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Health

Abbott deploys 2,500 out-of-state medical staff as youthful sufferers crowd hospitals

Abbott deploys 2,500 out-of-state medical workers as younger patients crowd hospitals

Dr. Joseph Varon (right) and Jeffrey Ndove (left) perform a hypothermia treatment procedure on a patient in the COVID-19 intensive care unit on Christmas Eve at United Memorial Medical Center December 24, 2020 in Houston, Texas.

Nakamura go | Getty Images

DALLAS – Texas hospitals are suspending voting and reaching out to 2,500 health workers from other states to tackle a surge in Covid cases as younger and healthier patients who haven’t been vaccinated against the days of treatment of the virus crowd.

The state is preparing for its most aggressive fight to date against the coronavirus as the Delta variant spreads across the country, hitting states with low vaccination rates and relaxed public health measures, particularly in the south and the Midwest.

Covid cases in the Lone Star State have exploded in the past few weeks. Texas averaged about 15,419 new cases per day on Wednesday, according to data compiled by Johns Hopkins University, up 34% from a week ago and more than double the seven-day average of 6,762 two weeks ago.

“What is worrying about the development is that the number of cases is growing much faster,” said Dr. Trish Perl, director of the infectious diseases division at UT Southwestern Medical Center in Dallas.

“We are seeing unvaccinated people who are younger than they were earlier in the pandemic, when we saw many hospitalizations over 65,” said Perl. “Now 18- to 49-year-olds are the biggest and highest gains, and many of these people have no underlying medical conditions.”

The spike in cases comes as Republican Governor Greg Abbott wages war on local school and government officials who reintroduced masked mandates, threatening $ 1,000 fines for communities and officials who oppose him. He initially banned local mask mandates in an implementing ordinance of 18

The second order also prohibited all public and private entities, government agencies, from requiring individuals to be vaccinated or to provide evidence of vaccination.

Local officials across Texas are defying state leaders and turning to the courts to challenge Abbott.

A person will receive the Moderna Covid-19 vaccine at the American Bank Center in Corpus Christi, Texas, USA on Thursday, February 11, 2021.

Nakumura go | Bloomberg | Getty Images

A district judge in Bexar County, home of San Antonio, on Tuesday issued an injunction against Abbott’s mask ban, which allowed local officials to restore mandates and other emergency orders to combat the Delta variant.

About 300 miles north, the Dallas Independent School District issued a temporary mask requirement for all counties on Monday.

Clay Jenkins, a Dallas County Democrat, followed suit with a new mask mandate for schools, businesses and county buildings Wednesday after a local judge issued an injunction preventing Abbott from enforcing his ban.

Abbott has vowed to fight the restraining orders. In a joint press release with Republican Attorney General Ken Paxton, the two said they are relying on personal responsibility to protect “the rights and freedoms of all Texans.”

“Attention-grabbing judges and mayors opposed orders from the very beginning of the pandemic, and the courts ruled on our side – the law,” Paxton said in the statement. “I am confident that the outcome of all lawsuits will come with freedom and individual choice, not mandates and government abuse.”

Austin Mayor Steve Adler, a Democrat, said he was weighing a citywide mask mandate when “the science, the data, and the doctors tell us this has to be something to keep the community safe”.

“Local school districts should be able to make this decision themselves in order to offer their children the best possible protection,” Adler said in an interview with CNBC on July 28th.

“I haven’t heard any scientific or data-driven rationale for policies that do not allow the enforcement of masking to protect public health,” Adler said, adding that he “strongly recommends that all children in schools wear” masks, and that teachers and guests at school do the same. “

Meanwhile, hospital stays continue to rise. Lyndon B. Johnson Hospital in Houston and St. Luke’s Hospital in nearby Woodlands have set up overflow tents outside to cope with the influx of patients, most of whom local officials say are unvaccinated. Texas lags behind the US in vaccinations, with 53.6% of the total population receiving at least one vaccination, compared with 58.9% nationwide, according to the Centers for Disease Control and Prevention.

A construction team is working to pitch tents hospital officials plan to pitch with an overflow of COVID-19 patients outside Lyndon B. Johnson Hospital in Houston on Monday, August 9, 2021.

Godofredo A. Vásquez | Houston Chronicle via AP

Abbott asked the Texas Hospital Association earlier this week to postpone voluntary medical procedures to free up beds in the intensive care unit, and said the state is hiring 2,500 medical staff outside of the state to relieve exhausted doctors and nurses.

“This help couldn’t come quickly enough. Many hospitals have already shut down non-essential services and are rerouting patients to add staff, ”Ted Shaw, president of the Texas Hospital Association, said in a statement Tuesday. “The hospital industry is losing frontline staff, especially nurses, to burnout and illness; many left the profession due to the extreme nature of the work during a relentless pandemic.”

More than 90% of all intensive care beds in Texas were occupied on Wednesday, according to the Department of Health and Human Services, with around 40% dedicated to Covid patients as of Wednesday.

While cases and deaths across the country have receded from their record highs in January, they’re on the rise again – but much faster in Texas. The state’s death toll is also rising, with a seven-day average of 57 daily Covid deaths on Monday, 36% more than last week, but below the record average of more than 341 deaths per day in late January 2021 data, according to Hopkins.

“It’s honestly heartbreaking. There is this feeling that they are invincible, but that’s not true, we are seeing seriously ill people,” said Perl of UT Southwestern Medical Center in Dallas. She said vaccinations are “the absolute best defense”.

Editor’s note: Nate Ratner and Robert Towey reported from New York and New Jersey, respectively.

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Politics

Unemployment falls however is increased for Black, Hispanic employees

Unemployment falls but is higher for Black, Hispanic workers

A man hands his resume over to an employer at the 25th annual Central Florida Employment Council Job Fair on the Central Florida Fairgrounds. More than 80 companies recruited for over a thousand positions.

Paul Hennessy | LightRakete | Getty Images

Unemployment fell to 5.4% when the economy created 943,000 jobs in July, with strong increases in all population groups despite persistent labor market inequalities.

The unemployment rate for blacks and Hispanic Americans fell to 8.2% and 6.6% respectively, but the numbers are high compared to the unemployment rate for whites and Asians. Unemployment was lowest among whites at 4.8% and among Asians it fell to 5.3%.

These numbers represent a broad improvement on June when the overall unemployment rate was 5.9%. Broken down by group, it was 9.2% for blacks, 7.4% for Hispanic workers, 5.8% for Asians, and 5.2% for whites.

The total employment rate or the share of employed or jobseekers remained largely unchanged. However, it actually fell slightly among blacks, suggesting that the fall in unemployment may be partly due to some blacks dropping out of the labor market.

Still, blacks are almost as likely to be in the labor force as whites, but earn 23% less on a weekly basis at $ 799 compared to $ 1,012, according to the Bureau of Labor Statistics median wage data for the second quarter.

Hispanics, who are more labor market participants than any other demographic, earn 26% less than whites at $ 779 a week. Asians are the top earners overall, with an average weekly wage of $ 1,281.

Black and Hispanic workers are disproportionately represented in low-wage industries such as transportation and warehousing, and leisure and hospitality.

For example, black workers make up about 13% of the US workforce, but 21% of all transportation and warehouse workers. Hispanic workers make up 17% of the labor force but 24% in the leisure and hospitality industries.

The differences are even greater when one compares the wages of white men and women across the different demographic categories. White women earn 19% less, black women nearly 40% less, Hispanic women 43% less, and Asian women earn 7% less.

Asian men were the highest earners overall, with an average weekly wage of $ 1,473.

The general employment trend is moving in the right direction as the economy recovers from the pandemic, said Heidi Shierholz, former chief economist at the Department of Labor under the Obama administration.

“Because people of color were disproportionately affected by this downturn and we are recovering from it, workers of color are seeing disproportionate gains,” said Shierholz, senior economist and policy director at the liberal Economic Policy Institute.

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Politics

Biden requiring federal staff to show Covid vaccine standing or undergo strict security guidelines

Biden requiring federal workers to prove Covid vaccine status or submit to strict safety rules

U.S. President Joe Biden speaks about the pace of coronavirus disease (COVID-19) vaccinations in the United States during remarks in the East Room of the White House in Washington, U.S., July 29, 2021.

Evelyn Hockstein | Reuters

“This is not about red states and blue states. It’s literally about life and death,” he said. “With freedom comes responsibility. Your decision to be unvaccinated impacts someone else.”

The new rules and perks come as officials at all levels of government struggle to bolster Covid vaccination rates that have flattened out in recent weeks, even as the highly transmissible delta variant spreads nationwide.

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Some state and regional leaders have already put new vaccine protocols in place. California and New York announced earlier this week that they will require most state employees to either get vaccinated or face mandatory weekly Covid testing.

Washington, D.C., Mayor Muriel Bowser earlier Thursday reimposed a requirement that masks be worn indoors, a measure that had been lifted months earlier, when new cases and deaths from Covid were on the decline.

Some major private corporations, such as Facebook and Google, are also making vaccination mandatory in order for employees in the U.S. to return to work.

In its own buildings, the federal government is requiring that every employee and on-site contractor “attest,” or confirm, their vaccination status, according to a White House fact sheet.

Those who do not will be required to wear a mask on the job, regardless of their location, and must comply with Covid testing once or twice per week, the White House said.

They will also have to be physically distanced from all other employees and visitors, and they may face restrictions on official travel, according to the fact sheet.

“It’s an American blessing that we have vaccines for each and every American,” Biden said Thursday afternoon. “It’s such a shame to squander that blessing.”

Biden also announced that a Covid reimbursement program, which paid back small- and medium-sized businesses that offered paid leave for their employees to get vaccinated, would be expanded to include workers’ family members and kids, as well.

And Biden called on school districts across the country to host pop-up vaccination clinics in the coming weeks, while directing federal pharmacy program partners to work with schools.

In his speech, Biden repeatedly stressed that despite the rise in cases, the vaccines remain highly effective at saving lives and preventing severe illness from Covid, including the delta variant. He noted that the overwhelming majority of people hospitalized and killed from the virus have not been inoculated, describing the current crisis as a “pandemic of the unvaccinated.”

Biden also attempted to assuage fears about so-called breakthrough infections among vaccinated people, saying that such cases are rare. He added that as of now, medical officials say there is no need for fully vaccinated people to seek out a booster shot — though he suggested that could change in the future.

“The vaccines are safe, highly effective. There’s nothing political about them,” Biden said, underscoring the point by praising Republican Senate Leader Mitch McConnell of Kentucky for consistently supporting vaccinations.

“And his state’s in pretty good shape,” Biden added.

The Biden administration had previously discouraged federal agencies from requiring vaccination for on-site work.

The president in May had also proclaimed that, “If you’ve been vaccinated, you don’t have to wear your mask.”

But after the Centers for Disease Control and Prevention reversed its guidance on wearing masks indoors, Biden, who is fully vaccinated, said he would follow the agency’s recommendations.

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Politics

Biden would require federal staff to get the Covid vaccine or undergo testing

Biden will require federal workers to get the Covid vaccine or submit to testing

President Joe Biden is expected to announce this week that his government will vaccinate federal employees against the coronavirus or undergo rigorous testing, NBC News reported Wednesday.

Biden will give a speech on Thursday to reveal the new rules following a review of the White House’s internal guidelines, two government officials told NBC. It is unclear when the changes will take effect.

Biden is also expected to announce new moves by his administration to increase the U.S. vaccination rate, which has slowed significantly in recent months and has fallen below the White House’s earlier targets, NBC reported.

The new measures come as the highly transmissible Delta variant spreads around the world, including the United States, where it represents a large proportion of new infections.

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Public health officials warn the US could face another surge in cases this fall. They also point out that the overwhelming majority of people hospitalized or killed by Covid are unvaccinated and that “breakthrough infections” tend to be milder among those vaccinated.

In preparation, the Centers for Disease Control and Prevention reversed their guidelines on wearing masks indoors on Tuesday. The CDC now recommends that fully vaccinated people and children wear masks indoors again in places with high Covid transmission rates and in schools.

On the same day, Biden said it was “being considered” whether the White House would require vaccination of all federal employees.

A government agency has already taken the plunge. On Monday, the Department of Veterans Affairs announced that it would order its health care workers to get vaccinated. VA Secretary Denis McDonough said it was “the best way to protect veterans”.

Biden also endorsed the CDC’s latest mask guidelines. And on Tuesday night, the White House Bureau of Management and Household Budget announced federal agencies that they must mandate masks for employees in all federal buildings in high-transmission areas, according to NBC.

The White House did not have to make a decision on compulsory vaccination until Tuesday night.

A source familiar with the considerations told CNBC at the time that a system of “vaccination certification” – which requires federal employees to confirm their vaccination status or follow safety measures such as wearing masks and regular tests – is “an option” under strong consideration. “

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Health

Medical Teams Name for Vaccine Necessities for Well being Care Employees

Medical Groups Call for Vaccine Requirements for Health Care Workers

A group of nearly 60 major medical organizations, including the American Medical Association and the American Nurses Association, called for mandatory vaccination of health workers on Monday. With the highly contagious Delta variant causing a new surge in coronavirus cases, vaccination is an ethical obligation for health care workers, the groups said in a joint statement.

“With the recent surge in Covid-19 and the availability of safe and effective vaccines, our health organizations and societies are advocating that all healthcare and long-term care employers require their employees to receive the Covid-19 vaccine,” said it in the statement. “This is the logical fulfillment of the ethical obligation of all healthcare workers to put patients and residents of long-term care facilities first and to take all necessary steps to ensure their health and well-being.”

The declaration was signed by a wide variety of professional associations, including representatives of doctors, nurses, pharmacists and infectious disease experts.

In recent weeks, more and more hospitals and health systems have announced that all employees must be vaccinated against the coronavirus. The US Equal Employment Opportunity Commission has stated that the mandates are legal and many hospitals already require their employees to get flu vaccinations.

“Health organizations rarely agree, but here they speak with one voice and unanimity,” said Dr. Ezekiel Emanuel, oncologist and bioethicist at the University of Pennsylvania, who organized the joint declaration. “I think that shows the widespread recognition that this is the right thing for this country.”

Although many healthcare workers have been eligible for vaccination since December when the first vaccinations were approved, a significant number remain unvaccinated. In New York, for example, about one in four hospital employees has not yet been vaccinated, according to state data. Only 58.7 percent of nursing home workers nationwide are fully vaccinated, according to the Centers for Disease Control and Prevention.

Some healthcare workers have spoken out against vaccine requirements. A small group of employees sued the Houston Methodist Hospital over his mandate. The lawsuit was dismissed last month and more than 150 hospital employees were fired or quit for refusing to be vaccinated.

Some employers have been reluctant to request the vaccines, which are currently under emergency approval, until they have received full approval from the Food and Drug Administration. This approval is expected but could take months.

Dr. Emanuel said some hospitals and health organizations used the lack of full approval as an excuse to postpone vaccine mandates. The joint statement stated that the Covid-19 vaccines were shown to be safe and effective.

“With more than 300 million doses administered in the United States and nearly 4 billion doses administered worldwide, we know the vaccines are safe and highly effective in preventing serious illness and death from Covid-19,” said Dr. Susan R. Bailey, the immediate past president of the AMA, said in a statement.

The joint statement said that exceptions could be made for the small subgroup of workers who cannot be vaccinated for medical reasons.

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World News

N.Y.C. to Require Metropolis Staff to Be Vaccinated by Mid-September

N.Y.C. to Require City Workers to Be Vaccinated by Mid-September

Attempts to get Americans vaccinated accelerated on Monday when the most populous state and largest city in the United States announced it would require its employees to be vaccinated against the coronavirus or have frequent testing.

All New York City urban workers, including police officers and teachers, as well as all state and local public and private health workers in California, must be vaccinated or tested at least weekly.

The Department of Veterans Affairs also became the first federal agency to order some of its employees vaccinated on Monday.

The mandates are the most dramatic response yet to the sluggish pace of vaccination across the country given the highly contagious Delta variant ripping through communities with low vaccination rates and one by federal health officials as a “pandemic of the unvaccinated.”

According to federal data, only 49 percent of people in the United States are fully vaccinated.

Misinformation and skepticism have haunted the launch of the vaccine, and in recent weeks coronavirus infections and hospital admissions have risen, with the number of new cases per day quadrupling in the past month.

Yet all three indicators are well below last winter’s devastating winter peaks, and vaccines have proven to be very effective protection against the coronavirus. Cities, private employers and other institutions are increasingly turning to mandates to ensure that more people are vaccinated.

Hospitals and health systems like New York-Presbyterian and Trinity Health have announced vaccination mandates and in some cases sparked union protests. The National Football League announced that it would punish teams with players who fail to be vaccinated. Delta Air Lines requires that new employees be vaccinated, but not current employees. And last week, a federal judge ruled that Indiana University could require vaccinations for students and staff.

New York City will require its approximately 340,000 urban workers to be vaccinated against the coronavirus or undergo weekly tests until schools reopen in mid-September, Mayor Bill de Blasio said.

The new California requirement, which will apply to approximately 246,000 state workers and many more healthcare workers, will be implemented by Aug. 23, Governor Gavin Newsom said.

At the VA, one of the largest federal employers and the largest integrated health system in the country, government officials said 115,000 frontline health workers will have to get vaccinated over the next two months. “I’m doing this because it’s the best way to protect our veterans, period,” said Denis McDonough, the veterans affairs secretary, in a telephone interview on Monday.

Eliza Shapiro, Dan Levin and Shawn Hubler contributed to the coverage.

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Politics

In Louisiana, Public Well being Employees Fight Vaccine Misinformation

In Louisiana, Public Health Workers Combat Vaccine Misinformation

Mayor Adrian Perkins, a Shreveport native and graduate of West Point and Harvard Law School who served in the Iraq and Afghanistan wars, was sued last year when he tried one. On Friday, he announced a new advisory urging residents to wear masks indoors, a day after the parish commission voted to postpone action on a mandate.

The falsehoods filling social media feeds dwarf whatever vaccine salesmanship power he has, he said. One complicating phenomenon, he said, was the sharing of misinformation between the Black community, which has a long-held skepticism of vaccines, and a white population that sees the vaccine and virus restrictions as government overreach.

Dr. Whyte framed her struggles getting people vaccinated as part of a broader negligence of public health. She said her department was continually underfunded despite significant rates of syphilis and maternal and infant mortality. It is wrestling with infant vaccinations and the spread of sexually transmitted diseases, and is fighting an increase in drug overdoses.

Her department has 99 employees, but few for preventing and tracking infectious disease. She oversees one epidemiologist and a community health worker supervisor who has no one to supervise. She is starting to see some help from federal funding appropriated during the pandemic: She plans to hire three community health workers soon, a social worker to replace one who retired years ago, and at least one more epidemiologist, most likely with funds provided by the C.D.C. She manages contact tracing with a small team.

As Dr. Whyte explained the city’s challenges in an interview, Calandre Singh, an epidemiologist in Shreveport for the state health department, interrupted with a warning. The funeral for a police deputy in neighboring Webster Parish was set for the next day and was likely to draw hundreds of people indoors, likely without masks — a possible superspreading event. Dr. Whyte and her team consulted with the organizers, who promised to enforce social distancing and a mask requirement. No outbreak has been tied to the event thus far, she said.

Within a month, Dr. Whyte anticipates even knottier debates about the need for masks and vaccines in schools. Federal regulators have not yet authorized the vaccine for the youngest children, but those 12 to 15 have been eligible for the Pfizer-BioNTech vaccine since May.

At times over the last year, Dr. Whyte has felt so emotionally wrung out that she has been tempted to quit. Her otherwise healthy husband, a physician, spent two months on a ventilator last year, an experience she describes vividly in her pitches to community members about vaccination. The exchange with Ms. Peavy at the City Council meeting had left her angry and depleted.

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Health

NYC to require vaccinations or weekly Covid exams for metropolis well being care, hospital staff: Sources

NYC to require vaccinations or weekly Covid tests for city health care, hospital workers: Sources

Bill de Blasio, Mayor of New York.

Jeenah moon | Reuters

New York City will require all employees in city health facilities and hospitals to be vaccinated or have weekly Covid tests, with positivity rates continuing to rise as the Delta variant spreads, City Hall officials told NBC New York.

Mayor Bill de Blasio will release details on the request Wednesday morning, including those that go with it, sources said. The plan targets the unvaccinated third of all healthcare and hospital workers in the city.

“It’s about the safety of a health system,” said Bill Neidhardt, the mayor’s press officer.

This is a developing story. Please check again for updates.

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Health

Biden’s new Covid vaccine push focuses on employees, college students, delta variant

Biden's new Covid vaccine push focuses on workers, students, delta variant

President Joe Biden on Tuesday once again pushed for all eligible Americans to get Covid vaccinations, stressing the importance of being protected against the highly transmissible delta variant.

Despite the U.S. being on track to hit 160 million people fully vaccinated in the coming days, Biden said, millions remain unvaccinated against Covid, “and because of that, their communities are at risk, their friends are at risk, the people they care about are at risk.”

“This is an even bigger concern because of the delta variant,” the president said.

“It seems to me, this should cause everybody to think twice,” Biden said. But “the good news is that our vaccinations are highly effective,” including against the delta variant, he added.

Biden detailed his administration’s latest push to increase vaccination rates two days after failing to reach his Covid vaccination goal for the Fourth of July.

His team is now training its focus on boosting vaccination availability in places such as doctor’s offices and work settings. They are also ramping up efforts to get vaccines to pediatricians and other child health-care providers, Biden said, with the goal of getting more adolescents ages 12 to 18 inoculated before they head back to school in the fall.

The team also aims to expand mobile clinic efforts and will work to refine door-to-door outreach efforts to get information about vaccines to Americans who have yet to get their shots, the president said.

“Our focus now is on doubling down on our efforts” to get more people vaccinated, White House press secretary Jen Psaki said at a briefing earlier Tuesday afternoon.

“There’s still more work to be done,” Psaki said, before noting that “the vast, vast majority of people are safe from the virus” once they are vaccinated.

“If you are not vaccinated, you are not. That is also a message that we’re going to continue to clearly communicate,” she said.

Biden in his speech at the White House highlighted that nearly 160 million people in the U.S. will be fully vaccinated by the end of this week.

There are currently 157 million people in the U.S. who are fully vaccinated, which is less than half of the total population, according to Centers for Disease Control and Prevention data. Among people in the U.S. ages 18 and up, the CDC’s percentage for those fully vaccinated rises to 58.2%, and it stands at 78.7% among those ages 65 or older, who face the greatest risk from Covid.

Biden in May had set the goal of having 70% of American adults vaccinated with at least one shot by Independence Day. On the holiday itself, roughly 67% of U.S. adults had received at least one dose, according to the CDC.

“The bottom line is, the virus is on the run and America’s coming back, coming back together,” Biden said. It’s “one of the greatest achievements in American history,” he said, “but our fight against the virus is not over.”

The delta variant, which was first observed in India, has now spread to at least 96 countries, including the U.S., according to the World Health Organization.

The variant, which the WHO says is about 55% more transmissible than another strain of the virus found in the United Kingdom, has threatened to derail some countries’ plans to lift social-distancing restrictions. About 25% of all new reported U.S. Covid cases are of the delta variant, according to the CDC, which predicts it will become the dominant variant.

White House chief medical advisor Dr. Anthony Fauci last month called delta the “greatest threat” to the nation’s fight against the pandemic.

Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, told CNBC last week that while the delta variant may cause an increase in cases, he doesn’t expect a massive surge in infections on the scale of those seen at earlier points in the pandemic.

“I don’t think it’s going to be a raging epidemic across the country like we saw last winter. I think that there’s going to be pockets of spread, and prevalence overall is going to pick up,” Gottlieb said on “Squawk Box.” 

The White House is deploying Covid-19 response teams across the nation focused on combatting the variant. The teams, composed of officials from the CDC and other federal agencies, will work with communities at higher risk of experiencing outbreaks.

There are still about 1,000 counties in the U.S. that have vaccination coverage of less than 30%, CDC Director Dr. Rochelle Walensky told reporters last week.

The counties are mostly located in the Southeast and Midwest and the agency is already seeing increasing rates of disease in these places due to further spread of the delta variant, she said.

— CNBC’s Ylan Mui contributed to this report.

Disclosure: Scott Gottlieb is a CNBC contributor and is a member of the boards of Pfizer, genetic testing start-up Tempus, health-care tech company Aetion Inc. and biotech company Illumina. He also serves as co-chair of Norwegian Cruise Line Holdings’ and Royal Caribbean’s “Healthy Sail Panel.”

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Health

Stress and Burnout Nonetheless Plague Entrance-Line Well being Care Staff as Pandemic Eases

Stress and Burnout Still Plague Front-Line Health Care Workers as Pandemic Eases

The interactions she has with Covid patients, many of them African American, often leave her shaken. She recalled a recent exchange with a woman in her 40s who was struggling to breathe. When Dr. Chopra asked whether she had been vaccinated, the woman shook her head defiantly between gasps, insisting that the vaccines were more harmful than the virus. The patient later died.

“It leaves me angry, frustrated and sad,” Dr. Chopra said. “These nonbelievers will never accept our viewpoint, and the result is that they are putting others at risk and overwhelming the health care system.”

The emotional fallout of the last 16 months takes many forms, including a spate of early retirements and suicides among health care providers. Dr. Mark Rosenberg, an emergency room doctor at St. Joseph’s University Medical Center in Paterson, N.J., a predominantly working class, immigrant community that was hit hard by the pandemic, sees the toll all around him.

He recently found himself comforting a fellow doctor who blamed himself for infecting his in-laws. They died four days apart. “He just can’t get past the guilt,” Dr. Rosenberg said.

At a graduation party for the hospital’s residents two weeks ago — the emergency department’s first social gathering in nearly two years — the DJ read the room and decided not to play any music, Dr. Rosenberg said. “People in my department usually love to dance but everyone just wanted to talk, catch up and get a hug.”

Dr. Rosenberg, who is also president of the American College of Emergency Physicians, is processing his own losses. They include his friend, Dr. Lorna Breen, who took her own life in the first months of the pandemic and whose death has inspired federal legislation that seeks to address suicide and burnout among health care professionals.

Most of the suffering goes unseen or unacknowledged. Dr. Rosenberg compared the hidden trauma to what his father, a World War II veteran, experienced after the hostilities ended.