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Health

Nursing Properties Face Dilemma: Vaccinate Employees or Don’t Get Paid.

Marita Smith runs a nursing home in Seattle while Janet Snipes runs one in Denver. They share years of industry experience and painful memories of Covid-19, but have vastly different views on a new federal policy making vaccinations mandatory for all care home workers.

Ms. Smith said unvaccinated people should not be caring for a vulnerable population that has already been hit hard by the pandemic. The industry is seeing rising infection rates and deaths among residents again, but not reaching the highs of last year, and the mandate is expected to avert further increases.

“It’s great,” said Ms. Smith, administrator of the St. Anne Nursing and Rehab Center, calling the policy a “pretty big deal” that would “flush out health professionals who shouldn’t be in the health service.”

Such exits are exactly what worries Ms. Snipes, executive director of the Holly Heights Care Center in Denver. She, too, wants all homeworkers to be vaccinated, but not at the risk of losing employees who fail to do so in the midst of a labor shortage in an already high turnover industry.

Of the 1.5 million nursing home workers in the United States, approximately 540,000 – 40 percent of the workforce – are unvaccinated. Their fate could be directly affected by a directive announced by President Biden on Wednesday mandating vaccination of all nursing home workers, with the rules expected to go into effect in September. Institutions that fail to meet this goal could face fines or lose federal reimbursement, a major source of income for many.

The practical effect of the policy is that workers must be vaccinated or lose their jobs. Ms. Snipes said several employees told her they could leave. One who referred to her as her best nurse told her she was “very, very scared” of the vaccine, partly because she is black and worried about past medical experiments.

Getting vaccinated “is the safest thing for our residents and staff, but we believe he must contract all health care facilities,” Ms. Snipes said of President Biden. “We cannot afford to lose staff to hospitals and assisted living facilities.”

Several large nursing home chains and some states have already issued vaccination mandates. Industry officials said vaccinations were highly recommended, but their position on the new policy mirrored that of Ms. Snipes.

“We’re going to lose tens of thousands, maybe hundreds of thousands of workers,” said Mark Parkinson, president and chief executive officer of the American Health Care Association, a large nursing home trade group. He said he was hoping for policy changes and had already worked with Dr. Lee A. Fleisher, Chief Medical Officer of the Centers for Medicare & Medicaid Services, talked about it and looked for a meeting with Xavier Becerra, Secretary for Health and Human Services.

The most important change the industry is seeking is a signal from the administration that at some point there will be a mandate for all healthcare facilities so that nursing home workers can see there is nowhere else they can go. “Make it a commitment for everyone,” said Mr. Parkinson.

In fact, around 2,000 hospitals have already placed vaccination orders, reducing job opportunities for unvaccinated healthcare workers.

Dr. Fleisher said the CMS and the Centers for Disease Control and Prevention saw a “direct link” in the latest data between rising infections in nursing homes and unvaccinated staff.

Updated

Aug. 19, 2021, 6:01 p.m. ET

“The higher the percentage of unvaccinated workers, the higher the percentage of cases we have seen in these homes,” said Dr. Butcher. “There was a strong relationship.”

Currently, 60 percent of nursing home workers nationwide are vaccinated, well below the previous industry target of 75 percent by the end of June.

Parkinson said the industry is also lobbying the government to “launch a much more intense media campaign to influence workers” that vaccines are safe and effective. The trade organization also wants the government to create a grace period for hesitant employees.

Uy, a geriatrician and medical director of a Philadelphia nursing home, said he had seen the human resource challenges and was “excited about the mandate.”

“I’m exhausted,” he said. “The vaccine is like a small fortress around the weakest, in which the people inside remain safe even though a fire is raging outside.”

The mandate aims to avoid an increase in Covid cases and deaths in a high risk population.

Of the 625,000 Covid deaths to date in the US, almost a fifth – 133,700 – were residents of nursing homes, according to the CDC

Understand the state of vaccination and masking requirements in the United States

    • Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in public places indoors in areas with outbreaks, reversing the guidelines offered in May. See where the CDC guidelines would apply and where states have implemented their own mask guidelines. The battle over masks is controversial in some states, with some local leaders defying state bans.
    • Vaccination regulations. . . and B.Factories. Private companies are increasingly demanding coronavirus vaccines for employees with different approaches. Such mandates are legally permissible and have been confirmed in legal challenges.
    • College and Universities. More than 400 colleges and universities require a vaccination against Covid-19. Almost all of them are in states that voted for President Biden.
    • schools. On August 11, California announced that teachers and staff at both public and private schools would have to get vaccinated or have regular tests, the first state in the nation to do so. A survey published in August found that many American parents of school-age children are against mandatory vaccines for students, but are more supportive of masking requirements for students, teachers and staff who do not have a vaccination.
    • Hospitals and medical centers. Many hospitals and large health systems require their employees to receive a Covid-19 vaccine, due to rising case numbers due to the Delta variant and persistently low vaccination rates in their communities, even within their workforce.
    • new York. On August 3, New York City Mayor Bill de Blasio announced that workers and customers will be required to provide proof of vaccination when dining indoors, gyms, performances, and other indoor situations. City hospital staff must also be vaccinated or have weekly tests. Similar rules apply to employees in New York State.
    • At the federal level. The Pentagon announced that it would make coronavirus vaccinations compulsory for the country’s 1.3 million active soldiers “by mid-September at the latest. President Biden announced that all civil federal employees would need to be vaccinated against the coronavirus or undergo regular tests, social distancing, mask requirements and travel restrictions.

And a recent CDC study of 4,000 nursing homes found that the effectiveness of Pfizer and Moderna vaccines among nursing home residents dropped from 75 percent in the spring to 53 percent by midsummer, when the delta variant spread further. “The results underline the crucial importance of the Covid-19 vaccination for employees, residents and visitors,” stated the authors of the study.

Health experts fear that unvaccinated employees could bring Covid-19 into a nursing home and infect residents. Nationwide, more than 80 percent of residents of nursing homes are vaccinated, but the number of cases in this population group is already increasing. In the week ending August 15, 354 care home residents died of Covid-19, the highest number since mid-March, and 3,585 tested positive, according to the CDC

The CDC has found that more employees are getting sick. In the week ending August 15, 5,810 nursing home employees contracted Covid-19, five times more than a month earlier, and 25 employees died.

Earlier this month, the Good Samaritan Society, which operates 142 nursing homes nationwide, announced that all 15,000 employees must be vaccinated by November 1, a position the company took after in homes where unvaccinated workers also tested positive , an increase in infections among residents was recorded. So far, the workforce has remained stable, said Randy Bury, the company’s CEO, who has argued in the past that such mandates would create safe and desirable jobs.

However, he argued that the Biden government’s new policy was wrong unless it was applied to the health sector as a whole. “What’s the difference in a nursing home versus a hospital?” Said Mr. Bury. “They are susceptible to the virus when they come into contact with unvaccinated employees.”

LeadingAge, a non-profit organization that represents 2,000 nursing homes and had previously requested mandates in individual homes, criticized the Biden policy for its narrow focus.

“The administration is right,” said Katie Smith Sloan, president and chief executive officer of LeadingAge, in a released statement. “We are at war. It would be a tragic misstep for the nurses who continue to struggle on the front lines to withdraw funds. “

Ms. Snipes, the director of Holly Heights in Denver, said she spent months training the staff and promoting vaccinations. She said most of her unvaccinated employees agreed to obey the mandate, but she mentioned three that she feared might leave. One told her that she did not want to put anything strange in her body. A second Catholic said he did not want an mRNA vaccine for religious reasons and that he had a letter of support from his bishop.

The third was the black nurse, who “sounds the most fearful of all the people I have spoken to,” said Ms. Snipes. “I want to save you as an employee.”

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Health

U.S. to require nursing houses workers get photographs or lose federal funding

President Joe Biden announced Wednesday that his government will require all nursing home workers to be vaccinated against Covid-19, the latest move to protect Americans if the Delta variant spreads.

“Today I announce a new step,” said Biden in a speech at the White House. “If you work in a nursing home and care for people on Medicare or Medicaid, you also need to get vaccinated.”

Biden’s remarks came after an administrative official confirmed to NBC News that the government will withhold federal funding from nursing homes that don’t fully vaccinate their employees.

The new policy, which would hold back funding for Medicare and Medicaid nursing homes that fail to comply, could go into effect as early as next month, the official said, although the timing is fluid. This would affect around 15,000 nursing homes, which employ more than 1.3 million people nationwide.

The move comes as the highly contagious Delta variant is causing a surge in new cases nationwide, and federal officials say they are starting to see signs of declining vaccine protection against mild and moderate illnesses.

According to data compiled by Centers for Medicare & Medicaid Services, roughly 60% of nursing home workers nationwide are vaccinated – much less than the 82.4% of residents who received the vaccinations. In some states, the percentage of nurses who have been vaccinated is even lower.

Some medical experts have asked the U.S. government to pressure nursing homes to vaccinate their staff, saying the unvaccinated staff put older residents at greater risk, who are more likely to become seriously ill or have something called a breakthrough infection.

“We have to go faster. So I’m taking vaccination measures where I can, ”Biden said in the speech.

The new rules for nursing homes are “all about keeping people safe and safe,” he said.

“This is no time to let our vigilance down. We just have to finish the job, with science, with facts and with confidence,” said the president.

Earlier in the day, federal health officials announced that they plan to provide booster shots to most Americans from the week of September 20th. They said it was “very clear” that immunity decreased after the first two doses, and with the dominance of the Delta variant, “we are gradually seeing signs of decreased protection against mild and moderate illnesses.”

“Based on our latest assessment, current protection against serious illness, hospitalization and death could decline in the coming months, especially for those at higher risk or who were vaccinated during the earlier stages of vaccination,” said the statement signed by CDC director Dr. Rochelle Walensky, Acting FDA Commissioner Dr. Janet Woodcock, White House Senior Medical Advisor Dr. Anthony Fauci, and other US health leaders.

Nursing home residents, health care providers, and the elderly – the first groups to be vaccinated in December and January – will be targeted, according to Dr. Francis Collins, director of the National Institutes of Health, likely prioritized to get extra vaccinations.

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Health

Biden Ramps Up Virus Technique for Nursing Properties, Faculties

WASHINGTON — The Biden administration moved on multiple fronts on Wednesday to fight back against the surging Delta variant, strongly recommending booster shots for most vaccinated American adults and using federal leverage to force nursing homes to vaccinate their staffs.

In remarks from the East Room of the White House, President Biden also directed his education secretary to “use all of his authority, and legal action if appropriate,” to deter states from banning universal masking in classrooms. That move is destined to escalate a fight with some Republican governors who are blocking local school districts from requiring masks to protect against the virus.

The shifts in strategy reflect the administration’s growing concern that the highly contagious Delta variant is erasing its hard-fought progress against the pandemic and thrusting the nation back to the more precarious point it was at earlier in the year.

Thus far, Mr. Biden has been reluctant to use the federal government’s power to withhold funding as a means of fighting the pandemic. But that changed Wednesday, when he said his administration would make employee vaccination a condition for nursing homes to receive Medicare and Medicaid funding. Officials said the decision would affect more than 15,000 nursing homes that employ 1.3 million workers.

“The threat of the Delta virus remains real, but we are prepared, we have the tools, we can do this,” Mr. Biden said in the East Room, adding, “This is no time to let our guard down.”

He accused politicians who were banning local school districts from requiring masks in the classroom of setting a “dangerous tone,” adding, “We’re not going to sit by as governors try to block and intimidate educators from protecting our children.” The administration is sending letters to eight states — Arizona, Florida, Iowa, Oklahoma, South Carolina, Tennessee, Texas and Utah — challenging their efforts to ban universal masking in schools.

For many Americans, the booster strategy will affect them the most. The government plans to offer third shots to adults who received the Pfizer-BioNTech or Moderna vaccines eight months after they received their second dose. About 150 million Americans have been fully immunized with one of those two vaccines.

“We are concerned that the current strong protection against severe infection, hospitalization and death could decrease in the months ahead, especially among those who are at higher risk” or who were inoculated in the early months of the vaccination campaign, Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said.

Assuming that regulators decide third shots are safe and effective, the effort will start Sept. 20. Officials said they were waiting on more data to decide whether the 14 million Americans who received Johnson & Johnson’s single-dose vaccine should also receive an additional shot, but suggested that they would be included as well.

Although some public health experts have said booster shots were prudent and expected, not all scientists are convinced it is the right move. And advocates for global health said it was morally wrong — and shortsighted — for the administration to give booster shots to Americans when so many people around the world were still waiting to be vaccinated.

For state officials and health care providers, already exhausted from an 18-month battle against a novel virus that seems to shift its shape the moment it seems under control, the booster-vaccination campaign will bring a fresh round of logistical challenges. Some worried it could sidetrack efforts to vaccinate the roughly 85 million Americans who were eligible for shots but remained unvaccinated.

“We now have to fight a war on two fronts,” said Dr. José R. Romero, the Arkansas secretary of health. “We have to continue to press the vaccine into those groups that have not accepted it, and then have another effort to vaccinate those at high risk.”

The move to make employee vaccination a condition for nursing homes to receive Medicare and Medicaid funding reflects months of frustration with the low vaccination rates among nursing assistants and other workers who care for highly vulnerable people.

Officials described it as the first time that Mr. Biden had threatened to withhold federal funding in order to force vaccinations.

In an interview before the president spoke, Education Secretary Miguel A. Cardona described another major turning point: his department will use its civil rights enforcement arm to allow schools to require masks. The move comes as many educators and parents fear a surge in cases as the school year is about to start and as pediatric Covid cases climb.

The C.D.C. has recommended that everyone in schools wears masks, regardless of their vaccination status, but some states and localities are refusing to issue rules requiring masks or preventing schools from imposing them.

“The president is appalled, as I am, that there are adults who are blind to their blindness, that there are people who are putting policies in place that are putting students and staff at risk,” Dr. Cardona said in the interview.

“At the end of the day,” he said, “we shouldn’t be having this conversation. What we’re dealing with now is negligence.”

Administration officials made clear that booster shots would depend upon a determination by the Food and Drug Administration that third shots are safe and effective — a ruling expected in the coming weeks. Whether those under the age of 18 will be eligible will also be up to the F.D.A. and a federal advisory committee of experts, they said.

Aside from some people with weakened immune systems who have already been authorized for third shots, officials advised that fully vaccinated people wait for what they promised would be a speedy but orderly national rollout of booster shots.

Updated 

Aug. 18, 2021, 7:51 p.m. ET

“Here’s what you need to know: If you are fully vaccinated, you still have a high degree of protection from the worst outcomes of Covid-19 — severe disease, hospitalization and death,” Dr. Vivek H. Murthy, the surgeon general, said at a White House briefing. “We are not recommending that you go out and get a booster today.”

Dr. Walensky presented a series of studies at the briefing that, she said, showed the vaccines’ efficacy wanes over time. Some doctors applauded the decision to offer booster shots.

“Given the prevalence we have of the Delta variant, doing everything we can to keep people out of the hospital — especially those at high risk — does make sense,” said Dr. Paul Biddinger, the director of the Center for Disaster Medicine at Massachusetts General Hospital.

But some scientists criticized the policy as overly broad, arguing that it is not clear that the general population needs a third shot.

Jennifer B. Nuzzo, an epidemiologist at Johns Hopkins University’s Bloomberg School of Public Health, said the studies cited by administration officials showed that the vaccines were doing what they were intended to do — protect against severe disease and hospitalization.

“I don’t think the metric of, ‘We’re seeing more infection’ is the right metric to be judging the efficacy of the vaccines,” she said. “The right metric is, ‘Does it prevent severe disease?’”

The administration’s move follows similar actions by Israel, Germany and France but goes against the recommendation of the World Health Organization, which is arguing extra vaccine supply should go to countries that have vaccinated far fewer of their residents.

“Vaccine injustice is a shame on all humanity and if we don’t tackle it together, we will prolong the acute stage of this pandemic for years when it could be over in a matter of months,” Dr. Tedros Adhanom Ghebreyesus, the organization’s director general, said at a news conference before the White House’s briefing.

Jeffrey D. Zients, the White House pandemic coordinator, said the administration was already donating 600 million doses of vaccines to needy countries and would continue that effort — a point Mr. Biden reiterated in the East Room.

“We can take care of America and help the world at the same time,” Mr. Biden said.

Administration experts said the booster policy was the result of dual, disturbing trends: a decline in the vaccines’ potency over time and the apparent ability of the Delta variant to somehow bypass their protection better than its predecessors.

One study they cited found the vaccines’ effectiveness at preventing infections among nursing home residents dropped to about 53 percent from 75 percent between spring and summer, when the Delta variant became dominant.

Understand the State of Vaccine and Mask Mandates in the U.S.

    • Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
    • Vaccine rules . . . and businesses. Private companies are increasingly mandating coronavirus vaccines for employees, with varying approaches. Such mandates are legally allowed and have been upheld in court challenges.
    • College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
    • Schools. On Aug. 11, California announced that it would require teachers and staff of both public and private schools to be vaccinated or face regular testing, the first state in the nation to do so. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.  
    • Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
    • New York. On Aug. 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required of workers and customers for indoor dining, gyms, performances and other indoor situations, becoming the first U.S. city to require vaccines for a broad range of activities. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
    • At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.

Dr. Walensky said preliminary data from another study of more than 4,000 frontline workers suggested that the vaccines might not work as well against the Delta variant than against prior variants. In that study, a decline in vaccine efficacy against infection appeared related to the variant, not to how long ago the workers were vaccinated, she said.

She also cited data from Israel showing a worsening in the infection rate among vaccinated people over time. Israel vaccinated much of its population faster than other countries, making it a potential harbinger of what is to come for the United States.

Dr. Murthy said there was “nothing magical” about the eight-month timeline for allowing boosters, describing it simply as the best judgment of health experts. He and other officials emphasized that the overwhelming majority of hospitalizations and deaths from Covid continued to occur among the unvaccinated.

“Protection against severe disease and hospitalization is currently holding up pretty well,” Dr. Walensky said.

First in line for booster shots will be health care workers, nursing home residents and other older adults, followed by the rest of the general population. Officials envision offering the extra shots at pharmacies and other sites where initial vaccinations are already underway, rather than reopening mass vaccination sites. More than five million people could be eligible for the shots as of late September.

Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases and the president’s top medical adviser for the pandemic, said studies had shown that third shots of the Moderna and Pfizer vaccines could boost the levels of antibodies that fight the virus tenfold — an increase he called “remarkable.”

Although they promised the booster rollout would be orderly and thoughtful, federal officials are clearly racing against the clock to offer extra shots before those who were vaccinated earliest could be more vulnerable to the threat of severe disease.

The F.D.A. must first authorize third doses, and an advisory committee of the C.D.C. must review the evidence and make recommendations. But neither Pfizer nor Moderna has yet submitted all the necessary data showing that third shots are safe and effective.

Pfizer is expected to finish submitting its data this month. Moderna and the National Institutes of Health are studying whether a half dose or full dose works best. The company plans to submit its data next month.

On the plus side, federal and state health officials said that much of the infrastructure for a rollout was already in place. Tens of thousands of pharmacies and other sites are already offering shots on a daily basis, and many state officials said they could easily expand their work.

The nation’s vaccine surplus also makes it unlikely that Americans will experience the kind of frenzy seen in the early weeks of the vaccine effort last winter, when older Americans desperate for shots flooded mass vaccination sites. “The bottom line is that we are prepared for boosters, and we will hit the ground running,” Mr. Zients said.

Some state officials sounded less sure of a smooth operation. “It’s hard even to predict how strong the demand will be,” said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, which was briefed on the administration’s plans Wednesday morning by C.D.C. experts.

“The big question is, do we do community vaccination clinics again, which worked very well in the initial run,” he said, “or is the demand going to be a little bit more spaced out over time?”

Apoorva Mandavilli and Daniel E. Slotnik contributed reporting.

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Health

Infants and Toddlers Unfold Coronavirus in Properties Extra Simply Than Teenagers, Examine Finds

In most cases, the chain of transmission ended with the infected child, but in 27.3 percent of households, children passed the virus on to at least one other resident.

Updated

Aug 16, 2021, 11:26 p.m. ET

Young people were most likely to bring the virus into the home: children aged 14 to 17 made up 38 percent of all index cases. Children who were 3 or younger were the first to get the disease in only 12 percent of households – but they were most likely to spread the virus to others in their homes. The likelihood of household transmission was about 40 percent higher if the infected child was 3 years or younger than if they were between 14 and 17 years old.

The results could be due to behavioral differences between toddlers and teenagers, medical experts said.

“When we think about what the social behavior of teenagers outside the home is, they spend a lot of time together, are often confined, often touching or sharing a drink,” said Dr. Susan E. Coffin, an infectious disease specialist at Philadelphia Children’s Hospital who was not involved in the study.

These behaviors could lead teenagers to contract the virus and bring it home, she said.

On the other hand, while very young children are likely to have less social interactions outside of the home, they tend to be in close physical contact with others in their household and, in addition, frequently put their hands and other objects in their mouths, which contributes to the spread could be the virus. “Once they get it into the household, it can be easily spread,” said Dr. Coffin.

It’s also possible that the youngest children have higher levels of virus in them or have higher levels of virus shedding than teenagers, the researchers found. Some studies have shown that although young children rarely become seriously ill, they can carry similar or even higher levels of the virus than adults. Although viral load is not a perfect predictor of infectivity, the data suggest that children may be as contagious as adults.

But the dynamics of disease transmission are complex, and the exact role children play in spreading the virus remains uncertain.

Categories
World News

Asia nations give away land, gold, cattle, houses

An elderly man will be given Covid-19 vaccine at the AstraZeneca Central Vaccination Center in Bang Sue Grand Station on July 13, 2021 in Bangkok, Thailand.

Sirachai Arunrugstichai | Getty Images News | Getty Images

Businesses and local governments in Asia are developing creative ways to promote vaccinations among people who are still reluctant to get one – distributing everything from gold to farm animals.

The Asia-Pacific region is battling a resurgence of Covid as major cities in China, Malaysia, Indonesia and Australia report rising cases daily, particularly from the highly contagious Delta variant of the disease.

But most of Asia is struggling with low vaccination rates as vaccination hesitation persists and vaccine misinformation spreads.

In addition, many countries cannot get enough doses for their populations.

According to Our World in Data, vaccine progress is lagging behind Europe and North America. On August 8, 41.6% of Europeans and 38.8% of North Americans were fully vaccinated, compared with only about 11.6% of people in Asia.

Hong Kong: apartment, gold and a private flight

Hong Kong companies are giving awards to raise vaccination rates amid public distrust of the government.

Several sponsors, including the real estate developer Sino Group, have arranged a raffle for the vaccinated. The grand prize is a new one-bedroom apartment valued at approximately Hong Kong $ 10.8 million ($ 1.39 million).

To support a government vaccination campaign, Cathay Pacific Airways has awarded 20 million airline miles in Asia. A winner can host a private party on board the airline’s new Airbus A321neo.

An organization of gold trading firms – the China Gold and Silver Exchange – is giving away Hong Kong dollars worth 1.1 million Hong Kong dollars to those who have received two Covid shots.

Incentives provided by companies totaled more than $ 73 million Hong Kong ($ 9.4 million), the South China Morning Post reported in June. According to Our World in Data, about 35% of Hong Kong’s population was fully vaccinated on August 8th.

Philippines: land, cattle and sacks of rice

Both local governments and private companies are doing their part to get more people to vaccinate.

The community of San Luis Pampanga has started a campaign to give vaccinated people the chance to win a cow.

Congresswoman Camille Villar offered a number of incentives to the people of her town when they were vaccinated. Las Pinas City residents have a chance of winning a home, motorcycles, and even groceries if they receive at least one dose of Covid vaccine, the Manila Times reported.

On the outskirts of Manila, in Sucat, according to Reuters, 20 people have the chance to take a 25-kilogram sack of rice home with them every week if they get their injections. The initiative aims to attract poorer residents who need an extra boost to get vaccinated, the news agency said.

While some give out rewards, others threaten those who don’t get vaccinated.

After weak participation in several vaccination centers in the capital Manila in June, the Philippine President Rodrigo Duterte is said to have warned residents: “If you do not want to be vaccinated, I will have you arrested.”

As the city prepared for a two-week lockdown on Friday, Reuters reported that thousands of people showed up at vaccination centers across Manila.

Only 9.8% of the country’s population was fully vaccinated by August 5, according to Our World in Data numbers.

Indonesia: live chickens

Indonesia has the second highest number of cases in Asia, according to data from Johns Hopkins University.

According to several media reports, government agencies in Cipanas, West Java Province, are distributing 500 live chickens to vaccinated seniors.

About 85% of Indonesia’s population are Muslim. Despite the religious approval of the country’s top Islamic body, many are concerned about whether the vaccines are halal or allowed by Islam.

“I was afraid that if I was vaccinated I would die immediately …

According to Our World in Data, 8.7% of the total population of Indonesia are fully vaccinated on August 8th.

India: gold, mixers and discounts

In India, McDonald’s fast food chain is offering vaccinated customers a 20% discount.

Goldsmiths in Rajkot, Gujurat, reportedly came together to encourage people over the age of 45 to get vaccinated. Women were given gold nasal needles for vaccination while men were given hand blenders, the Hindustan Times said.

India reported Friday that the country had given more than 500 million doses of vaccine.

However, so far only 8.2% of the population is fully vaccinated, as the figures from Our World in Data show.

According to local media reports, the country is threatened with a third wave of infections in the coming months.

China: eggs

China has been slow to start its vaccination program as the government was relatively successful in controlling the virus outbreak in the early days of the global pandemic. As a result, many citizens did not see the urgency of vaccination at first until new niches emerged in the country.

In March this year, a Beijing health center gave away 2.5 kilograms of eggs to residents who were 60 years of age or older when they received their first vaccination, the Associated Press reported.

However, some regions took a tougher approach.

Officials reportedly visited villages to persuade them to get vaccinated and were told it was their national duty, the Washington Post said.

The country had administered nearly 1.7 billion doses of vaccine as of August 3, the state media reported in Xinhua, citing the National Health Commission.

– CNBC’s Joanna Tan contributed to this coverage.

Categories
Health

Nursing Properties Confront New Covid Outbreaks Amid Requires Employees Vaccination Mandates

In saying last Friday that it was monitoring outbreaks at nursing homes related to the Delta variant, the C.D.C. said some measures under review would include “testing, quarantine, visitation, use of PPE and source control.”

Underscoring the concern of regulators about unvaccinated workers, Colorado just implemented a new rule that unvaccinated staff members at nursing homes must be tested for the virus, using a rapid test, every time they come to work. California is now requiring health care workers in the state to be vaccinated or undergo frequent testing.

Feelings are raw among nursing home staff and operators.

“I don’t want to lose anyone else,” said Marita Smith, administrator at Saint Anne Nursing and Rehab Center in Seattle. Eight of 32 residents died of Covid early on in the pandemic, including four who were already on hospice. Ms. Smith says the losses help explain why all 52 staff members have been vaccinated.

“I question their reason for being in the business if they don’t get it,” Ms. Smith said. “You just don’t want to turn your back.”

Some nursing home staff members resisting vaccination argue that they can protect residents without being inoculated. “I go home, stay home as much as possible, do grocery pickup instead of shopping, do a lot of hand washing. I’m not exposing myself to other people,” said Jessica M., a director of nursing at a home in Grand Junction, Colo., who is unvaccinated.

She declined to give her last name because she wasn’t authorized to speak to the media. She added that she wanted to make sure “the side effects aren’t worse than protecting someone from Covid.”

But consumer advocates and others point to the difficulties nursing homes have long had in protecting residents from infection. A government report issued in May found that nursing homes averaged three Covid outbreaks from May 2020 through January 2021, with two-thirds reporting the outbreaks began with an infected staff member testing positive.

Categories
Entertainment

For the Chocolate Manufacturing unit Theater, a Scrappy Celebration as It Strikes Properties

As the weekend Pride marches filled town, a different kind of festive procession passed through Long Island City, Queens. On Sunday afternoon, a small but enthusiastic crowd, accompanied by a live marching band and the screeching 7 train, ran – and danced – the mile and a half from 5-49 49th Avenue to 38-29 24th Street.

These addresses are the old and new locations of the Chocolate Factory Theater, an artist-run organization known for giving performers plenty of space, time, and freedom to create. After 17 years in its idiosyncratic rental building on 49th Avenue, the theater is moving to a larger – and probably equally idiosyncratic – permanent home on 24th Street. On Wednesday the founders and directors of the chocolate factory, Sheila Lewandowski and Brian Rogers, handed over the keys to the rooms, which have been rented since 2004, whose white brick walls have seen hundreds of adventurous performances. (Rogers said the next tenant will be a “doggy spa” whose owners are planning a renovation.)

To bid farewell to its long-standing home, the theater hosted two afternoons on Saturday and Sunday with performances along the street in front of the old building, culminating in the procession through the neighborhood on Sunday. The “outdoor quasi-mini-festival”, as it was called, presented more than 20 artists whose work was presented by the chocolate factory. In the performances of Justin Allen, Maria Bauman, Ayano Elson, Keely Garfield, Heather Kravas, Marion Spencer, the music duo Yackez and many others, the mood was solemn and gruff, a fitting homage to the rough room inside.

This intimate space often seemed inseparable from the work that takes place there; its quirks are an endless source of choreographic inspiration. Ask the Chocolate Factory regulars what they’re going to miss about it, and they might mention the nails sticking out of the walls, exposed radiators, or – a popular feature – the elevator shaft in one corner that houses the bright upstairs theater with gloomy basement association (also used for performances).

“I’ve always loved the elevator shaft and watched what people do with this corner, how people crawl in and out,” said Alexandra Rosenberg, executive director of the Center for Performance Research in Brooklyn, who attended both days of the festival. As house manager in the chocolate factory from 2007 to 2012, she also developed a predilection for work that wandered between upstairs and downstairs: “The basement is pretty doomy and gloomy and brings you into a kind of nightmare. It was very effective for many shows. “

On Sunday, the dancers Anna Sperber and Angie Pittman began a duet in this underground room before taking the audience out onto the street – technically the last performance in the old building.

While the rawness of the interior could be challenging, it was part of its appeal as well. “Sometimes a perfectly equipped, spotless room doesn’t really go with a messy, dirty, sweaty, smelly dance,” said Garfield, who took the audience to New York, New York on Saturday in a simple and playful dance routine.

Forced to grapple with architecture, “people did really creative things,” said choreographer Ishmael Houston-Jones, who stopped by the festival on Saturday. He remembered a work by Antonio Ramos that turned the awkward entrance – narrow and sloping – into a tunnel through which the audience stepped out at the end of the show.

“I liked the surface of everything,” said Kravas, who danced a resolute evasive solo to “Repetition” by the Fall on Sunday and disappeared into the building at some point. (To the song she did the whole thing again later.) “You really worked with walls and floors and nails and radiators. In a way, the room was like a different body. “

The room could be enchanting from afar. “I found the chocolate factory on the Internet,” Elson said Saturday after sharing a meditative passage from a recent paper. As a college student, she spent hours delving into the theater’s vast, public Vimeo archive, which contains full-length recordings of performances. Before ever visiting in person, she said it was “a space that I adored and learned from.”

Without permission to really explore, artists might not have found the space so generative. Rogers and Lewandowski, artists themselves (they used to be collaborators, married and then divorced), didn’t set the people there any limits.

“When they say, ‘Come here and play and experiment and move the furniture back and forth and don’t worry about making a mess,’ it really creates an atmosphere that is open to discovery and surprise,” said Garfield. who had several residences in the old building.

When the theater settles in its new home – two adjacent warehouses that were once a tool and mold factory – that ethos is likely to endure, along with the founders’ cultivation of local relationships. Spend some time outside the old room with Lewandowski who lives on the same block and you won’t get very far without a friendly break as she catches up with passing neighbors.

For Bauman – who presented an excerpt from her work “Desire: A Sankofa Dream” on Sunday, a strong pairing of dance and poetry – neighborly thinking is important.

“One thing I appreciate about the chocolate factory,” she said, “is that it not only sees itself as a home for artists, but also as a neighbor of the people, companies and families who are already here.” When she said goodbye was invited, she added: “I had great confidence that it would not be unreasonable for the neighborhood.”

It was a local band, the four members of Liftoff Brass, whose music fueled the move from one Queens theater to another. Lewandowski led the way, stopping to dance on street corners. Along 23rd Street, she pointed to the namesake of the Chocolate Factory, a former pastry shop where she and Rogers once shared a studio with visual artists.

But the mood was more forward-looking than nostalgic; there was a lot to celebrate. Through a rare deal with the city, the chocolate factory acquired its new building debt free, a big deal for a New York nonprofit of its size. Having a permanent facility, Rogers said, “is the only way I know for a small or medium-sized group like ours to survive long term.” The first season in the new build is slated to begin in October, he said.

As the march reached its destination and crossed the threshold of a cool and echoing warehouse, new possibilities came into view: a staircase that led to a small balcony; new corners and protrusions; Skylights let in the late afternoon sun.

“The room in the old chocolate factory is a room in each of us,” Garfield had said the day before, “so we’ll take it to the next room.”

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Health

Attending to Sure: A Nursing Dwelling’s Mission to Vaccinate Its Hesitant Employees

To them, the half-hour Tyler Perry video that played repeatedly on a giant screen in the multipurpose room seemed to have no response.

Ms. Sandri, who is of Chinese descent, began to understand. “I’m Asian, but I’m not Japanese, Thai or Indian and they are very different people,” she said. “Unless we understand the cultural sensitivities beyond the major skin color groups, we will not be successful in achieving herd immunity with some of these subgroups.”

She planned to have her maintenance director, a vaccinated African immigrant, speak to reluctant colleagues about his experiences and concerns, and find leaders of local African churches who might be willing to do the same.

She also doubled down on what she thought works best: listening to and addressing her employees’ concerns one at a time – what she described as a “time-consuming, conversational advancement on a case-by-case basis.”

The key, she said, was to tailor her message to what would resonate most with each person.

“For analytical subjects, we provided data on the number of cases, the number of people in studies, and the percentage of people with an immune response,” she said. “For relationship-based thinkers, we asked if they had vulnerable friends or family members and how having or not having the vaccine might affect the relationship.”

However, as the date of the third vaccination event approached in early March, Ms. Proctor was tired – from the pandemic and the long loss of freedoms, but also from hearing at work every day the importance of getting the shot. Ms. Sandri, whose office was just around the corner, stopped by frequently to chat and gently point out the benefits of vaccination.

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Business

Maggots, Rape and But 5 Stars: How U.S. Rankings of Nursing Houses Mislead the Public

The pandemic has exposed the shortcomings in the state’s rating system.

State health inspections do little to punish homes with poor records of preventing and controlling infection. According to The Times, from 2017 to 2019 inspectors cited nearly 60 percent – more than 2,000 – of the country’s five-star facilities for failing to follow basic safety precautions such as regular hand washing. Nevertheless, they received top marks.

In San Bernardino, California, inspectors have written to Del Rosa Villa about four different infection control violations. It kept its five stars. Ninety residents at the 104-bed facility contracted the coronavirus and 13 have died.

Del Rosa Villa officials did not respond to requests for comment.

The Life Care Centers of Kirkland, Washington, the first nursing home in the United States to document coronavirus cases, reported poor infection control despite its five stars in 2019. State inspectors wrote it down because they “failed to consistently implement an effective infection control program”.

Thirty-nine residents of the facility have died from Covid-19. The house has 190 beds.

Leigh Atherton, a spokeswoman for Life Care, said the citation was the only infection control flaw that inspectors had found on more than 32 previous visits. She said the house quickly fixed the problem.

If the rating system had worked as intended, it would have provided indications of which houses were most likely to get out of hand and which houses would be likely to get messed up.

That didn’t happen.

The Times noted that there was little correlation between star ratings and the condition of homes during the pandemic. In five-star facilities, the death rate from Covid-19 was only half a percentage point lower than in facilities with lower ratings. And the death rate was slightly lower in two-star facilities than in four-star homes.

The location of a facility, the infection rate in the surrounding community, and the race of nursing home residents were all predictors of whether a nursing home would have an outbreak. The star rating didn’t matter.

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Health

U.S. Permits Indoor Visits in Nursing Houses. Right here’s What to Know.

WASHINGTON – The Biden government on Wednesday released revised guidelines for visits to nursing homes during the coronavirus pandemic, which will allow guests to see residents whether they or the residents have been vaccinated.

The recommendations, published by the Centers for Medicare and Medicaid Services with comments from the Centers for Disease Control and Prevention, represent the first revision of the federal government guidelines for nursing homes since September. And they arrived after more than three million doses of vaccine had been administered in nursing homes, the agency said.

Federal officials said in the new guidelines that even if residents and guests have been fully vaccinated, outdoor visits are still preferable because of a lower risk of transmission.

The guidelines were also the latest indication that the pandemic in the United States was subsiding and coronavirus cases continued to decline across the country, although the seven-day average remained above 58,000. The CDC released the long-awaited guide for Americans fully vaccinated on Monday, telling them it was safe to gather at home in small groups with no masks or social distancing.

Approximately 62.5 million people have received at least one dose of a Covid-19 vaccine, including approximately 32.9 million people completely using the Johnson & Johnson single-dose vaccine or the two-dose vaccine manufactured by Pfizer-BioNTech and Moderna Series were vaccinated.

In a statement outlining the reasons for updating the recommendations, Dr. Lee A. Fleisher, the chief medical officer of the Centers for Medicare and Medicaid Services, reported the millions of vaccines given to nursing home residents and staff and a decrease in coronavirus cases in nursing homes.

“CMS recognizes the mental, emotional and physical stress that continued isolation and separation from family has placed on nursing home residents and their families,” he said.

At the start of the pandemic, the coronavirus raced through tens of thousands of long-term care facilities in the United States, killing more than 150,000 residents and employees, and responsible for more than a third of all virus deaths since late spring. However, since the introduction of vaccines, new cases and deaths in nursing homes have fallen sharply and have outpaced national declines, according to an analysis of federal data from the New York Times.

On the eight pages of recommendations, which are not legally binding, limit values ​​were suggested that “responsible indoor visits” should be allowed at all times, unless a guest visits an unvaccinated resident in a county where the Covid-19 -Positivity rate is more than 10 percent and less than 70 percent of the residents of the nursing home have been fully vaccinated. The guidance also states that visits should be limited if residents have Covid-19 or are in quarantine.

So-called compassionate care visits – if the health of a resident has deteriorated significantly – should be allowed regardless of the vaccination status or the positivity rate of the district, according to the guidelines.

If a positive case is found in a nursing home, visits should be canceled and residents and staff tested, the guidelines say. Visits can resume in other parts of the facility if there are no positive tests there. However, if cases are discovered in other areas, nursing homes should suspend all visits.