CLARKSVILLE, Tenn. (CLARKSVILLENOW) Montgomery County leaders have been briefed on plans for how the COVID-19 vaccine will be distributed in Tennessee, with the first doses going out this month.
Pfizer is prepared to send the first 56,000 doses of the COVID-19 vaccine directly to hospitals for Tennessees healthcare workers beginning this month, according to a Montgomery County news release.
According to the state plan, the vaccines will go out in the following prioritized order, with the population of each group listed.
Phase 1a1, about 450,000 people:
Phase 1a2, about 100,000 people:
Phase 1b, about 1.2 million people:
Phase 2, about 2.55 million people:
Phase 3, about 2 million people:
Phase 4, all others, about 500,000 people:
We are working closely with the state and local health departments to ensure that those who wish to receive a vaccine can do so in an orderly fashion, said County Mayor Jim Durrett. There is still some uncertainty on when and how many vaccines will be available to Montgomery County. As we find out more information we will continue to let the public know.
Durrett, County Chief of Staff Kyle Johnson and County Emergency Services Director Jimmie Edwards, along with county mayors and leadership across Tennessee, joined Gov. Bill Lees office on a call this morning to discuss how the federal COVID-19 Immunization Distribution Plan would be implemented in the State of Tennessee.
Details of the report are available at the following link COVID-19 Vaccination Plan.
The first shipment of the COVID-19 vaccine to Minnesota could be enough for only about 24,000 people, but more will be on the way.
Hundreds of thousands of Minnesota health care workers and long-term care residents have been designated as being the highest priority for getting the shot, leaving state officials with tough choices to make on who will be first in line.
Minnesota health officials declined to say Thursday how much the state would receive of the 6.4 million doses that vaccine maker Pfizer is shipping to the United States in the first round.
But several states, including New York and California, have disclosed their allotments, giving clues to the distribution formula tied to each states adult population.
Wisconsin health officials said this week they will be getting nearly 50,000 doses. Its adult population is roughly 5% higher than the 4.3 million adults in Minnesota.
Based on those numbers, as well as other state allocations, Minnesota is on track to receive about 47,000 doses. Like many of the COVID-19 vaccines being developed, each person needs two doses taken a few weeks apart to receive full protection.
The shipments are scheduled to start the week of Dec. 14, and more doses are expected to be delivered in subsequent weeks. Federal officials have said they hope to get 40 million doses from Pfizer and another drugmaker, Moderna, into the hands of the states, territories and six large cities by the end of the year.
The Pfizer vaccine is expected to receive an emergency use authorization from the U.S. Food and Drug Administration on Dec. 11, a step that would allow it to bypass normal approval protocols.
While the initial shipments will be small compared with the need, they will mark a significant turning point in the battle against the stealthy coronavirus.
Weve been talking about the light at the end of the tunnel, said state infectious disease director Kris Ehresmann. It is there and it is getting closer.
Since late October, Minnesota has seen an unprecedented number of new infections, hospitalizations and deaths.
The Health Department on Thursday reported 92 new COVID-19 deaths the second-highest one-day total of the pandemic, which has taken 3,784 Minnesota lives.
Hospitals had 376 COVID-19 patients in intensive care units, a slight decline from the previous day. Hospitals have freed up some space by delaying less urgent surgeries, but coronavirus patients accounted for 34% of all ICU beds.
Another 6,166 lab-confirmed infections were reported, bringing the total to 333,626 known cases, including 24,217 health care workers.
Health care workers are getting infected, often in nonmedical settings, but they are also required to quarantine if they have a high-risk exposure to someone with COVID-19.
Thats one reason a federal advisory panel this week recommended that health care workers be among the first to get the COVID-19 vaccine.
Minnesota alone has 355,000 health care practitioners and support professionals, including 25,000 licensed physicians and 160,000 people licensed by the Minnesota Board of Nursing.
Some have more direct contact with COVID-19 patients than others but any patient presents a risk because of asymptomatic spread of the virus.
The Advisory Committee on Immunization Practices (ACIP), an independent advisory group that makes recommendations to the federal government on vaccine distribution, addressed how limited supplies of the vaccine could be handled.
Jurisdictions might consider first offering vaccine to health care personnel whose duties require proximity [within 6 feet] to other persons, the group said in a report released Thursday.
Still, that leaves a fairly large group considering that health care workers include those in hospitals, long-term care facilities, outpatient clinics, home health care, pharmacies, emergency medical services and public health.
I would make the plea that firefighters do deserve to be in that first phase, said Chris Parsons, president of Minnesota Professional Fire Fighters, a group that represents 1,800 firefighters and paramedics.
Many firefighters serve dual roles. Trained as paramedics and emergency medical technicians, they are often the first to arrive at a medical emergency.
We are absolutely the front of the front line, he said. We are the tip of the tip of the spear.
A St. Paul fire captain, Parsons recently went on a call to attend to a heart attack, only to find a house full of COVID-19-infected family members.
We are usually operating in tight quarters so our exposure is very high, he said. As cases in the state have gone up, we have seen a spike in cases among our members.
Among others being considered for the first doses are long-term care residents.
We were thrilled to see the recommendations, said Patti Cullen, CEO of Care Providers of Minnesota. Our best guess is the first limited batch of vaccines would be available toward the end of December but there will not be enough to go around to both [nursing homes] and assisted living.
Minnesota has about 78,000 long-term care residents. Priority could be given to the states 22,000 in nursing homes because they tend to be sicker and most at risk for COVID-19 complications, ACIP said.
With the rapid pace of COVID-19 vaccine development, states are grappling with how to best distribute the shots.
I give the states A for effort. They are really trying but they are all over the map though in terms of preparedness, said Jennifer Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation. The biggest challenge for many will be a lack of funding.
Many states have been underfunding public health for years, she said. Now they are having to ramp up to an unprecedented level for a COVID vaccine.
The Health Department said it is not ready to release many details about the vaccine rollout, or supply, as it is still working with external agencies, including local public health agencies that will play a large role.
We plan to provide as much of that detail and context as we can in a briefing early next week, agency spokesman Doug Schultz said.
Staff writer Chris Serres contributed to this report.
The latest Gallup poll shows only 58% of Americans are willing to get a COVID-19 vaccine.
HOUSTON COVID-19 vaccines may be less than two weeks away now in Texas, but vaccine expert Dr. Peter Hotez and other health experts worry a bigger problem lies ahead. The vaccine won't do any good if too many people choose not to get it.
"We need a really high acceptance rate," Hotez said. "We have a tough job ahead of us."
Here's why officials are concerned: The latest Gallup poll shows only 58% of Americans are willing to get a COVID-19 vaccine. It's better than a few months ago, but still not good enough.
"You have to get 75% of the population vaccinated in order to stop transmission of this virus," Hotez said. "If you only have half the people taking it you're not going to get there."
Hotez says rejecting the vaccine would drag the pandemic on longer. The problem is bigger in Texas, a state already hard hit by COVID-19 where misinformation is spreading rampantly.
Only 43% of Texas adults get a flu shot every year, according to the CDC. That's already a big warning sign.
"Texas is one of the epicenters of the anti-vax movement and that's going to slow down the acceptance of COVID-19 vaccines," Hotez said.
Just this week, anti-vax groups hung anti-COVID-19 vaccine signs off Texas highways, including in Houston. The anti-vax movement has energized and increased their efforts as more promising COVID-19 vaccine news has started to come out.
"This is terrible," Hotez said. "We're not going to achieve success in public health unless we can figure something out about all this."
Hotez says all health officials need to do a better job of communicating the importance of vaccines and shutting down misinformation in real-time.
There are side effects of the vaccine, mainly 24-36 hours of just feeling cruddy. But the data shows they're safe, effective and the best way to get us all back to normal, Hotez says.
"95% efficacy, so they work, and they're going to induce viral antibodies that will keep you out of the hospital and the ICU and will save your life," Hotez said.
A video shared over 27,100 times on Facebook implies that the COVID-19 vaccine will contain a tracking microchip that will be injected in the individuals that receive the COVID-19 vaccine once it is ready. This is false.
Reuters Fact Check. REUTERS
The3:49-minutevideovisible here (archived version archive.vn/CNhct ) is a compilation of out of context or manipulatedfootage,that includesnews reports andcommentary from Bill and Melinda Gates and Jack Mathat havebeen selectively combined.
Some comments on the video include Say no to being tracked with a chip, I will cut off my arm before I let them microchip me or my kids and Scary! I dont want anyones microchip implanted in my body!!
Around timestamp 00:24, the videoincludesfragments ofa CBN interview here withJay Walker,executive chairman ofpre-filled syringe makerApiject,which got a $590 million U.S. loan to produce injectors for the eventual COVID-19 vaccineon Nov. 19( here ).
Inthisinterviewfrom May2020 ( youtu.be/WllUZVwQBZ8?t=209 )Walker is asked abouthow theoptional RFID chip would work, in referencetotheRadio Frequency Identification chip that could be part of the syringes label, not the injectable substanceitself(as explained in detail here on page 13).
In his full response, Walker compares the technology to a bar code and assures that it doesnt carry any personal information. He also explains that the microchip is purely optional, however, and the U.S. government hasnt even decided if theyre going to use it.
Steve Hofman, a spokesman of Apiject confirmed to Reuters via phone that this optional microchip will not be injected into the individual who receives the vaccine.
Hofman reassured that this technology is optional and that so far it hasnt been requested. He also added that the microchip cannot gather any personal information.
The microchip, he explained, is designed for two purposes: to allow the healthcare provider to confirm that the actual injectable and the vaccine in it has not expired and that it is not counterfeit. It would also confirm that that particular injection has been used. The health provider, Hofman added, would use a cellphone app to capture and revise this information.
Aroundthe timestamp2:10, the video in this claim itself includes footagefroma fact-check by Verify here in which theydebunkthis false allegation.
The video starts withacommentary from Bill Gatesthat has beenedited tomisleadinglycombine twopartsofhisspeech during a 2013 financial inclusion forum here . Thevideo on social mediamakes itlooklike Gates said that innovations like vaccines, we need a measuring system that tracks the vaccine.This has been clearly edited.
The original segments are visible youtu.be/6xkwAL3jwJs and youtu.be/6xkwAL3jwJs?t=173 .
The full footage shows that Gates referred to vaccines as an example of breakthrough innovations that have changed the future for billions of people (he also lists holding crops as another example for this). Later, Gates refers to a measurement system, but he is talking about the need for a system to track the progress of financial inclusion, not vaccines.
Reuters previously debunked the claim that Bill Gates planned to launch microchip skin implants to fight the coronavirus ( here ) and that a microchip implant would come with COVID-19 vaccines ( here ). Other fact checks on false claims regarding Gates and COVID-19 are visible here and here .
Around timestamp 1:32, the video includes footage from the launch ofa United Nations (UN)reporton digital cooperation youtu.be/UcB_aIq1OwA in 2019, which was developed by a panel co-chaired byMelinda Gates and Jack Ma, executive chairman of Chinese e-commerce giant Alibaba.
The video includesauthenticcommentary ofMelindaGates andJackMa, executive chairman of Chinese e-commerce giant Alibaba, who co-chaired the panel that developed the report in question here . However,when paired up within news reports of microchips,these commentsmay look misleading.
For example, the video shows that Melinda Gates says that technology gives incredible opportunities to create the world that we want. Some users commenting on the video appear to have misrepresented this as a reference to a surveilled world. A comment in the video reads: The world they want not the one we want as free citizens living in a democracy! Are they going to implant themselves?????
The full footage of her response visible youtu.be/UcB_aIq1OwA?t=205 shows that by the world we want,Gateswas referring to a more just and humane world.
Jack Mas commentary ( youtu.be/UcB_aIq1OwA?t=250 ) on the digital era also does not appear to be in reference to vaccines, but rather about how technological advances will shape the future. Ma later says: Nobody is the expert of future we should learn, we should embrace it and we should change our mentality, you know, to embrace this revolution.
The video also misleadingly includes other clips from old news reports about the microchip technology in humans, that are unrelated to the COVID-19 vaccine.
Around timestamp 3:00 it includes footage from an authentic PBS NewsHour, the comment by anchor Judy Woodruff however has been edited and is therefore missing context.
In theedited Facebookvideo, Woodruffswords have beenselectively cropped to make it look like shesaidthat people who support the implantation of microchipsdoittotake back control. The original footage here shows that Woodruffwasactually referring to take back control of their personal data.
Another segmentfeaturedaroundtimestamp 3:13from the PBS NewsHour is visible youtu.be/hLc_7CnWkxw?t=543
The video alsofeatures imagesfromthis report here from 2007,around timestamp 1:06 and2:31. The reportweighed into the possibilityof implanting children with microchipsfor security purposesand addressed the concernsfrom parents about using this technology.The audio paired up with theseimagesaround 1:06,however, appearsto be from a different video. Reuters was unable to identifythe sourceof thisaudio.
Thefootagefeaturedaround3:20is visible here .This piece from 2017 also reported on the debate around how microchips might bring benefits on daily tasks and weighs into the privacy concerns around this issue. The particular segment that is included in the video youtu.be/0Ixr4SzoVJA?t=97 , mentions the Seattle-based company Dangerous Things ( dangerousthings.com/ ) which sells a variety of chip implants.
Altered. COVID-19 vaccine syringes could contain RFID microchips on labels, but they wouldnt be injected into the individual that receives the vaccine. A video containing this claim features altered and out of context footage.
This article was produced by the Reuters Fact Check team. Read more about our fact-checking work here .
The month of November registered frightening peaks in the daily number of new coronavirus cases -- reaching 100,000 for the first time, as well as spikes in hospitalizations and deaths. On the second day of December, more than 200,000 new cases were reported for the previous 24 hours.
And as the impacts of Thanksgiving travel and gatherings begin to reveal themselves, and hospitals fill to capacity, experts say it is likely only going to get worse.
"Every single day, thousands more people are getting this virus, and we know that means that in a few days, in a week, hundreds of people are going to be coming to the hospital and hundreds of people are going to die," Dr. Shirlee Xie, a hospitalist and associate director of hospital medicine for Hennepin Healthcare in Minneapolis, told CNN's Ana Cabrera, her voice breaking with emotion.
"I think that sometimes when you hear statistics like that, you become numb to what those numbers mean," she said. "But for us, the people that are taking care of these patients, every single number is somebody that we have to look at and say, 'I'm sorry, there's nothing more I can do for you.'"
Millions of Californians face stay-at-home orders
In the last week, hospitalizations in Los Angeles County have tripled, and the number of available hospital beds in the area could dwindle to none in two to four weeks if cases continue to climb, Los Angeles Mayor Eric Garcetti said Friday.
In response to the growing threat, the Southern California region will be under a new stay-at-home order beginning at 11:59 p.m. on Sunday. The order will apply to Los Angeles, San Diego, Orange, Riverside and San Bernardino counties.
The San Joaquin Valley also will be under stay-at-home orders at that time, local officials announced earlier Saturday, after the region's ICU capacity fell below 15%. More than 4 million people live in the region.
While the Bay Area has not met that threshold of less than 15% capacity, officials warned they're seeing evidence of transmission over Thanksgiving weekend that could fuel a surge in their community.
"I don't think we can wait for the state's new restrictions to go into effect later this month," Contra Costa Health Director Chris Farnitano said Friday. "We must act swiftly to save as many lives as we can. This is an emergency."
"It really is time for us to pull back on the activity and see if we can turn this thing around before hospitals get overwhelmed," said Dr. Robert Wachter, chairman of the department of medicine at University of California, San Francisco, pointing out that California has had a "better than average performance" throughout the pandemic.
"I see other parts of the country that are still open, even though the case rates and hospitalization rates are far worse than here," he told CNN. "So, I think we're acting correctly."
Adults must get vaccinated for students to return to school
It will likely be months before all adults in the US can be vaccinated against the virus, and the wait will be even longer for children -- but they can still be protected by vaccine distribution, Wachter said.
"I think it's reasonable to expect that the kids will be back in school in the fall, not so much because all of them have been vaccinated -- although I hope they will -- but everybody around them has been vaccinated, and the rate of virus in their communities has fallen to a point that is perfectly safe for them to be in school," Wachter told CNN's Fredricka Whitfield.
The vaccine, which will come in two doses -- a challenge to produce and distribute in the necessary quantities -- will likely reach healthy, non-elderly Americans with no known underlying health conditions in late March to early April, Dr. Anthony Fauci said.
Kids are likely to be vaccinated relatively late in the game because Covid-19 vaccines have been largely untested in children. The National Vaccine Advisory Committee voted Friday to not recommend emergency use of a Covid-19 vaccine in children, noting that children generally experience mild disease.
But Wachter says that if adults get vaccinated, children could reap the benefits.
"If we can get everybody else vaccinated -- we can get all the adults vaccinated and get the virus to die out because we get somewhere near herd immunity -- the kids may be less important."
CNN's Dakin Andone, Christina Maxouris, Tina Burnside, Andrea Diaz, Maggie Fox, Anastasia Graham-Yooll, Jacqueline Howard, Jon Passantino and Paul Vercammen contributed to this report.
Each week, we answer "frequently asked questions" about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions."
After a long and toilsome week of Fortnite and family flicks, beleaguered parents of young children might well see a trip to the playground as a needed reprieve.
The benefits seem obvious enough: Catch some precious outdoor time while turning your child loose on swings and slides to the point of exhaustion bringing the week to a tranquil close. Ahh. (Sigh of relief).
Yet with COVID-19 in play (no pun intended) it's not always so simple.
This week, L.A. closed down its playgrounds for the second time, drawing furor from parents. And across the country, at least 16 states have done the same since the start of the pandemic.
With the specter of an ever-increasing infection count, it's fair to wonder, are playgrounds really a good idea right now?
According to Harvard Medical School physician Abraar Karan, if you're prudent, a playground trip is actually a great idea.
The first thing to note is that the risks of picking up the virus from surfaces so in the context of playgrounds, think: jungle gyms, rock walls, slides and swings are lower than initially assumed.
We know this thanks to breakthroughs in COVID-19 fomite research. A fomite is any object or particle that is covered with virus particles, possibly because someone recently sneezed or coughed respiratory droplets onto it. Fomites can include utensils, clothing ... and sliding boards ... says Sonali Advani, an assistant professor of medicine at Duke University.
If you touch a fomite, then bring your hands to your mouth, nose or eyes, you could become infected.
Even though there was concern early in the pandemic about this possible mode of transmission, the Centers for Disease Control and Prevention said in May that surfaces are "not the main way" the coronavirus spreads. Successive studies have fortified that belief.
Still, Advani says, while the risk of transmission from surfaces is low, "it is not absent."
What does this mean for playgrounds?
Well, Karan explains, since fomites, epidemiologically, are not a huge source of viral transfer, it's probably not likely that children will pick up the virus and later infect themselves while careening down a slide or monkeying around on the monkey bars. The bigger risk is respiratory transmission so it's critical you follow some of the general guidelines: masking, sanitizing hands after visiting, and physical distancing while on the scene.
"Outdoor playgrounds do have the benefit of being outdoors, of being able to space children out," Advani says. Outdoor airflow disrupts the flow of droplets and airborne particles. "But if everyone goes to the playground, it's going to get crowded."
As an extra precaution, Advani advises practicing situational awareness: If there are a lot of families at the playground when you arrive, try coming back in a few hours. And carry along a set of disinfectant wipes with you, wiping down surfaces before your kid gets on them just to be extra safe!
The last stage of a safe and successful playground trip in the age of COVID-19 is the cleanup.
"Washing your clothes isn't a bad idea [once you arrive home], Advani says. "It's not that hard to do, and you'll probably want to do it in any case." Even though the risk that your garb was contaminated by contact with fomites is low, it's better to be safe.
And don't forget to wash hands after a visit with soap and water. You can keep the playground spirit going by singing the alphabet song to make sure you hit the 20-to-30 second mark.
What should we make of the WHO's guidelines on no-masking while doing exercise?
This week, the World Health Organization released a controversial statement: masks shouldn't be worn during "vigorous intensity physical activity."
The message was intended to tighten guidelines the organization laid out in June, when WHO released an infographic detailing why it may be a bad idea to wear masks while exercising.
During vigorous activity, the WHO says, "sweat can make the mask become ... wet" which, the agency went on to say, can lead to bacterial growth on masks, and impede breathing ability.
Experts don't all agree with WHO's approach, and many flat-out rebuke it. So it can be hard to figure out what to do.
Indeed, the experts we spoke to say that while it has been well documented that the risk of non-masked outdoor exercise is pretty low, there can be important symbolic and public health advantages to having a mask on you. In deciding what to do, you should come up with a strategy that gives you options to tailor your approach to your environment, your perceived risk levels and other factors.
"Walking around, wearing a mask shows respect and it sends the message that you believe masking is important," Karan explains. "And the downside of masks is minimal."
In general, Karan says, it's fine to exercise with a mask on. And as long as you're washing your mask after a workout, you can ensure there's not a constant buildup of bacteria. He adds that there's been no large body of data to suggest that bacteria buildup has caused any medical issues.
But Advani acknowledges that it can be hard to mask while engaging in high-intensity exercise, simply on a breathing level. She proposes a solution: Carry a mask with you, and at traffic lights or stretches in the run where you may be around others, put it on if you feel inclined.
"It's not necessary to do while running [without anyone around], but having one on hand will always be helpful."
One other component of the WHO's brief stated that if distancing and ventilation are well-managed in a gym, it's OK to take off a mask while working out in that setting. To that point, both experts interviewed for this FAQ stressed that it's preferable to keep your exercise outdoors, where it's more difficult for the virus to spread.
Pranav Baskar is a freelance journalist who regularly answers coronavirus FAQs for NPR.
She's living in temporary accommodation found for her in the city by St. Mungo's, a homelessness charity, while a plan to get her into permanent housing is on hold.
"I was hoping to move on and sort my life properly but ... here we are," the 50-year old told CNN Business. "I wouldn't have believed if you had said a year ago that your job's going to stop in March and that's it, you might never work doing that again."
"I've really had to lower all of my expectations of life," she said. "If I knew that in a month I'd be working again, or even in spring ... but there doesn't seem to be anything to look forward to."
Coronavirus has revealed gaping holes in European social safety nets that are often seen as the gold standard. While many countries introduced support programs for workers affected by the pandemic, people are falling through the cracks. Most often, those who were already suffering the effects of inequality are hit the hardest lower-income workers, those in insecure jobs, young people, women and minority ethnic groups.
"Some of the social security systems in Europe are more extensive, better developed [than in the United States]," Michael Spence, a Nobel Laureate and former dean of Stanford Business School, told CNN Business.
He said that during the 2008 financial crisis, pre-existing programs involving governments and businesses helped many European countries avoid too many layoffs.
"But I think in the pandemic economy, the shock's so big that they kind of overwhelm the systems," he said. "The systems weren't built to withstand nearly overnight contractions of 25% in economies."
Insecure work
Lockdowns have seen economies come to an abrupt halt, and benefits systems in many countries have not been able to cope, according to Mike Brewer, chief economist at the Resolution Foundation, a British think tank aimed at reducing inequality.
He said the UK welfare state was "inadequate" for this type of crisis, a downturn far beyond the "natural ebbing and flowing of economic activity" of typical recessions.
The British welfare system was "not very generous" and relied on a fast-moving labor market, he said. "So it wasn't so much the scale of the pandemic, it was the fact that the pandemic just shut down the labor market ... that's destroyed the premise on which the UK welfare system has been designed."
Since self-employed and casual workers had few protections under pre-crisis systems, many governments have had to come up with emergency measures but even these programs are inadequate.
The United Kingdom introduced an employee furlough scheme and a self-employment grant. But many workers who are partly or recently self-employed, freelance or on zero-hours or flexible contracts are ineligible for either.
The programs were "designed in a hurry," Brewer said; as the pandemic drags on, the gaps are becoming more evident, and more of a problem.
Hospitality, retail and leisure have been worst affected by lockdowns, sectors in which many informal jobs are held by young, low-income or migrant workers.
The disproportionate impact on these workers, coupled with a lack of government support, means the gap between rich and poor is only widening. Members of low-income households are more likely to be out of work and running down their savings, while those in higher-income households, who are more likely to be in secure jobs that can be done from home, grow wealthier as they spend less, said Brewer.
The people worst affected
Brewer says it is "harmful to be out of work for long periods" and can have a long-term impact on future employment prospects so "young people now are going to be carrying that scar as they grow older."
Abigail Adams-Prassl, an associate professor in economics at the University of Oxford, told CNN Business that women and Black, Asian and other minority ethnic workers were also more likely to slip through the cracks.
Adams-Prassl said the ability to work from home also depends on domestic duties.
Childcare falls disproportionately on women, and the virus has often meant that children cannot attend school or childcare, says Adams-Prassl. She said the pandemic has exacerbated the financial shortfall for many UK childcare providers and there had been "nothing in terms of a targeted package of support for that sector or thinking about how to really support the employment of caregivers."
Women's groups have repeatedly raised the issue that social security systems can be problematic for those in abusive relationships, she added. "If you've got a partner who didn't lose their job, or who might have savings of their own, that can mean that you're ineligible for these forms of government support," said Adams-Prassl, adding that these patterns were also seen in France and Italy.
"All of these things existed beforehand," she said. "It's the fact that I guess it has affected many more people over the pandemic and it's just been so stark has made many, many more people aware of these issues. I think there's still a very long way to go in terms of thinking about what the policy response is."
Increasing existing inequalities
"Government interventions worked in the formal sector but less so with informal sector workers," she said, citing the examples of the tourism sector and migrant workers. "The problem is that it is very difficult to catch these people because they do not show up at all in the statistics."
She said Italy was already a "quite divided country" with the North and the center on one side, and the Mezzogiorno (south) on the other.
Meliciani said the southern regions "will suffer the most" in the long term. She said that to stop poverty increasing after the pandemic, government policies must address structural problems in the south, including the digital divide.
She said companies in the south needed incentives or tax relief to allow them to invest in digital technologies or other areas that could help them survive the crisis.
"There is considerable inequality in Cyprus in terms of income, wealth, employment, opportunities, and what I would call intergenerational gaps," Leslie Manison, a former senior economist at the International Monetary Fund and ex-advisor in the Cyprus Ministry of Finance, told CNN Business.
He said the government had introduced measures such as subsidizing salaries of employees in companies that had suspended their operations, and people in the informal sector often weren't eligible despite being worse affected by Covid.
"The subsidies haven't been connected, you could say, with active labor policies on retraining and so on, compared with a country like Germany," he added.
Experts say side effects from the COVID-19 vaccine range from soreness to fatigue. USA TODAY
With two coronavirus vaccines under emergency review by the Food and Drug Administration, the nation's attention is turning to who will get the vaccine firstand when.
A big question remains: Will Americans be required to get vaccinated?
For some, the short answer is yes, public health and legal experts say. But a mandate is not likelyanytime soon, and likely not to come from the federal government. Instead, employers and states may condition return or access to workplaces, schools and colleges upon getting the vaccine and mandate it once the FDA issues full approval, potentially months later.
"It's much more likely that a private organization or company will require you to be vaccinated to get certain access to places," said Arthur Caplan, a professor of bioethics at the NYU Grossman School of Medicine. "People worry about the president, governor, or county executive telling them what to do. I dont think thats going to happen."
At an August town hall hosted by Healthline, Dr. Anthony Fauci,director of the National Institute of Allergy and Infectious Diseases,said the vaccine won't be mandatory in the U.S. "I dont think youll ever see a mandating of vaccine, particularly for the general public," Fauci said. "If someone refuses the vaccine in the general public, then theres nothing you can do about that. You cannot force someone to take a vaccine."
And on Friday,President-elect Joe Biden told reporters that he would not make vaccinations mandatory. "But I would do everything in my power just like I don't think masks have to be made mandatory nationwide I'll do everything in my power as president of the United States to encourage people to do the right thing," Biden said.
Biden on mask mandates: He can't enforce them. Here's what he could do instead.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said a coronavirus vaccine won't be mandatory in the U.S.(Photo: AP)
Historically, states have had the power to mandate vaccinations. In 1905, as smallpox was spreading through Massachusetts, the Supreme Courtupheld the authority of states to enforce compulsory vaccination laws in the case of Jacobson v. Commonwealth of Massachusetts.
"Theres a long history in our constitution that permits the state to actfor public health and safety, and that hasalways included vaccination," saidLawrence Gostin,director of the O'Neill Institute for National and Global Health Law at Georgetown University.
"But although they have the power, I think it will be very unlikely that they will exercise that power," he said. "They would be fearful of causing a backlash and politicizing the vaccine."
It's more likely that vaccination requirementswill play out as they have in the past. Once fully approved by the FDA, a vaccinemay eventually be required for children in public and private schools and daycare settings, for college and university students, and for some health care workers and patients, Gostin said.
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All 50 states and Washington, D.C.,have laws requiring certain vaccines for students, and exemptions vary by state. All states grant exemptions to children for medical reasons, 45 states grant religious exemptions, and 15 allow philosophical exemptions for those who object to immunizations because of personal, moral or other beliefs, according to the National Conference of Legislatures.
Health care facilities across the country are increasingly requiring health care workers to be vaccinated against various diseases, and some facilities are adding these requirements due to mandates in state statutes and regulations, according to the CDC.
When it comes to the flu, 24states have flu vaccination requirements for long-term care facility health care workers, and 32 have them for long-term care facility patients, according to the CDC. As of 2016, 18 states had flu vaccination requirements for hospital health care workers.
Other employers also require certain vaccinations.
"Will the general public be required to get it? Thats highly unlikely. Thats not the American tradition orculture," saidPeter Meyers, professor emeritus at theGeorge Washington Universitylaw school and former director of the school's vaccine injury litigation clinic.
"We recommend it. We make it as easy as possible to get it. We make it free. If enough people take it, well have herd immunity."
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But officials have mandated vaccinesbeyond schooland employment settingsinthe past.Following a 2019 measles outbreak in Brooklyns Williamsburg neighborhood fueled by a growing movement against vaccinations,New York City ordered mandatory measles vaccinationsforanyone living, working or going to school in four ZIP codes in the neighborhood.
The order required all unvaccinated people who may have been exposed to the virus to get the vaccine, including children over 6 months old, unless immune or medically exempt. The city first threatened civil and criminal repercussions but eventually settled on a $1,000 fine. A Brooklyn judge upheld the order.
That order was for a vaccine that had been fully licensed by the FDA. The two coronavirus vaccines currently under review would be "authorized" by the agency based on early data, at the discretion of FDA scientists.The FDA only ever issued an emergency use authorization, known as an EUA, for a vaccine once before foran anthrax vaccine in 2005.
If authorized, a coronavirus vaccine's EUA statuswould make legal questions abouttheoreticalmandates in the immediate future more complicated. There are also logistical issues of supplyand distribution. There's no data on how vaccine candidates affect children or pregnant people.And it's still unclear if the vaccines prevent the transmission of the virus, in addition to preventing disease.
"Institutions may require individuals to take an FDA-approved vaccine or apply for an exception. However, EUA products are still considered investigational," FDA Commissioner Stephen Hahn told USA TODAY last week.
Fact check: Neither Biden nor Trump is calling for mandated COVID-19 vaccines
FDA Commissioner Stephen Hahn, testifies at a Senate Health, Education, and Labor and Pensions Committee on Capitol Hill, on September 23, 2020 in Washington, DC.(Photo: Getty Images)
It's unclear whetherschools or employers could legally mandate a vaccine under an EUA, saidDorit Reiss, a professor at the University of California Hastings College of Law. Shesubmitted comment to the FDA requesting that the agency's EUA documentation offer guidance on the question of mandates.
In the past,members of the FDA and Centers for Disease Control and Prevention have said that employers cannot require a vaccine under EUA, Reiss said. But the Secretary of Health and Human Services, under theFederal Food, Drug and Cosmetic Act, can establish the conditions of an EUA, including whether people have the option to accept or refuse the vaccine,and the consequences of doing so, if any.
"Im sure no government will be requiring anything in the short run as long as were operating under EUA," Caplan said. "It would be very strange to require something that hasnt been licensed or approved. The military could certainly require things, but for civilians, no."
Vaccine mandates: Flu vaccine now required for all Massachusetts students
Should employers force workers to get COVID-19 vaccine?Some experts say they should
When a coronavirus vaccine is first authorized and then eventually approved by the FDA, it may well take years before it becomes a requirement for school children or anyone, said Dr. Howard Koh, a professor at the Harvard T. H. Chan School of Public Health and former Assistant Secretary for Health under Barack Obama.
"For every vaccine thats new, it takes a while to gain familiarity and general acceptance. Much of that involves assuring the effectiveness of the long-term safety profile. Theres a comfort level that should be reached by everyone parents, families, employees. That process is going to take time," he said.
Some companies in industries that present a high risk of transmitting the virus such restaurants, gyms, salons, meatpacking, pro sports and nursing homes may also eventually require vaccinations for their employees, Caplan said. The Occupational Safety and Health Administration has previouslysaid employers have the right to mandate flu vaccines, butemployees can request medical or religious exemptions.
"You could face a situation where your income is dependent on getting a vaccine," said Robert Field, a law and public health professor at Drexel University.
If employers in service industries requiredvaccinations for employees, once a vaccine is licensed, they would "have a strong argument that termination would be objectively fair," Field said. For the time being, Fieldsaid he expects employers to avoid the legal risks of mandating a vaccine that has not been licensed.
The beststrategic approach to promote vaccination is to maximize communication and minimize barriers, saidRoss Silverman, a professor at Indiana Universitys Richard M. Fairbanks School of Public Health and Robert H. McKinney School of Law.
"What can we do to make this as easy as possible for people to say yes to?" he said. "The best approach to be taking in the near term is engaging communities, answering questions, andletting people know what the benefits and risks are, where theyre going to be able to get access to it and that there are no costs associated with getting the vaccine."
The question for now isn't who has to be vaccinatedbut who gets to be, saidMichelle Mello, a professor atStanford Law School.
"Most people will come around, so Im not even sure that we even need to have a conversation about mandates," Mello said."If its eight months from now and weve got ample supply and weve run through all the people who wanted to get the vaccine, and were still nowhere near herd immunity, it may be a different conversation."
Contributing: Elizabeth Weise and Adrienne Dunn, USA TODAY
Follow Grace Hauck on Twitter at @grace_hauck.
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RAYMOND The unexpected text came in at 9:48 a.m. Two tenants notified me theyd tested positive for COVID-19. Two days ago, I had a brief, masked interaction with them. Brief and distanced enough to be unlikely I got infected. But I also work in a health care center, which means we have to be extra careful. I notified my supervisors, already knowing what they would decide: 14 days quarantine, just to be sure.
I had a patient arriving in just a few minutes, so I also notified the reception desk tell the patient Im sorry, but I have to postpone. Hes angry at first, demanded to know why he drove all the way there just to be sent home. Until the receptionist relayed that I just found out that I had been exposed to the coronavirus then he understood and rescheduled.
Administrators want more details, including who Ive interacted with at the office over the past few days. Even though I was masked and goggled every time I stepped outside my office. All interactions had been very brief only a few seconds in passing except one. I had stepped into the receptionists office to ask a question and stayed for a few minutes. Not brief enough. Shoot. The receptionist and perhaps anyone she subsequently interacted with will also have to quarantine for 14 days. Luckily I didnt have any interactions with the doctors and physician assistants, and she was unlikely to have done so, either, or else my slip could have forced quarantines in our already thinly stretched medical staff.
As I wait to hear back from my supervisors, Im feeling guilty for having gone into the receptionists office instead of calling her on the phone. Im also feeling a little nervous about being in the situation in the first place. I know its not my fault Ive been wearing my mask and social distancing away from work but I feel like somehow Ive messed up and turned myself into a leper. Theres also a little anxiety about the outside chance that I really could be infected and not know it yet.
I finally hear back from my supervisors. Yes, I have to quarantine for 14 days, and I need to leave the center as soon as possible, avoiding interacting with anyone as I go. Ive already notified my wife, and we made a plan. Im going to stay in one end of the house, and shell stay in the other. One of us will have to sleep on a couch for the next two weeks, and since she needs access to her office, that means I get the bedroom. I also get the end of the house with the kitchen. Im feeling guilty again.
Now the waiting begins, to find out if I start experiencing symptoms. If I dont, I go for a COVID test in five days seven days after the potentially infecting interaction leaving enough time for false negatives to be unlikely. If I do well, I dont like thinking about that. Im in my 60s and overweight. The fatality rate for my age group is about 15 percent. I hope Ill be writing a follow-up to this column saying nothing happened in two weeks.
Notice, nothing has actually happened yet. None of us has any symptoms. The situation is more inconvenient than scary, so far. In all likelihood, I will be fine because I was wearing a mask and I was keeping my distance. My quarantine is really an abundance of caution, and despite the inconvenience, Im actually thankful for a state and a workplace that are following through on recommended precautions.
Practicing social distancing and mask wearing isnt perfect, but it has been working for me and for the state of Maine, which remains one of the least infected states per capita. Of course, with winter coming, the threat is growing. So, keep it up, Mainers. Keep your masks on and keep your distance. Lets keep Maine at the bottom of this list.
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Experts say side effects from the COVID-19 vaccine range from soreness to fatigue. USA TODAY
A trio of promising coronavirus vaccines promises to plunge a stake through the dark pandemic-riddled heart of 2020.
Thats the good news. Less encouraging is the reality that our national resolve will continue to be tested well into 2021 as a comprehensive inoculation rollout is likely only by summer.
In the meantime, winter is coming.
COVID-19 cases and deaths are skyrocketing nationwide, taxing hospital staff and facilities. More school disruptions seem inevitable, vexing students and frustrating parents. The recession has plunged millions into unemployment, challenging the incoming administration of President-elect Joe Biden to provide relief.
And partisan politics linger, undermining the kind of united front necessary to stem the tide of death and economic disruption.
The only way to face this is one day at a time, said Nina Lewellen, 30, of Detroit, whose birthday present last June was five days in intensive care with COVID-19. She is upset many of her Michigan peers continue to take the virus lightly as she continues to deal with repercussions including headaches and hair loss.
Nina Lewellen, 30, center, with her two children, Grace Lewellen, 10, left, and Grady Riney, 4. Lewellen was in the hospital for five days last June with COVID-19, and has been vocal about tell friends and neighbors in Detroit that the virus is not only real, but it is important to stay safe this winter as the case numbers climb.(Photo: Courtesy of Nina Lewellen)
The next few months promise to bring the worst of this pandemic to our door, so I can only hope that by sharing my own serious experience maybe I can get even one person to be careful, said Lewellen. The vaccines will help. But were a long way away.
Conversations with historians, futurists, doctors and business leaders around the country paint the coming year as both a challenge and opportunity, one that sees us all shouldering continued disruptions to the way we live and work but also, one day next year, newly appreciating the joys of attending a wedding or a throwing a Little League post-game barbecue.
The journey from here to there is a simple one, experts say. The more resolute we are in collectively facing the hardships 2021 brings us, the faster will we reap the freedom-filled rewards promised by the vaccines. And vice versa.
We are heading into the darkest days of our war on COVID-19, said Douglas Brinkley, historian at Rice University in Houston whose books have chronicled everything from the space race to World War II.
Our efforts to beat back the COVID-19 siege has revealed both the best and worst of American character.
On the one hand, this pandemic has shown we have short attention spans, dont trust science and believe in the survival of the fittest, Brinkley said. On the other, you see the tireless compassion of doctors and nurses working overtime to save lives. That deep community spirit is what we need now.
Or else that phrase seems to hang off the end of every observation made about 2021. The stakes, officials warn, are that high.
Plenty of people are sounding the alarm. Robert Redfield, the head of the Centers for Disease Control and Prevention, recently warned that the next three months will be the most difficult time in the public health history of this nation, with upwards of 450,000 deaths possible by February, up from around 280,000 currently.
World Food Program executive director David Beasley said Friday that2021 is literally going to be catastrophic," and the various humanitarian crises could be exacerbated as poorer nations waitlonger for the COVID-19 vaccine.
Philanthropist Melinda Gates, who along with her husband Bill has been working for decades to curb infectious diseases, said in a recent interview that vaccine skepticism in the United States threatens not only to undermine a COVID-19recovery but also extend the "stretch of very dark months ahead of us."
In Michigan, where increased testing has resulted in a 13% jump in positivity rates and rising 7-day death toll figures, Gov. Gretchen Whitmer pleaded for a rethinking of travel and holiday plans.
Medical staff members check on a patient in the COVID-19 intensive care unit at the United Memorial Medical Center in Houston, Texas. Healthcare leaders are warning that this winter could push hospitals and their staff to the breaking point as virus cases surge nationally.(Photo: Go Nakamura, Getty Images)
Los Angeles Mayor Eric Garcetti said Wednesday the areas mushrooming COVID-19 cases means residents should hunker down cancel everything." Sunday a stay-at-home order went into effect for 33 million Californians, including those in Southern California, the Bay Area and Central California to help stop the spread of a virus that is filling the state's ICUs.
Those warnings are powerful and even dire, and theyfallon fatigued ears.
Everyone is tired but unfortunately viruses dont care, they just replicate, said Timothy Brewer, professor of medicine and epidemiology at the University of California, Los Angeles. As long as its circulating, we need to be vigilant.
With a majority the nations hospitals at stretched capacity, the tipping point is here.
We are far from out of the woods just because there are vaccines that have good results, he said of products from Moderna and Pfizer that promise 95% effectiveness. Trial results from a third vaccine, from AstraZeneca, remain under review.
The vaccines themselves come with their own issues. Some require sub-Arctic temperatures up until the moment of injection, which presents a transportation and storage challenge. And then theres the fact that most require two shots, which in a nation of 330 million will be some undertaking.
Joel Zivot, an Emory University professor and ICU doctor, speaks with Hailey Wetta, a critical care physician. Both work with COVID-19 patients at Atlanta's Emory Decatur Hospital.(Photo: Courtesy of Joel Zivot)
People need to brace themselves from the cold reality of whats in front of us, and not stop any of the preventive measures meant to keep COVID-19 in check, said Joel Zivot, associate professor of anesthesiology and surgery at Emory University in Atlanta. He also works at Emory Decatur Hospitals intensive care unit, where he treats COVID-19 patients. He had the virus last summer.
In a recent article, Zivot posited that basic math which takes into account an 80% uptake of the vaccine that is 95% effective could yield between 500,000 and 2 million American deaths in 2021. Thatcalculation, whose wide death margin reflects whether the nation heeds heath community recommendations, excludes both how long it will take to make and distribute doses for all Americans,and how many will say yes.
The vaccine is not a panacea, he said. Itll take a year or more before some real material changes appear to the way we live. But, as I like to remind people, a year in a long life is a short time. We just have to be patient and think of the collective.
Health officials say they will continue to use media campaigns to influence often skeptical public opinions about both masks and the vaccine.
Liz Sharlot, director of communications at the Mississippi State Department of Health, said she aims to raise money to create a series of ads and public service announcements featuring testimonials from the first healthcare workers to receive the vaccine. Recent polls show that around 60% of Americans say they will take the vaccine when it becomes available.
"At first, health care workers will get these vaccines, soI want to use them in ads saying, 'I got it, it had few effects,'" says Sharlot. "If you hear it from people, it means something."
A Michigan group of business and health leaders spent $5 million on a coronavirus awareness campaigned aimed at younger Michiganders. A cartoon virus figure with dark sunglasses, dubbed "Rona," is seen here, on this digital outdoor ad, being pushed backwards as the words roll out: "Not here Rona." The campaign, leaders say, was successful in making some more aware of the need to social distance and wear masks, actions that have become politicized in Michigan and other states.(Photo: Courtesy of DTE Energy)
Last summer, Sharlot helped lead the departments ItIs Real campaign, featuring video interviewsof COVID-19 survivors.
In Detroit, a $5 million Rona 4 Real campaignis credited with changing the habits of younger Michiganders, who this summer were among those responsible for spreading the virus as they sought to mingle as cases fell. That campaign may get a twistas local leaders grow concerned that the existence of a vaccine may lead to a winter case spike.
"With the vaccine here, there's that same risk of younger people getting euphoric and reviving bad behavior," saidGerry Anderson, executive director of DTE Energy and co-chair of the Michigan Economic Recovery Council, which advised Whitmer on COVID-19 and spearheaded the Rona 4 Real campaign. "But well need discipline to hang in there.
Skepticism about COVID-19 may have contributed to prolonging the nations suffering well beyond what the United States had to endure during the last big viral conflagration, the 1918 Spanish Flu outbreak, said John Barry, author of The Great Influenza: The Epic Story of the Deadliest Plague in History.
A handout picture provided by National Guard Bureau shows soldiers in quarantine while recovering from the Spanish flu, at Camp Funston, Kansas, in 1918. That pandemic killed more than 600,000 Americans, back when the nation only have around 100 million citizens. But the Spanish Flu didn't last nearly as long, and the wearing nature of this COVID-19 pandemic is trying the patience of citizens as officials urge caution going into a possibly deadly winter.(Photo: US NATIONAL GUARD BUREAU HANDOUT, EPA-EFE)
While that event killed 675,000 Americans, or 0.5% of the 103 million population, and some 50 million worldwide, it took its biggest toll in only a 15-week period and passed through any given community in six to 10 weeks.
Theres really no comparison to the last plague, this one is much longer period of stress and were not done yet, Barry said. Wed all be better off if early on leaders had said what should have been said, This is going to a be long fight and we need to be prepared to fight it for the extended duration.
Economists looking ahead to 2021 see a mixed bag.
On the one hand, many spy the promise of a surge in discretionary spending as the vaccine gets widely distributed globally, bringing back everything from leisure travel to concerts and other group gatherings. Recently, the Organization for Economic Cooperation and Development projected global gross domestic product would rise next year by 4.2% after falling by the same percentage in 2020.
A Thanksgiving holiday traveler is directed as they pass through Los Angeles international Airport. State officials nationally worry such journeys may soon lead to a spike in COVID-19 cases and deaths, leading some, such as California Gov. Gavin Newsom, to warn that severe lockdowns could be imminent.(Photo: David McNew, Getty Images)
However, there will be no simple reset to the fall of 2019 as the virus batters the economy in the first quarter of 2021 JPMorgan economists have forecast a 1% contraction for the period and countless industries endure permanent change.
We wont return to pre-pandemic levels until the end of 2021, so in a way weve lost two years, said Andrew Butters, assistant professor at the Kelley School of Business at Indiana University in Bloomington.
In a recent report, Butters and his colleagues at the Kelley School predicted that employment is not likely to hit a pre-shut down peak until well into 2022, and while consumer spending ultimately may recover, it will be aimed at goods and not services as people remain wary of interaction for the foreseeable future.
After all of these changes weve seen in the economy in terms of businesses that have closed and jobs that no longer are viable, it would be nave to think none of these are going to stick, he said. Post-vaccine, there will be winners and losers in the new economy. Some sectors, firms and households will say, The economys back. And others will say, Not for me.
Other lasting changes despite the prevalence of a vaccine are likely to be behavioral, experts say.
These include a growing awareness of contagion and a corresponding aversion to big crowds, which in turn can, very sadly, dampen the natural curiosity we humans have about one another, said Maria Bothwell, CEO of Toffler Associates, a future-focused strategic advisory firm founded by Future Shock authors Alvin and Adelaide Toffler.
A waiter wears a mask and face covering at a restaurant with outdoor seating in Pasadena, California. The U.S. services sector, where most Americans work, has been hit hard by the COVID-19 pandemic as restaurant has been limited in an effort to curve the spread of the virus.(Photo: Marcio Jose Sanchez, AP)
But, Bothwell adds, it would be inaccurate to say that the pandemic has not brought positive changes to American society.
In her plus column: the ability of entrepreneurs to help society create new ways of doing business (the recent sale of messaging site Slack to Salesforce for $27 billion is bet on the permanent shift to remote working); a renewed appreciation for science and data-driven decision making (77% of Americans have at least some trust in scientists, according to a Pew Research Center poll); and a growing spotlight on healthcare inequity (the result of the poor and people of color suffering disproportionately from COVID-19).
On top of all that, youve also got a sense of elation, optimism and freedom that will surge over us as the vaccine helps us beat back the virus, Bothwell said. There will be more hugging and laughter. Thats something to look forward to.
Until then, its a matter of staying alive. Detroit resident Lewellen continues to tell anyone who will listen, whether on social media or in socially distanced meet-ups, about how serious this moment of national reckoning is.
I mean, what will it take for people to listen, losing someone? she said.
Lewellen, who caught the virus last summer from her asymptomatic 3-year-old, had a hellish experience at the hospital. Her breathing was so shallow doctors worriedthey would have to restart her heart. Once home, she was out of work for two months suffering from brain fog and insomnia.
Sal Lando, left, holds up signs during a protest against mandatory flu vaccinations, outside the Massachusetts State House, in Boston, last summer. Spurred by the pandemic, vaccine opponents have worked to reinvent their image around a rallying cry of civil liberties and medical freedom. Such a stance, health officials worry, could lead to a large percentage of Americans opting out of promising COVID-19 vaccines.(Photo: Nancy Lane, AP)
And that paled when compared to her mothers 10-day stay for COVID-19, which Lewellen says left her with cataracts in her eyes that only recently were removed.
While Lewellen is hopeful the vaccines will bring welcome relief at some point in 2021, for the moment she is girding for a battle to keep those around her safe.
Ill just keep doing everything I can to get the word out that people need to be very careful, said Lewellen. I know people are really fatigued by the masks and the restrictions, but this is not over.
Follow USA TODAY national correspondent Marco della Cava: @marcodellacava
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