, said Binkley, which today seems to be in short supply.
Rudy Giuliani is the face of privilege: Trumps lawyer freely acknowledged his celebrity status got him access to treatment that others did not have. But privilege is also the difference between the quick service available, for a price, through private testing, versus the lines that stretch for hours at public sites and the delayed results that go with them. Its the safety that comes with being able to work remotely from home in contrast to the risk of having to show up for work in a restaurant, grocery store, or classroom. Its the comfort of being able to travel by car, versus the need to rely on public transit, and the threat of losing that service to cuts as white-collar workers abandon commuter rail and subway systems.
With the vaccine comes the opportunity for even sharper divisions between the haves and have-nots. Massachusetts, like other states, has a vaccine distribution plan that promises safe, equitable, and effective delivery. Phase One covers health care workers; long-term care facilities; first responders; congregate care facilities, including corrections facilities and shelters; and home-based health care workers and health care workers doing non-COVID care. How will that play out in reality? Will prison staff and prisoners get equal access?
During a pandemic, these are not theoretical questions. They are a matter of life and death.
Joan Vennochi can be reached at joan.vennochi@globe.com. Follow her on Twitter @joan_vennochi.
TIJUANA (Border Report) The first doses of the COVID-19 vaccine are expected to arrive in Tijuana by Dec. 21, but residents are being told the vaccination wont be the final solution.
Baja Californias Secretary of Health Alonso scar Prez Rico said the vaccine takes time to generate antibodies and those who receive the shot still need between three and four weeks to see a benefit.
Prez Rico said when its all set and done, they expect vaccinations for only 60 percent of the population.
The amount were getting wont be enough to cover all residents, he said. Even by the first quarter of 2021, we wont have enough.
Prez Rico stressed the best way for people to protect themselves is to continue wearing facemasks and to practice social distancing by avoiding gatherings of more than 10 people.
Tijuana, and the rest of Mexico, plan on distributing the vaccine to health workers first, followed by senior citizens
In Tijuana, according to Prez Rico, 33 people died as a result of COVID-19 on Monday.
If we cant get this under control this week, were going to start the new year under more restrictions, he said. Everyone, especially those who cross the border between Mexico and the United States, must use facemasks and use them correctly to protect everyone.
According to statistics, 73 percent of patients in area hospitals are COVID-19 patients, with 164 new reported cases. And the number of cases is at its highest since the pandemic began, according to Baja health officials.
Visit theBorderReport.com homepagefor the latest exclusive stories and breaking news about issues along the United States-Mexico border.
YORK, Pa. (WHTM) Pfizers COVID-19 vaccine doses arrived at WellSpan Good Samaritan Hospital in Lebanon, PA, Tuesday morning. Health professionals will be administering the vaccine to care team members this week.
WellSpan was among the states first 100 hospitals to receive a vaccine shipment from Pfizer. In alignment with the PA Department of Healths phased approach to vaccination, the initial doses of the vaccine will be given to caregivers at the highest risk for exposure to COVID-19. As additional doses become available,vaccines will be offered to all WellSpan employees and patients.
The COVID-19 vaccine represents a bright spot for our teams who have tirelessly cared for their friends and neighbors with COVID-19, said WellSpan Health President and CEO Roxanna Gapstur, Ph.D., R.N. We are encouraged by the available data, which tell us the Pfizer vaccine is 95 percent effective in lowering a persons risk for developing COVID-19.
The vaccine has been through a rigorous process before receiving approval as safe and effective by theFood and Drug Administration (FDA). Based on the available research data, WellSpan Health endorses the COVID-19 vaccine.
We areconfident that this vaccine will slow the spread and help our community turn the corner in this pandemic, said Dr. Eugene Curley, Infectious Disease Specialist at WellSpan Health, who reviewed the available research data with his team members. We support the vaccine as safe and effective. WellSpan is encouraging team members to get vaccinated, and as additional doses become available, will encourage our community members to receive the vaccine.
Six other WellSpan hospitals are expected to receive their shipments this week, including WellSpan Chambersburg Hospital, WellSpan Ephrata Community Hospital, WellSpan Gettysburg Hospital, WellSpan Surgery and Rehabilitation Hospital, WellSpan Waynesboro Hospital and WellSpan York Hospital. Each of them is prepared to begin administering the vaccine to team members this week.
It will take several months until the vaccine is widely available for the general public. In the meantime, WellSpan encourages everyone to continue to follow safety precautions: wear a mask, wash your hands, and stay six feet apart from others.
Community members seeking additional information about the COVID-19 vaccine should visit WellSpans dedicated COVID-19 Information web page: https://www.wellspan.org/covid19/covid-19-vaccine/
With the FDAs approval of Pfizers COVID-19 vaccination on Dec. 11, thousands of health care workers may soon receive immunization shots in Santa Clara County within the next week.
Health officials expect 17,550 doses of the Pfizer vaccine and 39,300 doses of the Moderna vaccine to be available in the county over the next few weeks.
However, only a fraction of health care workers will have access to the vaccine.
Doses are so scarce that state health officials have broken down their first phase of vaccine distribution into multiple tiers. In the first tier are health care workers at acute care and skilled nursing facilities and hospitals within jails and prisons.
The first bit of vaccine coming to our county will not even be enough to get us through the first two bullets in tier one, said Public Health Officer Dr. Sara Cody. Thats a very large group of individuals that fall into tier one.
COVID-19 Testing Officer Dr. Marty Fenstersheib said the county will receive about 6,000 of the 17,550 Pfizer doses by mid-December, which will all go to acute care and skilled nursing staff. Fenstersheib said the county has about 75,000 acute care hospital workers, and the first round will only be available for 10% to 12% of them.
Urgent care workers and community health workers will be in the second tier of the first phase. Health officials expect the general public wont have access to COVID-19 vaccines for several months.
How will the county track who receives the vaccine and any adverse reactions to it?
County health officials encourage private and public health care providers to collect dataon peoples immunizations, vaccination dates and inventory to share with the state.
Vaccine providers can transmit data to the California Immunization Registry a database tracking immunizations of California residents via electronic health records or software that tracks patients immunizations, according to the countys vaccination plan.
Hospitals may use software such as PrepMod online software that tracks when people are vaccinated to alert patients when they need to receive a second dose of the Pfizer vaccine 28 days after the first. Both vaccines require a second booster shot and patients will be notified via email and texts.
The states immunization registry is confidential and can only be accessed by authorized medical staff and health officials.
Reactions to the vaccine
California requires every provider to report reactions from the vaccine to the federal Vaccine Adverse Events Reporting System (VAERS).
VAERS is a database and early warning system run by the FDA and Centers for Disease Control and Prevention to detect possible safety problems with U.S. licensed vaccines.
While the FDA has approved the vaccines under emergency authorization, three patients in the United Kingdom reported severe allergic reactions to the vaccine. British health officials said any person with a history of anaphylaxis or severe allergies to vaccines, medicine or food should not be immunized. However, they noted those conditions are rare.
The county will update its website to provide instructions on how health care providers should report any incidents to VAERS, though no guidance was listed as of Dec. 13.
Patients can report reactions to the vaccine directly to VAERS as well.
County leaders said they may come up with more requirements for private health care providers to prevent hoarding of vaccinations and to ensure theyre immunizing sufficient numbers of people within the county.
Its unclear how the county will ensure hospitals are distributing proper amounts of vaccinations.
Santa Clara County Supervisor Joe Simitian last week said he lacks confidence in private health care providers after they failed to conduct enough COVID-19 tests.
The hope and expectation is that responsibility will be undertaken by folks in the health carearena, who are in the private (and) nonprofit sector outside the governmental sphere, Simitian said. But we had that hope and expectation with testing only to be disappointed, frankly.
County Executive Jeff Smith said the county could imposevaccination requirements on private companies or take legal action against them for not complying with state and county vaccine regulations.
However, county leaders said collecting too much data could spark distrust among immigrant communities. A federal data sharing plan drew the ire of Smith, who said the plan could dissuade people from getting vaccinated if they are undocumented.
Were very concerned about the fact that any information transfer may discourage people from participating in the vaccine program, Smith said.
Contact Mauricio La Plante at [emailprotected] or follow @mslaplantenews on Twitter.
As essential workers, education employees will be included in Phase 1B of the state's vaccine rollout plan. (Jack Flagler/Community Impact Newspaper)
We know that the vaccine is here, but we know it is still months away from when we will all be able to benefit, Elizalde said during the districts Dec. 14 board meeting. We did get news that our teachers will be in the second phase because [the state knows] how important our teachers are to our schools. The lobbying that we did collectively, our voices were heard.
AISD spokesperson Eddie Villa told Community Impact Newspaper on Dec. 15 that, as essential workers, education employees will be included in Phase 1B of the state's vaccine rollout plan.
According to the Texas Department of State Health Services, Phase 1A includes getting the vaccine to health care workers. A draft of a Phase 1B plan includes teachers, long-term care residents, law enforcement, firefighters, adults age 65 and older and those individuals with medical conditions that put them at a greater risk.
Phase 1B is expected to begin in early 2021, depending on the availability of vaccines after Phase 1A is completed, Villa said. According to DSHS, there are 1.6 million health care workers in the state that make up Phase 1A.
Once available, Elizalde said the district will work with health officials to prioritize vaccines within its staff based on an employee's proximity to students and AISD families.
The way it was explained to us was it would be any of our staff members that have the most direct contact with students, and that we are to help provide that prioritization, she said. The districts are actually being given the autonomy to help tier within the organization.
Villa said the district is not a vaccine distributor, but it will continue to partner with local health experts regarding the rollout.
The first doses of the Pfizer's COVID-19 vaccine approved for emergency use by the U.S. Food and Drug Administration began arriving in Texas Dec. 14. UT Health Austin and Dell Medical School were the first Austin institutions to receive the vaccine, and began administering doses the morning of Dec. 15.
KANSAS A western Kansas mayor announced Tuesday that she is resigning, effective immediately, because of threats she has received after she publicly supported a mask mandate.
Dodge City Mayor Joyce Warshaw said she was concerned about her safety after being met with aggression, including threats via phone and email, after she was quoted on a USA Today article on Friday supporting the mandate, The Dodge City Globe reported.
I understand people are under a lot of pressure from various things that are happening around society like the pandemic, the politics, the economy, so on and so forth, but I also believe that during these times people are acting not as they normally would, Warshaw said.
The commission voted 4-1 on Nov. 16 to impose a mask mandate, with several exceptions.
Ford County, where Dodge City is located, has recorded 4,914 cases of COVID-19 since the pandemic began, according to the state health department. The county has about 33,600 residents.
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THE VIRUS OUTBREAK:
Poor countries face long wait for vaccines despite promises
Over-the-counter home test for COVID-19 gets U.S. green light
French theater, cinema workers protest against virus closure
Pandemic backlash jeopardizes public health powers, leaders
Swedens prime minister says health officials misjudged new infection wave
U.S. COVID-19 deaths top 300,000 just as vaccinations begin
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Follow APs coverage at https://apnews.com/hub/coronavirus-pandemic and https://apnews.com/UnderstandingtheOutbreak
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HERES WHAT ELSE IS HAPPENING:
BOISE, Idaho A proposed public health order that would have included a mask mandate for Idahos most populated region was voted down on Tuesday as hundreds of protesters again gathered outside the Central District Health building in Boise.
A previous attempt to vote on the order was abruptly halted last week after Boise city police asked the board to end the meeting early amid protest-related safety fears.
During Tuesdays meeting, three board members from Elmore, Valley and Boise counties the more rural counties in the region all voted against the mask mandate, saying theyd heard from constituents who were deeply opposed to the rule. But three board members from Ada County the most populated county in the state were in favor of the mask mandate, noting that Boise-area hospitals are reaching capacity because of an influx of COVID-19 patients, including many who are coming from neighboring counties.
The order lacked the required majority to pass.
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SACRAMENTO, Calif. California is distributing 5,000 body bags mostly to the hard-hit Los Angeles and San Diego areas and has 60 refrigerated trailers standing by as makeshift morgues in anticipation of a surge of coronavirus deaths.
The precautions come from hospitalizations that now are double the summertime peak and threaten to soon overwhelm the hospital system.
Gov. Gavin Newsom said Tuesday that the number of average daily deaths has quadrupled from a month ago. The surge is forcing an urgent scramble for more staff and space, a crush that might not abate for two months despite the arrival of the first doses of vaccines this week.
In Orange County, health officials said they plan to send large tents to four hospitals to help handle their patient caseloads.
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ATLANTA The first coronavirus vaccines were administered Tuesday in Georgia as new infections continued to soar and many schools closed in-person classes for the remainder of the last week before Christmas.
Gov. Brian Kemp and Public Health Commissioner Kathleen Toomey visited Savannah as the first four shots were administered to local health care workers.
The Republican governor warned the state is not out of the woods. The state is now averaging nearly 6,000 new infections a day, far above its summer peak. At least 14 Georgia school districts have sent all students home. Nearly 3,000 people are hospitalized statewide with confirmed cases of COVID-19.
Kemp continues to encourage people to maintain social distance, wear masks, wash hands and avoid large gatherings. But Kemp indicated again Tuesday that he will rely on voluntary compliance instead of trying to order businesses to close.
As Ive said from the beginning, no government mandate is going to make this virus go away, he said.
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TALLAHASSEE, Fla. -- Floridas largest hospital system said it was on track to immunize nearly 20,000 health care workers against COVID-19 as Gov. Ron DeSantis on Tuesday announced a delay in hundreds of thousands of doses of the Pfizer vaccine.
But DeSantis said the first batch of the Moderna vaccine 370,000 doses could begin heading to his state as soon as this weekend and would allow wider distribution of the medicine to hospitals across the state, pending federal authorization.
Florida began receiving its share of the coronavirus vaccine on Monday, and the state was expected to get about 450,000 doses produced by Pfizer over the next two weeks. But production issues could prevent them from being delivered.
Were just going to have to wait. Obviously, it would be shipped relatively soon if we got it, DeSantis said at a news conference in West Palm Beach. We dont know if were going to get any or not.
The state will take what it can get, DeSantis said, as it attempts to take control of a pandemic that has infected more than 1.1 million Floridians since COVID-19 made its first appearance in the state in March.
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WASHINGTON, D.C. -- Acting Defense Secretary Christopher Miller was among the first Cabinet members to get the vaccine. He traveled to Walter Reed National Military Medical Center in Bethesda, Md., on Monday and was given the first dose of Pfizer-BioNTechs coronavirus vaccine.
While Miller was there, a number of the medical centers front-line healthcare staff were also receiving the first of the two-shot regimen. It was the first day of the vaccines nationwide rollout.
Other high-ranking Pentagon military service leaders are expected to get the vaccine as soon as next week, in an effort to encourage the military force to also get shots, and to show that it is safe. Currently, getting the vaccine is voluntary within the military.
In a message to his force on Tuesday, Adm. Mike Gilday, chief of naval operations, urged service members to strongly consider getting the vaccine, not just for themselves but to help protect their shipmates. Saying he will receive the vaccine shortly, Gilday called the vaccine a proven effective measure to better protect the troops.
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MONTREAL Quebecs premier is closing all non-essential businesses across the Canadian province from Christmas until at least Jan. 11.
Premier Francois Legault says that big box stores will be prohibited from selling any goods that are deemed non-essential. The premier is also forcing all office towers to empty starting Thursday and requiring employees to work from home until at least Jan. 11.
Legault says elementary and secondary schools will close Dec. 17 and can reopen at the earliest on Jan. 11. He says hospitals across the province are under too much pressure because of the COVID-19 pandemic to allow non-essential businesses to stay open during the holidays.
Quebec reported 1,741 COVID-19 infections on Tuesday.
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SALT LAKE CITY -- An intensive care nurse in Salt Lake City became the first person in Utah to receive the COVID-19 vaccine.
Utah hospitals began administering vaccinations to front-line healthcare workers with the highest risk of exposure. Hospital leaders expect about a total of 100 doses to be administered across the state on Tuesday.
Christy Mulder, a nurse at University of Utah Hospital, was the first person in the state to receive the vaccine.
State Epidemiologist Dr. Angela Dunn says she is thrilled that vaccines are finally being distributed in Utah. But she urges people to continue public health measures like wearing masks and social distancing.
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CHARLESTON, W.Va. The death toll from the coronavirus pandemic in West Virginia pushed past 1,000 with the announcement Tuesday of a record 34 deaths.
Health officials said the deaths broke the one-day mark of 31 deaths reported last Wednesday.
At least 1,012 people in West Virginia have died from the virus since the pandemic began. The number of deaths has more than doubled since early November, along with virus-related hospitalizations.
The number of virus patients in hospitals reached 774 as of Monday. Thats up 124, or 19%, in the past week alone. That includes a record 207 patients in hospital intensive care units, up from 180 a week earlier.
There are more than 21,000 active cases in the state, where officials began administering a vaccine for the virus on Monday.
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RENO, Nev. -- A federal appeals court has ruled in favor of two Nevada churches that say the states COVID-19 restrictions violate their First Amendment rights.
The 9th U.S. Circuit Court of Appeals agrees with the churches in Las Vegas and rural Lyon County that the states limits are unconstitutional because they place harsher attendance limits on religious gatherings than casinos and other secular businesses.
The appellate court reversed earlier federal court rulings Tuesday that upheld Nevadas hard cap on the size of worship services. It instructed the district judges to preliminary enjoin Nevada from imposing attendance limits for churches stricter than those for other gatherings or businesses.
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PHOENIX -- Arizona on Tuesday reported more than 60 additional deaths as the current coronavirus surge saw the rolling seven-day averages of additional cases and deaths more than double over the past two weeks.
The state on Tuesday reported 4,134 additional known cases and 64 deaths, increasing the states totals to 424,382 cases and 7,422 deaths. The rolling average of daily new cases rose from 3,499 on Nov. 30 to 7,772.1 on Monday while the rolling average of daily deaths rose from 25 to 58.3.
The number of COVID-19-related hospitalizations reached 3,702 on Monday, setting another record.
Arizona on Friday exceeded the summer surges peak of 3,517 hospitalizations.
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PIKEVILLE, Ky. The new COVID-19 vaccine arrived at an Appalachian hospital in Kentucky, and medical workers received the first injections.
The Pikeville Medical Center was one of a handful of regional hospitals to receive the Pfizer-BioNTech vaccine on Tuesday.
Dr. Fadi Al Akhrass, Pikeville Medicals infectious disease specialist, received the first injection during a live-streamed news conference Tuesday afternoon. Al Akrass urged the public to have confidence in the vaccine.
Im a true believer that this is going to be our only option, and its going to be an amazing option to turn around this pandemic, he said.
The hospital, which was required to have facilities for ultra-cold storage, received 975 doses meant for medical workers. A Louisville hospital received the first Kentucky shipment of the vaccine on Monday.
Health care workers are first in line for the vaccine, but about 25,000 doses from the first batch to Kentucky will be dedicated to vaccinating people in long-term care facilities. Gov. Andy Beshear said he hopes to have the entire long-term care population vaccinated within two months.
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INDIANAPOLIS A coalition of some of Indianas top hospital systems is warning that facilities are struggling to cope with the surge in COVID-19 patients a sobering reminder that the coronavirus is still spreading quickly in the state despite the arrival of a vaccine.
With COVID-19 patient numbers hovering above 3,000 for nearly a month, Indiana hospitals are treating more than four times as many as they were in September and are worried they soon could get overwhelmed.
Local hospitals are fast approaching crisis, the Indianapolis Coalition for Patient Safety, which represents several central Indiana health-system systems, said Monday in a statement.
During an online news conference Monday, members of the hospital coalition painted a grim picture of what has been unfolding in their emergency rooms and intensive care units. They also pleaded with members of the public to continue wearing masks and socially distancing and to forgo in-person holiday gatherings.
The state Department of Health on Tuesday added another 129 COVID-19 deaths to the states death toll, pushing the overall figure of confirmed or presumed coronavirus deaths to 6,968 since the start of the pandemic.
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CHEYENNE, Wyo. A registered nurse who does coronavirus testing and contact tracing got Wyomings first COVID-19 vaccination Tuesday.
Terry Thayns regular job is overseeing maternal and child health matters for the Cheyenne-Laramie County Health Department, but this year, she has been busy working to contain the virus.
I was excited for the vaccine, Thayn said after getting the shot at a health department news conference. Whenever it was here, I was taking it.
Thayn is set to get a follow-up shot of the Pfizer vaccine in three weeks.
Her initial dose came from a shipment of 975 in a box that arrived Monday at the health department. Small glass vials of the vaccine came packaged in a box within a box and were kept cold by dry ice.
Almost 35,000 people have tested positive for the coronavirus and 321 have died of the virus in Wyoming since the pandemic began, according to state health officials.
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WASHINGTON Vice President Mike Pence says he looks forward in the days ahead to receiving a vaccine for COVID-19 and will do so without hesitation.
Pence is speaking Tuesday at a Catalent Biologics plant in his home state of Indiana. The plant is producing a vaccine developed by Moderna and the National Institutes of Health.
He is trying to inject confidence in the vaccine a day after the rollout of Pfizer-BioNTechs coronavirus shots and as the Food and Drug Administration says in a preliminary report that the Moderna vaccine is also safe and effective.
Pence declared, we have come to the beginning of the end of the coronavirus pandemic.
Pence is also stressing the need for Americans to stay focused on limiting the spread of the virus before a vaccine is in widespread use. He says cases and hospitalizations are continuing to rise in many parts of the country. The death toll from the coronavirus topped 300,000 Monday.
Its been a marathon this year. Its been a marathon of heartbreak for many American families, he said.
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WASHINGTON Senate Majority Leader Mitch McConnell is urging elected officials to step up and encourage wary Americans to be vaccinated against COVID-19.
The Republican leader said that as a childhood polio survivor, hes a huge supporter of being vaccinated.
Whenever my turn comes, Im going to be anxious to take the vaccine and do my part to reassure those who are doubtful about this, McConnell said at a press conference in Washington, D.C.
For those who say they will resist the vaccine, he said its not good news.
A doctor receives Chicago's first COVID-19 vaccination on Tuesday. In a new poll released the same day, respondents appeared to show less reluctance to receiving a coronavirus vaccine. Jose M. Osorio-Pool/Getty Images hide caption
A doctor receives Chicago's first COVID-19 vaccination on Tuesday. In a new poll released the same day, respondents appeared to show less reluctance to receiving a coronavirus vaccine.
Now that federal regulators have authorized one COVID-19 vaccine for emergency use in the U.S. and appear close to authorizing another it seems Americans are growing less reluctant about receiving an inoculation themselves. The Kaiser Family Foundation, or KFF, released a poll Tuesday showing a significant leap in the number of people saying they definitely or probably would get vaccinated.
About 71% of respondents to the late November and early December survey said they would get a vaccine, up from 63% in an August/September poll. KFF says the increase was evident across all racial and ethnic groups surveyed, as well as both Democrats and Republicans.
Of course, since the previous poll, there have been important advances in the development of a vaccine for COVID-19, which has cost more than 300,000 lives in the U.S.
Earlier this week, health care professionals began administering the first doses of a vaccine developed by Pfizer and BioNTech, just days after the vaccine obtained its emergency use authorization from the Food and Drug Administration. And on Tuesday, the agency's glowing analysis of a vaccine developed by Moderna suggested that another vaccine is on track for authorization.
The KFF poll results offer hopeful news for epidemiologists and federal officials, who, along with developing and distributing the Pfizer vaccine for widespread immunizations, have faced another yet another daunting task: simply persuading Americans to trust it and get it themselves.
"The FDA's review process means that all Americans can trust and be confident in vaccines not just COVID-19 vaccines, but all vaccines reviewed by the FDA and available in the United States," Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, asserted in a news briefing Saturday.
Just over a quarter of respondents in the KFF poll continued to express skepticism, saying that they either probably or definitely would not get a vaccine, even if it is available for free and determined by scientists to be safe. Among those who expressed this reluctance, most said that they were worried about possible side effects, or that they just do not trust the government.
This hesitancy is highest among Republicans, in particular, at 42% though even among members of the GOP, such skepticism appears to be eroding in recent months. The percentage of Republicans saying that they will probably or definitely get a COVID-19 vaccine leapt 9 points since the August/September poll, and now stands at 56%. That number is considerably higher 86% among Democrats.
In the year before COVID-19 swept the country, a smaller share of Americans changed residence than in any year since 1947, when the Census Bureau first started collecting annual migration statistics. This migration decline occurred during an upswing in the economy, when young adult millennials were beginning to get back on their feet after the Great Recession of 2007 to 2009. While no comparable migration statistics are available for the 10 months since the pandemic occurred, there now appears to be a new mix of migration patterns across different parts of the country, as evidenced by real estate, moving, and survey data suggesting selective migration upticks and downticks due to both safety and economic concerns.
Still, newly released pre-pandemic census statistics show a continuation of the decades-long migration decline, bringing the percentage of Americans who changed residence to a post-World War II low of 9.3%. This one-year ratebetween March 2019 and March 2020occurred on the heels of a year when the nations total population growth fell to a 100-year low, with a continued downturn in the nations foreign-born population gains. Thus, even before the pandemic, the nation was in the throes of stagnating demographic dynamics.
The new migration statistics draw from the Census Bureaus Current Population Survey Annual Social and Economic Supplement, which has tracked American relocations since 1947. They allow for analyses of different kinds of domestic moves over that 73-year period, chronicling a continued stagnation of American mobility. Especially noteworthy are the migration declines for the nations young adult population, now mostly occupied by millennials.
U.S. migration trends show a fairly consistent decline since the late 1940s to 1960s, when approximately one-fifth of Americans changed residence annually. This was a period of economic growth and robust housing consumption, with a younger population than today. Afterwards began a gradual but sustained downturn in migration due to a variety of demographic and economic forces, including the rise of dual-earner households (making them less footloose), an aging population, and more homogenous labor markets emerging across the country. By the late 1990s, only about 15% to 16% of the population moved each year, dropping to 13% to 14% in the early 2000s.
Migration dropped even furtherto the 11% to 12% rangeafter the Great Recession, no doubt reflecting the immediate impact of housing and labor market crashes. Since 2012, it has continued dropping to this years new low of 9.3%.
It is important to note that while both local moves (those within counties) and longer-distance moves (those across counties) have declined since the immediate postwar decades, their downturn has become more sustained since the recession and post-recession period. As shown in Figure 2a, local mobility hovered in the 8% to 9% range between 2005 and 2010. Since then, local mobility has plummeted to 5.4%. Because local moves comprise three-fifths of all moves, their consistent downward trend drove the overall pattern.
Since 2007 (the first year of the Great Recession), cross-county movement has hovered between 3.5% to 3.7%, as shown in Figure 2b. Prior to this, cross-county mobility levels were 4% or higherincluding rates in the 5% to 6% range in the 1990s.
To better understand the downward trends in local and cross-county moves, it is useful to understand the different motivations for each. According to recent census surveys, more than half of local movers cite housing-related reasons such as the desire for new, better, or more affordable housing. Another quarter cite family reasons, including establishing a new household or a change in marital status.
A plurality of longer-distance movers, on the other hand, cite labor market reasons such as starting or relocating to a new job for their migration. Changes in the nations housing market and labor market both during and subsequent to the economically turbulent late 2000 to 2010 decade could have been responsible for migration declines for most of the 2010 to 2020 decade.
While the migration slowdown occurred among most segments of the population, it is important to focus on young adults ages 18 to 34. This is historically the most mobile class of Americans, and can numerically drive the overall migration trend. But over the past decade, the millennial generationa large portion of this grouphas borne the brunt of housing and job crises that have deeply affected their mobility.
Figure 3 shows the rates of mobility by age in 2005 to 2006 and 2019 to 2020. It makes plain that young adults (the group with highest mobility rates in both years) showed the largest decline in those rates. For example, among young people ages 20 to 24, only 19% made a move between March 2019 and March 2020, down from 29% in 2005 to 2006. As the figure indicates, this downturn in mobility also affected the movement of children under age 18, who are largely the offspring of these young adults.
When focusing on annual changes in migration rates for 25- to 34-year-olds over this span, distinct patterns emerge for both local and cross-county migration (see Figures 4a and 4b). These patterns are broadly consistent with overall U.S. trends, and suggest that young adults are the driving force for them. Local migration for this age group dropped from a pre-2010 rate of 14% to 15% to a low of 10% in the year before the pandemic. Likewise, cross-county migration after 2006 hovers between 6% to 7%, down from rates of 8% or higher before.
Millennials moving into this age group were saddled with stuck-in-place issues associated with higher housing costs and underemployment, leading them to postpone key life events such as marriage, childbearing, and homeownership. And even though renters tend to move more frequently than owners, the rental market has become increasingly unaffordable. The new census data shows that annual migration rates of renter households have declined precipitously over time (from 30.2% in 2005 to 2006 to 17.7% in 2019 to 2020). On the other hand, cross-county migration trends for young adultswhile not reaching pre-2006 levelshave fluctuated over the past decade.
A demographic stagnation has characterized the nation over the course of the 2010 to 2020 decade, alongside a downturn in within-U.S. migration right up to the beginning of the COVID-19 pandemic. Clearly some aspects of stagnation (lower immigration, more deaths, and lower birth rates) are likely to continue as the country struggles to cope with health and economic challenges. But what about internal migration? There is evidence of some immediate COVID-19-induced migration of residents fleeing some large cities, and othersincluding young adultsare seeking a safe haven by living with other family members. And after an initial dampening of housing markets, some parts of the country have experienced a market uptick.
But it is yet to be determined how permanent any of these pandemic-related migration patterns turn out to be. In the long run, after the widespread adoption of a vaccine and a more normal housing market prevails, migraton rates could continue to shift downward, as they have fairly consistently done over the past few decades. For example, increased telecommuting may reduce employment-related migration.
Much of this is now unknown. What is known is that internal migration in the last decadeand especially in the year before the pandemicreached historic lows, particularly among young adults. These millennials and Gen Z youths are now in their peak migration ages, but the pandemic has hit them hard. Their future mobilityand that of upcoming generationswill tell us whether or not the countrys recent immobility will continue. If so, it would reinforce Americas demographic stagnation in ways that could further reduce dynamism in the nations housing and labor markets.
White flags planted by volunteers visualize lives lost in the U.S. to COVID-19 as part of an installation by artist Suzanne Firstenberg in Washington, D.C. The death toll has now reached 300,000. Roberto Schmidt/AFP via Getty Images hide caption
White flags planted by volunteers visualize lives lost in the U.S. to COVID-19 as part of an installation by artist Suzanne Firstenberg in Washington, D.C. The death toll has now reached 300,000.
More than 300,000 people have died from COVID-19 in the United States.
It is the latest sign of a generational tragedy one still unfolding in every corner of the country that leaves in its wake an expanse of grief that cannot be captured in a string of statistics.
"The numbers do not reflect that these were people," says Brian Walter, whose 80-year-old father, John, died from COVID-19. "Everyone lost was a father or a mother, they had kids, they had family, they left people behind."
There is no analogue in recent U.S history to the scale of death brought on by the coronavirus, which now runs unchecked in countless towns, cities and states.
It's equivalent to Sept. 11 happening nearly 100 times. One person now dies every 36 seconds from COVID-19.
"We're seeing some of the most deadly days in American history," says Dr. Craig Spencer, director of global health in emergency medicine at New York-Presbyterian/Columbia University Medical Center.
During the last two weeks, COVID-19 was the leading cause of death in the U.S., outpacing even heart disease and cancer.
Family members mourn the death of Conrad Coleman Jr. at his burial on July 3 in Rye, N.Y. Coleman, 39, died of COVID-19 on June 20, just over two months after his father, Conrad Coleman Sr., also died of the disease. John Moore/Getty Images hide caption
Family members mourn the death of Conrad Coleman Jr. at his burial on July 3 in Rye, N.Y. Coleman, 39, died of COVID-19 on June 20, just over two months after his father, Conrad Coleman Sr., also died of the disease.
"That should be absolutely stunning," Spencer says. "At what point do we wake up and say, this can't be normalized?"
And yet the most deadly days of the pandemic are still to come.
By the end of January, the U.S. is expected to have lost more people to COVID-19 than service members in World War II, according to projections from the Institute for Health Metrics and Evaluation at the University of Washington.
Even with a rapid rollout of vaccines, the U.S. may reach a total of more than half a million deaths by the spring, says Ali Mokdad of the Institute for Health Metrics and Evaluation.
Some of those deaths could still be averted. If everyone simply began wearing face masks, more than 50,000 lives could be saved, the institute's model shows. And social distancing could make a difference, too.
No other country has come close to the calamitous death toll in the United States. And the disease has amplified entrenched inequalities. Black and Hispanic/Latinos are nearly three times more likely to die from COVID-19 than whites.
"I'm really amazed at how we have this sense of apathy," says Dr. Gbenga Ogedegbe, a professor of medicine and population health at New York University Grossman School of Medicine. He says there's evidence that socioeconomic factors, not underlying health problems, explain the disproportionate share of deaths.
The disease, he says, reveals "the chronic neglect of Black and brown communities" in this country.
Nurse Michele Younkin (left) comforts Romelia Navarro as she sits at the bedside of her dying husband, Antonio Navarro, in St. Jude Medical Center's COVID-19 unit in Fullerton, Calif., in July. Antonio Navarro was Younkin's first COVID-19 patient to pass on her watch. Jae C. Hong/AP hide caption
Nurse Michele Younkin (left) comforts Romelia Navarro as she sits at the bedside of her dying husband, Antonio Navarro, in St. Jude Medical Center's COVID-19 unit in Fullerton, Calif., in July. Antonio Navarro was Younkin's first COVID-19 patient to pass on her watch.
Though the numbers are numbing, for bereaved families and for front-line workers who care for people to their dying moment, every life is precious.
Here are reflections from people who've witnessed this loss how they are processing the grief and what they wish the rest of America understood:
"There are things that we can do to still make a difference"
Darrell Owens, a doctor of nursing practice in Seattle, was startled to learn recently he had signed more death certificates for COVID-19 than anyone else in Washington state.
Owens runs the palliative care program at the University of Washington Medical Center-Northwest, where he's treated COVID-19 patients since early spring.
"I'm feeling much more anger and frustration than I did before because much of what we're dealing with now was preventable," Owens says.
"We're all in this great big storm, but some people are in a yacht and some people are on a cruise ship and some people are on a raft," he adds. "We're not all in this together."
Owens still finds moments of grace and meaning as he cares for the dying.
"The other day, there was a lady I was taking care of who'd come from a local nursing home, and it was very clear that she was nearing the end; her breathing patterns had changed," Owens says. "I just picked up her hand. I sat there. I held her hand for about 25 minutes until she took her last breath."
He stepped out and called the patient's daughter.
"It made such a difference for her that her mom was not alone," he says. "What an incredible gift that she gave me and that I was able to give her daughter. So there are things that we can do to still make a difference."
''It's not a hoax, and you will not understand how horrible this is until it enters your family"
Since his father died of COVID-19 in the spring, Brian Walter of New York City has helped run a support group on Facebook for people who've lost family and friends to COVID-19.
It's helped him grieve his father, John, whom he described as a loving man dedicated to his autistic grandson and to running a youth program for teenagers.
"It's been lifesaving in a lot of ways," Walter says. "Together, we face a lot of issues since we are grieving in isolation. But at the same time, we're also dealing with people that openly tell us that this is not a real condition, that this is not a real issue."
Some in their group admit that they denied the severity of the virus and shunned precautions until it was too late.
"It's not a joke, it's not a hoax, and you will not understand how horrible this is until it enters your family and takes away someone," he says.
All of this complicates the grief, but it has also led Walter and others in his group to speak out and share their stories, so that numbers don't obscure the actual people who were leading full lives before dying from COVID-19.
"I know what it's like to have to say goodbye to somebody over a Zoom call and to not have a funeral," Walter says. "You look at these things and say: 'There are hundreds of thousands of people that are going to be experiencing this before it's over.' "
"300,000 stories that got shut down too quickly"
Martha Phillips, an emergency room nurse who took assignments in New York and Texas in the spring and summer, says there is one patient who has become almost a stand-in for the grief of the many whose deaths she has witnessed.
It was the last COVID-19 patient she cared for in Houston.
"I reached down to just adjust her oxygen tubing just a little bit," Phillips recalls. "And she looks up at me and she sees me through my goggles and my mask and my shield and meets my eyes and she goes, 'Do you think I'm going to get better?' "
Medical staff member Susan Paradela places her hand on a patient last week in the COVID-19 intensive care unit at United Memorial Medical Center in Houston. Go Nakamura/Getty Images hide caption
Medical staff member Susan Paradela places her hand on a patient last week in the COVID-19 intensive care unit at United Memorial Medical Center in Houston.
"What do you say to someone who's not ready to die? Who has so much to live for, but got this and now they're trapped?"
Phillips remembered her name. Two months later, she discovered the woman's obituary online.
"That one was the hardest," she says. "But there's 300,000 people who had time left that was stolen from them, 300,000 stories that got shut down too quickly."
"Often what is most healing is ... to not be alone with it"
Katherine Evering-Rowe, a therapist in Philadelphia, helps run the COVID Grief Network, which provides free counseling for people in their 20s and 30s who've lost someone to the disease.
"We're hearing that it just feels like there aren't so many people in their lives that really get what losses to COVID are like for them," she says. "These are so often preventable losses."
People have a range of feelings when they're grieving, but Evering-Rowe says there is more anger and isolation with COVID-19.
IV pumps and electrocardiogram machines are seen in a patient's room last week in the COVID-19 intensive care unit at United Memorial Medical Center in Houston. Go Nakamura/Getty Images hide caption
IV pumps and electrocardiogram machines are seen in a patient's room last week in the COVID-19 intensive care unit at United Memorial Medical Center in Houston.
"Often what is most healing is ... to not be alone with it, being able to talk to other people, being able to congregate, to feel supported," she says. "And one of the big tragedies of COVID is that's not something available to people in the same way."
Many young adults are enduring the loss of a parent in some cases it's both parents or an entire household, she says.
These deaths have come when they still expected to have ample time left with their parents. And she says typically there are not spaces in American society for younger adults to process this kind of loss together let alone hundreds of thousands of them all at once.
"I think people are grieving one life at a time, and that's a lot of grief," she says.
"This is worse than being in war"
ER doctor Cleavon Gilman, a veteran of the Iraq War, says it's still hard to communicate the brutality of a disease that kills people in the privacy of a hospital wing, not on the streets.
"I get up, have a cup of coffee, tell my family goodbye and go into the hospital, where there are tens of patients who are critically ill, gasping for breath and getting intubated and dying," he says.
When Gilman was in New York City during the spring surge, he never imagined the U.S. would be losing thousands of people each day to COVID-19 so many months later.
"That 300,000 Americans would be dead and life would go on and people would not have empathy for their fellow Americans," he says. "I can tell you this is worse than being in war."
Dozens of volunteers helped geotag and collect flags in a recent art installation in Washington. Some flags were personalized with inscriptions by family members or friends of those who died. Roberto Schmidt/AFP via Getty Images hide caption
Dozens of volunteers helped geotag and collect flags in a recent art installation in Washington. Some flags were personalized with inscriptions by family members or friends of those who died.
The enemy is invisible, he says, the war zone is everywhere, and many refuse to take the most simple actions to combat the virus, even as morgues fill up in their own community.
"I call this a crime against humanity, because that's exactly what this is."
Throughout the pandemic, Gilman has shared photos and stories of people who've died from COVID-19 each day on social media. He wishes someone in every city or town of America would do the same.
"All the people that you're not going to see a big article about and you're not going to hear about them anywhere else," he says. "It's really important to honor them."
''Nobody wants to hear sad stories like these"
Nurse Jessica Scarlett saw more death in three months of caring for COVID-19 patients in McAllen, Texas, than she did in her previous 15 years as a nurse.
"It was just extremely difficult to see so much death," she says. "We'd see families praying in front of the hospital, praying for us and for their family on our way into work."
It was unlike any nursing she'd ever done before. Almost the entire hospital was on oxygen. Nurses would sit at the foot of the bed because there wasn't any other space.
She became intimately familiar with the progression of the disease, with patients needing more and more help breathing until eventually being placed on life support.
"And there's nothing you could do," she says. "There was one guy, he would always say, 'Please sit with me I'm really scared.' And the day before I left, he was intubated."
After that, Scarlett says she needed a break from such a "tremendous amount of death."
She's still trying to grasp all the tragedy, seeing daughters and mothers ending up in the hospital after a family reunion.
What happened inside that hospital felt like its own separate reality. She hasn't talked about her time there with almost anyone else, except other nurses.
"Nobody wants to hear sad stories like these, people don't want to," she says.
This story comes from NPR's reporting partnership with KHN (Kaiser Health News).
