Category: Covid-19

Paul Kirsch got vaccinated against COVID-19 as soon as he became eligible, telling his wife it was a must.

Kirsch had been diagnosed with amyotrophic lateral sclerosis (ALS) in 2018 and wanted to live as long as he could, even as his life became restricted by the degenerative disease taking over his body, said his wife, Emily Kirsch.

Even after getting vaccinated in April, Paul Kirsch was careful, aware that an infection could be fatal. The 65-year-old restricted his social world, meeting only with a select group of vaccinated friends and family, and only in their backyard in Wilsonville, his wife said.

But there was one gap in the protective armor: The very person hired to take care of him. Shortly after Paul Kirschs unvaccinated caregiver contracted COVID-19, Paul Kirsch began showing symptoms, his wife said. He died Sept. 5.

Paul Kirsch is one of at least 204 Oregonians who have died from a COVID-19 infection despite being fully vaccinated against COVID-19. While highly effective at preventing severe illness and death, the shots are not bulletproof.

Details of such breakthrough fatalities generally remain scarce, although those 80 and older have seen disproportionately high death rates. And, for those with underlying medical conditions, an infection can still prove lethal.

Kirschs death also highlights a gap in Oregons COVID-19 vaccine mandate for health care workers. While all employees in health care facilities such as hospitals and doctors offices must get shots by Oct. 18, anyone who works exclusively inside someones home does not.

Paul Kirsch grew up in Eugene and had led an illustrious life devoted to baseball, including playing and coaching in the minor leagues, finishing his career as a senior scouting supervisor for the Tampa Bay Rays.

Nichoel Fry, one of Paul Kirschs nieces, remembers him warmly, saying that as a younger man, he was always the charming center of attention. She recalls a summer evening in the backyard, with the whole family gathered around and laughing and her uncle driving the fun.

He was always the center of whatever hilarious thing was happening, Fry said.

But by his early 60s, what started as weakness in his right arm turned into a fast-paced progression of ALS, also known as Lou Gehrigs Disease. That didnt stop Paul Kirsch from living fully, his wife said.

By the time COVID-19 came to Oregon, Paul Kirsch couldnt walk or talk. In April 2020, he started communicating through a device that allowed him to use his eyes to select words and letters, which the device would then say out loud.

One of his caregivers, Amy Balderas, would spend eight hours a day Monday through Thursday giving Paul food, taking him to the bathroom, showering him and helping with other fundamental life tasks. She wore a mask at all times, Paul Kirschs wife said, but he did not.

Emily Kirsch said Balderas was the only caregiver to refuse to get vaccinated against COVID-19, telling her employer she feared there could be long-term effects from the vaccine. Despite all his other precautions, Paul Kirsch decided he would risk keeping Balderas on, his wife said, because she was very good at her job and had been with him for three years.

Aug. 20, a Friday, Balderas said she woke up with body aches and had a fever that lasted through the weekend. Paul Kirsch complained of a headache and fever that Sunday, Emily Kirsch said. Monday, Balderas symptoms were worse. She took an at-home COVID-19 test that came back positive and called Emily Kirsch to tell her.

Balderas said she doesnt know how she got COVID-19. She socialized with about five friends and went to the chiropractors office the week before she had symptoms.

Even though Balderas had COVID-19, Paul Kirsch refused to get tested for a coronavirus infection because he didnt have any obvious symptoms, his wife said. But two days after Balderas tested positive, Paul Kirsch was having trouble breathing and went to the emergency room at Legacy Meridian Park Medical Center. Staff tested him for COVID-19. The result came back positive, and he was immediately moved to the intensive care unit.

Because Paul Kirsch had an underlying condition, a coronavirus infection was particularly dangerous. He spent 10 days in the ICU, his breathing becoming more and more difficult.

If you need to go, the good Lords waiting for you, Emily Kirsch recalled saying to her husband as she stood by his hospital bed, holding his hand with one hand and rubbing his forehead with the other.

Are you ready? she asked.

A tear rolled down his right cheek, she said, and he raised his eyebrows which in the language they had created meant, Yes.

Paul Kirsch died the next day.

Though initially Emily Kirsch was angry at her husbands caregiver, she said with time she has become more understanding because she recognizes her husband made an explicit choice to keep her on, despite her refusal to get vaccinated.

Balderas said she is considering quitting her career in order to never again risk bearing responsibility for someones life.

It was very devastating to find out he had passed, Balderas, 40, said. And then to feel, like, Oh my gosh, what if I did give it to him?

While most Oregon health care workers must be fully vaccinated next month, that rule doesnt apply to the tens of thousands of caregivers who, like Balderas, provide care only in peoples homes. The Service Employees International Union 503, which represents at least 40,000 home care workers, pointed out that each person getting care is the employer and can set terms of their interaction -- including whether they want to hire someone who is unvaccinated.

A consumer can fire them if they choose not to be vaccinated, union spokesman Ben Morris said.

Labor law expert Dorit Reiss said there is a long history of allowing clients to work things out with their caregivers. It would also be all but impossible to track whether home care workers comply with a vaccination mandate, said Reiss, a University of California Hastings College of the Law professor.

Even with what she knows now, Balderas said she wouldnt get the shot. She is afraid of side-effects from all unfamiliar medications and the vaccine because of a one-and-a-half month stretch of panic attacks and a two-year stretch of anxiety following a bad reaction to a new medication.

Instead, Balderas said she would have quit her job caring for Paul Kirsch, her only client. He was very understanding of her reasons for not getting vaccinated, Balderas said.

In the days that he was sick, Paul Kirsch regularly expressed that he wished everyone would get vaccinated, given how dangerous it can be to people like him. The family included that plea in his obituary.

He was very passionate that everybody get vaccinated, Emily Kirsch said. Because of what he was going through.

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Fedor Zarkhin

503-294-7674; fzarkhin@oregonian.com

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Vaccinated man with ALS died from COVID-19, wished everyone who could would get the shot - OregonLive

A NHS nurse holds a Coronavirus testing kit as she speaks to the media at a drive through Coronavirus testing site in a car park on March 12, 2020 in Wolverhampton, England.Photo: Christopher Furlong (Getty Images)

A new approach to treating covid-19 may be on the horizon. Clinical trials of several antiviral candidates are expected to finish within the next few months, all taken as a simple pill provided before or soon after an infection is confirmed.

Antibiotics, which are used to treat bacterial infections, are some of the most important medicines ever created. But we have far fewer antivirals available, for several reasons. One limitation, for instance, is that its harder to create drugs that can safely stop a virus compared to bacteria, since viruses hijack our own cells to reproduce (some bacteria do as well, but most that cause us trouble dont). Thats why vaccines tend to be our first line of attack against viruses, which train the immune system to recognize a particular virus before it invades, ideally preventing a person from becoming sick in the first place.

Just as the pandemic has allowed scientists to make advances in vaccine technology and development, theres hope that it will speed up the antiviral pipeline, too.

As Kaiser Health News reported Monday, there are at least three experimental antivirals going through late-stage clinical trials in the U.S. right now. These drugs are being explored as early treatments, given within days of infection, while some are also being studied as prophylactics that are given right after a suspected exposure to someone with covid-19 to prevent illness. And unlike the antivirals that have seen some limited use so far during the pandemic, theyre taken orally as a pill.

On Monday, Pfizer (the co-developer of the first approved covid-19 vaccine in the U.S.) announced the start of a large trial testing out its candidate, code-named PF-07321332, as a prophylactic. Earlier this month, Merck and Ridgeback Biotherapeutics began a Phase II/III trial of their drug molnupiravir. And earlier in the summer, the companies Roche and Atea Pharmaceuticals began large trials of their drug called AT-527. These companies all intend to release data from these trials within the next few months, while Merck is looking for an emergency use authorization of its drug before the end of the year.

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The pills are said to work by interfering with the coronaviruss ability to replicate in a host cell, hopefully leading to a lower viral load and making it easier for the immune system to clear the infection. Ideally, these drugs would greatly reduce the length and severity of symptoms, preventing hospitalization and serious illness. And they may very well prevent an infection from taking hold altogether when taken as a prophylactic.

Of course, finding a highly effective treatment for covid-19 is easier said than done. The antiviral remdesivir, authorized for emergency use in the U.S., does seem to help hospitalized patients recover slightly faster, but theres limited data showing that it actually helps prevent death. Other treatments, like monoclonal antibodies, have shown more promise but are very costly and need to be delivered via infusion, limiting their usefulness and availability (some studies have shown that early treatment with these can prevent severe illness).

Perhaps the most comparable drug would be Tamiflu, an FDA-approved antiviral meant to prevent or reduce flu symptoms. Unfortunately, Tamiflu is very mediocre at best, and some scientists have argued that it never should have been approved in the first place.

The U.S. has already agreed to buy stockpiles of some of these newer generation antivirals for covid-19, should they turn out to be good enough to win authorization or approval. In the best-case scenario, theyll become a valuable partner to vaccines against future waves of covid-19 or even other coronaviruses in the future. But well need to await the data from these ongoing clinical trials before getting our hopes up.

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Pharma Companies Are Racing to Develop a Covid-19 Pill That Works - Gizmodo

ADA TOWNSHIP, Mich. (WOOD) A well-known drivers training instructor has died following a battle with COVID-19.

Randy RaRaRand, the owner of Jungle Survival Drivers Training died Sept. 16. He was 71 years old. He left behind his wife, three adult children and a grandson.

Rand taught defensive driving to hundreds of students in the Grand Rapids area over the years.

2003 is when he had his first location off of Spaulding (Avenue). It was a tiny little spot and his thing was Field of Dreams: If you build it, they will come, Rands daughter Sommer Rand said.

The school was known for its jungle-themed rooms and cars covered in paintings of leaves and big cats. Since its inception, the driving school has expanded to three locations in Ada, Wyoming and Dorr.

He worked for UPSfor close to 30 years and then retired from there and so he wanted to take a lot of the stuff that he did at UPS and implement it. Michigan had one of the highest fatality rates for teen drivers and so he wanted to teach defensive driving, Sommer Rand said.

At the end of August, Rand and his wife Jane came down with COVID-19. His wife was hospitalized but laterrecovered. Rands family says at one point, Randy Rand seemed to be turning the corner and then suddenlyhis case worsened. Rand was hospitalized.

He fought and fought and fought and ended up subsequently going on to a ventilator and his lung collapsed, his daughter explained.

Family said Rand was planning to celebrate his 46th anniversary with his wife this weekend. He was also set to walk his daughter down the aisle at her wedding in a few weeks.

He was so special to me and my dad knew that so I have no regrets. He knows how much I loved him and will love him forever, Sommer Rand said tearfully.

They say that thoughhe is no longer here, the imprint he has left on the community remains.

Im just glad that this (the driving school) was his dream and he had this vision and he was able to execute it seamlessly and its just grown so much, Sommer Rand said. Always drive the Jungle Way because he will be looking down on all of us forever and he will know if youre not following all of the checklists.

On Oct. 17, Rands family will host a celebration of life ceremony at the Ada Jungle Survival Drivers Training location. The memorial from 1 p.m. to 5 p.m. will be open to the public.

A friend of the family set up a GoFundMe account to help the family. Sommer Rand says theyre alsosetting up a memorial fund in her dads name to benefit his grandson Knox Jackson. The account is set upthrough Macatawa Bank. The family says donations canbe sent to P.O. Box 3119, Holland, MI 49422-9949.

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Family mourns West Michigan driving teacher who died of COVID-19 - WOODTV.com

Confirmed cases of COVID-19 have passed 232.8 million globally, according to Johns Hopkins University. The number of confirmed deaths stands at more than 4.76 million. More than 6.18 billion vaccination doses have been administered globally, according to Our World in Data.

New COVID-19 cases in New Zealand have jumped to their highest level in weeks, with 45 new confirmed cases reported - all in Auckland.

Pfizer has asked Brazil's health regulator to approve a third dose of its COVID-19 vaccine.

Costa Rica announced yesterday that all state workers will need to be vaccinated against COVID-19.

Algeria is set to begin production of the Sinovac COVID-19 vaccine, in partnership with China. It aims to meet domestic demand and export the surplus.

From next week, Croatia will require that all employees in the health and social care sectors be vaccinated or test negative for COVID-19.

Egypt is now providing immediate COVID-19 vaccinations without prior online registration. The move is aimed at encouraging vaccinations amid a fourth wave of infections.

Daily new confirmed COVID-19 cases per million people in selected countries

Image: Our World in Data

Singapore's health ministry has reported the country's highest one-day rise in confirmed COVID-19 cases since the start of the pandemic - 2,236.

The country has paused further reopening after a recent rise in cases following the relaxation of some COVID-19 measures. From this week, Singapore has tightened some restrictions, including limiting social gatherings to two people and making work from home a default.

Meanwhile, Romania reported a record 11,049 confirmed COVID-19 cases in 24 hours. Yesterday, the country had only 26 intensive care beds available, and was struggling to add more because of staff shortages.

Japan will lift a state of emergency in all regions on Thursday for the first time in nearly six months. It comes as the number of cases and deaths falls, easing the pressure on the health system.

Daily cases have fallen nationwide from more than 25,000 last month to 1,128 on Monday, but the opening will be gradual with some curbs on restaurants and large-scale events staying in place for about a month.

"Thanks to progress in vaccination and administration of neutralizing antibody drugs, we are entering a phase where medical services can be offered in a stable manner even if a certain degree of infections take place," Prime Minister Yoshihide Suga told a coronavirus task force meeting.

Each of our Top 50 social enterprise last mile responders and multi-stakeholder initiatives is working across four priority areas of need: Prevention and protection; COVID-19 treatment and relief; inclusive vaccine access; and securing livelihoods. The list was curated jointly with regional hosts Catalyst 2030s NASE and Aavishkaar Group. Their profiles can be found on http://www.wef.ch/lastmiletop50india.

Top Last Mile Partnership Initiatives to collaborate with:

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Joe Myers, Writer, Formative Content

The views expressed in this article are those of the author alone and not the World Economic Forum.

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COVID-19: What you need to know about the coronavirus pandemic on 29 September - World Economic Forum

A news conference meant to sum up the current state of the COVID-19 crisis in Oregon started out with a decidedly upbeat tone Tuesday -- with Gov. Kate Brown saying she had promising news about declining numbers of patients hospitalized and new daily infections identified.

The good news is that while we still have a long way to go, it appears things are slowly getting better, Brown said.

Deputy state epidemiologist Dr. Tom Jeanne also chimed in that while hospitalizations are still stressing the systems capacity, they are declining thanks to Oregonians heeding COVID-19 safety precautions, like wearing masks.

Thank you Oregonians for once again unselfishly stepping up to turn back the rising tide of infection, Jeanne said.

But by news conferences end, both the governor and the deputy state epidemiologist seemed to be sending mixed messages, acknowledging that while new known daily cases had been tumbling for the first three weeks of September they have now generally plateaued for the past week and officials are hopeful but uncertain of whats to come.

Jeanne said he was unsure of the impact mass outdoor events like University of Oregon, Oregon State University and high school football games may be having on flattening COVID-19 case rates. Both Jeanne and the governor acknowledged that the Pendleton Round-Up in particular has fueled highly concerning spread in eastern parts of the state.

Let me be really, really clear, Brown said when questioned by a reporter about her failure to mention the event until asked about it. I did not go to the Pendleton Round-Up, which I love ...because I was concerned about community spread.

When asked if she was worried about mid-Septembers Round-Up sparking a new surge in parts of eastern Oregon, Brown added: Im gravely concerned.

Brown, however, said she allowed the Round-Up to proceed because its up to individual Oregonians to follow the rules, and shes mandated some of the strictest nationally by requiring masks in all indoor public spaces and in outdoor settings where physical distancing cant be maintained from other people.

We have some of the strongest safety protocol in the entire nation, Brown said. ... If you watch an Ohio football game in Ohio, those stadiums filled with 100,000 people, there is hardly a mask there. That is very different here in Oregon.

Mask compliance at football games in Oregon has been mixed, with many covering up but many others sporting masks under their chins.

Mask requirements at the Pendleton Round-Up were reportedly seldom followed. Some people attended the event even though they had COVID symptoms, according to The East Oregonian, which said Umatilla County had linked 49 COVID-19 infections to Round-Up. Officials believe the true number is higher because many infected people wouldnt cooperate with contact tracers, the news organization reported.

Statewide, the number of new known daily COVID-19 cases has declined 28% and hospitalizations are down 26% over roughly the past four weeks. Deaths also have dropped from an average of 19 reported in a day to 16.

But the past week tells a different story. Only hospitalizations have continued to fall. Daily cases and deaths have remained relatively flat, with cases down only 2% in the past week.

As of Wednesday, new known cases were averaging about 1,630 per day. A forecast provided to the state last week predicted cases by Oct. 12 would either decrease to 1,480 or increase to about 2,050 per day.

Jeanne, the deputy state epidemiologist, said hes still optimistic about COVID-19 numbers declining in the fall. He said its still too soon to tell the full extent the start of K-12 school and colleges and big fall events like the Round-Up will or might have on Oregons longer term numbers.

Could all of those things be having some effect on our cases and potentially slowing the decline were seeing? Jeanne asked. Absolutely.

-- Aimee Green; agreen@oregonian.com; @o_aimee

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Oregons COVID-19 surge receded. Will those declines continue? - OregonLive

SIOUX FALLS, S.D. (KELO) Active COVID-19 cases decreased in South Dakota for the third time this week, according to the South Dakota Department of Health.

On Wednesday, there were 552 new total COVID-19 cases reported, bringing the states total case count to 144,546, up from Tuesday (143,995).

Active cases are now at 7,461, down from Tuesday (7,600).

The death toll from COVID-19 remained at 2,133. Its the first day the state did not report a new COVID-19 death since Sept. 1.

Current hospitalizations are at 205, up from Monday (200). Total hospitalizations are now at 7,378, up from Tuesday (7,359).

Total recovered cases are now at 134,952, up from Tuesday (134,262). The latest seven-day PCR test positivity rate for the state is 13.6% for Sept. 21through Sept. 27.

The DOH currently reports total tests each day. There have been 1,495,803 total tests reported as of Wednesday, up from 1,489,645 total tests reported Tuesday.

Of South Dakotas 66 counties, 61 are listed as having high community spread. High community spread is 100 cases or greater per 100,000 or a 10% or greater PCR test positivity rate.

There are 336 confirmed cases of the Delta variant (B.1.617.2, AY.1-AY.3) detected in South Dakota through sentinel monitoring.

There have been 172 cases of the B.1.1.7 (Alpha variant), three cases of P.1. (Gamma variant) and two cases of the B.1.351 (Beta variant).

As of Wednesday, 64% of the population 12-years-old and above has received at least one dose while 58% have completed the vaccination series.

There have been 437,805 doses of the Pfizer vaccine administered, 317,066 of the Moderna vaccine and 28,068 doses of the Janssen vaccine.

There have been 152,760 persons who have completed two doses of Moderna, an increase of 92 over the previous report. Theres been 208,713 persons have received two doses of Pfizer, up 238 people.

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COVID-19 in South Dakota: 552 new total cases; Death toll remains at 2,133; Active cases at 7,461 - KELOLAND.com

What GAO Found

Executive branch agencies' revenues from dedicated user fees were lower in fiscal year 2020 and in the first half of fiscal year 2021 compared to average annual revenues in fiscal years 2017 through 2019, the 3 fiscal years prior to the start of the COVID-19 pandemic. Following the declaration of the pandemic as a national emergency in March 2020, these revenues were about 39 percent lower than the previous 3-year average during the same period.

Executive Branch Agencies' Revenue from Dedicated User Fees in Fiscal Year 2020 Was Lower Overall than the Previous 3-year Average

Note: For more details, see figure 2 in GAO-21-104325.

The Federal Aviation Administration (FAA), National Park Service (NPS), and U.S. Citizenship and Immigration Services (USCIS) all prioritized spending on essential expenses, sought to increase available funds or operational flexibilities, and relied on carryover balances to cover essential expenses during the pandemic. However, FAA and NPS have not documented plans to review certain management plans and policies.

Each year, federal agencies collect billions of dollars in dedicated user fee revenue from fees charged to users of federal goods and services, which are dedicated by law for a specific purpose or program. The COVID-19 pandemic disrupted critical government operations for agencies that rely on these revenues.

The CARES Act included a provision for GAO to review the effects of the pandemic on public institutions of the U.S. This report examines how dedicated user fee revenues have changed since the onset of the pandemic and how selected agencies managed revenue changes related to the pandemic, among other objectives.

To determine revenue changes, GAO compared dedicated user fee revenues in fiscal years 2020 and 2021 to amounts from prior years. GAO selected three agencies to reviewFAA, NPS, and USCISbased on whether they relied on dedicated user fee revenue to a high (FAA and USCIS) or low (NPS) extent, among other factors. GAO interviewed officials at the selected agencies and reviewed relevant documents to determine how these agencies managed revenue changes, and compared those actions to internal control standards and leading practices for fee design.

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COVID-19: Reviewing Existing Policies Could Help Selected Agencies Better Prepare for Dedicated User Fee Revenue Fluctuations - Government...

September 29, 2021 | Austin, Texas | Press Release

Governor Greg Abbott today announced that the Texas Division of Emergency Management (TDEM), in partnership with local officials, launched a new COVID-19 therapeutic infusion center in College Station. The infusion center opens to the public tomorrow and has been provided with monoclonal antibodies to treat outpatient cases of COVID-19 with a doctors referral. This treatment is available at no cost to the patient. Local partners include Brazos County, the City of College Station, the City of Bryan, and St. Joseph Health Hospital.This facility in Brazos County will ensure Texans in the Bryan-College Station region who test positive for COVID-19 have access to this free and effective treatment," said Governor Abbott. "Thank you to our local government partners and St. Joseph Health Hospital for working with us to open this new infusion center."Governor Abbott, TDEM, and the Texas Department of State Health Services (DSHS) have established and expanded antibody infusion centers in communities across the state over the past several months. COVID-19 antibody infusion treatment can prevent a patient's condition from worsening and requiring hospital care. These facilities also help increase bed capacity in hospitals so that resources are available for the most ill patients. The State deployed similar measures beginning in November 2020 to communities across Texas.These state-sponsored infusion centers are in addition to the infusion treatment centers provided by more than 200 private health providers across the state.Antibody infusion centers are currently operating in the following communities, with more in the planning stages: Amarillo (TDEM) Austin (DSHS) Beaumont (TDEM) College Station (TDEM) Corpus Christi (DSHS) Edinburg (TDEM) Fort Worth (DSHS) Harlingen (TDEM) Houston (DSHS) Laredo (DSHS) Livingston (TDEM) Lubbock (TDEM) McKinney (TDEM) Nacogdoches (TDEM) Nash (TDEM) Odessa (TDEM) San Antonio (DSHS) Seguin (TDEM) Tyler (TDEM) The Woodlands (DSHS) Victoria (TDEM) Waco (TDEM)The treatment is free and available to Texans who test positive for COVID-19 and have a referral from a doctor. Texans can visit meds.tdem.texas.gov to find a therapeutic provider.

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Governor Abbott, TDEM Open COVID-19 Antibody Infusion Center In College Station - Office of the Texas Governor

The previous all-time high was recorded four days ago, on September 24, when 828 deaths were registered.

Kremlin spokesperson Dmitry Peskov acknowledged the country's regions had seen an increase in coronavirus cases while speaking to journalists on Tuesday.

The head of Russia's public health watchdog Rospotrebnadzor, Anna Popova, said last week it was hard to determine when cases would slow, with less than 50 million Russians having received a first dose of a vaccine.

"We have, let us say, 110-115 million adults. Of them, some 47 million have received one dose. This is less than a half [of Russia's adult population] ... so we have no grounds to say today that [infections] will stop," state news agency TASS quoted Popova as saying.

Russia is one of the countries worst affected by the pandemic, reporting the seventh highest number of cases globally, according to John Hopkins University data. It is currently battling a devastating third wave of infections.

In total, it has registered 7,464,708 cases across the country, while the total number of coronavirus-related deaths since the beginning of the pandemic now stands at 205,531, according to official figures.

It is struggling with persistently low vaccination rates -- a problem caused by high levels of hesitancy among its population. Just over a quarter of Russians have received the shot, compared to more than a half in the United States and two thirds in the United Kingdom, according Our World in Data.

In a bid to try and bolster vaccination numbers, Moscow authorities in June ordered that at least 60% of service industries staff -- spanning everything from catering to housing to transport -- had to get at least one shot by mid-July. Peskov said at the time that while vaccination was voluntary, workers were at risk of losing their jobs if they declined a shot.

Putin told a summit of the Collective Security Treaty Organization via video link that "several dozen people" from his entourage had contracted the virus.

Peskov previously said that the Russian president had tested negative for coronavirus and was "absolutely healthy."

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Russia reports its worst single-day Covid-19 death toll since start of pandemic - CNN

Karen Mahoney and her new husband, Brian Ray, told CNN they met 35 years ago over a love of skiing, and when they finally got engaged in March, the ski instructors didn't want to wait to get married. But Mahoney said there was really only one thing that mattered to her: having her parents and 96-year-old grandmother at the wedding.

"She's my only living grandparent, the only grandparent I've ever known, so it was very important for me for her to be there to watch the happiest day of my life," Mahoney said. "The most important part of the day for us was the promises we told to each other, and we wanted my parents and grandmother to witness that."

Mahoney said the couple has a friend who works for border patrol who had arranged for her to meet her family at the closed border previously, including when Ray asked her father, Paul, for her hand in marriage. So they asked the friend for help in making it work again.

He explained all the rules, including making sure they stayed on their given sides and did not exchange anything, and informed the patrol on duty as to what was going on if they saw the ceremony on the cameras in the area. They met up at the border outside Burke, New York, the day before their planned wedding on September 25.

The border crossing more resembles a meadow with a marker showing the country names. There were no gates or fences in the way. Mahoney's parents stood on their Canadian side and the couple, their wedding party and their officiant stood on the other.

They went through the whole wedding, all but signing the marriage certificate, which they reserved for the big wedding the next day at Mahoney's home in Cadyville, New York.

Ray and Mahoney said the experience was emotional.

"The minister asked them if they (my parents) acknowledge that Brian was vowing to love me the rest of our lives, and did they accept him into the Mahoney clan, and they responded, 'We do' and that was extremely emotional," Mahoney said.

"I cried," Ray said. "It was good for me, because I knew how much it meant to her to have her parents and her grandmother here and see us exchanging vows."

The couple met in 1985 when Ray taught Mahoney to ski. They remained friends through the years even after they both married other people and each had two boys. About 10 years ago, Ray was the one to teach Mahoney's boys how to ski.

After each was married for 19 years, they each divorced and were brought together by a Facebook post in which Mahoney was selling a beloved vehicle. Ray knew she loved the car and they got to talking about it, and the rest was history.

They dated for a year, and in March, Ray used their love of skiing to propose on top of a mountain in Vermont.

"Just an epic day of skiing and bluebird sky. It just was absolutely perfect," Mahoney said.

"Forever and a day and then some. That's our thing," Ray said.

Correction: A previous version of this story used the incorrect call letters for CNN affiliate WPTZ.

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Covid-19 restrictions kept her family from attending her wedding, so she got married on the Canadian border - CNN