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Would You Bounce In to Cease an Assault?

Would You Jump In to Stop an Assault?

Fear isn’t the only factor that determines whether viewers act in moments like this. Bibb Latané, a social psychologist who pioneered viewer intervention in the years following the murder of Kitty Genovese, described another dynamic: the sharing of responsibility that can lead to inaction among strangers who witness a crime .

An increase in anti-Asian attacks

    • In the early days of the coronavirus pandemic, a torrent of hatred and violence against people of Asian descent began in the United States last spring. Community leaders say the bigotry was fueled by the rhetoric of former President Trump, who called the coronavirus the “China virus”.
    • A wave of xenophobia and violence in New York has been compounded by the economic fallout from the pandemic that dealt a severe blow to the Asian-American communities in New York. Many community leaders say racist abuse is overlooked by the authorities.
    • In January, an 84-year-old man from Thailand was violently beaten to the ground in San Francisco, leading to his death in a hospital two days later. The videotaped attack has turned into a rally.
    • Eight people, including six women of Asian descent, were killed in the shootings at the Atlanta massage parlor on March 16. The suspect’s motives are being investigated, but Asian communities in the United States are on high alert because attacks against Asian Americans have increased over the past year.
    • A man was arrested and charged with hate crimes related to a violent attack on a Filipino woman near Times Square on March 30th. The attack sparked further outrage after security footage revealed that bystanders did not come to the woman’s immediate assistance.

Professor Latané, along with social psychologist John M. Darley, tried to replicate real emergencies through a series of laboratory experiments with people who did not know each other. The more viewers they found, the less likely it was that people would intervene. They also found that strangers unconsciously orientated themselves towards their fellow human beings, a concept known as social influence, and were less likely to intervene when others were similarly passive.

In an interview, Professor Latané said that the theories he and Mr Darley developed nearly five decades ago have often been overlooked by those who cling to popular notions of the emotionally distant viewer. He said these sentiments were often fueled by the news media, which tends to post incidents where witnesses failed to act while ignoring cases where viewers intervened. “It’s the unusual event that makes it current,” he said. “It was never about apathy, it was about social inhibition, and I’ve always thought it was unfair that New York should be judged for what happened to Genovese.”

Recent research examining real world interactions has challenged some of their earlier findings. For one, Professor Philpot’s 2019 study found that larger numbers of viewers increased the chances of intervention. When reviewing the surveillance footage, the researchers found that an average of at least three people had chosen an act, and they found that the presence of each additional bystander resulted in a 10 percent increase in the likelihood that a victim would receive help.

Although Professor Philpot said his research is not aimed at testing the theory of the side effect, the results suggest that there is safety in numbers. “While the presence of more bystanders can reduce the likelihood of each one of them intervening, it also provides a larger pool of potential helpers, increasing the overall likelihood that at least someone will help the victim,” he said.

Alan Berkowitz, an expert on the side effect and author of “Responsiveness: A Complete Guide to Viewer Intervention,” said other factors, including the race of the perpetrator or victim, could play an unconscious role in whether people help a stranger in need. “Research has found that viewers who are white, for example, may not feel like it is worth engaging in an incident with two people of color, but they may be more comfortable engaging in a fight between two whites male executives intervene, “said Dr. Berkowitz, a psychologist who runs workshops for students, community groups, and the military to find out how to intervene effectively to prevent acts of violence and sexual assault. “Once you are trained to become aware of these things and you are trained to conduct safe and effective interventions, you will feel more comfortable responding to your request for help.”

These tactics include distracting the perpetrator to call for help or find a way to get other bystanders to intervene more collaboratively. “It is very important to talk to other viewers as we often do not know that others are also affected,” he said.

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NY expands Covid vaccine eligibility to all adults beginning April 6, Cuomo says

NY expands Covid vaccine eligibility to all adults starting April 6, Cuomo says

New York Governor Andrew Cuomo will receive a Covid-19 vaccine at a church in Harlem, New York on March 17, 2021.

Seth Little | AFP | Getty Images

New York will expand its Covid vaccine eligibility to all over 30s starting Tuesday, followed by all residents 16 and over on April 6, Governor Andrew Cuomo announced on Monday.

President Joe Biden is moving almost a month before May 1, which is when states can largely open their supplies to all residents.

“Today we are taking a monumental step forward in the fight against COVID,” Cuomo said in a statement. “As we continue to upgrade eligibility, New York will make the vaccine available to every community to ensure justice, especially for color communities too often left behind.”

Nearly 30% of all New Yorkers have been reported to have received at least one vaccine. The state has fired 9,056,970 shots so far.

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The way to Nudge Individuals Into Getting Examined for the Coronavirus

How to Nudge People Into Getting Tested for the Coronavirus

In a randomized clinical trial of nearly 5,000 emergency patients, researchers found that the proportion of patients willing to take a rapid HIV test increased from 38 percent to 66 percent when the test was presented as a medical service they purposely provided had to refuse. rather than one they had to proactively ask for.

Similarly, if they are not enabled, but disabled, the likelihood of wider coronavirus screening program involvement is higher. “The more you ask people to put their own cognitive and behavioral efforts into this cause, the less likely they are to do so,” said Derek Reed, who heads the Laboratory of Applied Behavioral Economics at the University of Kansas.

And of course, the actual testing process should be quick and convenient, experts say, with strategically placed test locations and streamlined procedures that allow people to easily incorporate testing into their routines.

Experts also suggested asking people to think about the logistics of when and how to get tested. Studies show that people who clearly formulate a plan for how they want to achieve something – whether it’s a vote on an upcoming election or if they get a flu vaccine – are more likely to get their way.

Updated

April 1, 2021, 11:02 p.m. ET

One way, said Dr. Reed, would be to text people reminders of their test appointments and ask them to reply, for example, with a 1 if they want to go to the appointment, a 2 if they want to drive, or a 3 if you plan to to take the bus. “And then, depending on the answer, just automatically ping back Google map directions or a link to maps or timetables on the campus or community bus system,” he said.

These type of nudges are likely most effective for people who are already motivated to get tested but may have trouble getting through. “Often times, you have to nudge them a little, just removing friction, to get rid of those small costs,” said Sebastian Linnemayr, behavioral economist at RAND Corporation, a think tank in California.

Health officials could also reward people who participate in testing programs. “There must likely be some incentive at the patient level,” said Dr. May. “We saw the same thing with cancer screening. We have seen health insurers incentivize patients to participate in healthy lifestyles and to participate in screening programs. “

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Every day U.S. knowledge on March 30, 2021

Daily U.S. data on March 30, 2021

Amid growing fears of a fourth wave of US Covid-19 cases, government officials urged Americans to continue taking precautions to prevent the virus from spreading.

During a press conference on Monday, the director of the Center for Disease Control and Prevention Dr. Rochelle Walensky said she had a feeling of “impending doom” and urged the Americans to “hold out just a little longer”. Later that day, President Joe Biden said the “war on Covid-19 is far from over”. He condemned behaviors that could spread infection and said some states should suspend their reopening plans.

At the same time, a new CDC study of vaccinated health care workers showed that one dose of the Pfizer or Moderna vaccine was 80% effective in preventing coronavirus infections and 90% two weeks after the second dose. The pace of daily vaccinations is close to 3 million shots per day.

US Covid cases

About 66,000 new Covid cases are reported daily in the U.S. based on a 7-day average of Johns Hopkins University data that has ticked up. That number is well below the January high of around 250,000 cases per day, but more in line with the summer increase when daily cases hit close to 70,000 in late July.

Cases are increasing by 5% or more in more than half of the US states based on the change in the 7-day average of daily cases from a week ago.

US Covid deaths

According to Hopkins data, the US reports a weekly average of 990 Covid deaths per day. In total, more than 550,000 US coronavirus deaths have been reported.

US vaccine shots administered

Almost 2.4 million vaccine shots were administered on Monday, bringing the 7-day average of daily vaccinations to 2.8 million, a record level.

Biden said Monday that 90% of adults in the US will be eligible for Covid shots by April 19.

“For the vast majority of adults, you don’t have to wait until May 1st. You can be eligible for your shot on April 19th,” said Biden

US percentage of the vaccinated population

CDC data shows that 95 million people, nearly 30% of the US population, received at least one dose of a Covid vaccine. About 53 million are fully vaccinated with two shots of Pfizer or Moderna vaccines, or one shot of Johnson & Johnson.

About half of those over 65 are fully vaccinated, according to the CDC.

CNBC’s Noah Higgins-Dunn and Berkeley Lovelace Jr. contributed to this report.

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Covid-19 Vaccine Facet Results: Your Questions Answered

Covid-19 Vaccine Side Effects: Your Questions Answered

Almost three million people in the United States receive the Covid-19 vaccine every day. And each new burst raises new questions about what to expect after vaccination.

Last week I asked readers to send me their questions about vaccinations. Here are some of the answers.

Short-lived side effects such as fatigue, headache, muscle pain, and fever are more common after the second dose of the Pfizer BioNTech and Moderna vaccines, which each require two shots. (The Johnson & Johnson vaccine only requires a single shot.) Patients who experience uncomfortable side effects after the second dose often describe feeling like they have a bad flu and use phrases like “it blew me out” or ” I was useless for two days. “During vaccine studies, patients were advised to take a few days off after the second dose, just in case they had to spend a day or two in bed.

The data collected by v-safe, the app that anyone can use to track side effects after vaccination, also shows an increase in reported side effects after the second dose. For example, about 29 percent of people reported fatigue after the first Pfizer BioNTech shot, but that increased to 50 percent after the second dose. The muscle pain increased from 17 percent after the first shot to 42 percent after the second. While only about 7 percent of people had chills and a fever after the first dose, that number rose to about 26 percent after the second dose.

The New York Times interviewed several dozen of the people who were newly vaccinated in the following days. They reported a wide range of reactions, from no reaction to symptoms such as uncontrolled tremors and “brain fog”. While these experiences are not pleasant, they are a sign that your own immune system is having a strong response to the vaccine.

An analysis of the first 13.7 million Covid-19 vaccine doses given to Americans found that side effects were more common in women. While severe reactions to the Covid vaccine are rare, almost all cases of anaphylaxis or life-threatening allergic reactions have occurred in women.

The finding that women are more likely to report and experience unpleasant side effects from the Covid vaccine is consistent with other vaccines as well. Women and girls after flu vaccinations and vaccines against measles, mumps and rubella (MMR) and hepatitis A and B can produce up to twice as many antibodies. One study found that in nearly three decades, women accounted for 80 percent of all anaphylactic diseases in adults.

Although women report side effects more often than men, the higher rate of side effects in women also has a biological explanation. Estrogen can stimulate an immune response, while testosterone can weaken it. In addition, there are many immune-related genes on the X chromosome, of which women have two copies and men only one. These differences may explain why far more women than men suffer from autoimmune diseases, which occur when a robust immune response attacks healthy tissues in the body. You can read more about women and vaccine side effects here.

Side effects get all the attention, but when you look at data from vaccine clinical trials and the real world, you will find that many people don’t experience side effects beyond an aching arm. In the Pfizer vaccine studies, about one in four patients reported no side effects. In the Moderna studies, 57 percent of patients (64 or younger) reported side effects after the first dose – these jumped to 82 percent after the second dose, meaning that almost one in five patients reported no reaction after the second shot.

A lack of side effects doesn’t mean the vaccine isn’t working, said Dr. Paul Offit, professor at the University of Pennsylvania and a member of the Food and Drug Administration’s Vaccine Advisory Board. Dr. Offit found that a significant number of people reported no side effects during the vaccine trials, and yet the studies showed that around 95 percent of people were protected. “That proves you don’t have to have side effects to be protected,” he said.

Nobody really knows why some people have a lot of side effects and others don’t. We know that younger people develop a stronger immune response to vaccines than older people, whose immune systems become weaker as they get older. Women usually have stronger immune responses than men. But even these differences don’t mean you aren’t protected if you don’t feel a lot after the shot.

Scientists still aren’t sure how effective the vaccines are in people whose immune systems may be weakened by certain conditions, such as cancer treatments, HIV infection, or because they are taking immunosuppressive drugs. However, most experts believe that the vaccines still offer these patients some protection against Covid-19.

Updated

April 1, 2021, 11:02 p.m. ET

The bottom line is that although individual immune responses can vary, the data collected so far shows that all three US-approved vaccines – Pfizer-BioNTech, Moderna, and Johnson & Johnson – are effective against serious illness and death from Covid-19 .

You shouldn’t try to prevent discomfort by taking a pain reliever before receiving the shot. The concern is that premedication with a pain reliever like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), which can prevent side effects like arm pain, as well as fever or headache, could also weaken your body’s immune response.

While it’s possible that taking a pain reliever before your shots may have dampened your body’s immune response, vaccine experts say you shouldn’t worry and shouldn’t try to get another shot. Studies of other vaccines suggest that while premedication can reduce the body’s immune response to a vaccine, your immune system can build strong enough defenses to fight infection. A review of studies involving more than 5,000 children compared antibody levels in children who took pain relievers before and after vaccinations and in children who did not. They found that pain medication had no significant effect on the immune response and that children in both groups produced adequate levels of antibodies after their shots.

The high effectiveness of all Covid vaccines suggests that even if taking Tylenol before the shot weakens your body’s immune response, there is some margin and you are likely still well protected against Covid-19. “You should feel reassured that you have enough immune response to be protected, especially with vaccines that are this good,” said Dr. Offit.

“It’s okay to treat side effects with pain relievers,” said Dr. Offit, but if you don’t really need one, “don’t take it”.

While most experts believe it is safe to take a pain reliever to relieve post-vaccination discomfort, they do not recommend taking it preventively after the shot or if your symptoms are manageable without the drug. The concern about taking an unnecessary pain reliever is that it may weaken some of the effects of the vaccine. (In terms of vaccine, there is no significant difference if you choose acetaminophen or ibuprofen.)

During the Moderna study, about 26 percent of people took acetaminophen to reduce side effects, and the vaccine’s overall effectiveness was still 94 percent.

Research and individual reports suggest that people with a previously diagnosed Covid-19 infection may react more strongly and experience more side effects after their first dose of vaccine than people who have never been infected with the virus. A strong reaction to your first dose of vaccine could also be a sign that you were previously infected, even if you weren’t aware of it.

If you’ve previously tested positive for Covid-19 or had a positive antibody blood test, be prepared for a stronger reaction to your first dose and plan a few days off just in case. Not only will it be more convenient to stay at home and rest in bed, the vaccine side effects may be similar to symptoms of Covid-19, and your staff won’t want to be around you anyway.

Studies suggest that a dose might be appropriate for people with a previously confirmed case of Covid-19, but medical guidelines have not changed so far. If you received the Pfizer-BioNTech or Moderna vaccines, you should plan to receive your second dose, even if you have had Covid-19. Skipping your second dose can cause problems if your employer or airline requests proof of vaccination in the future. If you live in an area where Johnson & Johnson’s single-dose vaccine is available, you can be fully vaccinated after just one dose. Read more about the vaccine response in people with Covid-19 here.

The vaccines appear to be effective against a new variant that originated in the UK and is rapidly dominating the US. However, some variants of the coronavirus, especially one first identified in South Africa and one in Brazil, appear to be better able to evade antibodies in vaccinated individuals.

That sounds worrying, but there is reason to be hopeful. Vaccinated individuals exposed to a more resistant variant still appear to be protected from serious diseases. And scientists have a sufficiently clear understanding of the variants that they are already working on to develop booster shots that target the variants. The variants identified in South Africa and Brazil are not yet widespread in the United States.

People who are vaccinated should continue to wear masks in public and follow public health guidelines, but they shouldn’t live in fear of variations, said Dr. Peter J. Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. “If you are vaccinated you should feel pretty sure how protected you are,” said Dr. Hotez. “It is unlikely that you will ever go to a hospital or intensive care unit with Covid-19. In time, you will see a recommendation for a booster. “

I hope these answers will reassure you about your own vaccine experience. For a more complete list of questions and answers, see our dedicated vaccine tool, “Answers to All Your Covid-19 Vaccination Questions”.

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Each day knowledge for March 31

Daily data for March 31

The Covid-19 cases in the USA are on the up again. Nationwide infection rates are well below the high of around 250,000 new cases per day in January, but are approaching the numbers seen during the summer surge when the average daily case number hit nearly 70,000.

To expedite the vaccination campaign, many states are expanding licensing guidelines for those who qualify for a shot. Dr. Scott Gottlieb, a former commissioner for the Food and Drug Administration, said on CNBC’s “Squawk Box” Wednesday that the initial phase of expanded eligibility could frustrate some Americans.

“Some states are willing to qualify a wider population for vaccination and tolerate the fact that the first two or three weeks of it will be chaotic,” said Gottlieb. “Once a state opens the eligibility wide, a lot of people will complain that they can go to the website and not get an appointment. It will take a couple of weeks to clear that excessive demand.”

US Covid cases

Approximately 66,800 new coronavirus cases are reported daily in the US, based on a seven-day average of data from Johns Hopkins University. That number has seen an upward trend, raising concerns about a possible “fourth wave” of infections.

US Covid deaths

The daily death toll has fallen significantly since its winter peak, but it still stands at nearly 1,000 a day based on a weekly average from Hopkins data. Since the pandemic began, more than 550,000 deaths from Covid have been reported in the United States, more than any other country.

The introduction of the vaccine could be cause for optimism in this regard. With Americans’ most vulnerable populations protected, the death toll may not increase as much as it has in previous periods when the number of cases has increased.

US vaccine shots administered

As more states expand licensing rules for people who can get a vaccine – President Joe Biden said Monday that 90% of adults in the US will be eligible for shooting by April 19 – the daily rate of vaccination continues to rise.

After 1.8 million reported vaccine doses administered Tuesday, the 7-day average of shots administered in the US hit 2.8 million.

Some concerns about getting the vaccine may be easing. The Kaiser Family Foundation’s most recent survey on the vaccine monitor found a decrease in respondents who said they wanted to wait and see if they received the vaccine. 17% of respondents chose this answer in March, compared with 39% in December.

However, 13% of respondents in March said they would “definitely not” get a vaccine and 7% said they would only get a vaccine if it was necessary for work, school or other activities.

US percentage of the vaccinated population

Nearly 30% of the US population has received at least one dose of vaccine, and 16% of the population is fully vaccinated, according to the Centers for Disease Control and Prevention.

On Wednesday morning, Pfizer said its Covid-19 vaccine was 100% effective in a study in adolescents aged 12 to 15 years.

Disclosure: Scott Gottlieb is a CNBC employee and a member of the boards of directors of Pfizer, genetic testing startup Tempus, health technology company Aetion Inc., and biotech company Illumina. He is also co-chair of the Healthy Sail Panel for Norwegian Cruise Line Holdings and Royal Caribbean.

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Italy Pushes Again as Well being Care Employees Shun Covid Vaccines

Italy Pushes Back as Health Care Workers Shun Covid Vaccines

ROM – Giulio Macciò tested negative for the coronavirus and spent weeks receiving treatment for emphysema – and a nurse who refused to be vaccinated – in a locked hospital under the care of doctors and pulmonologists. He died unexpectedly on March 11th. A post-mortem swab found he had contracted the virus, as did 14 other patients and the unvaccinated nurse who had spent her shifts in its midst.

“It makes no sense for a person whose job it is to cure the sick to give them Covid and kill them,” said Massimiliano Macciò, the son of Mr Macciò, who made a complaint against the San Martino Hospital in the northern Italian city Genoa submitted. He believes the nurse, one of an estimated 400 who refused to be vaccinated against Covid-19 in the hospital, infected his father, who died unvaccinated at the age of 79.

As vaccination adoption accelerates, businesses everywhere are grappling with whether or not they can require their employees to be vaccinated, raising sensitive ethical, constitutional and privacy issues in Europe and the US. However, this dilemma becomes even more urgent when the person is your health worker.

In Italy, the original Western Front in the war on Covid, a rash of outbreaks in hospitals where medical workers have chosen not to be vaccinated, has raised fears that their attitudes pose a threat to public health. It has also sparked a strong response from an Italian government struggling to get vaccinations on track.

On Wednesday, Prime Minister Mario Draghi tested the legal limits of his government’s ability to address the problem by issuing a decree mandating vaccination of workers in health care facilities. It also allowed hospital employers, healthcare workers who refuse to suspend without pay.

Some legal analysts have stated that requiring health workers to be vaccinated with Covid-19 could violate Italian data protection laws and that dismissal or enforcement of unpaid leave based on a specific article protecting people who refuse health treatments could be unconstitutional.

However, recent court rulings have interpreted the law differently and Mr Draghi has made it clear that for a country that has suffered more than 100,000 Covid deaths, the security breach cannot be tolerated.

“It is absolutely not okay for unvaccinated workers to be in contact with the sick,” he said at a press conference last week as he announced his government’s intention to “intervene” if he was told by unvaccinated health workers was asked.

During much of the pandemic, nurses and doctors stood as national heroes, sacrificing their waking hours, their safety, and sometimes their lives to protect their compatriots. It shocked Italians that in some large hospitals, up to 15 percent of medical professionals, who were given preference over the elderly when vaccination was introduced, avoided vaccination.

“It’s really humiliating for the medical and health staff class to have to force people to vaccinate themselves,” said Roberto Burioni, a virologist at San Raffaele University in Milan.

He added that while it was extremely difficult to lay off workers in Italy, he hoped the decree would hurt the salaries of all vaccine skeptics, especially given the huge amount of data showing that the effectiveness of vaccines is worth the risk. He also feared that the high number of health professionals who refused to be vaccinated had worrisome consequences.

“Unfortunately, there is a large proportion of doctors who are profoundly ignorant,” said Burioni, who suggested that “the selection process to get people to graduate and then the medical license is not effective enough”.

While Italy’s populists, including the Five Star Movement and the League parties, have exploited vaccine skepticism for political gain in recent years, the country is not even considered the most vaccine skeptical in Europe, a dubious distinction normally accorded to France. Italy also got off to a quick start on vaccinations earlier in the year, precisely because the previous government gave priority to health professionals.

Updated

April 1, 2021, 11:02 p.m. ET

In January, Health Minister Roberto Speranza said on TV that Italy, like its European partners, believed that it was better to persuade people to vaccinate than to ask for it. “Those who have had to deal with the virus, our healthcare workers, are even more aware than the others,” he said. “I think readiness will be enough.”

But the Anti-Vax health workers hit a deep nerve.

In a nursing home outside Rome, almost all healthcare workers chose not to be vaccinated, and a group of three workers and 27 of the 36 elderly guests formed. Roberto Agresti, the owner of the house, feared the worst for her. “If we had a law that forced everyone to vaccinate, the virus would be over without us even realizing it,” he said.

In the southern city of Brindisi, the local health authority has initiated disciplinary proceedings against 12 health workers who have specifically refused to be vaccinated. It also examines why about 140 healthcare workers, including doctors, nurses, pediatricians and specialists, have refused to accept the Pfizer vaccine.

“We don’t want to punish the workers – we need them,” said Giuseppe Pasqualone, who heads the local health department. “But the risk of infection is not only very high for them, but also for fragile patients.”

Officials at the San Martino Hospital, where Mr Macciò died, said it was not clear whether the unvaccinated nurse was the source of the cluster, but they admitted it was a problem.

Salvatore Giuffrida, the director of Europe’s fourth largest hospital, said he was in favor of mandatory vaccination as it would also ensure the health of medical workers and strengthen lines of defense if a brutal third wave spreads across northern Italy.

“We can’t afford not to have her at work,” he said. “The goal is not to lose soldiers during a war in a nation that complains that they have no health care workers.”

He estimated that 15 percent of his caregivers, about 400 nurses, were not vaccinated. Just removing these nurses from the wards or, as some have suggested, redirecting them to control panels would be “a cure worse than the disease,” he said, because it would result in a 250 bed reduction.

He and other directors said Italy’s strict data protection laws were preventing hospitals from knowing which doctors and nurses weren’t vaccinated.

Paolo Petralia, the general manager of Lavagna Hospital in Chiavari, the site of another outbreak this month, said 90 percent of his doctors had been vaccinated, along with about 80 percent of the nurses and helpers.

“You are protected by data protection laws,” he said, citing a statement recently made by the Italian Data Protection Agency that the vaccination status of health workers should be unknown. “But that right lasts until it doesn’t interfere with another person’s right,” Petralia said.

Some Italian dishes have agreed. In 2017, Italy mandated some vaccinations for children, including measles, and banned the unvaccinated from school – a decision backed by the Italian Constitutional Court because it also protected public health. In the northern city of Belluno, a court ruled in mid-March that a nursing home employing several health care workers who did not get vaccinated could force them to take paid leave.

Mr Macciò, whose father had died in Genoa, said it was pointless for the people in charge of caring for his father to harm him. He said he complained to the doctors who told him their hands were tied because the nurses were protected by privacy regulations.

But amid Italy’s frustration and the new decree, something seems to be changing. Mr Macciò said the police asked for his help in identifying the nurses he saw when he went to pick up his father’s belongings.

“I hope that something good will come of it,” he said of his father’s death. “These people should change jobs.”

Emma Bubola contributed to the coverage.

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Psychological well being professionals are in excessive demand because the pandemic enters a second yr

Mental health professionals are in high demand as the pandemic enters a second year

Coronavirus has rocked the nation with a year of restrictions, bans, missed meetings and events, isolation, and a staggering loss of more than half a million Americans. As the pandemic extends for a second year, Americans struggling with increased rates of depression, anxiety, and insomnia are seeking mental health support, and providers are working hard to keep up with demand.

When the pandemic first started, Dr. Mary Alvord that there was an almost instant increase in those seeking treatment for anxiety and depression. Alvord is a psychologist and director of Alvord, Baker & Associates in Rockville, Maryland, a group of 19 clinicians primarily focused on children, adolescents and families.

“I think everyone was just in a state of disbelief that this was going on so quickly and so dramatically,” said Alvord. “That first rush was fear of the daily uncertainty of not knowing what was going to happen [regarding] the pandemic. And I think it led to a lot of sadness. “

Psychologists like Alvord report that they have seen more patients with anxiety and depression in the past year, and most say they treat patients remotely via telemedicine. Last fall, a third of psychologists said they saw more patients since the pandemic began, according to the American Psychological Association (APA).

Among psychologists treating anxiety disorders, nearly three-quarters of those surveyed by APA reported an increase in demand for treatment, while 60% of patients treating depression saw an increase. A similar increase in demand for treatments for traumatic and stress-related disorders and sleep-wake disorders has also been reported.

“We had a waiting list of about 187 people,” said Alvord. “We seem to take it down and then we go up again.”

Telemedicine use has expanded thanks to states-issued emergency directives to improve access to services during the pandemic, the APA said. The Centers for Medicare and Medicaid have also revised the rules to allow for expanded services via telemedicine. The group is pushing for this access to continue for at least six months after the federal government declares the pandemic is over.

There are still many barriers to treatment, including the number of mental health professionals available, cost, scarring, and time, but the expansion of telehealth has improved access to care for many.

“You can see a therapist in your own home, you don’t have to rely on transportation or childcare. I think that helps having access to it once you’re under treatment. But we still have a pretty big problem with the health system with having enough providers for the people who need them, “says Dr. Vaile Wright, Senior Director, Healthcare Innovation at APA.

However, Wright noted that the shortage of healthcare professionals was a long-standing problem prior to the pandemic. “Even if we do things like lower the retirement age or increase the workforce, we will never meet everyone’s needs,” he said.

The pandemic may have fueled the growth of telehealth services, but the course is expected to continue. According to financial data firm PitchBook, the global telemedicine market beyond therapy is expected to reach $ 312 billion by 2026, more than quadrupling from 2019 levels. A total of $ 1.8 billion was invested in virtual health companies in 2020, including Doctor on Demand and MDLive, both of which offer virtual therapies, PitchBook analysis shows.

Frontline health workers, parents of children under the age of 18, and fathers – more than mothers – have been seeking treatment lately, according to the APA. It’s too early to tell if those who sought treatment during the pandemic will continue to have access to care once life returns to normal, but advanced telehealth could help.

“I think the convenience consumers expect will encourage them to stay in treatment rather than having to come back in person. So that’s going to be a big component,” Wright said. “I also think that if individuals are unable to manage the stress they are experiencing, we will have long-term mental health consequences.”

In particular, Wright noted that key workers – including frontline healthcare workers – are most vulnerable to parents with children under 18, people from color communities, and younger adults with high levels of stress and stress.

Alvord of Alvord, Baker & Associates is also committed to expanding telehealth and has trained 10,000 mental health professionals on how to do this effectively and ethically over the past year. One silver lining for the extreme challenges facing the world over the past year is that the conversation about mental health has come to the fore.

“We’re all in it together, so the message is, ‘You are not alone,'” she said. “The mental health stigma has really gone because it’s okay not to be okay. There are normal levels of stress that is a part of life and the grief and loss and sadness that come with it.”

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‘It Takes Time’: I.C.U. Staff Assist Their Former Covid Sufferers Mend

‘It Takes Time’: I.C.U. Workers Help Their Former Covid Patients Mend

LOS ANGELES – Three days after his release from Martin Luther King Jr. Community Hospital, Gilbert Torres returned on a stretcher. A clear hose snaked from his nose to an oxygen tank. It was the last place he wanted to be.

But 30-year-old Torres, who had just spent two weeks in intensive care on a ventilator, was absent because his condition had worsened. He was there to visit a new outpatient clinic for Covid-19 survivors, to treat their remaining physical and psychological wounds – and to prevent them from having to be readmitted.

Several medical centers across the country, including Massachusetts General Hospital, have set up similar clinics, a sign that the need to address the long-term effects of Covid is increasingly recognized. Other hospitals that already had aftercare programs in the intensive care unit have added large numbers of Covid patients to their list: Indiana University Health Methodist Hospital, for example, has treated more than 100 patients. And some facilities, like Providence St. Jude in Fullerton, Calif., Have been doing recovery programs that also serve coronavirus patients who have never been hospitalized.

“We put a thousand percent of our energy into these patients,” said Dr. Jason Prasso, one of the intensive care physicians at the MLK hospital who started the clinic there. “We feel responsible for ensuring that they feel better after they leave the hospital.”

Long before the pandemic, doctors knew that some patients recovering from critical illness developed a constellation of symptoms known as post-intensive care syndrome, which can include muscle weakness and fatigue. Depression, anxiety, and cognitive impairment occur in about half of people who have spent time on ventilators in an intensive care unit. About a quarter of these patients develop post-traumatic stress disorder. The risk is higher in patients who have stopped breathing, have long hospital stays, and are being treated with medication to calm or paralyze – all of which are common in sick coronavirus patients. A new, peer-reviewed study of 45 ex-ICU patients with Covid-19 at Mount Sinai Hospital in New York found that more than 90 percent met the criteria for the syndrome.

Dr. Prasso and his colleagues started the clinic at MLK after discovering that many of the patients whose lives they had saved received little follow-up care. The hospital is in a low-income neighborhood where health services, which were inadequate before the pandemic, have become increasingly scarce.

Since opening in August, the clinic has seen more than 30 patients. Visits that take place on Tuesday morning and include a physical exam and mental health screening often involve discussions about housing, food security, and employment issues that can arise from long-term symptoms. Spiritual care is also offered to patients.

The first to go to Mr. Torres’ exam room in February was Rudy Rubio, a hospital chaplain who had often visited him in the intensive care unit. The pastor asked if they could pray together and offered to get him a Bible.

Mr Torres, whose parents fled the war in El Salvador, grew up in the neighborhood cleaning large rigs in a Blue Beacon truck wash. Although he was morbidly obese – a risk factor for severe Covid – he liked to run and cycle and was rarely needed to see a doctor. Little did he know how he got infected with the coronavirus or got so sick that doctors had to insert a breathing tube within hours of arriving at MLK. Before he showed any signs of improvement, they feared that he would not survive.

“You were spared,” said the chaplain in the clinic. “What are you going to do with this opportunity?”

When Dr. Prasso entered the room, Mr. Torres did not recognize him at first without protective clothing and helmet. “It was you,” he said when realization dawned.

When the doctor examined him, Mr Torres said he could walk short distances, but feared that if he did, his oxygen levels would drop. “It’s a bit of a mind game,” said Dr. Prasso. “You may feel short of breath, but your oxygen may still be completely normal.”

The clinic would ensure Mr. Torres got a portable oxygen machine as small tanks are in short supply nationally, the doctor said. He explained that it could take a few weeks to several months for patients to be weaned. Some may need it indefinitely.

Updated

April 1, 2021, 11:02 p.m. ET

Mr Torres raised another problem. A physiotherapist who was supposed to visit him had canceled. “Many of the agencies are a little bit against going into people’s homes because of Covid,” said Dr. Prasso. He said the clinic could instead enroll Mr. Torres on a pulmonary rehabilitation program so that he could work with therapists who would focus on restoring his lungs.

Mr Torres said he was concerned and was haunted by memories of ICU monitors beeping and a feeling of suffocation. He had hardly slept since his return and had not yet seen his 5-year-old son, who was temporarily living with grandparents. Mr. Torres was afraid of collapsing in front of him.

“Everything you feel is normal,” said Dr. Prasso. “Just know that what you went through was trauma. It takes time for this to heal. “

The two exchanged memories of the moment when Mr. Torres’ breathing tube was removed. “You asked me to take the tube out and as soon as we took the tube out you asked for it to be put back in,” said Dr. Prasso.

“It was hard to breathe,” said Mr Torres. “I didn’t want to be awake.”

“This guy had a vice handle on my hand,” said Dr. Prasso to Mr. Torres’ partner, Lisseth Salguero, who had joined him in the exam room. Family members who are themselves at risk for mental health problems are encouraged to accompany patients to the clinic. Ms. Salguero had developed Covid symptoms on the same day as Mr. Torres but recovered quickly. Since he had returned home she had woken up to check Mr. Torres’ oxygen levels at night. “I’m happy as long as he’s okay,” she said.

The extraordinary stress of being in intensive care during the Covid-19 era is often compounded by almost unbearable loneliness. Visitor restrictions designed to lessen the transmission of the virus can mean weeks apart from loved ones. “I kept asking for someone to hold my hand,” Mr. Torres recalled. “I wanted contact.”

The employees became de facto family. “You have no one but your nurses,” said Mr Torres.

For these ICU carers, caring for Covid patients while being among the few connections to their family leads to deep emotional ties. Nina Tacsuan, one of Mr. Torres’ nurses, couldn’t hold back her tears when she saw him in the clinic.

“Thank you for keeping me alive and for giving me a second chance,” Mr. Torres said to her. “I’m thankfull.”

“You are my age,” said Ms. Tacsuan. “It was just very difficult all along.”

Often the experience ends with heartbreak: at the time of Mr. Torres’s hospitalization, only about 15 percent of Covid patients at MLK treated with ventilators had survived to go home.

Those who survive, like him, inspire employees to keep going. As a rule, however, intensive care workers have no way of seeing their ex-patients once they are better. The clinic has changed that.

Ms. Tacsuan and a nurse manager, Anahiz Correa, joked that Mr. Torres was no longer welcome in their intensive care unit

When the ambulance picked him up to go home, Mr Torres said he was feeling much better than when he arrived. He reunited with his young son Austin a few days later and has continued to improve over the past few weeks.

Mr. Torres visited the clinic twice more, in February and March. Although he refused outpatient rehabilitation and instead chose to climb stairs and do other exercises at home, he said he felt cared for and was glad to have left.

A social worker there connected him to a family doctor in the MLK system for further follow-up examinations. An osteopath manipulated his back and taught him to stretch to alleviate the persistent discomfort from his time in the hospital bed. And last week, at his last appointment, the clinic put up a congratulatory banner shouting, “Surprise!” As he walked in to mark his “graduation” because he didn’t need to use an oxygen tank.

He said he needed more strength and stamina to return to his physically demanding truck wash job, but “I do a lot more things.” And fear is no longer haunted by him, he added. “I feel great.”

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Health

CDC director says U.Ok. pressure changing into the predominant pressure in elements of U.S.

CDC director says U.K. strain becoming the predominant strain in parts of U.S.

CDC director Dr. Rochelle Walensky speaks to the press after visiting the FEMA mass vaccination center at the Hynes Convention Center in Boston, Massachusetts on March 30, 2021.

Erin Clark | Pool | Getty Images

The highly contagious variant of coronavirus, first identified in the UK, is becoming the predominant strain in many regions of the United States, the head of the Centers for Disease Control and Prevention said on Wednesday.

The variant known as B.1.1.7 now accounts for 26% of the nationwide spread of Covid-19 cases, said CDC Director Dr. Rochelle Walensky reporters during a White House press conference on the pandemic. It’s the predominant variety in at least five regions, she added.

The UK identified B.1.1.7 last fall, which appears to be more deadly and spreads more easily than other strains. Since then, it has spread to other parts of the world, including the US, which on Tuesday identified 11,569 cases in 51 jurisdictions, according to the CDC.

Florida has the most confirmed cases of the new variant, according to a map from the CDC data, closely followed by Michigan, Wisconsin and California. Public health officials say they are working as soon as possible to identify more cases.

Walensky said on Wednesday that she expected further infections in the United States due to the portability of variant B.1.1.7. She urged the public to continue pandemic security measures such as hand washing, wearing masks and social distancing.

Walensky’s comments come two days after she issued a terrible warning to reporters. She said Monday that she feared the nation was facing “impending doom” as variants spread and daily Covid-19 cases rise again, threatening to send more people to the hospital.

“I’m going to pause here, I’m going to lose the script, and I’m going to think about the recurring feeling I have of impending doom,” Walensky said. “We can look forward to so much, so much promise and potential where we are and so much reason to hope, but right now I’m scared.”

According to the Johns Hopkins University, an average of more than 63,000 new Covid-19 cases per day have been reported in the U.S. That number is up 16% over a week.

The Chief Medical Officer of the White House, Dr. Anthony Fauci said Sunday that the recent surge in cases is not only being caused by new varieties of the virus, but that travel and the relaxation of business restrictions are also a factor in the increase in infections.

“This is a critical moment in our fight against the pandemic,” Walensky said on Wednesday. “We cannot afford to let go of our watch.”

– CNBC’s Nate Rattner contributed to this report.