Tag: Pandemic

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1+1=4? Latin America Confronts a Pandemic Schooling Disaster.

1+1=4? Latin America Confronts a Pandemic Education Crisis.

SOACHA, Kolumbien – Bereits zwei von Gloria Vásquez ‘Kindern hatten während der Pandemie die Schule abgebrochen, darunter ihre 8-jährige Ximena, die so weit zurückgefallen war, dass sie mit den grundlegendsten Arithmetiken zu kämpfen hatte.

“Eins plus eins?” Eines Nachmittags befragte Frau Vásquez ihre Tochter.

“Vier?” ahnte das kleine Mädchen hilflos.

Nun sagte sich Frau Vásquez, eine 33-jährige alleinerziehende Mutter und Motel-Haushälterin, die es nie über die fünfte Klasse geschafft hatte, sie könne nicht zulassen, dass ein drittes Kind die Schule verlässt.

“Wo ist Maicol?” fragte sie ihre Kinder und rief eines Nachts während einer anderen langen Schicht beim Bodenschrubben zu Hause an. “Studiert er?”

Maicol, 13, war es sicherlich nicht. Frustriert über die Arbeitsblätter, die ihm seine Lehrer per SMS geschickt hatten – die dem Unterricht am nächsten kommende, den seine Schule ihm seit mehr als einem Jahr geben konnte – war Maicol stattdessen seinem Onkel zur Arbeit gefolgt. Gemeinsam schleppten sie eine riesige Schubkarre durch die Straßen, wühlten durch Müll, sammelten Flaschen und Dosen, um sie für ein paar Cent pro Pfund zu verkaufen.

„Ich lerne nichts“, sagte er, als seine Mutter ihn erneut ausschimpfte, weil er zur Arbeit ging, anstatt zu studieren.

Bis weit in das zweite Jahr der Pandemie hinein steckt Lateinamerika in einer Bildungskrise. Es hat laut Unicef ​​die längsten Schulschließungen aller Regionen der Welt erlitten, in einigen Gebieten fast 16 Monate. Während viele Schüler in wohlhabenden Ländern ins Klassenzimmer zurückgekehrt sind, befinden sich 100 Millionen Kinder in Lateinamerika immer noch im vollständigen oder teilweisen Fernunterricht – oder, wie in Maicols Fall, in einer entfernten Annäherung daran.

Die Folgen sind alarmierend, sagen Beamte und Bildungsexperten: Angesichts der von der Pandemie angeschlagenen Volkswirtschaften in der Region und der stark ausgefransten Verbindungen zum Klassenzimmer brechen Kinder in Grund- und weiterführender Schule in großer Zahl ab, manchmal um zu arbeiten, wo sie können.

Millionen Kinder in Lateinamerika könnten das Schulsystem bereits verlassen haben, schätzt die Weltbank. In Mexiko haben nach Angaben der nationalen Statistikbehörde in diesem Schuljahr 1,8 Millionen Kinder und Jugendliche wegen der Pandemie oder wirtschaftlichen Not ihre Ausbildung abgebrochen.

Ecuador verlor schätzungsweise 90.000 Grund- und Sekundarschüler. Peru sagt, es habe 170.000 verloren. Und Beamte befürchten, dass die tatsächlichen Verluste viel höher sind, da unzählige Kinder, wie Maicol, technisch gesehen immer noch eingeschrieben sind, aber Schwierigkeiten haben, durchzuhalten. Mehr als fünf Millionen Kinder in Brasilien hatten während der Pandemie keinen Zugang zu Bildung, ein Niveau, das seit mehr als 20 Jahren nicht mehr gesehen wurde, sagt Unicef.

Der verbesserte Zugang zu Bildung war eine der großen Errungenschaften des letzten halben Jahrhunderts in Lateinamerika, da die Einschreibung von Mädchen, armen Studenten und Angehörigen ethnischer und rassischer Minderheiten sprunghaft angestiegen ist und viele in die Mittelschicht gehoben wurden. Jetzt droht ein Ansturm von Schulabbrechern, Jahre hart erkämpften Fortschritts zurückzudrängen, die Ungleichheit zu verschärfen und die Region möglicherweise für die kommenden Jahrzehnte zu prägen.

„Dies ist eine Generationenkrise“, sagte Emanuela Di Gropello von der Weltbank und forderte die Regierungen auf, Kinder so schnell wie möglich in die Klassenzimmer zu bringen. “Es gibt keine Zeit zu verlieren.”

Die Pandemie hat weltweit einen entsetzlichen Tribut gefordert. Aber durch einige Maßnahmen ist Lateinamerika härter – und länger – betroffen als jeder andere Teil der Welt.

Die Region mit weniger als 10 Prozent der Weltbevölkerung macht laut einer Analyse der New York Times fast ein Drittel der weltweit registrierten Covid-Todesfälle aus. Und da die Impfraten in vielen Ländern niedrig sind – zum Teil, weil wohlhabende Nationen zuerst Impfungen für ihre eigenen Bürger gesichert haben – verwüstet das Virus die Region immer noch.

Seit Beginn der Pandemie hat Lateinamerika einige der schlimmsten Ausbrüche der Welt erlitten, doch mehrere südamerikanische Nationen verzeichnen jetzt ihre höchsten täglichen Todeszahlen der Krise, selbst nach mehr als einem Jahr unerbittlicher Verluste. Für einige Regierungen ist kein Ende in Sicht.

Aber wenn die Sperren nicht enden und die Schüler bald wieder ins Klassenzimmer zurückkehren, „werden viele Kinder vielleicht nie zurückkehren“, warnt die Weltbank. Und „diejenigen, die wieder zur Schule gehen, haben Monate oder sogar Jahre an Bildung verloren.“ Einige Analysten befürchten, dass die Region mit einer Generation verlorener Kinder konfrontiert sein könnte, ähnlich wie an Orten, die jahrelang unter Krieg leiden.

Schon vor der Pandemie war der Schulabschluss in der Nachbarschaft von Frau Vásquez keine leichte Aufgabe.

Sie und ihre Kinder leben am Ende einer unbefestigten Straße, gleich hinter Bogotá, Kolumbiens weitläufiger, von Bergen gesäumter Hauptstadt, einer zutiefst ungleichen Stadt in einer der ungleichsten Regionen der Welt. Gewalt und Kriminalität sind hier ebenso an der Tagesordnung wie der Eiswagen, der jeden Nachmittag um den Block fährt. Für einige Kinder ist die Pandemie ein weiteres Trauma in einer scheinbar endlosen Folge.

Viele Eltern in der Nachbarschaft verdienen ihren Lebensunterhalt als Recycler und durchqueren die Stadt mit hölzernen Schubkarren auf dem Rücken. Und viele ihrer Kinder haben keinen Computer, kein Internet oder Familienmitglieder, die bei der Unterrichtsarbeit helfen können. Oft gibt es nur ein Handy für die Familie, sodass sich die Schüler um den Anschluss an die Schule bemühen müssen.

Frau Vásquez brach mit 14 die Schule ab, um ihre Geschwister großzuziehen, und es war ihr größtes Bedauern. Das Motel, das sie putzt, ist weit weg von zu Hause und zwingt sie manchmal, ihre Kinder länger als einen Tag allein zu lassen – 24 Stunden für ihre Schicht, mit mindestens vier Stunden Pendeln. Trotzdem schafft sie selten den monatlichen Mindestlohn des Landes.

Sie hatte gehofft, dass ihre Kinder – Ximena (8), Emanuel (12), Maicol (13) und Karen (15) – die sie „den Motor meines Lebens“ nennt, die Nachbarschaft verlassen würden, wenn sie nur diese nie endende Pandemie überstehen könnten mit intakter Schulbildung.

„Ich habe immer gesagt, dass wir eine schwierige Hand bekommen haben“, aber „sie haben viel Lust zu lernen“, sagte sie.

Bevor das Virus eintraf, besuchten ihre Kinder öffentliche Schulen in der Nähe und trugen die für kolumbianische Schüler typischen bunten Uniformen. Karen wollte Ärztin werden. Maicol, ein Darsteller. Emanuel, ein Polizist. Ximena war immer noch in der Entscheidung.

Bis Ende Mai waren die beiden Jungen noch offiziell in der Schule eingeschrieben, konnten aber kaum mithalten und versuchten, die Arbeitsblätter auszufüllen, die ihre Lehrer jede Woche per WhatsApp schickten. Sie haben keinen Computer, und es kostet Frau Vásquez 15 Cent pro Seite, die Aufgaben zu drucken, von denen einige Dutzende Seiten lang sind. Manchmal hat sie das Geld. Manchmal nicht.

Beide Mädchen waren ganz ausgestiegen. Ximena verlor ihren Platz in der Schule kurz vor der Pandemie im vergangenen Jahr, weil sie den Unterricht verpasst hatte, ein nicht so seltenes Ereignis in Kolumbiens überlasteten Schulen. Dann, während die Administratoren von zu Hause aus arbeiteten, sagte Frau Vásquez, sie könne nicht herausfinden, wie sie ihre Tochter wieder reinholen könne.

Karen sagte, sie habe den Kontakt zu ihren Lehrern verloren, als das Land im März 2020 gesperrt wurde. Jetzt wollte sie zurückkehren, aber ihre Familie hatte versehentlich ein von der Schule geliehenes Tablet zerbrochen. Sie hatte Angst, dass sie mit einer Geldstrafe belegt werden könnte, wenn sie versuchen würde, sich wieder einzuschreiben. Ihre Mutter hatte kein Geld zu zahlen.

Die Familie taumelte bereits, weil die Stunden von Frau Vásquez im Motel während der Krise verkürzt worden waren. Jetzt waren sie mit der Miete vier Monate im Rückstand.

Frau Vásquez machte sich besonders Sorgen um Maicol, die jeden Tag frustrierender als der letzte damit kämpfte, Arbeitsblätter über Periodensysteme und literarische Geräte zu verstehen.

In letzter Zeit, wenn er nicht gerade recycelte, suchte er nach Schrott, den er verkaufen konnte. Für ihn waren die Nächte mit seinem Onkel eine willkommene Atempause, wie ein Piratenabenteuer: neue Leute kennenlernen, nach Schätzen suchen – Spielzeug, Schuhe, Essen, Geld.

Aber Frau Vásquez, die diese Ausflüge verboten hatte, wurde wütend, als sie hörte, dass er arbeitete. Je mehr Zeit Maicol mit dem Recyclingwagen verbrachte, fürchtete sie, desto kleiner würde seine Welt werden.

Sie respektierte die Leute, die ihren Lebensunterhalt mit Müll sammelten. Sie hatte es getan, als sie mit Emanuel schwanger war. Aber sie wollte nicht, dass Maicol mit diesem Leben zufrieden war. Während ihrer Schichten im Motel, beim Putzen von Badezimmern, stellte sie sich ihre Kinder in der Zukunft vor, die hinter Computern saßen und Geschäfte führten.

„‚Schau’, würden die Leute sagen, ‚das sind Glorias Kinder’“, sagte sie. „Sie müssen nicht das gleiche Schicksal tragen wie ihre Mutter.“

Im letzten Jahr begann die Schule erst richtig, nachdem sie von der Arbeit nach Hause gekommen war. Eines Nachmittags holte sie Emanuels Lehrer einen Studienführer hervor und begann, eine Rechtschreib- und Grammatikübung zu diktieren.

„Es war einmal“, las sie.

„Es war einmal“, schrieb Emanuel, 12.

„Da war eine weiß-graue Ente –“

“Grau?” er hat gefragt.

Wenn es um Maicols fortgeschrittenere Lektionen ging, verlor sich Frau Vásquez oft selbst. Sie wusste nicht, wie man E-Mails benutzt, geschweige denn die Fläche eines Quadrats berechnet oder ihrem Sohn Planetenrotationen beibringt.

„Ich versuche, ihnen mit dem zu helfen, was ich verstehe“, sagte sie. “Es ist nicht genug.”

In letzter Zeit beschäftigte sie die Frage, wie ihre Kinder wann aufholen würden – oder wenn? — Sie kehrten jemals zum Unterricht zurück.

Der volle Bildungszoll der Pandemie wird erst bekannt, wenn die Regierungen Kinder wieder zur Schule bringen, warnen Experten. Frau Di Gropello von der Weltbank sagte, sie befürchte, dass viel mehr Kinder, insbesondere ärmere Kinder ohne Computer oder Internetverbindung, ihre Ausbildung abbrechen würden, wenn sie erkennen, wie weit sie zurückgefallen sind.

Mitte Juni kündigte das kolumbianische Bildungsministerium an, dass alle Schulen nach den Ferien im Juli zu Präsenzkursen zurückkehren würden. Obwohl das Land eine Rekordzahl von täglichen Todesfällen durch das Virus erleidet, haben Beamte festgestellt, dass die Kosten für die Schließung zu hoch sind.

Aber während die Schulleiter sich auf die Rückkehr vorbereiten, fragen sich einige, wie viele Schüler und Lehrer auftauchen werden. In Carlos Albán Holguín, einer der Schulen in der Nachbarschaft von Frau Vásquez, sagte der Schulleiter, dass einige Lehrer so viel Angst vor einer Infektion hätten, dass sie sich geweigert hätten, die erledigten Aufgaben abzuholen, die ihre Schüler abgegeben hatten.

Eines Morgens wachte Karen wie so oft vor Tagesanbruch auf, um ihrer Mutter zu helfen, sich auf ihre Schicht im Motel vorzubereiten. Seit ihrem Schulabschluss im vergangenen Jahr hatte Karen zunehmend die Rolle der Eltern übernommen, kochte und putzte für die Familie und versuchte, ihre Geschwister zu beschützen, während ihre Mutter bei der Arbeit war.

Irgendwann wurde die Verantwortung so groß, dass Karen weglief. Ihr Flug dauerte nur wenige Stunden, bis Frau Vásquez sie fand.

„Ich habe meiner Mutter gesagt, dass sie mich mehr unterstützen muss“, sagte Karen. „Dass sie mich nicht in Ruhe lassen konnte, dass ich ein Jugendlicher war und ihre Hilfe brauchte.“

Während Frau Vásquez sich in ihrem gemeinsamen Schlafzimmer schminkte, packte Karen den blauen Rucksack ihrer Mutter, schlüpfte in rosa Crocs, eine Gürteltasche, Kopfhörer und Wechselkleidung.

Auch Frau Vásquez war eines Tages zum Marsch gegangen, hatte ein Plastikhorn in die Menge geblasen und die Behörden aufgefordert, eine „würdige Bildung“ zu garantieren, die sie nannte.

Aber sie war nicht auf die Straße zurückgekehrt. Wenn ihr bei den Märschen etwas passierte, wer würde dann ihre Kinder unterstützen?

„Soll ich dir die Haare flechten?“ fragte Karen ihre Mutter.

An der Tür küsste sie Frau Vásquez zum Abschied.

Dann, nach Monaten der Härte, kam ein Sieg.

Frau Vásquez erhielt Nachrichten von den Lehrern von Maicol und Emanuel: Beide Schulen würden die Schüler in wenigen Wochen persönlich zurückbringen. Und sie fand endlich einen Platz für Ximena, die seit mehr als einem Jahr komplett aus der Schule ging.

„Ein Neuanfang“, sagte Frau Vásquez schwindelig vor Aufregung.

Karens Zukunft war weniger sicher. Sie hatte den Mut aufgebracht, die zerbrochene Tafel zurückzugeben. Die Administratoren haben ihr keine Geldstrafe auferlegt – und sie bewarb sich an einer neuen Schule.

Jetzt wartete sie darauf zu hören, ob es Platz für sie gab, und versuchte, die Sorge zu verdrängen, dass ihre Ausbildung vorbei war.

„Mir wurde gesagt, dass Bildung alles ist und ohne Bildung nichts“, sagte sie. „Und, nun, es ist wahr – ich habe es mit eigenen Augen gesehen.“

Die Berichterstattung wurde von Sofía Villamil in Bogotá und Soacha, Kolumbien, beigesteuert; José María León Cabrera in Quito, Ecuador; Miriam Castillo in Mexiko-Stadt; Mitra Taj in Lima, Peru; und Ana Ionova in Rio de Janeiro.

Categories
Health

Medicaid Enrollment Surpassed 80 Million, a Document, Throughout the Pandemic

Medicaid Enrollment Surpassed 80 Million, a Record, During the Pandemic

Medicaid’s enrollment soared during the pandemic, with nearly 10 million Americans joining the public health program for the poor, a government report released Monday showed.

Eighty million people were insured with Medicaid, a record. This reflected an increase of nearly 14 percent over the twelve month period ended January 31. The number also includes participation in the children’s health insurance program, which covers children whose parents earn too much for Medicaid but too little to be able to afford any other coverage.

The increase in enrollments shows the increasingly important role of Medicaid not only as a safety net, but also as a pillar of the American health system that protects a quarter of the population.

“This tells us that Medicaid is an important program for American families,” said Chiquita Brooks-LaSure, the Biden government official who oversees Medicaid. “What we have seen during this pandemic is people want access to affordable health insurance and how important it is during a public health crisis.”

The Affordable Care Act transformed Medicaid from a targeted health service designed to help specific groups – such as expectant mothers and people with disabilities – to a much broader program that provides largely free insurance to most people below a certain income threshold. A notable exception are the 12 states – mostly in the south – that have declined to expand Medicaid under the ACA

Medicaid, where the state and federal government share the cost, covers all adults with incomes up to 138 percent of the poverty line, which would be about $ 17,420 this year for a person who would qualify.

The expansion of Medicaid in most states since most of the ACA came into effect in 2014 has provided a source of public protection for the new unemployed that did not exist a decade ago. Adult enrollment in Medicaid grew twice as fast as child enrollment, suggesting that the widespread job loss associated with the pandemic has created a large group of newly eligible adults.

“There has been significant growth in Medicaid enrollments in recent economic downturns, but their focus has been on children,” said Rachel Garfield, co-director of the Medicaid and Uninsured Program for the Kaiser Family Foundation. “This time around, it’s interesting that a lot of the enrollment is among adults.”

She also noted that Medicaid enrollment increased much faster during the economic contraction of the pandemic than in previous downturns. In 2009, at the start of the Great Recession, fewer than four million Americans took part in the program.

There may also be increased interest among uninsured Americans who were already eligible for Medicaid but only chose to enroll because of heightened health concerns during the pandemic.

“So often when we look at who’s not insured, it’s people who are eligible but not enrolled,” said Ms. Brooks-LaSure, the Medicaid officer. “Right now we see that if we make it easy for people to sign up, they will.”

In the years before the pandemic, the number of Medicaid enrollments had decreased. More than a million children lost insurance coverage between December 2017 and June 2019, a trend that rocked health care advocates. Many attributed the changes to new rules during the Trump administration that made it more difficult to log in and stay logged in.

That changed last spring when the pandemic hit and Congress gave states additional money to fund their Medicaid programs. Congress announced a 6.2 percent increase in spending on the condition that states do not de-register patients or tighten eligibility requirements.

For example, a woman who gave birth would normally have lost coverage 60 days after giving birth, but due to legislation, she could stay on Medicaid for the duration of the pandemic. These rules will remain in effect until the federal government declares the public health emergency over.

Three states – Utah, Idaho, and Nebraska – expanded Medicaid last year after voters approved voting initiatives; these countries recorded particularly large swings in school enrollment. A fourth, Oklahoma, will expand Medicaid to most low-income adults starting next month.

Even after growing under the Affordable Care Act, the Medicaid program has loopholes that are difficult to fix. The 2012 Supreme Court ruling that upheld the law’s individual insurance mandate also made the expansion of Medicaid optional for the states.

As a result, millions of low-income adults in the 12 holdout states that include Florida and Texas are still without insurance. A recent study at JAMA found that Medicaid enrollment grew faster during the pandemic in states participating in the expansion, most likely because many more people were eligible for coverage.

Generous financial incentives offered by the recent stimulus package weren’t enough to convince any of the 12 states to expand Medicaid, but senior Biden government officials say they continue to hope some get on board.

“We hope we can encourage them,” said Xavier Becerra, the secretary for health and human services, in a call to reporters last week. “We want to make sure that they expand the supply and that it is affordable.”

Categories
Politics

Medicaid Enrollment Jumped Throughout the Pandemic, New Report Says

Medicaid Enrollment Jumped During the Pandemic, New Report Says

Medicaid enrollment soared during the coronavirus pandemic, with nearly 10 million Americans joining the public health program for the poor by January, a government report released Monday shows.

80 million people – more than ever in the history of the program – are now on Medicaid insurance, which is shared by the state and the federal government. The new figures show the increasingly important role of the program not only as a safety net, but also as a pillar of American health insurance, which covers a quarter of the population.

“The purpose of Medicaid during times like these is when there is an economic downturn,” said Peggah Khorrami, a researcher at Harvard Chan TH School of Public Health who has studied the program’s surge in enrollments during the pandemic. “As people lose their jobs, Medicaid comes in and we insure people that way.”

The Affordable Care Act transformed Medicaid from a targeted health service aimed at helping specific groups of people – such as expectant mothers and people with disabilities – to a much broader program that provides largely free insurance to most people below a certain income threshold. The exception is in 12 states, mostly in the South, that have resisted expanding Medicaid under the Health Act to cover all adults on incomes up to 138 percent of the poverty line, which would be $ 17,774 for one person this year .

However, the expansion of Medicaid in most states since most of the ACA came into effect in 2014 has proven important during the pandemic, creating a public source of protection for the newly unemployed that did not exist a decade ago. Adult enrollment at Medicaid grew twice as fast as child enrollment in the past year, suggesting that widespread job loss related to the pandemic has created a large group of newly eligible adults.

“There has been significant growth in Medicaid enrollments over the past economic downturn, but their focus has been on children,” said Rachel Garfield, co-director of the Medicaid and Uninsured Program for the Kaiser Family Foundation. “This time around, it’s interesting that a lot of the enrollment is among adults.”

Ms. Garfield also noted that Medicaid coverage rose much faster during this recession than in previous downturns. At the start of the Great Recession in 2009, fewer than 4 million Americans joined the program.

There may also be increased interest among uninsured Americans who were previously eligible for Medicaid but only chose to enroll because of heightened health concerns during the pandemic.

“The surge we are seeing is exactly how Medicaid works: the program steps in to support people and their families during difficult times,” said Chiquita Brooks-LaSure, who oversaw the Medicaid program, in a Biden administration Explanation.

In the years before the pandemic, the number of Medicaid enrollments had decreased. More than a million children lost insurance coverage between December 2017 and June 2019, a trend that rocked health care proponents. Many attributed the changes to new rules during the Trump administration that made it more difficult to sign up for the benefits.

Categories
Politics

Rising From Pandemic, New York Seeks a New Mayor to Face Looming Crises

Rising From Pandemic, New York Seeks a New Mayor to Face Looming Crises

The New York City mayor’s race began in the throes of a pandemic, in a shuttered city convulsed by a public health catastrophe, economic devastation and widespread protests over police brutality.

Now, with voters heading to the primary polls on Tuesday, New York finds itself in a very different place. As the city roars back to life, its residents are at once buoyed by optimism around reopenings, but also anxious about public safety, affordable housing, jobs — and the very character of the nation’s largest city.

The primary election marks the end of an extraordinary chapter in New York’s history and the start of another, an inflection point that will play a defining role in shaping the post-pandemic future of the city. The leading mayoral candidates have promoted starkly divergent visions for confronting a series of overlapping crises, making this primary, which will almost certainly determine the next mayor, the most significant city election in a generation.

Public polling and interviews with elected officials, voters and party strategists suggest that on the cusp of Tuesday’s election, Eric Adams, the Brooklyn borough president, is the front-runner, fueled by his focus on public safety issues and his ability to connect in working- and middle-class communities of color.

Yet even on the last weekend of the race, the contest to succeed Mayor Bill de Blasio appears fluid and unpredictable, and credible polling remains sparse.

Two other leading candidates, Andrew Yang and Kathryn Garcia, campaigned together on Saturday in Queens and Manhattan, a show of unity that also injected ugly clashes over race into the final hours of the election, as Mr. Adams accused his rivals of coming together “in the last three days” and “saying, ‘We can’t trust a person of color to be the mayor of the City of New York.’”

Mr. Yang, at a later event, noted that he had been “Asian my entire life.” (Mr. Adams later clarified that he meant that Mr. Yang and Ms. Garcia were trying to prevent a Black or Latino candidate from becoming mayor.)

The primary election will ultimately offer a clear sense of Democratic attitudes around confronting crime, a major national issue that has become the most urgent matter in the mayoral primary.

The outcome will also show whether New Yorkers wanted a political outsider eager to shake up City Hall bureaucracy, like Mr. Yang, or a seasoned government veteran like Ms. Garcia to navigate staggering challenges from issues of education to evictions to economic revival.

And it will reveal whether Democrats are in the mood to “reimagine” a far more equitable city through transformational progressive policies, as Maya D. Wiley is promising, or if they are more focused on everyday municipal problems.

In recent polls and last-minute fund-raising, Ms. Garcia, the city’s former sanitation commissioner, and Ms. Wiley, a former counsel to Mr. de Blasio, seem to be gaining late traction, while Mr. Yang, a former presidential candidate, remains a serious contender even amid signs that his momentum may have stalled.

But other factors may muddy the outcome.

For the first time in New York City, the mayoral nominee will be determined by ranked-choice voting, which allows New Yorkers to rank up to five candidates in order of preference. Some New Yorkers remain undecided about how to rank their choices, and whether to rank at all.

And with many New Yorkers accustomed to a primary that usually takes place in September, it is not at all clear what the composition of a post-pandemic June electorate will look like.

For such a high-stakes election, the contest has felt at once endless and rushed. For months, it was a low-key affair, defined by dutiful Zoom forums and a distracted city.

But if there has been one constant in the last month, it has been the centrality of crime and policing to the contest.

“Public safety has clearly emerged as a significant issue,” said Representative Hakeem Jeffries, New York’s highest-ranking House member, when asked to name the defining issue of the mayor’s race. “How to balance that aspiration with fair, respectful policing, I think has been critical throughout the balance of this campaign.”

Six months ago, few would have predicted that public safety would be the top issue of the race, only a year after the“defund the police” movement took hold in the city. Crime rates are far lower than in earlier eras, and residents are confronting a long list of challenges as the city emerges from the pandemic.

But amid a rise this spring in shootings, jarring episodes of violence on the subways, bias attacks against Asian Americans and Jews — and heavy coverage of crime on local television — virtually every public poll shows public safety has become the biggest concern among Democratic voters.

Mr. Adams, Ms. Garcia, Mr. Yang and Raymond J. McGuire, a former Citi executive, vigorously disagree with the “defund the police” movement. But no one has been more vocal about public safety issues than Mr. Adams, a former police captain who has declared safety the “prerequisite” to prosperity.

Mr. Adams, who had a complex career at the Police Department and battled police misconduct as a leader of 100 Blacks in Law Enforcement Who Care, an advocacy group, says that he was once a victim of police brutality himself, and argues that he is well equipped to manage both police reform and spikes in violence.

In recent weeks, however, Mr. Adams has come under growing scrutiny over questions of transparency and ethics tied to taxes and disclosures around real estate holdings. That dynamic may fuel doubts about his candidacy in the final days, as his opponents have sharply questioned his judgment and integrity.

If he wins, it will be in part because of his significant institutional support, as a veteran politician with union backing and relationships with key constituencies — but also because his message connects at a visceral level in some neighborhoods across the city.

“Mr. Adams! You got my vote!” Blanca Soto, who turns 60 on Monday, cried out as she walked by an Adams event in Harlem on Thursday.

“I am rooting for him because he’s not going to take away from the police officers,” said Ms. Soto, a health aide, who called safety her top issue. “I do want to see more police, especially in the subways. We had them there before. I don’t know what happened, but everything was good when that was going on.”

Mr. Stringer, the city comptroller; Shaun Donovan, a former federal housing secretary; Ms. Morales, a former nonprofit executive; and Ms. Wiley have taken a starkly different view on several policing matters. They support varying degrees of cuts to the Police Department’s budget, arguing for investments in communities instead. The department’s operating budget has been about $6 billion. Ms. Wiley, Mr. Stringer and Ms. Morales have also been skeptical of adding more police officers to patrol the subway.

Ms. Wiley argues that the best way to stop violence is often to invest in the social safety net, including in mental health professionals, violence interrupters and in schools.

Understand the N.Y.C. Mayoral Race

Ms. Wiley, who has been endorsed by some of the most prominent left-wing leaders in the country, including Representative Alexandria Ocasio-Cortez of New York and Senator Elizabeth Warren of Massachusetts, is seeking to build a coalition that includes white progressives as well as voters of color across the ideological spectrum.

Rival campaigns have long believed that she has the potential to build perhaps the broadest coalition of voters in the race, but polls suggest that she has not yet done so in a meaningful way.

Mr. Jeffries, who has endorsed Ms. Wiley and campaigned with her, said that she offers change from the status quo, “a fresh face” who is both prepared “and is offering a compelling vision for investing in those communities that have traditionally been left behind.”

Mr. Jeffries has said that he is ranking Mr. Adams second, and that if Mr. Adams were to win, it would be on the strength of Black and Latino communities “who have increasingly felt excluded from the promises of New York City, as it has become increasingly expensive.”

A number of campaigns and political strategists see Latino voters as the crucial, late-breaking swing vote, and the leading candidates all see opportunities with slices of that diverse constituency, with candidates including Mr. Adams and Ms. Wiley airing new Spanish-language ads in recent days — an Adams spot criticizes Ms. Garcia in Spanish — and Mr. Yang spending Thursday in the Bronx, home to the city’s largest Latino population.

Mr. Yang, who would be the city’s first Asian American mayor, is betting that he can reshape the electorate by engaging more young, Asian American and Latino voters as he casts himself as a “change” candidate.

Mr. Yang was a front-runner in the race for months, boosted by his strong name identification and air of celebrity, as well as a hopeful message about New York’s potential and an energetic in-person campaign schedule.

But as New York reopened and crime became a bigger issue in voters’ minds — and as Mr. Yang faced growing scrutiny over gaffes and gaps in his municipal knowledge — he has lost ground.

His tone in the homestretch is a striking departure from the exuberant pitch that defined his early message, as he sharpens his criticism of Mr. Adams and tries to cut into his advantage on public safety issues. Mr. Yang, who has no city government experience, has also sought to use that outsider standing to deliver searing indictments of the political class.

Ms. Garcia has moderate instincts — she was one of the few leading mayoral candidates to favor President Biden as her first choice in the presidential primary — but she is primarily running as a pragmatic technocrat steeped in municipal knowledge.

She has been endorsed by the editorial boards of The New York Times and The New York Daily News, among others, and has generated palpable traction in politically engaged, highly educated corners of the city, like the Upper West Side, even as Mr. Stringer and Mr. Donovan have also vied for the government experience mantle.

“I don’t think New York does that well, as progressive as I am, with a series of progressives who think that we should spend more time dealing with those kinds of issues rather than actual stuff that needs to be done,” said William Pinzler, 74, as he prepared to vote for Ms. Garcia at Lincoln Center. “Kathryn Garcia picked up the garbage.”

But Ms. Garcia, who has struggled to deliver a standout moment during several televised debates, is in many ways still introducing herself, and it is not yet clear whether she can attract the same kind of support citywide.

Asked what lessons national Democrats may take from the results of Tuesday’s contest, Representative Grace Meng, who has endorsed Mr. Yang as her first choice and Ms. Garcia as her second, and appeared with them on Saturday, pointed to questions of both personal characteristics and policy visions.

“How much people prioritize a leader with experience or vision to get us out of the pandemic, but also to address issues like public safety and education — I think that it’ll kind of be a filter through which we see the next round of elections nationally,” she said. “Wherever they may be.”

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Mother and father and caregivers reported psychological well being points extra usually than others through the pandemic, a C.D.C. examine says.

Parents and caregivers reported mental health issues more often than others during the pandemic, a C.D.C. study says.

Parents and unpaid caregivers of adults in the United States reported far higher rates of mental health issues during the coronavirus pandemic than people who held neither of those roles, federal researchers reported on Thursday.

About 70 percent of parents and adult caregivers — such as those tending to older people, for example — and about 85 percent of people who were both reported adverse mental health symptoms during the pandemic, versus about a third of people who did not hold those responsibilities, according to new research by the Centers for Disease Control and Prevention.

The study also found that people who were both parent and caregivers were eight times more likely to have seriously considered suicide than people who held neither role.

“These findings highlight that parents and caregivers, especially those balancing roles both as parents and caregivers, experienced higher levels of adverse mental health symptoms during the Covid-19 pandemic than adults without these responsibilities,” the authors said.

“Caregivers who had someone to rely on for support had lower odds of experiencing any adverse mental health symptoms,” they said.

The report follows innumerable anecdotes and several studies suggesting spikes in mental health problems among parents and caregivers during the pandemic. But the new C.D.C. report noted that “without prepandemic mental health data in this sample, whether adverse mental health symptoms were caused by or worsened by the pandemic is unknown.”

The study is based on data from online English-language surveys administered to panels of U.S. residents run by Qualtrics, a company that conducts commercial surveys, for the Covid-19 Outbreak Public Evaluation Initiative, an effort to track American attitudes and behaviors during the pandemic. The data was gathered from Dec. 6 to 27 last year, and from Feb. 16 to March 8 of this year, and relied on 10,444 respondents, weighted to match U.S. demographic data, 42 percent of whom identified as parents or adult caregivers.

The study noted that the results might not fully represent the U.S. population, because of factors like the surveys only being presented online and in English.

The surveys included screening items for depression, anxiety, Covid-19 trauma and stress-related disorders, and asked respondents whether they had experienced suicidal thinking in the past month. About half of the parent-caregivers who responded said that they had recently had suicidal thoughts.

Elizabeth A. Rohan, a health scientist at the C.D.C. and one of the study’s authors, said in an interview that what set this research apart was a large sample size and a broad definition of caregiver, which allowed for a more inclusive picture of people in that role.

“Our net captured more people than other surveys,” Dr. Rohan said.

Dr. Rohan said that the study reinforced the need to destigmatize mental health issues among caregivers and for better support systems. Communication is key, she said, and “it doesn’t have to be professional help.”

She added, “We cannot underestimate the importance of staying connected to one another,” which is helpful whether the person is “a trusted friend, a family member or a professional.”

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.

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Health

Why Asia, the Pandemic Champion, Stays Miles Away From the End Line

Asia Struggles to Cast Off the Pandemic Despite its Early Lead

SYDNEY, Australia – Across the Asia-Pacific region, the countries that led the world in containing the coronavirus are now languishing in the race to leave it behind.

As the US, which has suffered far worse outbreaks, now crampers stadiums with vaccinated fans and planes with summer vacationers, the pandemic champions of the east are still caught in a cycle of uncertainty, restriction and isolation.

In southern China, the spread of the Delta variant led to a sudden lockdown in Guangzhou, a major industrial capital. Taiwan, Vietnam, Thailand and Australia have also cracked down on the recent outbreaks, while Japan grapples with its own fatigue from a fourth round of infections fueled by fears of a viral disaster from the Olympics.

Wherever they can, people move on with their lives, with masks and social distancing and outings near their home. Economically, the region weathered the pandemic relatively well, as most countries successfully mastered their first phase.

But with hundreds of millions of people from China to New Zealand still unvaccinated – and with concerned leaders keeping international borders closed for the foreseeable future – tolerance for restricted lives is getting thinner, even though the new varieties add to the threat.

Put simply, people are fed up and ask: Why are we behind us and when will the pandemic routine for the love of the good finally come to an end?

“When we’re not stuck, it’s like we’re waiting in the glue or mud,” said Terry Nolan, director of the vaccines and immunization research group at the Doherty Institute in Melbourne, Australia, a city of five million people barely out of his last lockdown. “Everyone is trying to get out to find a sense of urgency.”

While languishing varies from country to country, it is generally due to a lack of vaccines.

In some places, such as Vietnam, Taiwan and Thailand, there are hardly any vaccination campaigns. Others, like China, Japan, South Korea, and Australia, have seen a sharp surge in vaccinations in recent weeks, but are far from offering vaccines to anyone who wants one.

But almost everywhere in the region, the trend lines point to a trend reversal. While Americans celebrate what feels like a new dawn for many of the 4.6 billion people in Asia, the rest of this year will be very similar to last, with extreme suffering for some and others in a limbo of subdued normalcy.

Or there could be more volatility. Companies around the world are monitoring whether the new outbreak in southern China affects the port terminals there. Across Asia, sluggish vaccine rollouts could also open the door to spiraling barriers that are inflicting new damage on economies, ousting political leaders and changing the dynamics of power between nations.

The risks are rooted in decisions made months ago, before the pandemic caused the worst of the carnage.

Since the spring of last year, the US and several countries in Europe have been relying heavily on vaccines, accelerated approval and spending billions to secure the first batches. The need was urgent. In the United States alone, thousands of people died each day at the height of its outbreak when the country’s epidemic was catastrophically failed to manage.

But in countries like Australia, Japan, South Korea, and Taiwan, infection rates and deaths have been kept relatively low by border restrictions, public adherence to antivirus measures, and widespread testing and contact tracing. With the virus situation largely under control and the ability to develop vaccines domestically limited, there was less of a need to place huge orders or believe in solutions that were not yet proven at the time.

“The perceived threat to the public was low,” said Dr. C. Jason Wang, Associate Professor at Stanford University School of Medicine who studied Covid-19 Policy. “And governments have responded to the public perception of the threat.”

As a virus control strategy, border controls – a preferred method across Asia – only go so far, added Dr. Wang added: “To end the pandemic, you need both defensive and offensive strategies. The offensive strategy is vaccines. “

Their introduction to Asia was defined by humanitarian logic (which nations around the world needed vaccines), local complacency, and raw power over pharmaceutical production and export.

Earlier this year, contract announcements with the companies and countries that control the vaccines appeared to be more frequent than actual shipments. In March Italy blocked the export of 250,000 doses of the AstraZeneca vaccine, which Australia had designated to control its own angry outbreak. Other deliveries were delayed due to manufacturing issues.

“Shipments of the vaccine you buy actually end up on the docks – it’s fair to say they don’t come close to meeting the purchase commitments,” said Richard Maude, senior fellow at the Asia Society Policy Institute in Australia.

Peter Collignon, a doctor and professor of microbiology at the Australian National University who worked for the World Health Organization, put it more simply: “The reality is that vaccine makers keep them to themselves.”

In response to this reality and the rare blood clot complications that have arisen with the AstraZeneca vaccine, many politicians in the Asia-Pacific region have tried early on to stress that there is little rush.

The result is now a huge gap between the United States and Europe.

In Asia, around 20 percent of people have received at least one dose of a vaccine; in Japan, for example, only 14 percent. In France, on the other hand, it is almost 45 percent, in the USA more than 50 percent and in Great Britain more than 60 percent.

Instagram, on which Americans once scolded Hollywood stars for enjoying a mask-free life in Zero Covid Australia, is now littered with images of grinning New Yorkers hugging friends who have just been vaccinated. While snapshots from Paris show smiling guests in cafes wooing summer tourists, people in Seoul are obsessive about refreshing apps that locate leftover cans and usually can’t find anything.

“Does the leftover vaccine exist?” a Twitter user recently asked. “Or did it disappear in 0.001 seconds because it’s like a ticket for the front row seat at a K-Pop Idol concert?”

Demand has increased as some of the supply bottlenecks have started to ease.

China, struggling with hesitation about its own vaccines after months of controlling the virus, administered 22 million vaccinations on June 2, a record for the country. Overall, China has reported having administered nearly 900 million doses in a country of 1.4 billion people.

Japan has also stepped up its efforts and relaxed the rules that only allowed select medical professionals to give vaccinations. The Japanese authorities opened large vaccination centers in Tokyo and Osaka and expanded vaccination programs to workplaces and universities. Prime Minister Yoshihide Suga now says all adults will have access to a vaccine by November.

In Taiwan, too, vaccination efforts recently got a boost when the Japanese government donated around 1.2 million doses of the AstraZeneca vaccine.

But all in all, Taiwan’s experience is somewhat typical: it has still only received enough doses to vaccinate less than 10 percent of its 23.5 million residents. A Buddhist association recently offered to buy Covid-19 vaccines to expedite the island’s anemic vaccination efforts, but it was told that only governments can make such purchases.

And with vaccinations lagging across Asia, so will any robust international reopening. Australia has signaled that it will keep its borders closed for another year. Japan is currently banning almost all non-residents from entering the country, and an intensive review of overseas arrivals into China has left multinational corporations without key workers.

The immediate future of many places in Asia seems likely to be one of hectic optimization.

China’s response to the Guangzhou outbreak – testing millions of people in days, closing entire neighborhoods – is a quick iteration of dealing with previous outbreaks. Few in the country expect this approach to change anytime soon, especially since the Delta variant that devastated India is now in circulation.

At the same time, vaccine holdouts are facing increased pressure to get vaccinated before the available doses are up, and not just in mainland China.

Indonesia has threatened residents around $ 450 fines for refusing vaccines. Vietnam has responded to its recent surge in infections by soliciting donations from the public to a Covid-19 vaccine fund. And in Hong Kong, officials and business leaders are offering a range of incentives to alleviate severe vaccination hesitation.

Still, the prognosis for much of Asia this year is obvious: the disease has not been defeated and will not be in the foreseeable future. Even those lucky enough to get a vaccine often leave with mixed feelings.

“This is the way out of the pandemic,” said Kate Tebbutt, 41, a lawyer who received her first shot of the Pfizer vaccine last week at the Royal Exhibition Building near Melbourne’s central business district. “I think we should be further ahead than we are.”

Coverage was contributed by Raymond Zhong in Taipei, Taiwan, Ben Dooley in Tokyo, Sui-Lee Wee in Singapore, Youmi Kim in Seoul, and Yan Zhuang in Melbourne, Australia.

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Health

Asia Struggles to Forged Off the Pandemic Regardless of its Early Lead

Asia Struggles to Cast Off the Pandemic Despite its Early Lead

SYDNEY, Australia – Across the Asia-Pacific region, the countries that led the world in containing the coronavirus are now languishing in the race to leave it behind.

As the US, which has suffered far worse outbreaks, now crampers stadiums with vaccinated fans and planes with summer vacationers, the pandemic champions of the east are still caught in a cycle of uncertainty, restriction and isolation.

In southern China, the spread of the Delta variant led to a sudden lockdown in Guangzhou, a major industrial capital. Taiwan, Vietnam, Thailand and Australia have also cracked down on the recent outbreaks, while Japan is grappling with its own fatigue from a fourth round of infections riddled with fears of a virus disaster from the Olympics.

Wherever they can, people move on with their lives, with masks and social distancing and outings near their home. Economically, the region weathered the pandemic relatively well, as most countries successfully mastered their first phase.

But with hundreds of millions of people from China to New Zealand still unvaccinated – and with concerned leaders keeping international borders closed for the foreseeable future – tolerance for restricted lives is getting thinner, even though the new varieties add to the threat.

Put simply, people are fed up with asking themselves: Why are we behind us and when will the pandemic routine for the love of the good finally come to an end?

“When we’re not stuck, it’s like we’re waiting in the glue or mud,” said Terry Nolan, director of the vaccines and immunization research group at the Doherty Institute in Melbourne, Australia, a city of five million people barely out of his last lockdown. “Everyone is trying to get out to find a sense of urgency.”

While languishing varies from country to country, it is generally due to a lack of vaccines.

In some places, such as Vietnam, Taiwan and Thailand, there are hardly any vaccination campaigns. Others, like China, Japan, South Korea, and Australia, have seen a sharp surge in vaccinations in recent weeks, but are far from offering vaccines to anyone who wants one.

But almost everywhere in the region, the trend lines point to a trend reversal. While Americans celebrate what feels like a new dawn for many of the 4.6 billion people in Asia, the rest of this year will be very similar to last, with extreme suffering for some and others in a limbo of subdued normalcy.

Or there could be more volatility. Companies around the world are monitoring whether the new outbreak in southern China affects the port terminals there. Across Asia, sluggish vaccine rollouts could also open the door to spiraling barriers that are inflicting new damage on economies, ousting political leaders and changing the dynamics of power between nations.

The risks are rooted in decisions made months ago, before the pandemic caused the worst of the carnage.

Since the spring of last year, the United States and several countries in Europe have been betting heavily on vaccines, accelerated approval, and spending billions to secure the first batches. The need was urgent. In the United States alone, thousands of people died each day at the height of its outbreak when the country’s epidemic was catastrophically failed to manage.

But in countries like Australia, Japan, South Korea, and Taiwan, infection rates and deaths have been kept relatively low by border restrictions, public compliance with antivirus measures, and widespread testing and contact tracing. With the virus situation largely under control and the ability to develop vaccines domestically limited, there was less of a need to place huge orders or believe in solutions that were not yet proven at the time.

“The perceived threat to the public was low,” said Dr. C. Jason Wang, Associate Professor at Stanford University School of Medicine who studied Covid-19 Policy. “And governments have responded to the public perception of the threat.”

As a virus control strategy, border controls – a preferred method across Asia – only go so far, added Dr. Wang added: “To end the pandemic, you need both defensive and offensive strategies. The offensive strategy is vaccines. “

Their introduction to Asia was defined by humanitarian logic (which nations around the world needed vaccines), local complacency, and raw power over pharmaceutical production and export.

Earlier this year, contract announcements with the companies and countries that control the vaccines appeared to be more frequent than actual shipments. In March Italy blocked the export of 250,000 doses of the AstraZeneca vaccine, which Australia had designated to control its own angry outbreak. Other deliveries were delayed due to manufacturing issues.

“Shipments of the vaccine you buy actually end up on the docks – it’s fair to say they don’t come close to meeting the purchase commitments,” said Richard Maude, senior fellow at the Asia Society Policy Institute in Australia.

Peter Collignon, a doctor and professor of microbiology at the Australian National University who worked for the World Health Organization, put it more simply: “The reality is that vaccine makers keep them to themselves.”

In response to this reality and the rare blood clot complications that have arisen with the AstraZeneca vaccine, many politicians in the Asia-Pacific region have tried early on to stress that there is little rush.

The result is now a huge gap between the United States and Europe.

In Asia, around 20 percent of people have received at least one dose of a vaccine; in Japan, for example, only 14 percent. In France, on the other hand, it is almost 45 percent, in the USA more than 50 percent and in Great Britain more than 60 percent.

Instagram, on which Americans once scolded Hollywood stars for enjoying a mask-free life in Zero Covid Australia, is now littered with images of grinning New Yorkers hugging their vaccinated friends. While snapshots from Paris show smiling guests in cafes wooing summer tourists, people in Seoul are obsessive about refreshing apps that locate leftover cans and usually can’t find anything.

“Does the leftover vaccine exist?” a Twitter user recently asked. “Or did it disappear in 0.001 seconds because it’s like a ticket for the front row seat at a K-Pop Idol concert?”

Demand has increased as some of the supply bottlenecks have started to ease.

China, struggling with hesitation about its own vaccines after months of controlling the virus, administered 22 million vaccinations on June 2, a record for the country. Overall, China has reported having administered nearly 900 million doses in a country of 1.4 billion people.

Japan has also stepped up its efforts and relaxed the rules that only allowed select medical professionals to give vaccinations. The Japanese authorities opened large vaccination centers in Tokyo and Osaka and expanded vaccination programs to workplaces and universities. Prime Minister Yoshihide Suga now says all adults will have access to a vaccine by November.

In Taiwan, too, vaccination efforts recently got a boost when the Japanese government donated around 1.2 million doses of the AstraZeneca vaccine.

But all in all, Taiwan’s experience is somewhat typical: it has still only received enough doses to vaccinate less than 10 percent of its 23.5 million residents. A Buddhist association recently offered to buy Covid-19 vaccines to expedite the island’s anemic vaccination efforts, but it was told that only governments can make such purchases.

And with vaccinations lagging across Asia, so will any robust international reopening. Australia has signaled that it will keep its borders closed for another year. Japan is currently banning almost all non-residents from entering the country, and an intensive review of overseas arrivals in China has left multinational corporations without key workers.

The immediate future of many places in Asia seems likely to be one of hectic optimization.

China’s response to the Guangzhou outbreak – testing millions of people within days, closing entire neighborhoods – is a quick replay of dealing with previous outbreaks. Few in the country expect this approach to change anytime soon, especially since the Delta variant that devastated India is now in circulation.

At the same time, vaccine holdouts are facing increased pressure to get vaccinated before the available doses are up, and not just in mainland China.

Indonesia has threatened residents with fines of around $ 450 for refusing vaccines. Vietnam has responded to its recent surge in infections by soliciting donations from the public to a Covid-19 vaccine fund. And in Hong Kong, officials and business leaders are offering a range of incentives to alleviate severe vaccination hesitation.

Still, the prognosis for much of Asia this year is obvious: the disease has not been defeated and will not be in the foreseeable future. Even those lucky enough to get a vaccine often leave with mixed feelings.

“This is the way out of the pandemic,” said Kate Tebbutt, 41, a lawyer who received her first shot of the Pfizer vaccine last week at the Royal Exhibition Building near Melbourne’s central business district. “I think we should be further ahead than we are.”

Coverage was contributed by Raymond Zhong in Taipei, Taiwan, Ben Dooley in Tokyo, Sui-Lee Wee in Singapore, Youmi Kim in Seoul, and Yan Zhuang in Melbourne, Australia.

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Health

Suicide makes an attempt amongst younger ladies surged by greater than 50% throughout pandemic, CDC says

Suicide attempts among young girls surged by more than 50% during pandemic, CDC says

Chameleon eye | iStock | Getty Images

Suicide attempts increased among 12 to 17 year olds, especially teenage girls, during the Covid-19 pandemic and got worse the longer the social distancing orders and bans on, according to new data from the Centers for Disease Control and Prevention Government continued.

Visits to emergency rooms in hospitals among adolescents had already increased in early May 2020 as the pandemic spread in the United States, the CDC said in a study published on Friday. From the end of July to the end of August 2020, the average weekly number of emergency room visits for suspected suicide attempts in 12 to 17-year-old girls rose by 26.2% compared to the same period of the previous year.

The disruption of daily life from pandemic lockdowns and social distancing orders could have contributed to the increase in suicide attempts, the CDC said. In spring 2020, there was a 16.8% decrease in emergency room visits for men and women between the ages of 18 and 24 compared to the same period in the previous year.

As of June 2020, 25% of the same age group surveyed adults reported having had suicidal thoughts in the past 30 days related to the pandemic, in line with 2019. However, actual visits to the emergency room for attempted suicide increased during the pandemic, the CDC said With.

For adolescent girls, the average weekly visits to the emergency room for suspected suicide attempts increased by 50.6% from February 2021 to March 2021 compared to the same period last year.

Visits to the emergency room for suspected suicide attempts include visits for suicide attempts as well as some non-suicidal self-harm, according to the CDC.

The data was collected by the CDC from the National Syndromic Surveillance Program emergency department visit data in 49 states. Not all states had consistent emergency room visit dates, and no data on race and ethnicity were available at the time of the study.

Suspicions of suicide attempts are often higher in young girls than in young boys, but in this study the difference was more pronounced due to the pandemic than in previous studies. The study points to an increase in emergency room visits for suspected suicide attempts, not an increase in actual suicides, the CDC emphasized in the study.

The increase in alleged suicide attempts by young people could be attributed to social distancing, including a lack of connection with schools, teachers and friends. Other factors could include mental health barriers to treatment, an increase in substance abuse, and concerns about the health and economic situation of the family at home.

Average emergency room visits due to mental health problems and suspected child abuse have also increased in 2020 compared to 2019, potentially contributing to the increase in alleged suicide attempts.

The study finds that the increased amount of time spent with children at home may have made parents aware of their children’s mental health issues and prompted them to seek emergency room treatment, which may have contributed to the increase.

The study also found that the data likely underrepresented the actual number of alleged suicide attempts as Americans were reluctant to go to hospitals during the pandemic for fear of contracting Covid-19.

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255.

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For Small Gyms, Dealing with the Pandemic Meant Increasing

For Small Gyms, Handling the Pandemic Meant Expanding

This article is part of Owning the Future, a series on how small businesses across the country have been affected by the pandemic.

On the evening of March 14, 2020, Kari Saitowitz, owner of the Fhitting Room, a small or “boutique” fitness studio with three locations in Manhattan, returned from a dinner out, to find a disturbing message. A college friend who was a pulmonologist at NewYork-Presbyterian Brooklyn Methodist Hospital had sent a text about the alarming number of cases of the new, contagious respiratory disease they were seeing.

“The message said, ‘Please take this seriously,’” Ms. Saitowitz recalled. “And he specifically said, ‘Kari, you will probably have to close the gym for a while.’”

The next morning, she received emails from two of her senior trainers, who had taught classes the previous day. They, too, were concerned, not only about their own safety, but also about their clients, some of whom were older.

“That was the tipping point,” she said. After convening a group of full- and part-time employees, including trainers and members of the cleaning staff, she decided to close the studio. That afternoon, she sent an email blast to the membership, saying that “for the health of our community,” she was temporarily closing the Fhitting Room.

The following day, March 16, Gov. Andrew M. Cuomo announced the closure of all gyms, restaurants, bars, theaters and casinos.

Now Ms. Saitowitz, like so many other small-business owners, faced another urgent decision: “‘How do I keep my business alive?’”

The key, she decided, was to figure out ways to continue delivering what her customers wanted — what they really wanted. “It’s more than just a workout,” she said. “People come here because of the conversation, the socialization, for the fun and motivation of a class.”

How could she replicate that when the gym was closed?

The answer, for Ms. Saitowitz and other boutique fitness gyms — a broad designation that includes Pilates and yoga studios, and facilities that focus on indoor cycling or, as is the case with the Fhitting Room (the name is a play on H.I.T., the acronym for high-intensity training), group fitness classes — was to quickly expand the way that their services could be provided; an approach that some in the industry are now calling “omnichannel.”

For Ms. Saitowitz, it meant ramping up the creation of an on-demand video library of workouts, switching live classes to Zoom and, in September, striking a partnership with the retailer Showfields to use a rooftop event space on its Bond Street building to hold socially distanced outdoor classes.

All of that has had an effect on its members. “Before the pandemic I was going maybe three times a week,” said Suzanne Bruderman of Manhattan, a Fhitting Room member since it opened six years ago. “Once the pandemic hit, all of my behaviors shifted and it basically became a five-day-a-week habit.”

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June 3, 2021, 8:18 p.m. ET

But all of these changes required more than a tutorial in Zoom; they necessitated a radical change in thinking in an industry that has been providing its product in essentially the same way since Vic Tanny’s first “health clubs” opened in the 1930s.

“Prior to the pandemic, clients had to visit a brick-and-mortar business to consume the product,” said Julian Barnes, chief executive of Boutique Fitness Solutions, an advisory firm to small gyms and fitness studios. The new multiple-channel approach “means meeting your client wherever he or she is,” he said. “If she wants to work out live, give her that ability to take a class live. If she wants to work out at 2 a.m., and pull up a video of her favorite class, give her the ability to do that. If she wants to work out outdoors, give her the ability for that.”

Mr. Barnes estimated that, before the pandemic, the United States had about 70,000 of these small gym and studios. “A lot of them were uprooted from their original business model,” said Tricia Murphy Madden, who is based in Seattle and is national education director for Savvier Fitness, a fitness product and education company. “What I’m seeing now is that if you’re still operating the way you did 16 months ago, you’re not going to survive.”

When gyms in Texas were ordered closed, Jess Hughes, founder and president of Citizen Pilates, was determined to keep her three Houston studios open. Using little more than an iPhone and a ring light, Ms. Hughes and some of her instructors began producing video workouts in the studio. The on-demand Citizen Virtual catalog now has over 100 at-home workouts accessible from any device with a paid subscription ($19 per month). She later expanded the offerings through a partnership with JetSweat, a fitness on-demand library with 28,000 monthly subscribers.

Going online allowed them to expand beyond individual customers. “We also started doing virtual private corporate classes through Zoom,” Ms. Hughes said. These once-a-week classes allowed employees of a number of midsize Houston companies to stay in shape — and have shared experiences — while they worked remotely.

She also began offering branded apparel with slogans like “Citizen Strong,” which proved particularly popular when the studio reopened, with restrictions, in May. Moving all equipment six feet apart reduced her total capacity by 30 percent. (“We received zero rent relief from any of our landlords,” she added.) Yet Ms. Hughes has managed to increase her membership by 22 percent, mostly locally. “What I like to say is that we were brand consistent but socially distant,” she said.

Social distancing wasn’t enough for Matt Espeut, who was twice forced to close down his Fit Body Boot Camp gym in Providence when Rhode Island’s Covid cases surged. Like Ms. Saitowitz and Ms. Hughes, Mr. Espeut was determined to stay in business, and he felt offering new services was the way to do it. Because weight loss is a major part of his gym’s mission, he invested his Small Business Administration loan into the cost of a medical-grade body scan machine that measures body composition. “Now we can home in on people losing fat, and gaining muscle,” he said.

The $6,000 machine, the addition of nutritional counseling — including supplements sold in the gym and online — and offering many new, socially distanced classes enabled Mr. Espeut to achieve something he wouldn’t have thought possible a year ago: He has increased his gym membership by 15 percent, to 196 from 170.

He added one more thing after reopening in January: a new décor, including a fresh coat of paint and new floor mats. “I think people would like to forget 2020,” he said. “I wanted people to see right away that things are different.”

For many small gyms, they are — although the expansion into different channels is still a means to an end: Getting everyone back in the spaces that workout enthusiasts love to share.

“We didn’t panic at first,” recalled Lisa O’Rourke, an owner of Spin City, an indoor cycling studio in Massapequa Park, N.Y. “We had a healthy business going, and we thought it was going to be temporary.” As the lockdown extended into April, though, “the panic set in.” Ms. O’Rourke began offering members-only YouTube workouts featuring her instructors. Over the summer, that expanded to include outdoor classes in the parking lot.

Early in the lockdown, another thought occurred to Ms. O’Rourke as she surveyed her empty studio. “We had all these bikes sitting there doing nothing,” she said. “So, we decided to loan them to our members.” While some studios leased out their equipment — bikes, kettlebells and other equipment — Spin City offered the loaners for free.

“I had members offer us money,” she said. “But we turned them down. You know, they helped create our success, and during the pandemic, you felt bad for everybody. They didn’t need another expense.”

A year after the pandemic began, Spin City has gained a total of 50 members, on top of 275 to 300 members prepandemic. All the bikes are now back in the studio — albeit six feet farther apart. Ms. O’Rourke has speculated on what would have happened if she hadn’t opened these new channels.

“They would have all bought Pelotons,” she said with a laugh.

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Fauci’s 2,000 emails a day present how little U.S. officers knew within the early days of the Covid pandemic

Fauci's 2,000 emails a day show how little U.S. officials knew in the early days of the Covid pandemic

Dr. Anthony Fauci, Direktor am National Institute of Allergy and Infectious Diseases, nimmt an einer Anhörung des Gesundheits-, Bildungs-, Arbeits- und Rentenausschusses des US-Senats teil, um die COVID-19-Reaktion zu untersuchen, wobei der Schwerpunkt auf einem Update von Bundesbeamten auf dem Capitol Hill in Washington liegt , 18. März 2021.

Anna Geldmacherin | Schwimmbecken | Reuters

Am 12. April 2020 schickte ein Beamter der National Institutes of Health eine E-Mail an Dr. Anthony Fauci, den führenden Experten für Infektionskrankheiten des Landes, und den damaligen CDC-Direktor Dr. Robert Redfield, der sich über die zunehmenden Feindseligkeiten zwischen den USA und der Weltgesundheitsorganisation wegen des Coronavirus Sorgen machte Pandemie.

Dann drohte Präsident Donald Trump, der internationalen Gesundheitsorganisation die Finanzierung zu entziehen, weil sie „jeden Aspekt“ des Ausbruchs falsch gemacht hatte

„Ich bin besorgt über den jüngsten Kampf zwischen den USA und der WHO, weil er die aktuellen weltweiten Bemühungen zur Kontrolle der Ausbreitung von COVID-19 beeinträchtigen könnte“, heißt es in der E-Mail, die auch Fragen zur Genauigkeit des chinesischen Covid-19-Falls aufwirft und Daten zum Todesfall.

Fauci antwortete: „Diese Pandemie war für viele Länder auf der ganzen Welt, einschließlich China und den USA, eine extreme Herausforderung. Ich kann nur sagen, dass ich (und ich bin mir sicher, dass Bob Redfield genauso denkt) lieber nach vorne blicke und keine Schuld zuschreibe.“ oder Schuld.”

“Es liegen genug Probleme vor uns, die wir gemeinsam bewältigen müssen”, fügte er hinzu.

Notfallmediziner (EMT) heben einen Patienten, bei dem eine Coronavirus-Krankheit (COVID-19) festgestellt wurde, in einen Krankenwagen, während er Schutzkleidung trägt, während der Ausbruch der Coronavirus-Krankheit (COVID-19) in New York City, New York, andauert. USA, 26. März 2020.

Stefan Jeremiah | Reuters

E-Mails veröffentlicht

Die Nachricht des NIH-Beamten, dessen Name geschwärzt ist, wurde als Teil einer Sammlung von Tausenden von Faucis E-Mails aus der ersten Hälfte des Jahres 2020 veröffentlicht, die BuzzFeed News und andere Medien über das Informationsfreiheitsgesetz erhalten hatten. Als Direktor des Nationalen Instituts für Allergien und Infektionskrankheiten innerhalb der NIH stand Fauci im Mittelpunkt des Sturms.

Die ängstliche Note und Faucis ominöse Antwort veranschaulichen das Chaos des Augenblicks.

Covid-Fälle und Todesfälle in den USA hatten erschreckende neue Höchststände erreicht, seit Trump einen Monat zuvor die Pandemie zum nationalen Notstand erklärt hatte. Staatsoberhäupter hatten drakonische Sperrbefehle erlassen, die Millionen von Menschenleben auf den Kopf gestellt und einen wirtschaftlichen freien Fall ausgelöst haben. Tests, soziale Distanzierung und Kontaktverfolgung steckten in den Kinderschuhen, Krankenhäuser waren überfordert, wichtige Schutzausrüstungen wurden knapp und Impfstoffe mussten noch entwickelt werden.

US-Präsident Donald Trump erklärt die Coronavirus-Pandemie zu einem nationalen Notfall, während Vizepräsident Mike Pence und Gesundheitsminister Alex Azar während einer Pressekonferenz im Rosengarten des Weißen Hauses in Washington am 13. März 2020 zuhören.

Jonathan Ernst | Reuters

Der Präsident, der im Januar und Februar Chinas Reaktion auf den Ausbruch des neu auftretenden Virus gelobt hatte, hatte seinen Ton scharf geändert, die WHO und Peking kritisiert und beide für die Krise verantwortlich gemacht.

Fauci hatte in den Tagen und Wochen vor der offiziellen Erklärung der WHO am 11. März 2020 E-Mails von Personen erhalten, die besagten, dass eine Pandemie wahrscheinlich sei.

Einige fragten ihn, ob sie große persönliche Veranstaltungen absagen sollten, während andere Ideen für mögliche Behandlungen und Lösungen für den Ausbruch ausspuckten. Einige fragten, ob er der Meinung sei, dass die Amerikaner angemessen vorbereitet seien.

2.000 E-Mails pro Tag

Fauci bewies Geduld, Diplomatie und Fleiß in seinen oft nächtlichen Antworten an hochrangige US-Beamte, berühmte Künstler und normale Menschen. Die E-Mails zeigen auch den enormen physischen und manchmal emotionalen Tribut, den die Pandemie von Fauci forderte, der unter einer manchmal unzusammenhängenden Reaktion unter der Trump-Administration zu einer der vertrauenswürdigsten Informationsquellen zu Covid-19 geworden war.

Am 18. Februar 2020 erhielt Fauci eine E-Mail von einem scheinbar alten Bekannten, der fragte, ob er am Wochenende zu einem möglichen Treffen in der Stadt sei. Fauci entschuldigte sich, schrieb, dass er keine Verbindung herstellen könne und fragte, ob sie sich ein anderes Mal treffen könnten, während er ununterbrochen arbeitete.

„Das Weiße Haus und HHS haben mich rund um die Uhr, einschließlich Samstag und Sonntag, mit der Coronavirus-Krise beschäftigt. Ich habe meine Frau … in den letzten 10 Tagen insgesamt etwa 45 Minuten lang gesehen“, schrieb er. “Ich hoffe, dass du verstehst.”

Anthony Fauci, Direktor des National Institute of Allergy and Infectious Diseases, Center, spricht, während US-Vizepräsident Mike Pence (rechts) und Deborah Birx, Koordinatorin der Coronavirus-Reaktion, während einer Pressekonferenz im Besprechungsraum des Weißen Hauses in Washington zuhören. DC, USA, am Montag, 2. März 2020.

Andrew Harrer | Bloomberg | Getty Images

Bis Ende März, als die USA etwas mehr als 153.000 Covid-Fälle hatten, entschuldigte sich Fauci dafür, dass er so lange gebraucht hatte, um zu einem anderen alten Freund zurückzukehren, und sagte, er erhalte mehr als 2.000 E-Mails pro Tag. In einer separaten E-Mail einige Tage später an Dr. J. Larry Jameson, einen Arztkollegen an der University of Pennsylvania, sagte Fauci, er sei „völlig überfordert“ und bekomme „3 bis 4 Stunden Schlaf pro Nacht“.

Hilfsangebote

Seine E-Mails sind gespickt mit Pitches von Leuten mit sehr unterschiedlichem Fachwissen, die ihre besten Vermutungen zum Umgang mit der anhaltenden Krise abgeben.

Eine Person, die sich Anfang März meldete und sich selbst als „weder Arzt noch Wissenschaftler“ bezeichnete, schlug vor, dass die Regierung US-Erwachsene anderen bekannten und „weniger tödlichen“ Coronaviren aussetzt, um zu versuchen, ein gewisses Maß an Immunität gegen das neue Virus zu entwickeln.

Fauci antwortete um 22.50 Uhr: “Danke für Ihren Hinweis. AS Fauci.”

Quilter Ami Simms hat sich Mitte März gemeldet, um dem NIH ihre Dienste bei der Herstellung eines Musters für Gesichtsmasken anzubieten. Sie sagte, sie habe in der Vergangenheit Quilter für andere Zwecke mobilisiert und es gab “Millionen von Kanalisationen, die sich freuen würden, jetzt zu helfen und zu helfen”. Fauci leitete die E-Mail an Dr. Andrea Lerner, eine Top-Ärztin seiner Agentur, weiter.

Frau mit hausgemachter Gesichtsmaske

Isabel Pavia | Moment | Getty Images

Seine Antworten zeigen, dass die Eingabe, die den Posteingang verstopft, nicht immer willkommen war.

„Bitte lesen Sie dies und finden Sie heraus, worüber er spricht, und handeln Sie nach Ihrem Ermessen“, schrieb Fauci in einer E-Mail vom 7. ” zur Covid-Erkennung.

„Heute Abend sind nur noch 498 E-Mails zu versenden“, fügte Fauci hinzu.

Die vielfältigen Ratschläge und Fragen, die Fauci in diesen ersten Monaten erhielt, zeigten, wie viel führende US-amerikanische und internationale Wissenschaftler, einschließlich Fauci selbst, zu Beginn der Pandemie nicht über Covid wussten.

Unheimliche Frühwarnungen

Die Frage nach Masken kam früh und oft auf, und einige von Faucis Ratschlägen erwiesen sich später als falsch.

In einer E-Mail vom 5. Februar 2020 an die Präsidentin der American University, Sylvia Burwell, die unter dem ehemaligen Präsidenten Barack Obama als HHS-Sekretärin tätig war, riet Fauci ihr davon ab, am Flughafen eine Maske zu tragen. “Die typische Maske, die Sie in der Drogerie kaufen, ist nicht wirklich effektiv, um das Virus fernzuhalten, das klein genug ist, um das Material zu durchdringen”, schrieb er.

Fußgänger, die Schutzmasken tragen, um die Ausbreitung eines tödlichen Virus zu stoppen, das in der chinesischen Stadt Wuhan begann, gehen am 25.

Charly Triballeau | AFP | Getty Images

Der chinesische Immunologe George Gao wandte sich Ende März an Fauci, um sich für die Kritik an der US-Maskenpolitik zu entschuldigen. „Wie konnte ich so ein Wort ‚großer Fehler‘ über andere sagen? Das war die Formulierung des Journalisten. Ich hoffe, Sie verstehen“, schrieb Gao am 28. März.

Die USA würden ihre Maskenrichtlinien erst im Juli ändern.

Einige der E-Mail-Ketten erwiesen sich auch als unheimlich prophetisch.

Der Kolumnist der Washington Post, Michael Gerson, wandte sich am 2. März 2020 an Fauci, als es in den USA 91 bestätigte Fälle gab, und sagte, NIH-Direktor Dr. Francis Collins habe ihm gesagt, dass 5 bis 20 % des Landes mit Covid infiziert sein könnten.

“Eine Pandemie erscheint jetzt wahrscheinlich”, sagte er. “Abhängig von der Sterblichkeitsrate könnte dies zu Hunderttausenden von Todesfällen führen”, schrieb er. Fauci sagte, er habe Recht. Selbst wenn die Sterblichkeit bei 1% lag und nur 5% der US-Bevölkerung sie bekam, “könnten wir ein paar hunderttausend Tote haben”, antwortete er um 6:11 Uhr

Wuhan Institut für Virologie

Eine E-Mail vom 1. Februar von Faucis stellvertretendem Direktor am Nationalen Institut für Allergien und Infektionskrankheiten, Hugh Auchincloss, zeigt an, dass die Agentur versuchte festzustellen, ob sie an der sogenannten Funktionsgewinnforschung am Wuhan Institute of Virology beteiligt war. Das Labor wurde seitdem ins Rampenlicht der Debatte über die Ursprünge des Virus gerückt, nachdem Medienberichte aufgetaucht waren, dass mindestens drei Forscher dort im November 2019 an einer Covid-ähnlichen Infektion genug erkrankt waren, um sich in ein Krankenhaus zu begeben.

Während des Besuchs des Teams der Weltgesundheitsorganisation (WHO), das mit der Untersuchung der Ursprünge der Coronavirus-Krankheit (COVID-19) beauftragt ist, am 3. Februar 2021 in Wuhan, Provinz Hubei, China, halten Sicherheitspersonal Wache vor dem Wuhan Institute of Virology.

Thomas Peter | Reuters

Fauci hatte Auchincloss eine 2015 in Nature Medicine veröffentlichte Studie mit dem Titel „Ein SARS-ähnlicher Cluster von zirkulierenden Fledermaus-Coronaviren zeigt Potenzial für die Entstehung des Menschen“ geschickt. Die Studie wurde teilweise vom NIAID finanziert und hatte mehrere Autoren, meist von renommierten US-Institutionen. Einer von ihnen war jedoch am Wuhan-Institut ansässig, wo Forscher den umstrittenen Forschungsstil verwendeten, der einen Krankheitserreger aufnimmt und ihn tödlicher oder ansteckender macht, um Wege zu seiner Bekämpfung zu untersuchen.

“In dem Papier, das Sie mir geschickt haben, heißt es, dass die Experimente vor der Verstärkung der Funktionspause durchgeführt wurden, aber seitdem vom NIH überprüft und genehmigt wurden. Ich bin mir nicht sicher, was das bedeutet, da Emily sicher ist, dass keine Coronavirus-Arbeit das P3-Framework durchlaufen hat. Sie wird es versuchen.” um festzustellen, ob wir entfernte Verbindungen zu dieser Arbeit im Ausland haben.”

US-Präsident Joe Biden sagte im vergangenen Monat, er habe den US-Geheimdiensten befohlen, sich eingehend mit den Ursprüngen von Covid zu befassen, und sagte, es sei ebenso wahrscheinlich, dass es aus der Natur hervorgegangen oder aus einem Labor durchgesickert sei.

Fauci der Frauenschwarm

Als angesehener Experte für Infektionskrankheiten in wissenschaftlichen Kreisen, machten Faucis hochkarätige Rolle und sein sachlicher Stil als führende Autorität in der Pandemie ihn zu einem bekannten Namen – und zu einer widerstrebenden Popkultur-Ikone, wie seine E-Mails zeigen.

„Ich hätte mir das nicht einmal ausdenken können“, schrieb Fauci am 10. April über einen Artikel in The Atlantic, in dem er seinen schnellen Aufstieg zum „Herzenschwarm“ -Status inmitten der Pandemie beschrieb.

Brad Pitt als Dr. Anthony Fauci bei den “Fauci Cold Open” bei “Saturday Night Live” am 25. April 2020.

ABC | NBCUniversal | Getty Images

“Unsere Gesellschaft ist wirklich total verrückt”, schrieb Fauci als Reaktion auf einen ähnlichen Artikel, der “Fauci Fever” und die Online-“Sexualisierung” des heute 80-jährigen Virologen dokumentiert.

Sein Gesicht war auf Kleidung, Essen und Getränken eingebrannt, und er wurde ständig sowohl in den Nachrichten- als auch in den Unterhaltungsmedien erwähnt. Fauci reagierte in einer E-Mail vom 31. März auf einen Artikel der Washington Post über seine „Kultgefolgschaft“ und nannte ihn „wirklich surrealistisch“.

“Hoffentlich hört das alles bald auf”, schrieb Fauci. Er fügte in einem Follow-up hinzu: “Es ist überhaupt nicht angenehm, das ist sicher.”

Aber die Aufzeichnungen zeigen, dass Fauci von mindestens einer Darstellung von ihm geschmeichelt wurde: Brad Pitts Version von Saturday Night Live. “Pitt war unglaublich”, schrieb Fauci am 27. April an einen Kollegen. “Ein Rezensent der SNL-Show sagte, dass Pitt ‘genau wie ich’ aussah. Diese Aussage hat mein Jahr gemacht.”

“Jetzt haben Sie auch die Antwort darauf, wer Sie in dem Film spielen würde”, antwortete Tara Schwetz, die stellvertretende Direktorin des NIH. Fauci frönte der Idee: “Du könntest die Rolle meiner Freundin vom Medizinstudium spielen, was dir die Möglichkeit geben würde, mit Brad Pitt zusammenzuarbeiten.”