Gov. Michelle Lujan Grisham is expected to allow hospitals to begin rationing care based on how likely a patient will survive, a move many physicians had hoped to avoid but say is necessary given New Mexicos spiraling number of hospitalizations amid the COVID-19 outbreak.
A declaration permitting hospitals to implement crisis standards of care, which the Lujan Grisham administration is expected to announce in the coming days, is the latest sign the states hospital system has reached its breaking point under the strain of the coronavirus pandemic.
The news was first reported by the Washington Post on Saturday.
Tripp Stelnicki, a spokesman for the Governors Office, said Lujan Grisham hasnt authorized or enacted the crisis standards of care, but on Friday signed an executive order that will make it easier for hospitals to implement such standards.
In the simplest possible terms, it provides for the temporary facilitation of that assistance that may become necessary outside providers regular scope of practice and support. So, if and when the Department of Health deems it necessary, they can, Stelnicki wrote in an email.
In the executive order, Lujan Grisham asked the secretary of health to request the states Medical Advisory Team make a recommendation on when crisis care standards should be implemented.
Public health officials are scheduled to hold a virtual news conference early this week to explain the move in greater detail, Stelnicki said.
Some in the medical community applauded the move.
In a statement, Dr. Jason Mitchell, chief medical officer at Presbyterian Healthcare Services, one of the states largest health care providers, said such a declaration provides another lever for hospitals to meet the demand during this surge.
This is an incredibly concerning time for our entire community, and especially for our clinicians and staff, Mitchell said Saturday. We will care for our patients as safely and effectively as possible. We urge our fellow New Mexicans to prevent further spread of COVID-19 by limiting gatherings, practicing social distancing, masking up and staying home whenever possible.
In a separate statement, Dr. David Gonzales, chief medical officer for Christus St. Vincent Regional Medical Center in Santa Fe, said the hospital has seen a significant increase in COVID-19 patients in recent weeks.
In the event that we have a strain on hospital capacity and resources we, like other New Mexico hospitals, will utilize the established crisis standards of care as a consistent guide for triaging patients when health care resources become inadequate, Gonzales said Saturday.
Over the past couple of months, the virus has spread exponentially across the state, leading to an alarming number of COVID-19 deaths and hospitalizations. The state Department of Health on Saturday reported 1,925 new cases and 32 more deaths, including three in Santa Fe. The state said 925 people were hospitalized with COVID-19 on Saturday.
While New Mexico has seen a drop in its daily case count in recent weeks, which many attribute to Lujan Grishams decision in November to enact a two-week shutdown of nonessential businesses, the numbers are still far higher than they were before the latest surge began in early fall.
The state on Wednesday released its first color-coded map of New Mexicos 33 counties as part of an initiative that would loosen business restrictions in counties where the virus is less prevalent. No county had earned green status, and only one county, San Miguel, was in the yellow. The rest of the state was awash in red.
For weeks, health officials have warned what will happen if the states hospitals continue to be inundated with COVID-19 patients.
When we go crisis of care, it means we may have to share equipment like ventilators, Mitchell said in late October. It may mean people are in tents outside in the parking lot in hospital-type MASH units. It may mean that health care providers who have not practiced in a hospital for many years may have to come in and relearn how to run ventilators and take care of patients. It is a time when if you have other health care needs like the birth of a child, a car accident or any other emergency, you may not have a place to go.
This is a place where nobody wants to be, he added.
Each major hospital has its own individual surge plan it has activated to help manage resources during the outbreak.
The scenario that confronts New Mexico hospitals is precisely the one Lujan Grisham said the state was trying to avoid as it imposed restrictive health orders both in the spring and later in the year. In March, she warned the states health care system, relatively small and understaffed compared to those of neighboring states, could not handle an endless wave of patients and care for patients who would be coming to the hospital for non-COVID-19 issues.
For the first nine months of the pandemic, the states hospital system has avoided going into a crisis of care mode by finding ways to increase capacity, such as converting operating rooms into patient rooms. But as the spread rate continued to spike, hospital beds filled up.
We are out of ICU beds, Mitchell said last week. We really are totally full.
The states Medical Advisory Team, led by Dr. Michael Richards, vice chancellor for clinical affairs at the University of New Mexico Health System, prepared a supplement to the New Mexico Crisis Standards of Care Plan in April, when the public health crisis began to unfold.
Under the plan, medical professionals would use complicated formulas in deciding who would be given priority for medical resources such as ventilators. They would consider a patients chances of surviving as well as preexisting conditions such as lung disease, heart disease, dementia and fragility.
In some cases, patients might have to share a ventilator.
Its a physicians worst nightmare, Mitchell said of having to ration care.
InvestorPlace
Back in July, I recommended seven of the best stocks to buy for 2021 and beyond. As a group, theyve done very well over the past three months. For instance,Livongo Healthwas acquired by Teladoc Health (NYSE:TDOC) on Oct. 30 for $11.33 per share in cash and 0.592 times shares in Teladoc.But looking for a bit of a twist on my stock selection process, Ive decided that this list will be based on the first letter of all 12 months. That means my stock pick for January will have a corporate name beginning with J, then an F for February and so forth.All 12 will also have a market capitalization of $2 billion or more and positive free cash flow for the trailing 12 months. By this time next year, Im confident that my picks, on the whole, wont disappoint.InvestorPlace - Stock Market News, Stock Advice & Trading Tips7 Cheap Stocks Ready for Big Gains in 2021So, without further ado, here are my 12 best stocks for a brand new year:Johnson & Johnson (NYSE:JNJ)Fidelity National Information Services (NYSE:FIS)McDonalds (NYSE:MCD)Adobe (NASDAQ:ADBE)MercadoLibre (NASDAQ:MELI)Johnson Controls (NYSE:JCI)Jeld-Wen Holding (NYSE:JELD)Apple (NASDAQ:AAPL)SVB Financial (NASDAQ:SIVB)Otis Worldwide (NYSE:OTIS)NextEra Energy (NYSE:NEE)Dollar General (NYSE:DG)Stocks to Buy: Johnson & Johnson (JNJ)Source: Alexander Tolstykh / Shutterstock.comJohnson & Johnson represents the month of January on my list of best stocks to buy for 2021. Right now, its having a sideways kind of year in the markets. Its year-to-date (YTD) total return through Dec. 4 is just 2.6%.Based on a trailing 12-month free cash flow (FCF) of $18.3 billion and a current enterprise value (EV) of over $399 billion, JNJs FCF yield is a reasonable 4.7%. It might not be value territory I consider anything above 8% to be cheap but its pretty darn good.As InvestorPlace colleague Faisal Humayun recently stated, JNJ stock has an excellent product offering.From a business perspective, the company provides diversified exposure to the segments of consumer health, pharmaceuticals and medical devices. The companys pharmaceutical segment growth for Q3 2020 was impressive with most therapeutic areas delivering strong numbers.Not to mention, JNJ is still very much in the Covid-19 vaccine race. That suggests that 2021 could be a breakout year for this Dividend Aristocrat.Fidelity National Information Services (FIS)Source: Maryna Pleshkun/Shutterstock.comNext on my list of best stocks to buy is Fidelity National Information Services, representing the month of February. This payment processor is having an underwhelming year relative to the U.S. markets as a whole. Currently, FIS stock has a YTD total return of just over 7%, about half the markets rate of return in 2020.Based on a trailing 12-month free cash flow of $2.57 billion and an enterprise value of $109.75 billion, though, Fidelity Nationals FCF yield is very decent at 3.8%.You wont find a lot of commentary from InvestorPlace contributors on this stock, despite the fact it does have a part to play in the technology side of the financial services industry.However, on Nov. 19, the Florida-based company announced that it earned the top spot for the sixth consecutive year in a ranking of 100 leading providers of risk and compliance technology.Additionally, while Covid-19 has slowed the rate at which FIS can process transactions, it still has managed to generate organic revenue growth during its third quarter of 1% to about $3.2 billion. The company also increased adjusted net income by 18% to $887 million.7 Growth Stocks Flying Under the RadarSo, this is not a glamorous stock but its services are certainly in demand.McDonalds (MCD)Source: CHALERMPHON SRISANG / Shutterstock.comTo represent March for the coming year, Ive picked the golden arches of MCD stock. Like many of the names on this list, McDonalds has an okay year going, up 7.11% YTD today. Thats better than many of its restaurant peers, but its trailing the U.S. markets as a whole.Thanks to Covid-19 shutdowns, McDonalds trailing 12-month free cash flow isnt nearly as strong as it usually is, now at $4.25 billion. Currently, the industry leader has an FCF yield of 2.7% based on an enterprise value of about $205 billion.Despite operating in one of the hardest-hit industries, McDonalds has continued to look beyond the novel coronavirus, continually finding ways to transform its business without upsetting the core customer.For instance, the company recently gave Beyond Meat (NASDAQ:BYND) the cold shoulder by announcing it would be testing a line of meatless alternatives in 2021, including the McPlant burger. Interestingly despite developing the plant-based burger with Beyond Meats input the fast-food company decided to go its own way.The decision to go on its own was a result of two reasons. First, MCD didnt want to alienate its meat-loving customers. Secondly, its not a fan of letting licensees and other brands into its house. Beyond Meat would have surely taken some shine off of the Golden Arches.McDonalds has had a tough time, but it always bounces back. That makes it one of the best stocks to buy for the upcoming year.Adobe (ADBE)Source: r.classen / Shutterstock.comAdobe, the mastermind behind the PDF and so much more, is my pick for the month of April. Its having an excellent year in the markets right now, with a YTD total return of over 47%. Thats considerably better than both its software peers and the U.S. markets as a whole, making it one of the best stocks to buy right now.Adobes trailing 12-month free cash flow is $4.9 billion, while its enterprise value is nearly $232 billion for an FCF yield of 2.1%. Both its enterprise value and EV-EBITDA multiple have also risen dramatically in the past five years. In 2016, the company had an enterprise value of $48 billion and an EV-EBITDA of 26.1. Presently, the stock has an EV-EBITDA multiple of 48.3.7 Stocks to Sell for DecemberIn early February, I said ADBE stock was all but certain to hit $400 in 2020. It did and then some. Moving forward, I think its all but certain to hit $500 perhaps $600 in 2021.MercadoLibre (MELI)Source: rafapress / Shutterstock.comMercadoLibre is sometimes referred to as the Amazon (NASDAQ:AMZN) of Latin America, although it more closely resembles Alibaba (NYSE:BABA). For my list of best stocks to buy in 2021, it represents the month of May.Currently, MELI stock is having a fantastic year in the markets with a YTD total return of over 170%. Like Adobe, MercadoLibre is faring far better than both its internet retail peers and U.S. markets as a whole.This companys trailing 12-month free cash flow is $810 million, while its enterprise value is almost $76 billion for an FCF yield of 1.1%. While that might seem low, MercadoLibres free cash flow has never been higher. Likewise, its revenues are on fire and growing like weeds. True to the Amazon comparison, this name will also probably see exponential growth in its free cash flow over the next few years.Ive been a fan of the company since as far back as 2013, when it was trading around $120. At the time, I argued that it had a dominant position in Latin American e-commerce and its stock would benefit from that.As I write this, shares are priced around $1,555 and moving higher in 2021.Johnson Controls (JCI)Source: ShutterstockThere arent a lot of great companies with a J as the first letter in their name. There are even fewer with strong free cash flow. Nonetheless, Johnson Controls represents the month of June on my list of best stocks to buy.Interestingly, while its only generally matching the YTD performance of the U.S. markets as a whole, JCI stock is doing better in 2020 than it has in some time. Over the past five years, its delivered an annualized total return for shareholders of about 9.1%, well below the markets.However, up almost 14% over the past three months, the company appears to be gathering speed heading into 2021.In early November, Johnson Controls also announced its fourth-quarter results, which were excellent despite the challenging business environment. In fiscal 2020, it had sales of $22.3 billion and net income of $1.69 billion, flat to a year earlier.Thats not bad for a company that manufactures, installs and services products designed for offices, industrial properties and other types of commercial real estate all of which were hurt by the pandemic.Johnson Controls trailing 12-month free cash flow is nearly $1.8 billion, while its enterprise value is about $39 billion for an FCF yield of 5.3%.The 7 Best Cheap Stocks to Buy for DecemberI view JCI as a nice stock for risk-averse investors who also like a little dividend income its dividend yield is 2.27% at the moment.Jeld-Wen Holding (JELD)Source: IgorGolovniov / Shutterstock.comBy far the smallest of the 12 names on this list, JELD stock has a market cap of $2.42 billion. This maker of windows and doors represents the month of July on my best stocks to buy list.Back in late January of 2017, Jeld-Wen went public at $23 a share.Now, though if you bought shares in its IPO and are still holding youve made almost no money on your investment. Year-to-date, its got a total return of just 2.7%, well below the booming returns of its building products and equipment industry peer group. Those stocks have mostly benefited from Covid-19.The companys trailing 12-month free cash flow is $250 million, while its enterprise value is $3.8 billion for an FCF yield of 11.3%.However, on Nov. 3, the company reported third-quarter results that were better than analyst expectations. On the top-line, revenue was $1.11 billion, $2 million higher than the consensus estimate. On the bottom line, it had adjusted earnings per share of 52 cents, eight cents higher than analyst expectations. President and CEO Gary Michel said the following:Consumers focus on their homes, coupled with our strategy to deliver profitable market share with key customers, is driving increased demand for products in both residential new construction and repair and remodel channels.As the focus remains on homes in 2021, I expect Jeld-Wen to snap out of its funk and do well.Apple (AAPL)Source: WeDesing / Shutterstock.comFor August, the famous maker of the iPhone is the next pick of this list. However, if there were a month beginning with the letter B, Id recommend Berkshire Hathaway (NYSE:BRK.A, NYSE:BRK.B) because its a much better value play and happens to own almost 965 million shares of AAPL stock.Apples YTD total return is over 66%, which sounds rather ordinary, given its almost 30% annualized total return over the past 15 years. Id take it every day of the week.As for free cash flow and enterprise value, they are almost $73.4 billion and $2.1 trillion, respectively. Thats an FCF yield of 3.5%, an excellent valuation for one of the worlds largest public companies.Put simply, Apple has become so much more than a maker of smartphones.According to AppleInsider.com, Apples new M1-equipped Mac mini has jumped to the number one position in sales in the Japanese market for desktop computers after only two weeks of availability. Further, Apple now has a 27% market share in Japan, up from roughly 13% a year earlier.10 Best Stocks to Buy for Investors Under 30So, I dont think you can go wrong owning Apple over the long haul. Clearly, its one of the best stocks to buy for the coming year.SVB Financial (SIVB)Source: ShutterstockNext, representing the month of September is my favorite U.S. bank. SVB Financial is the holding company that operates Silicon Valley Bank, the Santa Clara-based financial institution that focuses on entrepreneurs and innovators.Right now, its having an awesome year compared to peers in regional banking. While SIVB stock is up nearly 43% YTD, most of its peers are down. Its also leaving the U.S. markets in the dust. That said, I wont bother noting the free cash flow for this name because its not meaningful for banking institutions. Instead, the balance sheet matters most.SIVB reported Q3 2020 results that included earnings per share of $8.47, almost double the $4.42 per share it earned the year prior. The president and CEO of SVB Financial, Greg Becker, noted:We had an exceptional quarter driven by outstanding balance sheet growth, higher core fee income, strong investment banking revenue, solid credit resulting in a reduction of reserves, and outsized equity gains related to client IPO activity [] These results reflect the resilience of our markets and our ability to execute effectively.SIVB was on my 2013 list of the five best stocks to buy for the next 20 years, right up there with Amazon. I think you owe it to yourself to check it out in 2021.Otis Worldwide (OTIS)Source: rafapress/shutterstock.comBack in early April, this elevator company spun off from United Technologies, which merged with Raytheon (NYSE:RTX) to become one of the worlds largest aerospace and defense companies.While it wont have a full 12-month track record until April, this representative for the month of October has risen 43.5% YTD, suggesting 2021 could deliver an excellent performance.In the trailing 12 months, Otis has a free cash flow of $1.47 billion andan enterprise value of about $33 billion. That makes for an FCF yield of 5.2%, so its reasonably priced.Whats more, the companys third-quarter results demonstrate that its holding its own during the pandemic. Top-line organic sales fell 1.2% in Q3 2020 to $3.3 billion while its operating profit grew 7% on an adjusted non-GAAP basis. Also, operating margins increased 120 basis points to 15.4%.In November, Toronto-based portfolio manager Christine Poole made OTIS stock one of her three top picks on BNN Bloombergs Market Call, suggesting that its 17% global elevator market share makes it an excellent long-term investment with an excellent balance between sales and service, at 57% and 43% respectively.7 Value Stocks That May Come Back into Style After the PandemicThat makes it worthy of this best stocks to buy list for 2021. Can you say recurring revenue?NextEra Energy (NEE)Source: madamF / Shutterstock.comRecently, I recommended this Florida-based utility company because of its renewable energy business, NextEra Energy Resources, which generates almost 40% of overall earnings. I maintain that NEE stock is one of the best stocks to buy for 2021, representing the month of November on this list.NEE stock is a thing of beauty if consistent returns are your thing. YTD, its up about 20%. Over the past three-, five- and 10-year periods, it has annualized total returns of 25.1%, 26.8% and 20.5%, respectively. Lets say its crushing its peers over any of those periods.NextEras free cash flow in the trailing 12-months is $2.1 billion, while its enterprise value is $190 billion, for an FCF yield of -3.2%. So, its certainly not cheap.But InvestorPlaces Mark Hake made an interesting observation on Nov. 25 when he suggested that NextEra would buy another utility with its strong share price. As Hake would agree, thats Capital Allocation 101.NextEra made overtures to Duke Energy (NYSE:DUK) and Evergy (NYSE:EVRG). Both rejected the offers. However, Im sure something will shake out soon enough. Like Hake said, a bid might come with more cash.What I do know for certain is that NextEra is one of North Americas best-run utilities.Dollar General (DG)Source: Jonathan Weiss / Shutterstock.comRepresenting the final month of the year is Dollar General, the dollar-store discount chain with 17,000 locations in 46 states. Its having another strong year, up almost 37% YTD. Combine that with a 10-year annualized total return of 20.8%, and youve got one heck of a long-term investment.As for trailing 12-month free cash flow, it has $3.1 billion, along with an enterprise value of nearly $64 billion. Right now, its FCF yield is 5.9%.On Nov. 14, the company announced the opening of its 17,000th store in Fountain, Colorado. As a nice gesture to the community, Dollar General donated $17,000 to one of the local schools. In the companys press release heralding the occasion, CEO Todd Vasos said:Since our founding more than 80 years ago, we have remained focused on helping customers save time and money.In my book, helping customers save time and money are the hallmarks of any successful business.Back in November, I also recommended Dollar General as one of three stocks of relative values compared to Nio (NYSE:NIO), the Chinese electric vehicle maker. And while I like Nio long-term, it isnt a name to buy for the short-term at current prices. DG stock is much more down-to-earth.8 Tech Stocks That Could Benefit from a Biden PresidencyAs long as working folk need to save money, Dollar Generals business remains a solid bet. In turn, that makes it one of the best stocks to buy going into the uncertainty of 2021.On the date of publication, Will Ashworth did not have (either directly or indirectly) any positions in the securities mentioned in this article.Will Ashworth has written about investments full-time since 2008. Publications where hes appeared include InvestorPlace, The Motley Fool Canada, Investopedia, Kiplinger, and several others in both the U.S. and Canada. He particularly enjoys creating model portfolios that stand the test of time. He lives in Halifax, Nova Scotia.More From InvestorPlaceWhy Everyone Is Investing in 5G All WRONGTop Stock Picker Reveals His Next 1,000% WinnerRadical New Battery Could Dismantle Oil MarketsThe post The 12 Best Stocks to Buy for a Whole New Year of Returns in 2021 appeared first on InvestorPlace.
Since the pandemic began in March, roughly 350,000 Minnesotans have tested positive for COVID-19 and more than 300,000 have recovered enough from the coronavirus they likely wont pass it to others.
But that doesnt mean theyre done with COVID-19.
Its been less than a year since scientists first identified SARS-CoV-2 that has shaken the globe, infecting at least 64 million and killing more than 1.4 million people.
There are so many things that we are still learning about, that are still unknown, said Dr. Nick Lehnertz, a Minnesota Department of Health medical specialist in the infectious disease division who is studying COVID-19 and its long-term effects.
In Minnesota, the coronavirus has killed more than 3,800 people and sent another 17,600 to hospitals, including nearly 4,000 who required critical care.
Vaccines are expected to soon become available to a very limited number of medical workers and long-term care residents. In the meantime, its important for everyone else to understand what scientists now know about coronavirus transmission, recovery, immunity and reinfection. Here are the answers to some common questions:
SARS-CoV-2 typically has an incubation period of between two and 14 days after a person contracts the coronavirus. Many people never experience symptoms and most are contagious before they know they are infected.
Thats why it is important to understand that a negative test one day doesnt mean there isnt an infection a few days later.
Lehnertz says there is also a distinction between quarantine and isolation.
Someone who is exposed to COVID-19 or suspects they are infected should quarantine themselves at home for 14 days, regardless if they have symptoms or test negative.
On the other hand, someone who tests positive for COVID-19 should isolate themselves, including from others in their household, for at least 10 days from the onset of symptoms or a positive test, preferably whichever is longer.
Generally speaking, you are contagious up to nine days from the onset of symptoms, Lehnertz said.
Most people who get COVID-19 are feeling better a week or two after the onset of symptoms. Yet, the virus has been known to have dramatically different effects on different people.
A small minority of people who catch the coronavirus experience symptoms, such as fatigue and body aches, for weeks or months after first getting sick. Not a lot is known about these so-called long-haulers, but Lehnertz says a number of clinics around the country are studying patients whose symptoms persist.
There are also a number of other health concerns that can arise in people whove contracted SARS-CoV-2 and recovered.
One of the best known is multi-system inflammatory syndrome, which typically appears in children, and causes different organs to become inflamed. To date, there have been 42 cases diagnosed in Minnesota and no fatalities.
There have also been shorter-term complications, including difficulty concentrating, depression, muscle pains and heart palpitations. More serious long-term impacts that have been recorded include inflammation of the heart, breathing problems and kidney injury.
Little is known about why these conditions occur and the lasting impact of contracting COVID-19. Health officials say anyone recovering from the disease should monitor other symptoms and health concerns and contact their physician.
Everyone knows themselves, Lehnertz said. People will know when something is not right.
The simple answer is yes, but it is probably highly unlikely. The science is complicated and theres a lot thats still unknown.
Lehnertz says there have only been a handful of proven examples of reinfection out of 64 million known COVID-19 cases worldwide. In order to prove a reinfection, scientists need to compare both strains of the SARS-CoV-2 that infected an individual to be sure.
Viruses are constantly mutating over time and there are several identifiably different strains of COVID-19. Sequencing the DNA of two samples collected from the same person at different times is the only real way to know for sure if someone was infected twice.
Thats the gold standard, Lehnertz said. Thats when we can see, yep, this is completely different.
Whats more common, but still unlikely, is people who test positive for the same strain of the coronavirus repeatedly over a long period of time. These people shed virus fragments for weeks or months and may test positive repeatedly, but are not suspected to be transmitters after the initial contagion period.
This is a question that will take more time to answer.
There is some evidence that people whove recovered from COVID-19 have virus-fighting antibodies for months. In others, the presence of antibodies begins to dwindle after a while.
Just because antibodies cannot be detected doesnt mean the immune system will not remember COVID-19 and how to fight it.
It will likely take a number of years before scientists have a clear picture of SARS-CoV-2 immunity and how often people need to be vaccinated against it.
When push comes to shove, we just dont know enough about the duration of immunity and how it would affect a second infection, Lehnertz said.
In fact, the Centers for Disease Control and Prevention say people who have recovered from a coronavirus infection may still benefit from getting vaccinated. Guidance released in late November cites all the current unknown factors about the coronavirus.
What remains unclear is when previously-infected individuals will be eligible to get vaccinated.
For the foreseeable future, health officials say everyone should wear masks, social distance, avoid crowds and stay home when they are sick because there are so many unanswered questions about COVID-19.
The biggest reason for those mitigation efforts is to protect people who havent gotten sick yet especially those who are medically vulnerable.
But theres also good reason to shield those who believe theyve recovered from COVID-19 since theres so much unknown about the long-term impacts.
Its not a huge ask to wear a mask, Lehnertz said. We are all in this together, right? Just wear the mask and stay 6 feet away. Its not hard.
Saturday marked a third consecutive day where more than 5,000 new COVID-19 cases were reported in Massachusetts.
There were 5,356 new confirmed cases of the coronavirus Saturday, up from Friday's figure, the Department of Public Health announced. Massachusetts also reported 41 more deaths from COVID-19.
This number of cases still comes in under the high mark of the week, when the state reported 6,477 new cases Thursday though 680 of those cases came from a delay in reporting, according to that day's report.
There have now been 10,715 confirmed deaths and 242,812 cases, according to the DPH. Another 263 deaths are considered probably linked to COVID-19 at this time.
The average rate of COVID-19 tests stayed relatively level at 5.4%, according to the report just a small change from Friday's 5.44%.
With COVID-19 deaths and infections hitting record highs and discouraging economic numbers, Washington is under pressure to break deadlock on a new relief bill.
The number of patients hospitalized for COVID-19 increased again Saturday to 1,428. Of that total, 283 are listed as being in intensive care units and 138 are intubated, according to DPH.
In Nantucket, officials are concerned about a rising trend in cases in recent days.
Saturday morning, 64 new cases of COVID-19 were reported from tests conducted at Nantucket Cottage Hospital over the past couple days.
The seven-day positivity rate in the town, meanwhile, has risen to 10.9% - a mark nearly double that of the average statewide, and the highest level seen there since the start of the pandemic, Nantucket officials said.
Most of the infected patients have been in their 20s and 30s, but in all has ranged from 9 months to 60 years old.
"We are grateful, and lucky, that none of these recent active cases of COVID-19 have required hospitalization yet, but the sheer number of people we have diagnosed over the past week is very troubling," the Nantucket Department of Health said in a statement Saturday.
Gov. Charlie Baker on Friday evening said the Commonwealth had submitted its order for a first round of vaccines to the CDC. The federal government allocated Massachusetts nearly 60,000 doses of the Pfizer COVID-19 vaccine in a first shipment.
The first doses will likely be reserved for frontline health care workers, people over the age of 65 or with underlying health conditions and other essential workers.
When Kenneth Macur became president at Medaille College in 2015, the small, private school in Buffalo, N.Y., was surviving paycheck to paycheck, he said. Enrollment was declining and the small endowment was flat.
Then came the coronavirus pandemic. The campus shut down and revenue plummeted 15%. Dr. Macur saw what he considered an opportunity: With the approval of the board of trustees, he suspended the faculty handbook by invoking an act of god clause embedded in it. He laid off several professors, cut the homeland security and health information management programs, rescinded the lifelong job security of tenure and rewrote the faculty handbook, rules that had governed the school for decades.
I believe that this is an opportunity to do more than just tinker around the edges. We need to be bold and decisive, he wrote in a letter to faculty on April 15. A new model is the future of higher education.
Dr. Macur and presidents of struggling colleges around the country are reacting to the pandemic by unilaterally cutting programs, firing professors and gutting tenure, all once-unthinkable changes. Schools employed about 150,000 fewer workers in September than they did a year earlier, before the pandemic, according to the Labor Department. Thats a decline of nearly 10%. Along the way, they are changing the centuries-old higher education power structure.
The changes upset the shared governance model for running universities that has roots in Medieval Europe. It holds that a board of trustees has final say on how a school is run but largely delegates academic issues to administrators and faculty who share power.
New Salem is in many ways exemplary of North Dakotas small town ideals. It has three bars, a grocery store, premium farmland, a 1986 9-man football championship and a communal spirit passed down for generations.
Its like Pleasantville, said Bill Kramer, who owns The Field bar with his wife Jacey, describing a community just large enough to have amenities, but still small enough that everyone has to pitch in sometimes working several jobs to keep the place running.
The size of New Salem, home to some 1,000 people, has acquired a new kind of significance in the latest chapter of the COVID-19 pandemic in North Dakota: A 2019 census estimate puts the town at 989 residents, the same number of North Dakotans who have died with COVID-19 as of Friday, Dec. 4.
As the state has passed its 1,000th COVID-19 death, one way to grasp the incomprehensible may be to picture North Dakota without New Salem. It's like losing the cow town completely.
Its pretty devastating to everything. To even think that a town like that would be off the map with how many people have died in nine months is pretty disturbing, Kramer said. You cant replace that generation of people the experience, the knowledge.
As in many North Dakota towns, life from the outside looks pretty close to normal in New Salem. The grind of grain elevators still lays the soundtrack for downtown streets. Right now, the telephone poles along Main Avenue are lit with electric snowflakes, and many of the nearby houses are rimmed in Christmas lights.
A closer look reveals the subtle differences. During Sunday Masses at St. Pius V Catholic Church, the nave is sparsely populated with parishioners sitting pews apart. School children sport colorful masks that sometimes slip beneath their noses as they run to the buses. The owner of the local grocery, Deb Tellmann, hasnt seen her uncle since March even though he lives just a few blocks from her store, in the town nursing home.
The mayor, Lynette Fitterer, the first woman elected to that office in the towns history (in a 2010 election that she recalled as a frickin landslide), said that, for the most part, New Salem has taken these adjustments in stride. In her day job, Fitterer is the retail manager at Dakota Frontier Cooperative, a fuel station and co-op on the road into town, and she said most people who stop into the store wear masks now. She'll remind friends if they don't.
Lynette Fitterer, mayor of New Salem, N.D., is the retail manager at Dakota Frontier Cooperative, a fuel station and co-op on the road into town. Michael Vosburg / Forum Photo Editor
Even though Fitterer has received her share of calls and complaints about pandemic precautions, she said folks have mostly managed to keep their heads on straight. I really believe people in town here have just gone with it, she said. It is what it is.
Still, New Salem has some stubborn ways. Fitterer said the hardest part of her decade as mayor has been getting people on board with needed changes. For her, that means things like repaving old roads, fixing water mains and bumping up the town sales tax. COVID-19 brought change of a different order.
There was a time, probably two months ago, where I honestly considered doing a mask mandate in New Salem, Fitterer said, recalling a stretch when a local outbreak forced high school classes to go virtual and when many of her friends tested positive. But she joked, I dont know I think looking back now, I probably would have been crucified on Main Street.
But masks have been slowly adopted over the last two months in New Salem, with the town gradually acknowledging the seriousness of the virus as family and neighbors got sick.
The town of New Salem, N.D., is seen Monday, Nov. 30, 30 miles west of Bismarck. Michael Vosburg / Forum Photo Editor
High school students warm up for basketball practice Monday, Nov. 30, in New Salem, N.D. Michael Vosburg / Forum Photo Editor
For some of the youngest residents in town, reality dawned almost with the flip of a switch.
In mid-October, the New Salem Holsteins football team (now 11-man) had to forfeit its last game of the season because of a virus outbreak that knocked out some of its star players. A win would have delivered them to the state playoffs. In-person high school classes went on hiatus the next week, and on the following Monday holdouts slowly donned masks, a response to what Superintendent Brian Christopherson described as positive peer pressure. It was just like that, he recounted. Slow at first, but as the day went on, some of the popular kids had a mask on, and then some of the other kids. I had hundreds of masks to give out.
At the same time, the handful of bars and restaurants in town have gotten quieter.
The Field so named years ago, according to its owners, so that farmers could always say that they were "in the field" has been a vital watering hole in New Salem for generations. A favorite spot of nearby farmers, its barstools have their own place in the area's long history of big money land deals. Theres been millions of dollars of business done on napkins in that place, Kramer said.
In the pandemic, The Field has lost this central position. A bar that the Kramers said used to regularly pack in more than 100 people at a time, even drawing patrons from the nursing home on some pre-pandemic days, now sees about 30 different faces on a good day.
Employees of the Elm Crest Rehabilitation Center gather at the main entrance Monday, Nov. 30, in New Salem, N.D. Michael Vosburg / Forum Photo Editor
Bill Kramer, who owns The Field bar with his wife Jacey in New Salem, N.D., talks Monday, Nov. 30, about how his business has struggled during the pandemic. Michael Vosburg / Forum Photo Editor
But even with pandemic anxiety on the rise in New Salem, many residents snubbed warnings for months. The Kramers said some of their patrons can be especially stubborn, so much so that its difficult to pin down just how widespread COVID-19 has been in the surrounding community because so many people dont want to admit that they came down with the virus.
Youre not getting those farmers and ranchers and those old cowboys to go in. Theyre sitting at home with their cold, Jacey Kramer said.
I know hundreds of people that definitely had it, and they refused to go get it tested, Bill Kramer added. He suggested that some New Salem farmers seemed readier to contend with death than check themselves into a hospital. Ive heard about them going and just keep combining when they couldnt breathe, and they just went right through it.
Main Avenue is seen Monday, Nov. 30, in New Salem, N.D. Michael Vosburg / Forum Photo Editor
For June Doll, the pandemic has upended life, despite the care she and her family took to follow precautions.
A lifelong New Salemite, June recalled that her friends set her up on a blind date in 1963, just before her freshman year of high school. She and her date, a senior named Ron Doll, soon fell in love. Four years later, after June graduated, the two got married and bought a dairy farm south of town, where they lived and worked for more than 50 years.
When COVID-19 hit the Doll family in October, June, Ron and their son all got sick. Ron, who already had a depleted immune system, got it worst of all, coming down with the virus a few weeks before his 74th birthday. The family rushed him 30 miles east to Bismarck, where he was airlifted to a Fargo hospital the same day.
June, her son and two daughters couldnt visit Ron and had to talk to him through FaceTime. He didnt know that he was in Fargo, June said. In the weeks after Rons airlift, he was unconscious almost the entire time. The virus just took over his lungs and pretty much destroyed him," she said.
After three weeks, doctors told June that she would have to make a decision about keeping her husband alive. She and her children drove to Fargo and stayed overnight in a motel, prepared to take Ron off his ventilator the next day. "We thought we knew what we were doing that day," June said. "But I couldn't do it when we got there."
The Dolls had their priest, the Rev. John Guthrie, administer a final prayer service, bringing him in over a video call from New Salem. June and her son, who had already gotten COVID-19, were in the hospital room with Ron. Her two daughters said goodbye through the window.
Its not something that I want anybody else to go through, June said. Its pretty heartbreaking to make those decisions about someone elses life.
Rev. John Guthrie of St. Pius V Catholic Church in New Salem, N.D., said the COVID-19 pandemic is proof of the ties between this small community out in central North Dakota and the rest of the world. Michael Vosburg / Forum Photo Editor
For Guthrie, who ministers at St. Pius, the alienation of the pandemic and losses like the Dolls make him question why this is happening, and how it could all figure into God's plans.
But for all of the sickness and doubt, he said he hopes for a different New Salem when the pandemic is over. Everyone is eager to get back to their old lives, he said, but maybe 'get back' is not the right word.
COVID-19, Guthrie explained, is tragic proof of the ties between this small community out in central North Dakota and the rest of the world. He said he hopes that, if any good comes out of the virus, it will be to prompt reflection on the responsibilities owed between neighbors, communities and countries.
This is a call to something much deeper than where weve been, he said, a challenge posed to his neighbors as much as to himself. Am I willing to change? Am I willing to grow?
Readers can reach Forum reporter Adam Willis, a Report for America corps member, at awillis@forumcomm.com.
CLEVELAND, Ohio When COVID-19 first hit, I didnt know anyone who had the virus.
Several months into the pandemic, I knew some. A few were very seriously ill, most were not. But in the last month, I know several people who have become ill from it or at least tested positive.
In the recent surge, if you dont know someone who has the virus ... just wait, you probably will.
Some people who have come down with the virus have been made to feel like a leper.
Thats what Bishop Joey Johnson of Akrons House of the Lord mentioned to me. We are talking about those who have tested positive feeling as if they did something wrong.
Yes, some were hitting the bars, not wearing masks and symbolically spitting in the face of the virus.
But most of the people we know have been careful when they go out, wearing masks and trying to stay safe.
When I called Father Bob Stec, the pastor of Brunswicks St. Ambrose Catholic Church, he said he had just finished talking to a person who had tested positive.
Some of us can wear a masks 1,000 hours a day, wash our hands all the time and almost never leave the house and still get it, said Stec. Its out there. We cant condemn these people.
FEELING GUILTY
Ive talked to some people who have tested positive. They had to call the people who were recently around them so they can be tested.
As one person told me, I feel like I messed up everyones life. We waited almost a week for results. They all came back negative.
This person was the type Stec described: Not doing stupid stuff. Wearing a mask. Caught the virus anyway. Some people have stronger immune systems.
We cant keep pointing fingers at people like they did something wrong when they get sick, said Johnson.
Those people have to quarantine for at least 14 days. In some cases, it becomes a serious situation with trips to the doctor. It can be very lonely and frightening.
SAYING DUMB THINGS
Karen (not her real name) said her daughter tested positive and some people said, Dont worry, shes young.
Karen added: I know those words were meant to comfort, but they didnt ease my fears...age doesnt matter and the severity of the symptoms were nothing like Ive ever seen.
Her daughter recovered, but it was an ordeal.
Mary (not her real name) said after her mother died of complications from COVID-19, some people told her, Well, your mother had underlying conditions.
That doesnt change the fact Marys mother died and she is grieving.
We need to think before we speak, said Stec.
Confession time: When I heard someone had died from the virus, I wondered if they had high blood pressure, or dealt with cancer or other pre-existing conditions. Its a natural tendency to mentally search for a unique reason the other person got sick and died so we think it wont happen to us.
But dont bring it up when talking to the person who suffered the loss.
We should ask ourselves, What would I need to hear in her position? " said Stec. When people are hurting, we forget about how our words can negatively impact them.
Many people living in the land of COVID-19 say they appreciate a simple, Were praying for you. We care about you.
Offer to go to the store and run errands while the person is home recovering. You can leave stuff on the doorstep. You can leave cards, send texts and emails of prayers.
As Stec said, Put yourselves in their position and figure out what they need.
THE FEAR FACTOR
Fear is everywhere right now, from politics to the virus.
Johnson and Stec both said its really hard to go through these times without God.
The battle isnt just medical, its also spiritual. Thats why depression, drug use and frustration levels have skyrocketed. The days seem to drag by as the COVID-19 numbers rise.
One of my favorite verses is 1 Peter 5:7-9: Cast all your anxiety on him because he cares for you. Be alert and of sober mind. Your enemy the devil prowls around like a roaring lion looking for someone to devour. Resist him, standing firm in the faith, because you know that the family of believers throughout the world is undergoing the same kind of sufferings.
During these times, those with COVID-19 and their families feel all alone. They need to know you care about them, even if you cant see them in person for a while.
Dont be afraid to make a call or send an uplifting email or text. But dont play doctor or pandemic expert. Pray first, then connect.
As Stec stressed, Just think before you do it.
RECENT TERRY PLUTO FAITH & YOU COLUMNS
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Driving myself crazy? Perfectionism during the pandemic
Another night with the frogs: Do I want to get well?
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Pioneer Pastor Diana Swoope dies, inspiration to those with cancer.
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News of a good immune response in animals bodes well for testing future COVID-19 vaccines. CMB/Getty Images hide caption
News of a good immune response in animals bodes well for testing future COVID-19 vaccines.
News today from Harvard's Center for Virology and Vaccine Research may help solve a problem that future COVID-19 manufacturers are sure to face: how to make sure that new and potentially better vaccines actually work without doing extremely large and expensive studies.
Writing in the journal Nature, the researchers show that a certain class of antibodies in a monkey's blood predicted protection from COVID-19. If that hold true for humans, a relative simple blood test may show whether an experimental vaccine is working.
Here's the dilemma: Once a vaccine is approved, it's unethical to test it against a placebo. Approving new vaccine would require researchers to compare two vaccines against each other, instead of having a vaccine and a placebo--which would take a lot more people than the 30,000 for the initial trials.
Most researchers agree the key to solving this problem is finding something known as correlates of immunity.
"Correlates of immunity are very important because they give us insight into how vaccines work, says Dan H. Barouch, M.D., Ph.D., Principal Investigator at the Harvard vaccine center.
The idea is if you could measure something in a people's blood that would show whether a vaccine works or not, you could then focus more on whether the vaccine was safe--because researchers would already know it's likely effective.
"So it would be much more convenient for future testing of 19 vaccines to have a well-established correlate of protection," Barouch says.
This approach is already used in approving the annual flu vaccine. "There's a new influenza vaccine that's licensed every year," he says, because of genetic changes in the influenza virus.
"It would not be possible to do a large-scale clinical efficacy trial of an influenza vaccine candidate every single year," says Barouch, so regulators rely on correlates of protection.
The correlate of protection for the coronavirus vaccine, Barouch and his colleagues found, was neutralizing antibodies. These are antibodies that can prevent a virus from infecting cells. It's possible to test for the presence of these antibodies in people's blood.
It's been assumed all along that neutralizing antibodies were necessary for a vaccine to induce to be effective, but no one know for sure if neutralizing antibodies alone were enough.
The new research conducted with rhesus macaque monkeys suggests they are.
Researchers took blood from monkeys that had been infected with the coronavirus that causes COVID-19, and then recovered. That blood contained neutralizing antibodies to the coronavirus that helped the monkeys fight off the infection.
"We isolated [those antibodies], we purified them and then we transfer them alone into nave animals," Barouch says. Nave animals are ones who had never been sick.
They then exposed the monkeys to the coronavirus. Most showed no signs of infection, and of those receiving a higher amount of antibodies, none showed signs of infection.
The implication is if a vaccine can induce someone's immune system to make those antibodies, that alone might be sufficient to believe the vaccine will work. Some scientists have argued that vaccines must provoke other kinds of immune responses known a cellular immunity. This research suggests that might not be the case.
There are some caveats. The study was done in a small number of monkeys. Also, it's possible that human neutralizing antibodies won't work as well as the monkey neutralizing antibodies did.
Nonetheless, Barouch is bullish about the implications of this research. "This is good news for vaccines because this level of neutralizing antibodies should be readily achievable by a variety of different vaccine candidates," says Barouch.
Those likely to confront the issue during the first weeks that vaccines are available include hospitals and health care systems whose high-risk workers will be given priority access to the shots.
The ethical issues surrounding Covid-19 vaccine mandates are particularly thorny for hospitals, said Lawrence Gostin, director of Georgetown University's O'Neill Institute for National and Global Health Law.
The hospital is there to heal, he said. Theyre mandated to protect all their staff, and all of their patients, and somebody certainly has rights to freedom and autonomy but they dont have the right to expose other people to dangerous infections.
The two vaccines now undergoing FDA review, from Moderna and Pfizer, have proven more than 90 percent effective in late-stage human studies of tens of thousands of people, with no serious side effects. They are poised for emergency authorization less than a year after they were created a record-breaking achievement made possible by accelerating the normal development timeline.
But hospitals and health systems have so far seen a tepid response to the vaccines among their workers. National Nurses United, the countrys largest nursing union, is fighting against any vaccination mandates until detailed data from the Moderna and Pfizer trials is publicly available.
We do believe this will be an experimental vaccine for some time, said Michelle Mahon, a representative of the union. She added that nurses are not generally skeptical of vaccines and that last year, more than 92 percent of registered nurses got a seasonal flu shot.
Another major health workers union, SEIU-United Workers West, has been urging for months that Covid-19 vaccines remain voluntary. But the group says that its members should still be given priority to access to the shots.
A representative of the Federation of American Hospitals said none of its members all for-profit health systems are making vaccination mandatory at this point. A hospital lobbyist told POLITICO that some health systems are considering requiring their employees to get the vaccines only after they have full FDA approval.
Those plans could change if health care workers become more comfortable with the vaccines over time. Americans overall trust and willingness to get Covid-19 shots has ticked up since Moderna and Pfizer released the final results of their vaccine trials last month.
Roughly 60 percent of U.S. residents would be willing to get a coronavirus shot, according to a Gallup poll released in November up from 50 percent in September.
Getting health care workers on board with Covid-19 vaccination will be crucial to increase acceptance of the shots, a top Centers for Disease Control and Prevention Official said Friday.
I know the person most people listen to most is their health provider, said Jay Butler, CDCs deputy director for infectious diseases. We want to make sure information is provided to providers as quickly as possible.
News of a good immune response in animals bodes well for testing future COVID-19 vaccines. CMB/Getty Images hide caption
News of a good immune response in animals bodes well for testing future COVID-19 vaccines.
News today from Harvard's Center for Virology and Vaccine Research may help solve a problem that future COVID-19 manufacturers are sure to face: how to make sure that new and potentially better vaccines actually work without doing extremely large and expensive studies.
Writing in the journal Nature, the researchers show that a certain class of antibodies in a monkey's blood predicted protection from COVID-19. If that hold true for humans, a relative simple blood test may show whether an experimental vaccine is working.
Here's the dilemma: Once a vaccine is approved, it's unethical to test it against a placebo. Approving new vaccine would require researchers to compare two vaccines against each other, instead of having a vaccine and a placebo--which would take a lot more people than the 30,000 for the initial trials.
Most researchers agree the key to solving this problem is finding something known as correlates of immunity.
"Correlates of immunity are very important because they give us insight into how vaccines work, says Dan H. Barouch, M.D., Ph.D., Principal Investigator at the Harvard vaccine center.
The idea is if you could measure something in a people's blood that would show whether a vaccine works or not, you could then focus more on whether the vaccine was safe--because researchers would already know it's likely effective.
"So it would be much more convenient for future testing of 19 vaccines to have a well-established correlate of protection," Barouch says.
This approach is already used in approving the annual flu vaccine. "There's a new influenza vaccine that's licensed every year," he says, because of genetic changes in the influenza virus.
"It would not be possible to do a large-scale clinical efficacy trial of an influenza vaccine candidate every single year," says Barouch, so regulators rely on correlates of protection.
The correlate of protection for the coronavirus vaccine, Barouch and his colleagues found, was neutralizing antibodies. These are antibodies that can prevent a virus from infecting cells. It's possible to test for the presence of these antibodies in people's blood.
It's been assumed all along that neutralizing antibodies were necessary for a vaccine to induce to be effective, but no one know for sure if neutralizing antibodies alone were enough.
The new research conducted with rhesus macaque monkeys suggests they are.
Researchers took blood from monkeys that had been infected with the coronavirus that causes COVID-19, and then recovered. That blood contained neutralizing antibodies to the coronavirus that helped the monkeys fight off the infection.
"We isolated [those antibodies], we purified them and then we transfer them alone into nave animals," Barouch says. Nave animals are ones who had never been sick.
They then exposed the monkeys to the coronavirus. Most showed no signs of infection, and of those receiving a higher amount of antibodies, none showed signs of infection.
The implication is if a vaccine can induce someone's immune system to make those antibodies, that alone might be sufficient to believe the vaccine will work. Some scientists have argued that vaccines must provoke other kinds of immune responses known a cellular immunity. This research suggests that might not be the case.
There are some caveats. The study was done in a small number of monkeys. Also, it's possible that human neutralizing antibodies won't work as well as the monkey neutralizing antibodies did.
Nonetheless, Barouch is bullish about the implications of this research. "This is good news for vaccines because this level of neutralizing antibodies should be readily achievable by a variety of different vaccine candidates," says Barouch.
