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More than half of Black-owned businesses may not survive COVID-19

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One report found 41 percent of Black-owned businesses have been shuttered by COVID-19 compared to just 17 percent of white-owned businesses.

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Black defendant argues masks at trial could prejudice jury

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A Black man who is going to trial on a murder charge believes jurors could be prejudiced against him if he is forced to wear a mask BANGOR, Maine -- A Black man who is going to trial on a murder charge believes jurors could be prejudiced against him if he is forced to wear a mask.

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Asian woman allegedly attacked in New York subway station for wearing protective mask

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The victim was allegedly called “diseased b****” before being attacked by a man at Grand Street station in an assault potentially linked to fear of the coronavirus.

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COVID-19: Do Face Masks Work To Prevent Its Spread? Here's What The Experts Say | TIME

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Virginia Ali, co-owner of Ben's Chili Bowl, one of the many black owned businesses on U Street, sits ... [+]
AFP via Getty Images

Nearly half of Black small businesses had been wiped out by the end of April as the pandemic ravaged minority communities disproportionately, according to a report from the New York Fed.

Black-owned businesses were more than twice as likely to shutter as their white counterparts, the report found.

"Nationally representative data on small businesses indicate that the number of active business owners fell by 22% from February to April 2020-the largest drop on record," the report said.

"Black businesses experienced the most acute decline, with a 41% drop. Latinx business owners fell by 32% and Asian business owners dropped by 26%."

That figure has likely increased substantially as the pandemic has dragged on with a resurgence of cases this summer that has taken the country's number of infections to a world record of over 5 million.

The number of white-owned small firms, in contrast, fell just 17%.

Why have Black businesses been twice as likely to close as their white counterparts, just as Black unemployment is often double that for whites?

It's institutional racism, obviously-but the New York Fed report analyzes how that manifests itself in banking relationships and lending decisions, in cumulative, generational ways.

"Volumes of COVID-19 cases coincide with Black-owned business locations: two-thirds of counties with high levels of Black business activity pre-COVID-19 are in the top 50 COVID-affected areas," the New York Fed said.

In the meantime, the coverage gaps in the Paycheck Protection Program left many Black-owned businesses out of the government relief bonanza.

"These loans reached only 20% of eligible firms in states with the highest densities of Black-owned firms, and in counties with the densest Black-owned business activity, coverage rates were typically lower than 20%," the report showed.

At the same time, Black-owned firms, already smarting from a Great Recession that hurt them badly, already entered the crisis with "weaker cash positions, weaker bank relationships, and preexisting funding gaps."

"Even the healthiest Black firms were financially disadvantaged at the onset of COVID-19," said the report.

Follow me on Twitter. Check out my website or some of my other work here.

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The Covid-19 Crisis Has Wiped Out Nearly Half Of Black Small Businesses

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Nearly half of Black small businesses had been wiped out by the end of April as the pandemic ravaged minority communities disproportionately, according to a report from the New York Fed. Black-owned businesses were more than twice as likely to shutter as their white counterparts, the report found.

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Rochester businesses question ‘orange zone’ costs, benefit for takeout only

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ROCHESTER, N.Y. (WROC) — Alex Tahou of Nick Tahou Hots, like many restaurants in Rochester, is open, but just for takeout. “It’s slow anyway, but it’s worse now with the orange z…

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The pandemic is taking a toll on teens' mental health

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Note: This brief was updated on March 20, 2023 to incorporate the latest available data.

Concerns about mental health and substance use remain elevated three years after the onset of the COVID-19 pandemic, with 90% of U.S. adults believing that the country is facing a mental health crisis, according to a recent KFF/CNN survey. The pandemic has affected the public's mental health and well-being in a variety of ways, including through isolation and loneliness, job loss and financial instability, and illness and grief.

Over the course of the pandemic, many adults reported symptoms consistent with anxiety and depression, with approximately four in ten adults reporting these symptoms by early 2021, before declining to approximately three in ten adults as the pandemic continued (Figure 1). Additionally, drug overdose deaths have sharply increased - largely due to fentanyl - and after a brief period of decline, suicide deaths are once again on the rise. These negative mental health and substance use outcomes have disproportionately affected some populations, particularly communities of color and youth. As the end of the declaration of the public health emergency nears - on May 11, 2023 - many people continue to grapple with worsened mental health and well-being and face barriers to care.

This brief explores mental health and substance use during, and prior to, the COVID-19 pandemic. We highlight populations that were more likely to experience worse mental health and substance use outcomes during the pandemic and discuss some innovations in the delivery of services. We analyze and present findings using the most recent data available at the time of this publication - including the Household Pulse Survey and the CDC WONDER database. Key takeaways include:

Symptoms of anxiety and depression increased during the pandemic and are more pronounced among individuals experiencing household job loss, young adults, and women. Adolescent females have also experienced increased feelings of hopelessness and sadness compared to their male peers.

Deaths due to drug overdose increased sharply across the total population coinciding with the pandemic - and more than doubled among adolescents. Drug overdose death rates are highest among American Indian and Alaska Native people and Black people.

Alcohol-induced death rates increased substantially during the pandemic, with rates increasing the fastest among people of color and people living in rural areas.

After briefly decreasing, suicide deaths are on the rise again as of 2021. From 2019 to 2021, many communities of color experienced a larger growth in suicide death rates compared to their White counterparts. Additionally, self-harm and suicidal ideation has increased faster among adolescent females compared to their male peers.

Several changes have been implemented in the delivery of mental health and substance use services since the onset of the pandemic, including the utilization of telehealth, steps to improve access to treatment for opioid use disorders, expansion of school-based mental health care, and the rollout of the 988 crisis line. As the public health emergency declaration comes to an end, it is possible that some of these changes will be interrupted.

Prevalence of Mental Illness and Substance Use During the Pandemic

Anxiety and depression

The pandemic was associated with a high prevalence of anxiety and depression symptoms in adults. Research suggests that these symptoms increased during the pandemic, but the extent of this increase is unclear. Throughout the pandemic, symptoms of anxiety and depression have been more pronounced among several populations.

For example, individuals experiencing household job loss were more likely than their counterparts to report symptoms of anxiety and/or depression (53% vs. 30%) in February 2023 (Figure 2). Job loss and unemployment - which have long been associated with adverse mental health outcomes - increased substantially early on in the pandemic.

Fifty percent of young adults (ages 18-24) reported anxiety and depression symptoms in 2023, making them more likely than older adults to experience mental health symptoms (Figure 2). Young adults have experienced a number of pandemic-related consequences - such as closures of universities, transitioning to remote work, and loss of income or employment - that may contribute to poor mental health. Additionally, young adults in college settings may encounter increased difficulty accessing treatment.

Symptoms of anxiety and/or depression were also elevated among women (36%) compared to men (28%) in February 2023 (Figure 2). Even before the pandemic, women were more likely than men to report mental health disorders, including serious mental illness.

Concerns about youth mental health further increased with the onset of the pandemic and the recent uptick in gun violence. In a recent KFF/CNN survey, roughly half of parents (47%) said the pandemic had a negative impact on their child's mental health, including 17% who said it had a "major negative impact". Poor mental health has been more pronounced among adolescent females in particular. As shown in Figure 3, the gap in the share of adolescent females and males reporting feelings of hopelessness and sadness - symptoms indicative of depressive disorder - widened from 2019 (47% vs. 27%, respectively) to 2021 (57% vs. 29%, respectively). Many female adolescents also reported adverse experiences in 2021, which can negatively impact mental health.

Substance use and deaths

The pandemic has coincided with an increase in substance use and increased death rates due to substances. In 2021, there were over 106,600 deaths due to drug overdose in the U.S. - the highest on record. This spike in deaths has primarily been driven by substances laced with synthetic opioids, including illicitly manufactured fentanyl.

Further, the overall drug overdose death rate rose by 50% during the pandemic (Figure 4), but varied across states. While drug overdose death rates increased across all racial and ethnic groups, the increases were larger for people of color compared to White people. White people continue to account for the largest share of deaths due to drug overdose per year, but people of color are accounting for a growing share of these deaths over time. In 2021, the highest drug overdose death rates were among American Indian Alaska Native (AIAN) people (56.6 per 100,000), Black people (44.2 per 100,000), and White people (36.8 per 100,000) (Figure 4). Differences in drug overdose deaths by sex were also exacerbated during the pandemic. As shown in Figure 4, the gap in the drug overdose death rates between males and females increased from 2019 (29.6 vs. 13.7 per 100,000, respectively) to 2021 (45.1 vs. 19.6 per 100,000, respectively).

Research suggests that substance use among adolescents has declined, yet drug overdose deaths have sharply increased among this population, primarily due to fentanyl-laced substances. Among adolescents, drug overdose deaths have more than doubled from 2019 (282 deaths) to 2021 (637 deaths) following a period of relative stability. Male, Black, and Hispanic youth have experienced the highest increases in deaths due to drug overdose.

During the pandemic, excessive drinking increased along with alcohol-induced deaths. Alcohol-induced death rates increased by 38% during the pandemic, with rates the highest and increasing the fastest among AIAN people. AIAN people died of alcohol-induced causes at a rate of 91.7 per 100,000 in 2021, six times more than the next highest group - Hispanic people at a rate of 13.6. Black people also experienced significant increases in alcohol-induced deaths during COVID, with rates increasing more than 45% (Figure 5). Both rural and metropolitan areas experienced an increase in alcohol-induced deaths during the pandemic, but rural areas saw the largest increase (46% increase compared to 36%).

Suicidal ideation and deaths

Concerns about suicidal ideation and suicide deaths have also grown during the pandemic. Notably, self-harm and suicidal ideation has increased among adolescent females. Thirty percent of adolescent females seriously considered attempting suicide in 2021 compared to 14% of their male peers (Figure 6). Other analyses found that as the pandemic progressed, emergency department visits for suicide attempts increased among adolescents, primarily driven by females.

Suicide deaths in the U.S. began to increase in 2021 after briefly slowing in 2019 and 2020, although some research suggests that some suicides may be misclassified as drug overdose deaths since it can be difficult to determine whether drug overdoses are intentional. From 2019 to 2021, many communities of color experienced a larger growth in suicide death rates compared to their White counterparts. In 2021, suicide deaths by firearm accounted for more than half ( 55%) of all suicides in the U.S., but varied greatly across states.

The pandemic has also raised concerns about mental illness, suicide, and substance use among other populations. Essential workers and people with chronic health conditions may have experienced worsened mental health due to increased risk of contracting or becoming severely ill from COVID-19. Many of these individuals, particularly those with chronic conditions, were already at-risk of experiencing poor mental health outcomes prior to the pandemic. LBGT+ people have historically faced mental health problems at higher rates than their non-LGBT+ peers. The pandemic has continued to negatively impact LBGT+ people's mental health in disproportionate ways. In addition, people experiencing prolonged COVID-19 symptoms, or long COVID, may be more likely to develop new mental health conditions or to experience worsening of existing ones.

Changes in the Delivery of Mental Health and Substance Use Disorder Services

Leading up to the pandemic, many people faced barriers accessing mental health and substance use disorder services for reasons including costs, not knowing where to obtain care, limited provider options, and low rates of insurance acceptance. Young adults, Black adults, men, and uninsured people were less likely to receive services compared to their peers.

In recent years, access to care barriers may have worsened due to pandemic disruptions and closures, workforce shortages, and increased demand for services. In response to growing need, some policies and strategies were implemented to address access challenges, such as growth of telehealth, improved access to opioid use disorder treatment, the expansion of school-based mental health services, and the rollout of 988; however, challenges remain.

The delivery of mental health and substance use disorder services via telehealth grew sharply during the pandemic. By 2021, nearly 40% of all mental health and substance use disorder outpatient visits were delivered through telehealth. These behavioral health services via telehealth have also been more utilized in rural areas than urban areas during the pandemic. This underscores the role telehealth can play in improving access to behavioral health services in rural areas, which often face additional provider and resource shortages. Further, community health centers - which serve low-income and medically underserved communities, including communities of color and those in rural areas - experienced a large increase in behavioral health visits in 2021, largely driven by telehealth. During the pandemic, many state Medicaid programs expanded coverage of behavioral health telehealth services. This includes broadening the range of behavioral health services offered virtually and allowing for more provider types to be reimbursed for telehealth services. Many state Medicaid programs reported that telehealth has helped maintain and expand access to behavioral services during the pandemic. Some private payers have also improved coverage for mental health and substance use services by removing pre-pandemic telehealth coverage restrictions. Although telehealth can broaden access to care, in-person care may be necessary or preferred for some or for those experiencing challenges with technology and digital literacy.

As opioid-related overdose deaths have sharply increased, measures to improve access to treatment have been implemented. Following the onset of the pandemic, the federal government allowed for new flexibilities in opioid use disorder (OUD) treatment to ease access barriers, for example allowing for take-home methadone doses and covering telehealth treatment, and the Biden administration has proposed making these flexibilities permanent. Further, the 2023 Consolidated Appropriations Act eliminated the X-waiver requirement for prescribing buprenorphine, which substantially increases the number of providers who are authorized to prescribe buprenorphine to treat OUD. Voluntary guidelines for providers have also been issued to help reduce opioid overprescribing and misuse. At the same time, the Drug Enforcement Agency recently proposed returning to previous rules that required in-person visits before prescribing controlled substances to patients via telehealth, though there are some exceptions.

In response to growing mental health concerns among youth, integration of mental health services in school-based settings became a priority. Recent legislation aims to expand mental health care in schools - a setting that is easily accessible by children and adolescents. Specifically, legislation provides funding to expand and train mental health providers in schools; implement suicide, drug, and violence prevention programs; and provide trauma support services, among others. Further, recognizing Medicaid's importance in covering and financing behavioral health care for children, CMS is now required to provide updated guidance on how to support and expand school-based behavioral health services. The recently passed Consolidated Appropriations Act (CAA) continues to build on prior pandemic-era legislation that promotes access to behavioral health care for children. For example, to ensure more stable coverage for low-income children the CAA requires states to provide 12 months of continuous eligibility for children in Medicaid and CHIP.

An easy-to-remember number for the suicide and behavioral health crisis hotline, 988, was launched in 2022. On July 16, 2022, the federally mandated crisis number, 988, became available to all landline and cell phone users, providing a single three-digit number to access a network of over 200 local and state funded crisis centers where those in need may receive crisis counseling, resources and referrals. After 988 implementation, national answer rates increased alongside increases in call volume. Long-term sustainable funding of local 988 crisis call centers remains uncertain in many states. In addition to 988, some states are developing behavioral health crisis response systems, such as mobile crisis or crisis stabilization units, which will enable a specialized behavioral health response for behavioral health crises that require intervention. The CAA included provisions aimed at strengthening and evaluating 988 and the developing behavioral health crisis continuum.

Despite steps taken to improve the delivery of mental health and substance use services, challenges remain. Provider workforce challenges are widespread, with nearly half of the U.S. population ( 47%) living in a mental health workforce shortage area. Shortages may contribute to access challenges and contribute to increases in psychiatric boarding in emergency rooms. Additionally, provider network directories are often outdated, further contributing to access challenges. While recent legislation has taken steps in response - including funding for at least 100 new psychiatry residency positions, grants for mental health peer support providers, and improvements to provider directories through the CAA - these are relatively small measures in the face of big access challenges. The lack of a diverse mental health care workforce may contribute to limited mental health treatment among people of color. Separately, even with insurance coverage, individuals with mental health needs face challenges accessing care. While Medicaid enrollees have limited out-of-pocket costs there is variation in who is eligible and the range of services covered across states. Additionally, the end of Medicaid's continuous enrollment provision - on March 31, 2023 - could result in millions of disenrollments over the next year which could disrupt access to behavioral health services. Among private insurance enrollees, enrollees, with mental illness face high out-of-pocket costs; and these costs vary substantially across states. While most adults with mental illness have private insurance, rates of mental illness and substance use disorders are most prevalent among nonelderly adults with Medicaid.

Looking Ahead

Although steps have been taken to address negative mental health impacts stemming from the pandemic, mental health and substance use concerns remain elevated. Heightened racism and increasing gun violence may also contribute to poor mental health outcomes. Further, negative mental health impacts have been more pronounced among several populations, including communities of color, young adults and children - populations which have historically experienced increased barriers to care. Additionally, despite renewed discussions and new federal grants for state parity enforcement under the CAA, challenges with mental health parity persist - including lack of clarity on specific protections, low compliance rates, and slow federal enforcement. Finally, the COVID-19 public health emergency will end in May 2023, which may at least partially unravel steps taken toward delivering mental health services via telehealth and improving access to substance use disorder services.

History has shown that the mental health impact of disasters outlasts the physical impact, suggesting today's elevated mental health needs will continue well beyond the coronavirus outbreak itself. As we emerge from the COVID-19 pandemic and the federal public health emergency draws to an end, it will be important to consider how the increased need for mental health and substance use services may persist long term, even as new cases and deaths due to COVID-19 hopefully subside.

This work was supported in part by Well Being Trust. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.

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The Implications of COVID-19 for Mental Health and Substance Use | KFF

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This brief explores mental health and substance use during, and prior to, the COVID-19 pandemic. We highlight populations that were more likely to experience worse mental health and substance use outcomes during the pandemic and discuss some innovations in the delivery of services.

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Why Black and Latino communities are hesitant to take COVID-19 vaccine | GMA

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Chicago COVID-19 Statistics: African American Community Hit Hard By The Coronavirus

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One reason why coronavirus hits Black people the hardest

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How and why COVID-19 is disproportionately affecting Latinos

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Centers for Disease Control and Prevention

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Risk for COVID-19 Infection, Hospitalization, and Death By Race/Ethnicity

Race and ethnicity are risk markers for other underlying conditions that affect health including socioeconomic status, access to health care, and exposure to the virus related to occupation, e.g., frontline, essential, and critical infrastructure workers.

How to slow the spread of COVID-19

¹ Data Source: Data reported by state and territorial jurisdictions (accessed 03/10/2021). Numbers are ratios of age-adjusted rates standardized to the 2019 US intercensal population estimate. Calculations use only the 53% of case reports that have race and ethnicity data available; this can result in inaccurate estimates of the relative risk among groups.

² Data source: COVID-NET ( https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covid-net/purpose-methods.html , accessed March 1, 2020, through February 27, 2021). Numbers are ratios of age-adjusted rates standardized to the 2019 US standard COVID-NET catchment population.

³ Data source: NCHS provisional death counts ( https://data.cdc.gov/NCHS/Deaths-involving-coronavirus-disease-2019-COVID-19/ks3g-spdg, data through March 6, 2021). Numbers are ratios of age-adjusted rates standardized to the 2019 US intercensal population estimate.

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Risk for COVID-19 Infection, Hospitalization, and Death By Race/Ethnicity Race and ethnicity are risk markers for other underlying conditions that affect health including socioeconomic status, access to health care, and exposure to the virus related to occupation, e.g., frontline, essential, and critical infrastructure workers.

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Ibram X Kendi: Stop blaming Black people for dying of the coronavirus
For centuries, Black people have spoken about the struggles we face, pointing to root causes like poverty, housing segregation, unemployment, and environmental degradation. And for centuries, those concerns have largely gone ignored. The same thing has happened with the pandemic. Long before any data confirmed our worst fears, Black people knew that the coronavirus would disproportionately devastate our already vulnerable communities. Driven by that foresight, I launched a newsletter, Coronavirus News for Black Folks, in early April. As the death toll crept up and up, the brutality of American racism became even clearer. Black people with clear symptoms of COVID-19 were turned away from receiving tests, sometimes on multiple occasions, only to die at home. Black families were entire ly destroyed as members died within weeks and days of one another. By the end of July, twice as many Black children as white children had died of COVID-19: In Michigan, the first child to die from the virus was a 5-year-old Black girl who spent two weeks on a ventilator.

While a large swath of Americans, myself included, are able to safely stay at home, Black people are disproportionately essential workers, who have no choice but to brave the pandemic and head to work. Many have lost their lives working jobs they felt were unsafe and underpaid. "Our white executive director has not been in the office for the past six weeks, has not asked how any of us are holding up, and has not emailed us to say thank you," a 20-something security guard told me in April. "I feel betrayed. I used to love my position and the people I work with. Now I'm resentful of the protection some people are afforded while others, like myself, are sent out to the front lines." (The security guard was granted anonymity for fear of professional reprisal.)

As if the havoc wreaked by the virus weren't already bad enough, the racial disparities will persist as the U.S. works its way out of the pandemic. Just as one in three Black people knows someone directly who has died from COVID-19, one in three Black people has said they will not get the vaccine, according to a recent Kaiser Family Foundation study. Clinical trials have shown that the vaccine is safe and effective, but a long-standing mistrust in America's predominantly white medical institutions is only deepening, and so the number of Black lives lost to this virus will continue to rise, even though we now have a way to end it.

Thankfully, moments of Black kinship still emerge even during all the suffering. The same week that marked more than 50,000 Black deaths saw a horizon of hope. Sandra Lindsay, a Jamaican-born nurse in Queens, New York, became the first person to be vaccinated in the United States, after receiving the shot from Michelle Chester, also a Black woman. Even a pandemic can't break the resilient bond of Black America.

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The Virus Is Showing Black People What They Knew All Along

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Ibram X Kendi: Stop blaming Black people for dying of the coronavirus For centuries, Black people have spoken about the struggles we face, pointing to root causes like poverty, housing segregation, unemployment, and environmental degradation. And for centuries, those concerns have largely gone ignored. The same thing has happened with the pandemic.

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This week, Illinois passed the grim milestone of 10,000 deaths from COVID-19.

On Thursday, Chicago's public health director Dr. Allison Arwady issued a stern warning about the state of the virus.

"There is not a single person in Chicago who is not at some level of increased risk from COVID, because our outbreak is surging in ways we have never before seen," Arwady said.

But COVID-19 continues to have a disproportionate impact on the Chicago area's Latino communities.

"What we're seeing is there has been a continued increase in primarily communities of color. And specifically the Latino community has infection rates that are triple the rates that we see among our white neighbors, and double the rates we see among our Black neighbors," said Dr. Marina Del Rios, director of social emergency medicine at the University of Illinois hospital in Chicago.
WTTW News is renewing its commitment to covering COVID-19. Find our full coverage of the pandemic here.
In the late spring and early summer, coronavirus cases among Latinos in Chicago skyrocketed, making up for around half of the city's total cases.

Since then, the city and state have expanded testing facilities and resources, including several pop-up testing sites in predominantly Latino communities.

But as the weather gets colder, Del Rios says she'd like to see more investment in long-term, "weatherized" testing facilities to maintain adequate testing as infections continue to surge.

"A lot of the testing that has been done in our communities has been mobile testing sites, which are great, but as the temperatures drop, we need to make sure people are safe when they go to get the test, and they have locations that are readily available anytime of the week to get tested in their own communities," she said.

And for people and families battling the virus, associated health care costs continue to translate into economic ones, and vice versa.

Del Rios says she's seeing COVID-19 patients who are waiting to seek medical care for far too long - in some cases because they don't have health insurance.

"A lot of folks have lost their jobs, and by losing their jobs they've lost health care coverage, in addition to that a lot of Latinos who may not be U.S. citizens don't qualify for a lot of the federal aid relief we have," Del Rios said. "So my concern is that because of the lack of health coverage people are waiting too late to seek medical care, and what that means is when we see them, it's at a more complicated stage of the illness."

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How the COVID-19 Surge is Impacting Chicago's Latino Communities

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This week, Illinois passed the grim milestone of 10,000 deaths from COVID-19. On Thursday, Chicago's public health director Dr. Allison Arwady issued a stern warning about the state of the virus. "There is not a single person in Chicago who is not at some level of increased risk from COVID, because our outbreak is surging in ways we have never before seen," Arwady said.

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The surviving family of Christian Robbins - father Ted, mother Sarah, sister Sophia and brother Ethan - try to celebrate his life daily in Richland, Wash. (Leah Nash for The Washington Post)

He visits the grave every day.

And every day, Ted Robbins asks himself the questions that have plagued him since the night his 16-year-old son killed himself, one month into the pandemic.

What if Robbins hadn't canceled their family vacation? What if their school hadn't closed down? What if his son Christian could have leaned on his best friends through this rough patch, as he had in the past?

But one question haunts him the most: "What if the pandemic never happened - would my son still be alive?"

As the pandemic continues into the holiday season, rates of anxiety, depression, and suicidal ideation are rising. (The Washington Post)

Since the coronavirus arrived, depression and anxiety in America have become rampant. Federal surveys show that 40 percent of Americans are now grappling with at least one mental health or drug-related problem. But young adults have been hit harder than any other age group, with 75 percent struggling.

Even more alarming, when the Centers for Disease Control and Prevention recently asked young adults if they had thought about killing themselves in the past 30 days, 1 in 4 said they had.

America's system for monitoring suicides is so broken and slow that experts won't know until roughly two years after the pandemic whether suicides have risen nationally. But coroners and medical examiners are already seeing troubling signs.

In Arizona's Pima County, officials have sent two health bulletins alerting doctors and hospitals to spikes in suicides. In Oregon's Columbia County, the number of suicides by summer had already surpassed last year's total. In the sprawling Chicago suburbs, DuPage County has reported a 23 percent rise compared with last year. And in the city itself, the number of suicides among African Americans has far surpassed the total for 2019, even as officials struggle to understand whether the deaths are being driven by the pandemic, racial unrest or both. What has shocked medical examiners in Chicago is the age range - from a 57-year-old deputy police chief to a 9-year-old child.

Since Christian's death, many parents have called his father Robbins for advice, and several of Christian's classmates have confided about their own struggles with suicidal thoughts.

On a recent visit to the cemetery in Richland, Wash., where Christian is buried, Robbins found two teenage girls he recognized from Christian's funeral sitting at his grave. One was sobbing.

The girl said she, too, suffered from depression and was wrestling with suicidal thoughts. She had called a hotline, but the local crisis center had only 16 psychiatric beds for teens and all were full. She was put on a waiting list.

"You don't know how bad it is right now," she told him. "Almost every one of my friends has thought about it."

A broken system

From the moment the coronavirus arrived, it has exposed and deepened every crack in America's foundation. But when it comes to suicide prevention, the country's system was already falling apart.

Even as suicide rates have fallen globally, they have climbed every year in the United States since 1999, increasing 35 percent in the past two decades. Still, funding and prevention efforts have continued to lag far behind those for all other leading causes of death.

Then came the pandemic.

Experts warned that the toxic mix of isolation and economic devastation could generate a wave of suicides, but those dire predictions have resulted in little action.

"Sometimes, I just want to grab people and shake them awake," said Robbins, as he walked up the well-worn cemetery path on a recent Friday to the shiny bronze marker bearing his son's name.

He said Christian had been struggling for months with depression and early symptoms of bipolar disorder. During a particularly bad period last year, they had rushed to a crisis center - afraid Christian might hurt himself. So Robbins was vigilant about how the pandemic might affect his son. "I could see the storm coming," he said.

Robbins listened from his home office as Christian talked and laughed with his siblings, monitoring changes in his mood. They played games together, watched movies, talked on long drives. Every night, he wrapped his son in a fierce bear hug and told him, "I love you."

"I remember thinking to myself that Friday before he took his life, 'This covid situation is bad, but it's going to be okay. He's going to be okay,' " Robbins said.

He discovered only later from notes on Christian's laptop just how badly the pandemic was fraying his son's mind. Because of the virus, Christian could no longer hang out every weekend with his three best friends, who had helped him through past bouts of depression. His son told him that a voice inside was whispering how worthless he was, how he was hated by everyone.

Throughout the pandemic, Robbins pointed out, President Trump and conservatives have repeatedly cited fears of suicide as they pushed to reopen businesses. But they and Democrats have done little about it, even as prevention groups begged for help. Since the crisis began, $175 billion in emergency funding has been allocated to hospitals and other medical facilities, but less than 1 percent of that has gone specifically to mental health and substance abuse services.

Now winter is approaching, bringing another wave of infections, another surge of fear, uncertainty and devastation.

"Why aren't school districts reaching out to students they know have problems?" Robbins said. "Why aren't we, as a country, doing anything about this part of the pandemic that's killing people we love?"

'Stuck in life'

What makes this moment especially perilous for young people is that their suicide rates were already rising faster than those of any other group. Between 2007 and 2018, suicides increased 56 percent among teens and young adults.

The pandemic could accelerate that trend. A federal study in August on the coronavirus's mental impact found that the youngest people surveyed had the highest rates of increased anxiety, depression, substance use and other mental health problems.

"At that age, you're looking for your place in the world, searching for your identity," said Jonathan Singer, a suicide researcher and president of the American Association of Suicidology. "To be stuck in life right now, not able to get a job, not able to plan and see a way forward - to be home and feeling like you're a burden - it's challenging."

Brad Hunstable was working in his home office April 17 when his younger daughter ran in yelling that her 12-year-old brother had hurt himself.

Hayden had never struggled with depression or mental health problems, Hunstable said. But just before the pandemic, his son - an avid player of the video game Fortnite - had tossed his controller and accidentally broken the family's flat-screen TV.

At the time, Hunstable and his wife told Hayden that he would have to earn a new monitor by doing extra chores and being kind to his 8-year-old sister.

For weeks, their son held up his end. "I was so proud of him. He was learning, evolving. He was becoming a man," Hunstable said.

But on that April afternoon, Hunstable later found out, his son had broken the replacement TV and become furious with himself.

It happened just four days before Hayden's 13th birthday. Hayden had planned to celebrate on Fortnite. After schools shut down, the online game became his main connection with friends

"I think he felt like he ruined his birthday," Hunstable said. "You combine that with not seeing others, not being able to do the sports he loved and the stress of everything going on. It was a perfect storm that led to this one impulsive act, an act he couldn't take back."

Coming to grips with that reality has been hard. "I was so mad one day, I took a baseball bat to a tree and just smashed it for hours," said Hunstable, who lives in Fort Worth.

When people ask about his son, he tells them, "Covid killed my son but not the way you think."

In recent weeks, Hunstable has urged other parents to talk openly to their children about mental health. He created a nonprofit to push schools to do so, too.

Research shows that even modest interventions - such as asking people if they're okay - can reduce suicides.

Large-scale studies found that when hospitals asked emergency room patients if they had had suicidal thoughts and then followed up, it cut the risk of suicidal behavior by half. Adding such screening questions during the pandemic - at schools, primary-care offices and hospitals - could save thousands, experts say.

Lowering barriers to mental health care would also reduce deaths, experts say. Much of the problem, however, lies in the unequal way America treats mental health compared with physical illnesses.

"Why isn't there a mental health leader on the coronavirus task force?" said Vaile Wright, clinical research director at the American Psychological Association. "Our physical and mental health are completely intertwined, and we need to treat them that way."

One of the few actions undertaken by U.S. leaders this fall - after a decade of discussion - was to authorize a three-digit number, similar to 911, for people to call during a mental crisis. But the 988 number won't take effect until July 2022. And crisis centers in charge of those calls are facing severe cuts because the pandemic has decimated state and local budgets.

A brewing storm

Suicidal thoughts are not the only sign of a crisis.

Other maladies bubble up first: alcohol consumption, anxiety, depression, unemployment, homelessness, domestic violence, post-traumatic stress disorder, drug use. All of them elevate suicide risk.

Experts compare the effect to a storm that takes time to build and crest but has a tragically long tail once it hits. Because of that, it could take years for the full mental impact of this pandemic to play out.

In the years after the 1918 flu pandemic, suicides appeared to rise, but records from that era are sparse and unreliable. Studies of natural disasters have been similarly inconclusive.

Immediately after a crisis, suicides sometimes decrease briefly because of a "pulling-together effect." In the first six months after the Sept. 11, 2001, terrorist attacks, suicide rates among New Yorkers declined.

A similar phenomenon was evident in some regions this spring. Connecticut - one of the few states that maintain real-time suicide data - registered a 20 percent drop during the first half of this year. Rates in Massachusetts have been relatively flat.

But countries that track suicides more closely than the United States said they are starting to see sharp upticks. Japan said suicides in August increased 15 percent. Nepal has similarly reported increases. Thailand recently said its suicides have risen 22 percent compared with the year before. Thailand's Health Ministry has directed police to monitor social media to find people in distress and is setting up a reporting system to get suicide statistics faster. "We definitely cannot wait," a ministry spokesman said.

For a glimpse at what lies ahead for the United States, most experts say, the most applicable data comes from past economic disasters.

Studies have established strong correlations between suicide and financial pressures such as unemployment, eviction and displacement - all of which have risen sharply during the pandemic.

In the two years after the 2008 Great Recession, America's suicide rate increased four times as fast as in the eight years before.

"But we can't and shouldn't treat a rise in suicide as inevitable," said Colleen L. Carr, director of the National Action Alliance for Suicide Prevention, "because there are things we know that can reduce it."

Desperation and a gun

Pamela and Dan Kaiser say the haphazard way America has handled the pandemic contributed to their son's death. But they also question why it was so easy for their son to buy a shotgun on the day he decided to kill himself, even as other businesses were shut down.

"How are gun shops considered essential in the middle of a pandemic?" asked Pam Kaiser, 59, from her home in Traverse City, Mich.

Nearly half of all suicides involve firearms. And as pandemic fears have grown, so have gun sales.

During the first eight months of this year, more firearms were sold than in all of 2019, according to an analysis of FBI data by the research group Small Arms Analytics. The country is on track this year to have the most gun sales ever.

For months, Aaron Kaiser, 24, had been struggling with depression and anxiety. There was a suicide scare last year - a note his mother found in his room.

When the pandemic hit, his parents were initially relieved. "We were all under one roof. We could take care of him, watch over him," Pam Kaiser said.

Then Aaron's therapist closed her practice. He became increasingly irritable and withdrawn. The college where he was taking classes shut down. His father got laid off from the company where he had worked for 27 years, and Aaron told his parents he felt like a burden.

His mother called a long list of mental health programs - as far away as Colorado - trying to get him treatment. But in the early weeks of the pandemic, her calls went straight to voice mail.

One day, she found a sticky note in Aaron's room that said simply: "I'm sorry. I love you all."

Alarmed, she called Aaron on his phone, and he dismissed it as an old note. He asked if they needed anything from the grocery store. He didn't come home the next day.

Pam called the police while Dan checked their family's credit card activity online to see where Aaron could be. His heart dropped when he saw a charge for $560.67, at a gun shop a few miles from home.

Before Dan could even print out the statement, a sheriff's deputy was walking up their driveway to tell them about the body discovered in a nearby park.

"For the rest of our lives, we will blame ourselves for not protecting him," Pam said. "But how was it that easy for my son to buy a gun on the day he decided he wanted to kill himself?"

Roughly 90 percent of suicide attempts by guns are fatal. In contrast, only 4 percent of attempts by all other means result in death. A study of 26 million death records found that gun owners were nearly four times as likely to die by suicide as people who do not have guns.

"If people are buying guns during this pandemic for a sense of safety and security, they need to know what the risks are," said David M. Studdert, a Stanford University professor who led the study.

'It's not too late'

It has been seven months since that night Ted Robbins's son sneaked out and shot himself.

He keeps a jar of pictures by his bed and a cast the funeral home made of Christian's hand. Every night before he sleeps, Robbins places his hand into his son's.

He found an online support group and told its leaders he wanted to help others struggling in the pandemic. Last month, Robbins received an urgent call: a father, whose 16-year-old daughter had just killed herself.

Robbins listened as the man described his daughter's loss of hope - with so many still dying from the virus, protests in the streets, America at war with itself. He listened as the man second-guessed every choice he made in the final days of his daughter's life.

He recognized the rawness in the father's voice. An hour into their conversation, Robbins told the man the kind of thing he has struggled for months to say to himself: "You loved her. You did everything you could. You didn't cause her death."

Before he hung up, Robbins promised to add the man's phone number to a growing list of struggling families Robbins checks on amid the pandemic.

In daily visits to his son's grave, he often tells Christian about these people he is trying to save.

"There's so many kids out there, so many families that still have a chance. For them, it's not too late."

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). You can also text a crisis counselor by messaging the Crisis Text Line at 741741.

Updated March 11, 2021

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For months, he helped his son keep suicidal thoughts at bay. Then came the pandemic.

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He visits the grave every day. And every day, Ted Robbins asks himself the questions that have plagued him since the night his 16-year-old son killed himself, one month into the pandemic. What if Robbins hadn't canceled their family vacation? What if their school hadn't closed down?

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Many people are eager for their chance to get the COVID-19 vaccine, but there are those who don't share that feeling - especially in communities of color.

Mike Hutchinson said he will be getting the vaccine when it's widely available. He's already had COVID-19 and wants to prevent it from coming back.

"I definitely plan to get it if becomes readily available for me because I have two daughters and just because of the close contact I am with people," he said.

But Hutchinson, who is Black, said he knows not everyone shares his opinion.

On social media, you can find people of color discussing whether they'll get the COVID-19 vaccine. Many point to moments in history where Black people were mistreated in the American health care system.

Brooke Love, a mixed-race woman in Milwaukee, said she has concerns because of her underlying medical conditions.

History also plays a part in her concerns. She mentioned the Tuskegee study, which experimented on 600 Black men with syphilis for 40 years, beginning in 1932. Doctors lied to the men and left the disease untreated to test how syphilis developed in Black people compared to the white population.

"I also learned just recently about a gynecological experiment where this gynecologist, he was actually practicing on enslaved women of color and did different things to them even without anesthesia," she said.

But Love said if she sees that others who have the same medical conditions get the shot and do okay, she'd consider the vaccine.

Paige Westmoreland identifies as Black and Latino. She's a student at UW-Milwaukee and she explained that she's still on the fence about the COVID-19 vaccine and she understands folks being hesitant.

"I know a lot of people are nervous because it was very, well, rushed. You know a lot of vaccines take years to develop and I see why people are, you know, coming back at that statement saying, 'well we, you know, we don't always have worldly pandemics where we need a rushed vaccine'," she said.

Westmoreland said she'll be paying attention to how the first round of recipients respond to treatment before she can give a definite answer.

There are a number of reasons Black people may be leery about the COVID-19 vaccine. Their concerns may be part of broader misgivings and may keep them from going to the doctor on a regular basis.

Some don't feel that the medical field has their best interests in mind. That's according to Dr. Lucy Mkandawire-Valhmu, an associate professor in the College of Nursing at UWM. She said disparities in health outcomes contribute to the mistrust.

"African Americans are 60% more likely to be diagnosed with diabetes, according to the Office of Minority Health. You know, they're 3.5 times more likely to be diagnosed with end stage renal disease, you know. And then when we think about infant mortality - on every measure, you know, African Americans experience disparities," said Mkandawire-Valhmu.

Existing disparities exacerbated the impact of COVID-19, hitting Black and Latino communities harder than others early on.

According to Dr. Tito Izard, there were disparities in how public health officials responded to the threat of the coronavirus in communities of color. He is the president and CEO of Milwaukee Health Services. Izard calls the public health response "inadequate."

"We should have seen a FEMA-like response initially. We failed to create a COVID-19 distribution center to be able to make sure that people had access to masks, hand sanitizer, disinfectant agents and all of those things," said Izard. "Now it starts to impact on how people feel about government, and how they actually will feel about vaccinations."

These same disparities make Dr. Emilia Arana concerned for vaccine access. She's director of pediatrics at Sixteenth Street Community Health Centers.

"COVID has made all the inequalities even more evident, meaning that populations that were already facing poor access to health care, now, they have seen higher COVID numbers, higher hospitalizations rate, and unfortunately, a higher number of deaths. So, these populations that are at higher risk, deserve better attention regarding the distribution of the vaccine," said Arana.

Dr. Arana said there are multiple steps that need to be taken in order to build trust between the medical system and communities of color. Part of it involves health professionals acknowledging how these groups have been wronged.
Do you have a question about race in Milwaukee that you'd like WUWM's Teran Powell to explore? Submit it below.
_

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For Black Americans, History Of Medical Mistreatment & Disparities Leaves Some Leery Of Vaccine

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Many people are eager for their chance to get the COVID-19 vaccine, but there are those who don't share that feeling - especially in communities of color. Mike Hutchinson said he will be getting the vaccine when it's widely available. He's already had COVID-19 and wants to prevent it from coming back.

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Unless someone has an unusual medical condition that would render vaccination contraindicated, the short answer is yes, it is unethical to refuse to vaccinated against COVID-19.

I am not a doctor, nor a philosopher studying normative questions of whether a particular course of action is ethical or unethical. However, I do study behavioral ethics - the science of moral decision making - which provides several reasons people might choose not to be vaccinated. None of them good.

Studies show that people are irrationally optimistic, tending to believe that the car wrecks, cancers and divorces that happen to other people are not going to happen to them. Why get vaccinated if you just know that you won't get COVID-19? Since March, I have watched countless interviews with people lying in hospital beds who explained how utterly shocked they were that they had contracted the coronavirus.

People also have a tendency to be overly confident regarding their abilities. "The human mind is an overconfidence machine," writes columnist David Brooks in his book "The Social Animal: The Hidden Sources of Love, Character and Achievement." Why get the vaccine if you are sure that medical experts are wrong?

In America, we've had an unfortunate tendency to divide into contentious groups. People tend to take their cues as to how to act from those in their in-group, a phenomenon called the conformity bias. For the past four years, there's been the Trump team and the never-Trump team. Why would you get vaccinated if your team believes that we have already "turned the corner" or that COVID-19 is going to "just go away"?

People love being right and hate being wrong. Their brains frequently help them preserve their self-image by rejecting new evidence that contradicts their preexisting beliefs. When cult leaders predict the end of the Earth and then the end doesn't come, followers often become even more fervent believers because their egos can't stand admitting they've been wrong. If this phenomenon of belief persistence has enabled some to believe that COVID-19 is no big deal despite hundreds of thousands of deaths, why get vaccinated?

And people feel more blameworthy if their actions lead to bad consequences than if their inactions do, so they often tend toward inaction.

Those opposed to vaccinations - who irrationally fear the side effects of drugs on their child but know that the disease being vaccinated against is also harmful - often choose not to vaccinate. They would feel more responsible if their child suffered from the supposed side effects because they made the choice to vaccinate. But if they choose to do nothing, the bad consequences that follow from their inaction seem less their fault. Both courses involved a choice followed by consequences, but the choice not to vaccinate seems the less blameworthy path.

Simply put, there are many failures of human rationality, and they can lead to indefensible moral choices.

Consider this hypothetical: Your young daughter collapses for no apparent reason. After examination, a cardiologist strongly recommends immediate surgery for a heart condition. The surgery is not without risk, but the surgeon indicates the risks of not operating are far greater.

The following are such bad reasons not to elect to have the surgery that many would deem them immoral: 1. "She's OK; my family has always been healthy." 2. "My online research tells me that the cardiologist is wrong." 3. "A lot of my friends believe the president when he says, 'I don't think science knows, actually." 4. "Something bad might happen during the surgery if I approve it, and I'd never forgive myself."

People who don't get vaccinated need to muster the moral imagination to think of how that decision will fail to protect those who are vulnerable in our communities. If skeptics don't get vaccinated, they will undermine herd immunity, causing more people to die. And that is immoral. Enduring the mostly minor side effects expected from the vaccines is part of the contribution that people are reasonably expected to make for the common good.
Robert Prentice is director of the Ethics Unwrapped program in the Center for Leadership & Ethics at The University of Texas at Austin.
A version of this op-ed appeared in USA Today.

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Is It Unethical to Refuse a COVID-19 Vaccine? - UT News

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Unless someone has an unusual medical condition that would render vaccination contraindicated, the short answer is yes, it is unethical to refuse to vaccinated against COVID-19. I am not a doctor, nor a philosopher studying normative questions of whether a particular course of action is ethical or unethical.

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The country's first Covid vaccine could be authorized for emergency use as soon as Thursday. If Pfizer and BioNTech get the green light, distribution is set to begin within days.

But as difficult as the research, development and distribution stages have been, some experts argue the hardest part of fighting the virus is actually what comes next: convincing the U.S. population to take the vaccine.

Roughly four in ten Americans say they would "definitely" or "probably" not get a vaccine, according to a recent survey by the Pew Research Center. While this is higher than it was two months ago, to achieve herd immunity, experts say that about 70% of the population needs to be vaccinated or have natural antibodies.

Employers, however, may not be taking "no" for an answer.

Under the law, an employer can force an employee to get vaccinated, and if they don't take it, fire them.

Dallas labor and employment attorney

"A couple of my corporate clients are leaning toward making the Covid vaccine mandatory," said Rogge Dunn, a Dallas labor and employment attorney.

His clients range from companies in manufacturing to food and beverage - industries that have been battered for months due to the pandemic and government-mandated lockdowns. A vaccine promises employers a return to some form of normal, which is desperately needed as businesses look to recover profits.

One of Dunn's clients in the restaurant sector thinks a compulsory inoculation requirement could be a game changer for business.

"They think it gives them a competitive advantage," explained Dunn. "They could say to their customers, 'Hey, our restaurant is safe. All of our employees have been vaccinated.'"

It may be, in part, a PR tactic, but Dunn said it is totally within an employer's rights to implement this kind of requirement.

"Under the law, an employer can force an employee to get vaccinated, and if they don't take it, fire them," said Dunn.

Dorit Reiss, a professor at the University of California Hastings College of Law, said that private businesses have pretty extensive rights. "Requiring a vaccine is a health and safety work rule, and employers can do that," said Reiss.

Take the health-care system. Dr. Hana El Sahly, who oversees a clinical trial for Moderna's vaccine candidate, believes hospitals could eventually make Covid inoculation a condition of employment, similar to how the annual influenza vaccine is required of all medical staff.

"We all have to demonstrate that we took our flu shot before we go out and see our patients on the wards," said El Sahly. "When we are sick, we cannot deliver vital functions to the community."

There are, however, a few notable exceptions to this kind of blanket requirement. If a work force is unionized, the collective bargaining agreement may require negotiating with the union before mandating a vaccine.

Anti-discrimination laws also provide some protections. Under the Americans with Disabilities Act, workers who don't want to be vaccinated for medical reasons are eligible to request an exemption. In this case, an employer would have to provide reasonable accommodation, such as allowing the employee to work remotely.

Under Title VII of the Civil Rights Act of 1964, if taking the vaccine is a violation of a "sincerely held" religious belief, they, too, would potentially be able to opt out.

When the FDA meets this week, they will decide whether to grant an emergency use authorization, or an EUA, to Pfizer and BioNTech. It may seem like semantics, but an EUA is not the same thing as full approval.

"An emergency use authorization is not a license," said Reiss. "There's a legal question as to whether you can mandate an emergency observation. The language in the act is somewhat unclear on that."

Mandatory vaccination protocols, therefore, may have to wait until the FDA completes the entire approval process for the Pfizer-BioNTech vaccine.

What is clear, however, is that if an employer does choose to mandate the Covid vaccine, a company is not liable should an employee develop side effects from a vaccine. Instead, experts say that any claims would be routed through worker's compensation programs and treated as an on-the-job injury.

For now, Dunn is advising his clients to wait three months until after a significant number of the population has been vaccinated. In the meantime, some of the businesses Dunn represents are considering incentives instead.

There are a few carrots that employers could offer. "One option is that if you get the vaccine, you don't have to have your temperature taken every day, or you don't have to wear the same level of PPE," Reiss said.

There's also talk of offering financial perks to employees who opt in to taking the vaccine. Dunn said some of his clients, including a restaurant and one company in the manufacturing sector, are seriously considering giving a cash bonus to employees who get inoculated.

And for those who still refuse? Rather than firing them, Reiss said employers could require that they complete an educational course that delves into trial efficacy data and the experience of participants.

Yasir Batalvi, a 24-year-old living in the Boston area, was one of 30,000 people who joined the trial for the Moderna vaccine. Despite initial concerns about the potential side effects, he said he's no longer worried.

"I'm not too concerned about actual long-term effects," said Batalvi. "We know from most vaccination trials that any adverse events show up in the first couple of months."

Ultimately, the U.S. is still in the midst of an employment crisis. Record unemployment numbers have put immense pressure on the labor market, especially in service-based industries, where workers are most at risk. That is a big part of why the Centers for Disease Control and Prevention has advised prioritizing frontline employees in the queue for inoculation.

So workers may not have much of a choice if they want to keep a job.

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Yes, your boss can fire you if you refuse to get a Covid vaccine

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The country's first Covid vaccine could be authorized for emergency use as soon as Thursday. If Pfizer and BioNTech get the green light, distribution is set to begin within days. But as difficult as the research, development and distribution stages have been, some experts argue the hardest part of fighting the virus is actually what comes next: convincing the U.S.

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Officials acknowledge that the coveted shots are disproportionately going to white people and that planners' efforts to course-correct are having limited effect.

Rose Woodside, 93, left, and her daughter, Adora Lee, 70 talking a nurse at a pre-vaccine screening in Washington, D.C. They obtained appointments after the city began giving priority to people in neighborhoods hit hardest by the virus. Credit... Kenny Holston for The New York Times

WASHINGTON - As soon as this city began offering Covid vaccines to residents 65 and older, George Jones, whose nonprofit agency runs a medical clinic, noticed something striking.

"Suddenly our clinic was full of white people," said Mr. Jones, the head of Bread for the City, which provides services to the poor. "We'd never had that before. We serve people who are disproportionately African-American."

Similar scenarios are unfolding around the country as states expand eligibility for the shots. Although low-income communities of color have been hit hardest by Covid-19, health officials in many cities say that people from wealthier, largely white neighborhoods have been flooding vaccination appointment systems and taking an outsized share of the limited supply.

People in underserved neighborhoods have been tripped up by a confluence of obstacles, including registration phone lines and websites that can take hours to navigate, and lack of transportation or time off from jobs to get to appointments. But also, skepticism about the shots continues to be pronounced in Black and Latino communities, depressing sign-up rates.

Early vaccination data is incomplete, but it points to the divide. In the first weeks of the rollout, 12 percent of people inoculated in Philadelphia have been Black, in a city whose population is 44 percent Black. In Miami-Dade County, just about seven percent of the vaccine recipients have been Black, even though Black residents comprise nearly 17 percent of the population and are dying from Covid-19 at a rate that is more than 60 percent higher than that of white people. In data released last weekend for New York City, white people had received nearly half of the doses, while Black and Latino residents were starkly underrepresented based on their share of the population.

And in Washington, 40 percent of the nearly 7,000 appointments initially made available to people 65 and older were taken by residents of its wealthiest and whitest ward, which is in the city's upper northwest section and has had only five percent of its Covid deaths.

" We want people regardless of their race and geography to be vaccinated, but I think the priority should be getting it to the people who are contracting Covid at the highest rates and dying from it," said Kenyan McDuffie, a member of the City Council whose district is two-thirds Black and Latino.

Alarmed, many cities are trying to rectify inequities. Baltimore will offer the shot in housing complexes for the elderly, going door-to-door.

"The key with the mobile approach is you can get a lot of hard-hit folks at the same time - if we just get enough supply to do that," said the city's health commissioner, Dr. Letitia Dzirasa.

Officials in Wake County, N.C., which includes Raleigh, are first attempting to reach people 75 and over who live in nine ZIP codes that have had the highest rates of Covid. "We weren't going to prioritize those who simply had the fastest internet service or best cell provider and got through fastest and first," said Stacy Beard, a county spokeswoman.

Fixing the problem is tricky, however. Officials fear that singling out neighborhoods for priority access could invite lawsuits alleging race preference. To a large extent, the ability of localities to address inequities depends on how much control they have over their own vaccine allocations and whether their political leadership aligns with that of supervising county or state authorities.

The experiences of Dallas and the District of Columbia, for example, have resulted in very different outcomes. Dallas County, predominantly Democratic, has been thwarted by the state health department, under the aegis of a Republican governor, which quashed the county's plan to give vaccines to certain minority neighborhoods first. But Washington was able to quickly course-correct.

Image

Adora Lee, a resident of Washington's Ward 8, receiving the vaccine. "People who live in Ward 3 and people who live in Ward 8, they've got different social realities," she said. "This is no joke for us." Credit... Kenny Holston for The New York Times

A few days after its 65-and-older population became eligible for the vaccine on Jan. 11, Mr. McDuffie, the city councilman in the District of Columbia, flagged the issue of wealthier residents getting disproportionate access to the vaccine in a call with city officials. Overall, 74 percent of deaths and 48 percent of cases in Washington have been among Black residents, who make up 46 percent of the population; 11 percent of deaths and 25 percent of cases have been among white residents, who make up nearly the other half of the district.

By the end of that week, the city announced a new policy - offering the first day of new appointments to people in ZIP codes with the highest rates of infection and death from the virus. Under the new system, more appointments would be added a day later and people from other neighborhoods could sign up then. The city also quadrupled the number of workers helping people make appointments through its call center, to 200.

But email lists in wealthier neighborhoods lit up in protest.

"It looked like maybe Ward 3 was being punished for being more computer savvy," said Mary Cheh, a city council member representing the ward, where houses in neighborhoods near American University or the Potomac River routinely sell for more than $2 million. "I was inundated with emails from people who were just really angry about it."

The day after the policy change, Ms. Cheh wrote to her constituents, citing the data about the shots and saying that "our anxiety to get one right away should not cloud the pursuit of equitable vaccine distribution."

"When I sent out that note, people said, 'Oh thank you, I understand now,'" Ms. Cheh said. Still, she called the city's new system "a very blunt instrument," and said it would be fairer to base need on an individual's risk, not an entire neighborhood's.

Adora Iris Lee, 70, lives in one of Washington's priority neighborhoods - Congress Heights, part of Ward 8 in the district's southern area, which is heavily Black and has had the highest number of Covid deaths. She said she still had spent more than three hours on hold, but obtained appointments for herself and her mother, who is 93.

"Being able to call at a time that was designated for us - I felt good about that," Ms. Lee said. "People who live in Ward 3 and people who live in Ward 8, they've got different social realities. This is no joke for us."

Still, Mr. Jones, of Bread for the City, said that even with the new system, hardly any of the people coming for shots at his clinic were its regular patients. The clinic started reaching out to its regulars and, with the city's permission, reserved all its first doses for them and for clients of other social service organizations last week.

"It's not just a case of preserving the spots for people," Mr. Jones said. "Somehow we've got to persuade them to use those spots."

A vaccine line at Fair Park in Dallas last month. Credit... Pool photo by Smiley N.

Dallas County's rollout plans for the vaccine included an inoculation hub in a neighborhood that is largely African-American and Latino. But when the sign-up website went live, the link speedily circulated throughout white, wealthier districts in North Dallas.

"Instead of getting a diverse sampling, we had a stampede of people who were younger and healthier than those who had initially gotten the links," said Judge Clayton Jenkins, head of the Dallas County Commissioners Court. Observers told commissioners that those in line were overwhelmingly white.

The county commissioners quietly contacted Black and Latino faith leaders in South Dallas, who encouraged constituents to show up for shots without appointments, as long as they offered proof that they were 75 and older.

That plan worked for a day or so.

"Then city council people in North Dallas got calls and the mayor said it would be open to everyone over 75," Judge Jenkins said. "That led again to a huge stampede of people from the suburbs who had reliable cars."

John Wiley Price, a Dallas commissioner who represents voters in South Dallas, argued that the 27,000 people who had signed up from 11 vulnerable ZIP codes should be given the vaccine ahead of other neighborhoods. Already, more than 300,000 Dallas County residents had registered; The county was only receiving a weekly allocation of about 9,000 doses.

But when Judge Jenkins inquired whether geographical priority would pass muster, state officials said that if Dallas proceeded with the plan, the state would withhold the county's supply.

According to a state health department spokesman, inoculation hubs had to agree to vaccinate any Texan, because not every county has a site. If Dallas excluded residents by geography, providers would be in breach of contract.

Dallas backed down.

A mass Covid vaccination event in Denver on Saturday. Credit... Michael Ciaglo/Getty Images

Even successful efforts to target impoverished neighborhoods are running into another problem. Many Black and Latino people are hesitant to get the vaccine.

In Colorado, 1 of 16 white residents have received the vaccine so far, compared to 1 of 50 Latinos, who comprise 20 percent of the state's population, according to a Colorado Springs newspaper, The Gazette.

"There are a lot of Chicanos who are like, 'I want to wait, I have questions, I need some answers,' " said Julie Gonzales, a state senator from Denver, who starts her workday sending condolences to constituents, many of them Latino, who have lost family members to the virus.

Public health experts and outreach campaigns need to be attuned to cultural nuances that differ among Latino generations, Ms. Gonzales said. "It's one thing to speak to an old-school Chicano who has been here for generations versus someone who is concerned about whether I.C.E. can find out their personal information if they try to get the vaccine," she said, referring to the federal Immigration and Customs Enforcement agency.

A tracking poll by the Kaiser Family Foundation, conducted just before President Biden took office, found that while the share of people overall who wanted to get the vaccine as soon as possible has increased since December, 43 percent of Black adults and 37 percent of Hispanic adults said they wanted to "wait and see how it's working," compared with 26 percent of white adults.

When initial statistics in Philadelphia showed that only 12 percent of vaccine recipients were Black, city health officials recoiled. Blindsided by an inexperienced start-up company whose vaccination strategies faltered, health officials also attributed the low numbers to hesitation among city nursing home workers and hospital aides, many of whom are Black.

Now that the city has expanded eligibility, it is hopeful that the distribution will become more equitable. The vaccine is going to residents with high-risk medical conditions, as well as first responders, people who work in public transit and those in retail and food service jobs who come into contact with the public.

"Many of these are people who are paid less, tend to be from communities of color and are at high risk because they are exposed to lots of people," said James Garrow, a spokesman for the Philadelphia Department of Public Health.

Some cities now provide vaccination pop-up clinics in Black churches. Denver is directing doses to community clinics that serve the underinsured.

Dallas has a new bilingual call center. Still, according to the latest county data, white people, who make up 28.5 percent of Dallas's population, have gotten 62.6 percent of its vaccine doses.

Even in Washington, D.C., frustrations linger despite clear progress. Last week, city officials announced results of their tweaked distribution plan: Just over half of shots have now gone to residents of neighborhoods given priority, up from 29.6 percent during the first week that older people were vaccinated.

Yet, during a daylong session last week, council members heard pained accounts from people like Janett Gasaway, 77, who still has not been able to get vaccine appointments for herself or her 89-year-old husband. Despite multiple calls - she on their landline, he on his cellphone - on the days that appointments are offered to the most vulnerable ZIP codes, they haven't succeeded. On Thursday, 1,745 appointments were gone in 18 minutes.

"It is not working," she said.

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Even in Poorer Neighborhoods, the Wealthy Are Lining Up for Vaccines

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Officials acknowledge that the coveted shots are disproportionately going to white people and that planners' efforts to course-correct are having limited effect. WASHINGTON - As soon as this city began offering Covid vaccines to residents 65 and older, George Jones, whose nonprofit agency runs a medical clinic, noticed something striking.

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Gov. Andrew M. Cuomo's valentine to New York City restaurants has left close observers of the city's coronavirus data scratching their heads. Mr. Cuomo said Friday that "on our current trajectory," New York City could reopen indoor dining on Feb. 14, typically a busy day for the restaurant industry.

As the governor spoke, average per-capita case counts in New York City were 64 percent higher than when he announced an indefinite ban on indoor dining in December.

Average Covid-19 hospitalizations in the city, while trending downward, were still 60 percent higher late last week than they were when Mr. Cuomo closed the restaurants.

And the test positivity rate was more than a percentage point higher.

Mr. Cuomo has said that the decision to open any part of the economy is based on four metrics: new cases per capita, hospitalizations, the test positivity rate and the rate at which people are infecting one another.

That fourth measure, known as , has improved for New York State since December and is now less than 1, meaning each infectious person will infect fewer than one other person. A state official said models used by the state put New York City's between 1.03 and 0.95.

Gareth Rhodes, a deputy superintendent at the state Department of Financial Services and a member of the governor's Covid-19 task force, said the important metrics are not where the numbers are but where they are headed - and that trends are all headed downward, both across the state and in the city.

He said the opposite was true in December, when trends suggested a climb in cases and hospitalizations.

Mr. Rhodes also noted that businesses began reopening in May even though more than 6,000 people remained hospitalized because trends indicated the numbers would improve and that they did.

The C.D.C. places on-site dining with capacity limits in the "higher risk" category for coronavirus transmission, with the highest risk being indoor dining without precautions. Mr. Cuomo's plan to reopen indoor service on Valentine's Day includes a 25 percent capacity limit and other restrictions.

New York City is at an extremely high risk level for coronavirus, according to an assessment by The New York Times and public health experts.

The decision to reopen indoor dining came amid growing criticism of the governor for scorning the expertise of public health officials over the advice of the business lobby.

Even the governor's own virus data proved less rosy than he presented on Friday, a review of the numbers shows.

Mr. Cuomo suggested test positivity rates for New York City had fallen by 30 percent with a chart depicting a drop using data points chosen from daily swings.

In fact, the numbers he presented - 7.1 percent and 4.9 percent - were the highest and lowest daily numbers in January to that point, extremes that did not exactly reflect the overall trend.

Here is the daily test positivity data, presented alongside a seven-day average to account for daily fluctuations. The averages show a more modest 17 percent drop in test positivity, compared with the 30 percent drop in Mr. Cuomo's chart.

The governor's chart had other issues: The vertical axis wasn't labeled and did not begin at zero, so, at a glance, it suggested that the latest positivity rate was closer to zero than it actually was. And the graph's curve did not follow any underlying values between the two data points.

However you look at it, the positivity rate was still higher than it was on Dec. 11, when Mr. Cuomo announced the ban on indoor dining. It has remained steady since.

Mr. Cuomo acknowledged on Friday that emerging variants of the virus could affect the infection rates in the coming weeks, and said the state would keep a close eye on hospital capacity numbers to determine whether further closures may be needed.

"I understand all the possibilities," he said. "And if there are facts, and if the facts change, then we will have a different situation."

Tracking the Coronavirus

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N.Y.C.'s Covid Metrics Are Dire. Cuomo Is Reopening Restaurants Anyway.

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Gov. Andrew M. Cuomo's valentine to New York City restaurants has left close observers of the city's coronavirus data scratching their heads. Mr. Cuomo said Friday that "on our current trajectory," New York City could reopen indoor dining on Feb. 14, typically a busy day for the restaurant industry.

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As new variants of the coronavirus spread within the United States, health professionals have suggested that Americans wear two masks. (John Farrell/The Washington Post)

The Washington Post is providing this news free to all readers as a public service.

Follow this story and more by signing up for national breaking news email alerts.

Wear your mask is becoming wear your masks.

The discovery of highly transmissible coronavirus variants in the United States has public health experts urging Americans to upgrade the simple cloth masks that have become a staple shield during the pandemic.

The change can be as simple as slapping a second mask over the one you already wear, or better yet, donning a fabric mask on top of a surgical mask. Some experts say it is time to buy the highest-quality KN95 or N95 masks that officials hoping to reserve supplies for health-care workers have long discouraged Americans from purchasing.

What you need to know about the coronavirus variants

As with other parts of the pandemic response, the United States lags behind other parts of the world when it comes to masks. Several Asian countries, including Singapore and South Korea, have mass-produced high-quality masks to send directly to residents. In recent weeks, European countries have begun mandating medical-grade masks in public settings as the virus strain first identified in the United Kingdom threatens to ravage communities. British scientists estimate it could be as much as 70 percent more transmissible.

"The existence of more-transmissible viruses emphasizes the importance of us upping our game and doing not more of the same but better of the same," said Tom Frieden, former director of the Centers for Disease Control and Prevention. Frieden has called for people to wear higher-quality masks. "Yes, that is confusing to people, but the key is to share what we know when we know it and be frank about what we don't know."

Catch up on the most important developments in the pandemic with our coronavirus newsletter. All stories in it are free to access.

Anthony S. Fauci, the nation's top infectious-disease expert, touted double-masking during a Monday appearance on the "Today" show, saying two layers "just makes common sense that it likely would be more effective."

But on a Wednesday town hall appearance on CNN, Fauci appeared to reverse course and instead stressed following CDC guidance, which does not call for wearing two masks or N95s. New CDC Director Rochelle Walensky, appearing alongside Fauci, also warned that N95 masks are uncomfortable to wear and may dissuade consistent use if expanded to the general public.

The CDC encourages Americans to choose well-fitting masks with "two or more layers of washable, breathable fabric" and to avoid surgical masks and other face coverings meant for health-care workers.

President Biden has embraced masks as a core strategy for ending the pandemic, mandating face coverings on planes, in airports and in all federal buildings. But he has not called for a medical-grade-mask mandate or mass production of high-quality masks.

The CDC and White House did not immediately respond to requests for comment.

Some public health experts said the federal government should have prioritized certifying or manufacturing better masks earlier so Americans do not have to fend for themselves to avoid counterfeits or upgrade their own.

The Trump administration in March coordinated with underwear makers to send five masks to every household, officials told The Washington Post, but the plans fell apart because of logistical concerns and other issues, including complaints that the masks looked like underwear or jockstraps.

Abraar Karan, a physician at Brigham and Women's Hospital and Harvard Medical School has, since last spring, called on government and industrial leaders to mass-produce comfortable, effective masks. He said the country could have avoided its current situation, with Americans learning how to better protect themselves largely alone.

"This seems just like the rest of our covid tragedy: We just don't have answers, we just put out fires constantly, and we are asking people to do things on their own," Karan said. "You've always needed better masks. We needed better masks from the start."

Linsey Marr, a Virginia Tech engineering professor who has researched mask effectiveness, said the public has better tools to reduce viral loads getting into the air and into bodies.

Without a medical-grade face covering, Marr said, people can get the best, simplest protection by wearing a cloth mask tightly on top of a surgical mask. They can also make a three-layer mask by cutting a high-efficiency filter, such as a vacuum bag, to place between two tightly-woven fabric masks.

The difference is like getting two recommended doses of coronavirus vaccines instead of one - the additional mask offers more complete protection against the virus.

CDC acknowledges role of airborne transmission in spread of coronavirus

From practicing mindfulness to spending time outdoors, here are some tips for overcoming what some are calling "pandemic fatigue" and avoiding burnout. (Drea Cornejo/The Washington Post)

"Those standard cloth masks might be around 50 percent effective in terms of protecting yourself," Marr said. "Maybe that was good enough before when combined with distancing and trying to avoid being in crowded indoor spaces."

Masks are among the simplest tools in the fight against the coronavirus but also among the most politically fraught. Some have turned masks into a symbol of government overreach.

At the heart of dismal U.S. coronavirus response, a fraught relationship with masks

Federal officials, including Fauci, were criticized when they urged people to cover their face after initially advising against masks in the early weeks of the pandemic. Many experts said the changing guidance made senseas the shortage of protective equipment for health-care workers eased and scientists better understood the spread of the virus - including that it is spread by asymptomatic people. But the initial confusion has been used to cast doubt on the proven efficacy of masking and the broader government response to the pandemic.

"So in other words Fauci and everybody else really has no idea what to do or what is safe," former Major League Baseball player Jordan Schafer tweeted in response to a news article about the scientist recommending two masks. "Fauci has told us not to wear a mask, to wear one mask, and now to wear two masks. Can we just get transparency please and accurate info."

Cady Fusté of Seattle started wearing a cloth mask over a surgical mask this month. She made the shift at the advice of her mother's doctor - a double lung transplant has put her mother at a higher risk.

"Science evolves. It makes total sense to me," said Fusté, 35, who works in photo production. "If you think about it, if you can still smell someone's perfume, it's probably not that effective to something that's airborne. A thin layer of cotton is probably not as ideal as a surgical mask."

Behavioral psychologists say public health authorities must be mindful of a backlash as they start to shift mask guidance. When people living through a crisis are confused, they often stick to their habits.

"When you look at leaders and you see mixed messages like the ones you've seen in the past, you tend to latch onto the ones that make you feel comfortable," said David Abrams, a professor of social and behavioral health at New York University and a former National Institutes of Health official.

Abrams said it is essential to acknowledge that the guidance is changing and to be patient if people do not change their behavior immediately.

"Let's face it: This is changing very quickly and science is making progress and sometimes we even make mistakes and correct them," Abrams said. "There's nothing wrong with that or learning how to do something better. The double-masking is a good example of that."

Linda Aldoory, a public health communications researcher at the University of Maryland, said there may be no swaying people who have already lost faith in the government to change their mask behavior, which is why other messengers should be enlisted.

"If we could get every famous influencer and celebrity to wear new masks and wear double masks ... that might actually be a great way to start a new social norm to getting the kind of masks they want worn," Aldoory said.

Danny Ryan, a 27-year-old who works in communications in D.C., said he was swayed to switch to two cloth masks in part after he saw Biden and Vice President Harris doubling up in recent weeks. He also reconsidered the protection of a single mask after seeing his breath while waiting outside for a coronavirus test, although experts say that is not a sign of a malfunctioning mask.

"It just stuck in my head - they are wearing two masks, protecting them underneath and maybe more above," said Ryan, who now keeps extra masks by his door. "To be perfectly honest, I just feel safer doing it with updates in the news about the new variants."

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Time to double or upgrade masks as coronavirus variants emerge, experts say

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The Washington Post is providing this news free to all readers as a public service. Follow this story and more by signing up for national breaking news email alerts. Wear your mask is becoming wear your masks.

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teen mental health: how to support your child in a pandemic - cnn

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How to support your teen's mental health through Covid-19

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There is a trend of elevated depression, anxiety and post-traumatic stress disorder among teens as they cope with the Covid-19 pandemic. Those issues were already common in the US, and now it's worse. Here's how to support the teens in your life.

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Young people have turned to digital devices to fill holes left by the COVID-19 pandemic, a practice that elevates depression, anxiety and hopelessness, suggests a California study released Wednesday.

"Our kids weren't built to live their lives chained to supercomputers," said Jennifer Siebel Newsom, who is married to the California governor and founder of the California Partners Project, which wrote the study alongside the Child Mind Institute.

"COVID has really shown us how damaging this new normal is to our kids' mental health."

This problem is not a new one. Even before COVID-19, 95% of teens could access a smartphone and spent multiple hours a day on a screen, according to the Pew Research Center in 2019.

But in March, schools across the nation closed and shelter-in-place requirements forced many teens home.

"What many teens initially embraced as a short, unexpected school break has become an extended trip to new territory, with no return ticket," the study says.
More students could be headed home soon: Schools want to end online classes for struggling kids, but COVID-19 cases may ruin that plan
Teens' new existence is "plagued by loss," said Dr. Harold Koplewicz of the Child Mind Institute: "the loss of school, the loss of social experience, the loss of academic accomplishment, the loss of extracurricular activities, the loss of freedom."

The internet and electronic devices emerged as the platforms where social, educational, professional and developmental activities take place, the study says.
'Feels like the world is against you': Young people struggle with finding mental health support amid COVID-19 pandemic
And though the internet is essential to staying connected in a pandemic, Koplewicz said, people are using it "as a way to numb themselves." Problems arise when they can't stop.

With everything uprooted, "you can't really blame" teens for their media use, Newsom said. But several solutions' to teens' destructive use of technology do exist.

Some of those tips for parents and teens include:

Keep moving and prioritize sleep

It is important to keep healthy sleep and exercise habits, Newsom said.

Getting enough sleep improves students' ability to concentrate, maintain a good mood and healthy weight and even improves the quality of a person's skin, the study says.

"Kids cannot go to bed with devices in their room," Newsom said. What's more, sticking to a bedtime routine that is screen-free can allow the brain fully to recharge.

As for exercise, the study recommends engaging in an hour of moderate physical activity every day to keep the mind and body feeling good.

"If you can't get outside, turn on the music and dance, or do some yoga," Newsom said.

Mindful reality checks

Living in a pandemic means that we are all socializing on screens, the study acknowledges. But teens should take time to consider how they feel and what they think when they're using tech.

"If you notice that you actually feel worse after you post, know that this is common, and look for more reliable ways to improve your mood," the study says.

Newsom advocated for having that internal conversation even before using tech - to ensure that a person is "emotionally conscious" before looking at a screen.
The pandemic is taking a toll on America: A new CDC study shows who we need to worry about most
"Why are you picking it up? What are you feeling right now? Are you in an anxious state? Are you in a fearful state?" Newsom said.

This advice applies to parents, teens and other adults, she added.

Be a role model and empathize
Worried about your kid's screen time? Most parents are.
The best way for parents to promote healthy screen use is to model it themselves, Newsom said, and to be honest and open about their own challenges with overusing tech.

"I'm learning myself that when I'm online, delegating something or ordering something, whether it's food or making a doctor's appointment, that I have to communicate what I'm doing to the kids, so they don't think I'm just surfing the internet or social media," she added.

The study also suggests trying to designate special screen-free times of the day or rooms of the house and stick to those rules yourself.

Empathizing with the rough time teens are having during the pandemic is paramount. The best thing parents can do to help teens?

"Validate that their experience in many ways is worse than the experience of older adults," Koplewicz said.

Recognize the warning signs

If you notice that you or your teen is more withdrawn than usual, is experiencing severe mood swings or has drastic changes in behavior, talk to your pediatrician, the school psychologist or a mental health specialist, Newsom said.

Crisis Text Line provides free, 24/7 confidential support via text message to people in any crisis when they dial 741741.

Peer support resources are also listed at warmline.org.

The Trevor Project also offers a peer support network called TrevorSpace for young people ages 13 to 24, and the Trans Lifeline is a peer support service run by trans people for callers who are transgender or questioning.

Survivors of sexual assault can call the National Sexual Assault Hotline at 800-656-HOPE (4673) or visit hotline.rainn.org/online and receive confidential support.

If you or someone you know may be struggling with suicidal thoughts, you can call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) any time day or night or chat online.

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Teens glued to screens in COVID pandemic need sleep and reality checks, experts say

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The COVID-19 pandemic has caused devastating tech overuse in teens. Here's why -- and tips for changes that will help prevent depression and anxiety.

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With COVID-19 continuing to spread, and millions of Americans still out of work, one of the nation's most urgent problems has only grown worse: hunger.

In communities across the country, the lines at food pantries are stretching longer and longer, and there's no clear end in sight. Before the pandemic, the number of families experiencing food insecurity - defined as a lack of consistent access to enough food for an active, healthy life - had been steadily falling. But now, as economic instability and a health crisis takes over, new estimates point to some of the worst rates of food insecurity in the United States in years.

"COVID has just wreaked havoc on so many things: on public health, on economic stability and obviously on food insecurity," said Luis Guardia, the president of the Food, Research and Action Center.

It's a crisis that's testing families, communities and the social safety net in ways that may have seemed unthinkable before the pandemic began. Here's a closer look at the landscape:

Nearly 1 in 4 households have experienced food insecurity this year

Even before the pandemic hit, some 13.7 million households, or 10.5% of all U.S. households, experienced food insecurity at some point during 2019, according to data from the U.S. Department of Agriculture. That works out to more than 35 million Americans who were either unable to acquire enough food to meet their needs, or uncertain of where their next meal might come from, last year.

For about a third of these households, access to food was so limited that their eating patterns were disrupted and food intake was reduced. The rest were able to obtain enough food to avoid completely disrupting their eating patterns, but had to cope by eating less varied diets or utilizing food assistance programs.

The coronavirus pandemic has only worsened the problem. According to one estimate by researchers at Northwestern University, food insecurity more than doubled as a result of the economic crisis brought on by the outbreak, hitting as many as 23% of households earlier this year.

Millions more children are experiencing food insecurity

In non-pandemic times, households with children were nearly 1.5 times more likely to experience food insecurity than households without children, according to the USDA, which reported that 13.6% of households with children experienced food insecurity last year. More than 5 million children lived in these homes.

Then came the coronavirus. An analysis by the Brookings Institution conducted earlier this summer found that in late June, 27.5% of households with children were food insecure - meaning some 13.9 million children lived in a household characterized by child food insecurity. A separate analysis by researchers at Northwestern found insecurity has more than tripled among households with children to 29.5%.

School lunch programs were already struggling to meet rising demand before the pandemic. With COVID-19 now keeping children out of school, many don't have access to school lunches at all.

"The other thing that COVID has done is it's really affected kids a lot in terms of food insecurity," Guardia said. "One of the things we've noticed across the board is that households with children are more food insecure. And we believe that also has to do with school closures. So a lot of kids get their nutrition from school meals, and that's been disrupted."

Black families are twice as likely as whites to face food insecurity

The data shows that food insecurity is more likely to wreak havoc on some communities than others.

Black and Hispanic Americans are particularly disproportionately affected. According to USDA data, 19.1% of Black households and 15.6% of Hispanic households experienced food insecurity in 2019. White Americans fell below the national average, with 7.9% experiencing food insecurity.

College graduates experienced food insecurity at a rate of just 5% last year. For those without a high school degree, the rate skyrocketed to 27%. Adults who have a disability - in particular adults who have a disability and are not in the work force - also experience more than two times the rate of food insecurity as adults who do not have a disability.

19 million Americans live in food deserts

Location is another factor at play. People who live in food deserts are often more likely to experience food insecurity because food is harder to obtain where they live. About 19 million people, or roughly 6% of the population, lived in a food desert and 2.1 million households both lived in a food desert and lacked access to a vehicle in 2015, according to the USDA.

Food can also be costlier where they live. A 2010 estimate from the USDA found that groceries sold in food deserts can cost significantly more than groceries sold in suburban markets, meaning people in low-income communities impacted by food insecurity often pay more money for their food. Milk prices, for example, were about 5% more in some spots while prices for cereal were sometimes 25% higher.

The definition of food desert can change depending on where you live. In urban settings, you need to live more than a mile away from a supermarket to be considered inside a food desert. For rural areas, it's greater than 10 miles. Rural areas are slightly more likely to be food deserts than urban areas and, according to Feeding America, and while they make up just 63% of counties in the country, they make up 87% of counties with the highest rates of food insecurity.

38 million people used SNAP in 2019

One in nine people in the U.S. used SNAP - the Supplemental Nutrition Assistance Program (also known as food stamps) - in 2019, according to the Center on Budget and Policy Priorities. SNAP benefits vary depending on the need of the participant, but the average SNAP benefit for each member of a household was $129 per month in fiscal year 2019.

SNAP is the largest food assistance program for low-income Americans in the nation, and because of COVID-19, demand for the program has been growing. In March, when the Families First Act passed as part of the government's emergency response to the pandemic, the maximum benefit for SNAP recipients was temporarily expanded by an estimated 40%. An analysis from the New York Times shows that SNAP grew by 17% from February 2020 to May 2020, three times faster than in any previous three-month period.

Yet even with that expanded food aid, the program hasn't managed to meet the nation's food security needs. Congressional Democrats have sought to increase funding for SNAP and other nutrition assistance benefits, but prospects appear uncertain.

COVID-19 could double the number of people experiencing food insecurity globally

The problem is hardly unique to the U.S. According to the United Nations World Food Program, the global pandemic has the chance to double the number of people experiencing acute food insecurity, from 135 million in 2019 to 265 million in 2020.

"COVID-19 is potentially catastrophic for millions who are already hanging by a thread," the program's chief economist, Arif Husain said in a statement published this spring. "It is a hammer blow for millions more who can only eat if they earn a wage. Lockdowns and global economic recession have already decimated their nest eggs. It only takes one more shock - like COVID-19 - to push them over the edge. We must collectively act now to mitigate the impact of this global catastrophe."

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Food Insecurity In The U.S. By The Numbers

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With COVID-19 continuing to spread, and millions of Americans still out of work, one of the nation's most urgent problems has only grown worse: hunger. In communities across the country, the lines at food pantries are stretching longer and longer, and there's no clear end in sight.

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Monica Wahlberg has been submitting unemployment claims for the last 14 weeks, but she hasn't seen a cent yet.

After losing her dream job as the director of a Madison, Wisconsin, community arts center in June, Wahlberg was able to carry on for a while without unemployment benefits, thanks to a severance package and her savings. Wahlberg, 45, held out hope that she would be able to find another job in her field, especially since she was asked to do phone and video interviews for a range of potential employers.

But just getting by became more and more challenging as the months dragged on and her pantry supplies dried up along with her savings. After her church sponsored a pop-up food pantry over the summer, her pastor finally asked if she needed some of the leftover supplies. "I appreciated that. I realized I hadn't had any of these canned goods for a while," Wahlberg says.

Wahlberg isn't alone. About 4 in 10 Americans report that they experienced food insecurity for the first time during the Covid-19 pandemic, according to a new poll of 2,000 U.S. adults released Tuesday by Two Good Yogurt and conducted by market research company OnePoll.

About half of those polled say they've struggled to afford food, while 37% report skipping meals themselves so there was enough food for their children to eat. Yet 63% said they didn't realize they were experiencing food insecurity, which is generally defined as when an individual doesn't have reliable access to a sufficient quantity of affordable food.

The majority of Americans experiencing food insecurity, about 60%, say the expiration of many federal assistance programs, such as enhanced unemployment benefits and stimulus payments, has made it even more difficult. About half report that they're struggling to provide food for their families more now than they were at the beginning of the pandemic.

Food insecurity didn't start with the pandemic, but the crisis did exacerbate existing problems.

Prior to the start of the pandemic in March, about 35 million Americans - including approximately 11 million children - lived in households that were food insecure, according to Feeding America, a leading national nonprofit food bank network. That was the lowest food insecurity rate the U.S. had seen in 20 years.

If the unemployment rate averages 10.5% this year and the poverty rate comes in above 14%, which Feeding America expects the U.S. to hit, more than 50 million people will experience food insecurity, including about 17 million children, the organization estimates. The U.S. unemployment rate rose to a record high of 14.7% in April, according to the Bureau of Labor Statistics.

Federal programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Emergency Food Assistance Program (TEFAP) are helping, but food banks and pantries are picking up a lot of the slack. Food banks have been experiencing ballooning demand for months now, which may not be sustainable long-term.

"The problem hasn't gone away," says Laura Lester, director of the Alabama Food Bank Association. "The initial crushing blow of everything has eased up a little, but not as much as you would think."

The high level of demand comes at a cost, Lester says. Her network of food banks has started discussing the "inevitable food cliff." When that happens, food banks may need to limit their services.

That's because food banks are generally responsible for sourcing, storing and delivering supplies to local food pantries. Typically, they'd rely on donated food to supply the majority of their provisions, but that's not enough to keep up now. As a result, food banks are buying more food than ever before to meet the demand.

New York-based City Harvest spent about $10 million on food purchases from March through November. That's up nearly 50 times the $208,000 the organization typically spends in a normal fiscal year.

City Harvest expects that number to continue to rise, says CEO Jilly Stephens. The organization predicts that demand will rise dramatically in January since more federal programs are set to expire at the end of the year, including the Farmers to Families Food Boxes and the Pandemic Unemployment Assistance.

"We don't see the numbers diminishing," Stephens says, especially as things get harder. "When the days get colder and shorter, people need that food."

Plus, it can take people a while to turn to emergency food. Like Wahlberg, there may be many Americans who are struggling right now, but haven't yet turned to food assistance programs or pantries because they're first maxing out their credit cards or spending down their savings.

"Many people will exhaust all sorts of resources before they go and stand in line for food," Stephens says.

Yet perhaps more troubling than food banks' expected shortages is the fact that many people who are grappling with hunger don't know how to get the assistance they need. Nearly 4 out of 5 survey respondents say they struggled to find the support they needed.

Wahlberg was no different. Although she accepted the leftovers from her church's pop-up food pantry, she didn't start to regularly use food pantries until a few months later.

Through a local program focused on workers displaced by the pandemic, Wahlberg received a six-week, part-time job making $15 an hour at Madison-based The River Food Pantry. It was only after she joined The River that she started to regularly make use of their food assistance services.

Initially, though, she'd help didn't grab anything for herself, even though she was struggling. "They asked me, have you picked up food? And I was like, 'No, but I'd like to,'" Wahlberg says. When she did, Wahlberg says there was no judgement or issues.

"There is a stigma of, 'I volunteer and I donate - I don't use these services.' But that really needs to be broken down," Wahlberg says. Working at a food pantry and being a client is what's keeping her afloat right now.

"If I had to spend my own money on food, then that's money I have to cut from my heating bill or my Internet or my telephone," she says. While phone service and Internet may seem like luxuries, she needs those things to apply for jobs, she says.

Although her six weeks with the job placement program recently expired, Wahlberg says the pantry decided to keep her on through the end of the year working 10 hours a week. "I still don't have a [full-time] job and I'm literally living off of my paycheck from The River," Wahlberg says.

But she's quick to point out that she's fortunate to have that paycheck, as well as support from family and friends who have been able to help her out this year. From a board member for her condo association who used their stimulus check to pay Wahlberg's dues for a few months to friends who send her checks in the mail every once in a while, she's able to get by.

"I'm doing OK, but it's through the grace of God and the generosity of my network," she says.
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Covid-19 pandemic is the first time 40% of Americans have experienced food insecurity

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Monica Wahlberg has been submitting unemployment claims for the last 14 weeks, but she hasn't seen a cent yet. After losing her dream job as the director of a Madison, Wisconsin, community arts center in June, Wahlberg was able to carry on for a while without unemployment benefits, thanks to a severance package and her savings.

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by: LUIS ANDRES HENAO and JESSIE WARDARSKI, Associated Press

Posted: / Updated:

Sharawn Vinson, front left, and family members and friends cheer for her daughter, Maddison Washington, 11, as they watch her virtual graduation from middle school in the living room of their three-bedroom apartment in the Brooklyn borough of New York on Friday, Aug. 21, 2020. After months of pandemic isolation and living with the fear of hunger as bills piled up, Vinson and her kids continued volunteering to help feed their own community. (AP Photo/Jessie Wardarski)

This is an archived article and the information in the article may be outdated. Please look at the time stamp on the story to see when it was last updated.

NEW YORK (AP) - At the peak of the coronavirus pandemic this spring, Sharawn Vinson often woke up crying. A recurring thought was making the unemployed single mother desperate: That her kids could go hungry.

There was also fear of contracting the virus, which has disproportionately hit low-income Black families like hers. Meanwhile some of the largest protests against racial injustice in decades were transpiring right outside their window, after the family had experienced its own terrifying encounter with police earlier in the year. There were unpaid bills, and feelings of shame from having to go to a soup kitchen in search of a meal.

So Vinson made the painful decision to send 11-year-old twins Mason and Maddison to live with their father, six states to the south, knowing that way they'd at least be fed.

"I needed them to breathe," Vinson said, wiping away tears in her living room of peeling gray walls in a Brooklyn housing development.

Vinson was not alone in struggling to put food on the table in this historically tumultuous year. In New York City alone, an estimated 2 million residents are facing food insecurity, a number that the city's mayor estimates nearly doubled in the pandemic amid the biggest surge in unemployment since the Great Depression. The scope of the problem outstrips previous crises such as the Great Recession, according to those who are working to combat it, and it's not going away anytime soon.

"It's never been this tragic for such a sustained period of time. Since COVID hit, the numbers of people in line at food pantries and soup kitchens skyrocketed, and it's not going down," said Rosanna Robbins, director of food access and capacity at City Harvest, the city's biggest food rescue organization. "And so I think for us it's just adjusting to the fact that we expect there to be a real need for free food for a very long time to come."

When New York schools closed in March, Vinson's children lost overnight the free breakfasts and lunches they relied on in normal times. Grocery store shelves were poorly stocked, and her pantry was almost bare. She began skipping meals to make sure they ate, and having them wake up later to try to trick hunger by giving them two meals a day instead of three.

"You never realize how important schools are until you don't have them," Vinson said.

"I'd open the refrigerator and I'd see struggle," she added, "and also sacrifice."

Oldest daughter Jasmin, 25, and 5-year-old grandson Hunter were living at a homeless shelter but came to visit her at the Lafayette Gardens public housing complex, where the family would share whatever they could scrape together for lunch.

"It got to the point where the kids would unconsciously save a chicken wing for Hunter," Vinson said.

The family was cooped up for weeks during lockdown, living on just $1,800 a month in worker's compensation from an on-the-job injury Vinson suffered last year when she fell and tore her meniscus.

From the dusty kitchen window of their 16th-floor apartment, they could see the deserted basketball court, slides and monkey bars at the Classon Playground, closed due to the pandemic.

As she tried to stretch meals of spaghetti and frozen burgers, the kids would argue over everything from who got to control the TV remote to who got the last snack. "Everybody was depressed, angry," Vinson said.

Vinson was no stranger to hunger, having been raised in poverty by her mom, also a single mother. Vinson had the first of her six children at age 18 and recalls struggling to pay for diapers and food. But from her mother she learned values that have helped sustain her in difficult times, such as grit and generosity.

She took comfort in prayer and gospel music. One song in particular spoke to her: Melvin Crispel III's "Not the End of Your Story."

"I know that this is just not it," she said of getting through the pandemic. "There's more, there's something, it's not the end."

Across the city, lines at pantries stretched for blocks. Social distancing was complicating food distribution efforts, and many pantries lost older volunteers who stayed home due to high risk of severe effects of COVID-19. A network of churches, volunteers, city government offices, restaurants and immigrant centers stepped in to fill the void.

Vinson then saw a Facebook post seeking volunteers fora pantrythat is run by Kiana Muschett-Owes, the owner of Katie O's restaurant, and nonprofit Rethink Food NYC, which helps fund meals for her initiative, Soul Food for the People. The pantry has provided hundreds of meals to people in need along with notes bearing inspirational prayers or good wishes such as "What doesn't kill you will build you."

"I said, you know what? That's something that's up my alley," said Vinson, whose job before injury and the pandemic was at a shelter for people with mental illnesses and chemical addictions.

Vinson also felt she could set an example for her children. She began bringing Jasmin and the twins to help distribute the food as fellow volunteers, helping teach them values she got from her own mother. It was also a way to make sure her kids got at least one meal a day, from the pantry.

Things seemed to be looking up, but protests and clashes sparked by the police killing of George Floyd raised haunting memories of the incident from earlier in the year when police stormed the apartment building searching for a shooting suspect and pointed their guns at Mason as he was cleaning the litter for his cat, Shadow.

It traumatized the boy and made him angry at police, she said. One day this summer, as she sat outside watching the latest protest, a neighbor called out her name. Across the street, Mason was jumping up and down on top of a patrol car. Vinson ran over.

"And when I grabbed him and I went to chastise him, I was at a loss for words, because how do I tell you not to be angry when four of their brothers in blue had guns to your head?" she said. "How do I tell you not to retaliate?"

Soon after, she called her ex-partner in North Carolina, and on June 4 the twins headed south.

Living without them was hard, she said, but it bought her time to stabilize her ability to provide for them. She saved up food stamps and some money, and found a job working for the 2020 U.S. Census.

One day she asked the restaurant owner who ran the pantry if she could bring back some trays for her housing complex. That effort has since grown to dozens of meals plus groceries and protective face masks that she and other volunteers distribute each Saturday.

The twins finally came home in August, in time for Maddison to celebrate her remote graduation from middle school along with friends and family and for Mason to take part in the first practice of the Brooklyn United Youth Football season.

The police department apologized for the incident involving Mason and hosted him and a group of other kids and their families to discuss their concerns over pizza and chicken wings with high-ranking officers.

"These kids have been enduring a lot in the last couple of months, from the COVID wave to the Black Lives Matter, to the protesters, to the police brutality," Vinson said. "And not too many times people stop and ask, How do they feel?"

The coronavirus outbreak has slowed significantly in New York compared with earlier this year. But times remain tough: Their rent is four months overdue, and the cable is about to be cut off. On a recent day the bathroom flooded, sending water running through the halls.

Still, Vinson feels fortunate.

"There's so many people who are out here who are hungry," she said. "I got my grandson, I got my kids and I got my life. What do I got to complain about?"

___

Associated Press religion coverage receives support from the Lilly Endowment through the Religion News Foundation. The AP is solely responsible for this content.

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A family struggle as pandemic worsens food insecurity

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NEW YORK (AP) - At the peak of the coronavirus pandemic this spring, Sharawn Vinson often woke up crying. A recurring thought was making the unemployed single mother desperate: That her kids could go hungry. There was also fear of contracting the virus, which has disproportionately hit low-income Black families like hers.

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The coronavirus has put food banks throughout the United States in a nightmare position. They are dealing with higher demand, declining donations and fewer people who can volunteer.

Locally, the Greater Chicago Food Depository is bracing for a loss of volunteers because of this fall's big surge in COVID-19 cases and the city's new stay-at-home advisory.

In the fiscal year that ended on June 30, the food depository distributed more than 93 million pounds of food, the equivalent of 77.5 million meals. It was by far the most food the depository has distributed in its 41-year history.

"There is an increase in need," Greg Trotter, spokesman for the depository, told the Sun-Times. "With winter coming and the pandemic raging on, we are very worried."

The Greater Chicago Food Depository serves a network of more than 700 food kitchens, shelters and pantries, organizations that this fall are providing food to 50% more people each month than they were in January.

Tens of thousands of Chicago area residents have long experienced food insecurity and depended on food kitchens and pantries. That is not new. But the pandemic, which has caused unemployment rates to soar, has greatly added to the problem. In Chicago, the unemployment rate was 13.8% in September, more than triple the 3.7% rate back in January.

According to an analysis by Feeding America, Chicago and Cook County rank third in the nation, behind only Houston and Los Angeles, for the number of people - an estimated 798,130, including 256,800 children - who live in food-insecure households. That means they're not sure where their next meal's coming from.

How can you help? You might want to donate money to the Greater Chicago Food Depository.

Or you might want to volunteer to stack cans, pack boxes and the like - in a pandemic-safe environment involving masks, hand sanitizers and social distancing.

To make a donation or sign up, go to: https://www.chicagosfoodbank.org

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Feeding the hungry grows all the more difficult during a pandemic

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The coronavirus has put food banks throughout the United States in a nightmare position. They are dealing with higher demand, declining donations and fewer people who can volunteer. Locally, the Greater Chicago Food Depository is bracing for a loss of volunteers because of this fall's big surge in COVID-19 cases and the city's new stay-at-home advisory.

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U.S. Department of Health and Human Services

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COVID-19 | Five Things About Staying Mentally Healthy During the COVID-19 Outbreak

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Since the onset of the COVID-19 pandemic, food insecurity has increased in the United States. This is particularly true for households with young children.

I document new evidence from two nationally representative surveys that were initiated to provide up-to-date estimates of the consequences of the COVID-19 pandemic, including the incidence of food insecurity. Food insecurity occurs when a household has difficulty providing enough food due to a lack of resources.

The COVID Impact Survey and The Hamilton Project/Future of the Middle Class Initiative Survey of Mothers with Young Children asked validated questions taken from the U.S. Department of Agriculture's (USDA) food security questionnaire in late April 2020.[i] Households and children are considered food insecure if the respondent indicates the following statements were often or sometimes true:

The food we bought just didn't last and we didn't have enough money to get more.

The children in my household were not eating enough because we just couldn't afford enough food.

To compare April 2020 estimates of food insecurity with statistics from earlier time points, I use the same questions listed above to replicate these results with the Current Population Survey Food Security Supplement (FSS), the source of USDA's official food insecurity statistics.[ii]

Figure 1 illustrates the high levels of food insecurity observed in the COVID Impact Survey and in the Survey of Mothers with Young Children. By the end of April, more than one in five households in the United States, and two in five households with mothers with children 12 and under, were food insecure. In almost one in five households of mothers with children age 12 and under, the children were experiencing food insecurity.

Rates of food insecurity observed in April 2020 are also meaningfully higher than at any point for which there is comparable data (2001 to 2018; Figure 2). Looking over time, particularly to the relatively small increase in child food insecurity during the Great Recession, it is clear that young children are experiencing food insecurity to an extent unprecedented in modern times.
Food Insecurity Has Deteriorated More among Households with Children
In the Survey of Mothers with Young Children, 17.4 percent of mothers with children ages 12 and under reported that since the pandemic started, "the children in my household were not eating enough because we just couldn't afford enough food." Of those mothers, 3.4 percent reported that it was often the case that their children were not eating enough due to a lack of resources since the coronavirus pandemic began.

By comparison, in the 2018 FSS, 3.1 percent of mothers with a child age 12 and under reported that their children were not eating enough because they could not afford enough food ever in the past twelve months. The incidence of hardship among children as measured by responses to this question has increased 460 percent.

But responses to this question alone do not fully capture child food insecurity. To estimate food insecurity, the USDA aggregates a battery of questions on access to food from the Current Population Survey. In total for 2018, 7.4 percent of mothers with children under the age of 12 had food insecure children in their household, more than double the share who said that the children in their household were not eating enough because they couldn't afford enough food (3.1 percent). If the ratio between this single question and the overall measure of child food insecurity were to continue to hold today, 17.4 percent children not eating enough would translate into more than a third of children experiencing food insecurity.

The Survey of Mothers with Young Children found that 40.9 percent of mothers with children ages 12 and under reported household food insecurity since the onset of the COVID-19 pandemic. This is higher than the rate reported by all respondents with children under twelve in the COVID Impact Survey (34.4 percent) but the same as women 18-59 living with a child 12 and under (39.2 percent.) In 2018, 15.1 percent of mothers with children ages 12 and under affirmatively answered this question in the FSS, slightly more than the 14.5 percent that were food insecure by the complete survey. The share of mothers with children 12 and under reporting that the food that they bought did not last has increased 170 percent.

Food insecurity in households with children under 18 has increased by about 130 percent from 2018 to today. Using the COVID Impact Survey, I find that 34.5 percent of households with a child 18 and under were food insecure as of late April 2020. On this single question ("the food we bought didn't last...") in the 2018 FSS, 14.7 percent of households with children 18 and under affirmatively answered this question; this value is slightly higher than the overall rate of food insecurity among households with children 18 and under for that year.

High levels of food insecurity are not just a problem of households with children. Prior to the crisis, in 2018, 11.1 percent of households were food insecure and 12.2 percent of households answered the single question in the battery affirmatively. The Urban Institute's Health Reform Monitoring Survey, in the field from March 25 to April 10, used the six-question short form food insecurity module and found that 21.9 percent of households with nonelderly adults were food insecure. By late April 2020, 22.7 percent of households reported in the COVID Impact Survey not having sufficient resources to buy more food when the food that they purchased didn't last. Overall rates of household food insecurity have effectively doubled.
Families Need More Resources to Handle these Material Hardships
Policymakers must act to protect the health and well-being of the American people, especially children.

Luckily, food insecurity is an unusual policy challenge in that it recommends a clear solution. To reduce the number of people, including children, who have insufficient food due to a lack of resources, policymakers can supply the resources.

To increase food security, economic security, and economic stimulus, Congress should increase the generosity of food security programs immediately and ensure that benefits levels stay elevated consistent with economic data. Governors should work with USDA to implement these programs. Specifically:

Increase maximum Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp program) benefits by at least 15 percent and double the minimum benefit;

Provide SNAP emergency allotments, authorized under Families First, to those households that are eligible to receive the maximum level of benefits (more than 5 million children reside in these households and they have received no additional SNAP benefits during this crisis);

Extend Pandemic-EBT through this summer and through at least the end of the 2020-2021 school year to ensure there are sufficient resources to purchase food in the event of ongoing schooling disruptions (Pandemic-EBT is a new program which provides the value of school meals as a grocery voucher to eligible families when schools are closed, a little more than $100 per child per month);

Support families with children ages 5 and under through an additional SNAP multiplier or by broadening eligibility for Pandemic-EBT; and,

Suspend SNAP work requirements for students and sustain the ABAWD SNAP work requirement suspension.

At the very beginning of the COVID-19 crisis, Diane Schanzenbach and I called for "at least" a 15 percent benefit increase to SNAP. Evidence presented in this piece reiterates that a 15 percent increase to SNAP should be the floor.

New nationally representative surveys fielded since the pandemic began show that rates of food insecurity overall, among households with children, and among children themselves are higher than they have ever been on record. Food insecurity represents an urgent matter for policymakers in the capitol and in state houses across the country. Food security programs, centrally SNAP and Pandemic-EBT, must be strengthened and expanded immediately.

[i] The COVID Impact Survey is a nationally representative survey conducted by NORC at the University of Chicago on behalf of the Data Foundation; it uses the AmeriSpeak panel and was in the field from April 20 to April 26, 2020. The Hamilton Project and the Future of the Middle Class Initiative, both affiliates of the Brookings Institution, conducted a nationally representative survey of mothers with children ages 12 and under using SurveyMonkey from April 27 to April 28, 2020. Technical documentation for the COVID Impact Survey can be found here. The Survey of Mothers with Young Children was developed by Lauren Bauer and Richard Reeves; Katherine Guyot and Emily Moss contributed substantially to the development of the survey and we acknowledge the contributions of The Hamilton Project, Future of Middle Class Initiative, and Economic Studies staff at the Brookings Institution. Both surveys used an iterative raking procedure to adjust the surveyed data to match demographic weighting variables obtained from the 2020 Current Population Survey. The COVID Impact Survey was weighted to reflect the U.S. population 18 and over while the Survey of Mothers with Young Children was weighted to reflect the population of mothers with at least one of their own children age 12 and under in their household. Additional technical documentation regarding the Survey of Mothers with Young Children is available from the author.

[ii] While this is a cleaner approach than comparisons to the complete food insecurity battery, the food insecurity time period about which the three surveys ask are each different. I have presented the most conservative estimates throughout this piece, comparing affirmative responses on single questions from the food insecurity battery for the last twelve months (FSS), the last 30 days (COVID Impact Study), and since the coronavirus pandemic began (Survey of Mothers with Young Children). Additional analyses are available from the author.

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The COVID-19 crisis has already left too many children hungry in America

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Since the onset of the COVID-19 pandemic, food insecurity has increased in the United States. This is particularly true for households with young children. I document new evidence from two nationally representative surveys that were initiated to provide up-to-date estimates of the consequences of the COVID-19 pandemic, including the incidence of food insecurity.

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'A Pandemic Within A Pandemic': Coronavirus Lays Bare Long-Standing Racial Disparities

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Black Americans have disproportionately suffered from the coronavirus due to long-standing racial disparities in everything from health care to wealth accumulation. Experts examine the ways racism plays a role in America's institutions, including, but not limited to, police departments. This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations.

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It's no secret that COVID-19 has made a huge impact on small businesses. A recent survey from SCORE outlines just how big the effects have been so far.

Overall, the report, which included responses from 3,500 diverse business owners, found that more businesses are struggling financially. And many Black and Hispanic owned businesses face even greater challenges. However, it also found that businesses have been able to quickly pivot in key areas. And many are still feeling optimistic about the future.

SCORE Survey - COVID Impact on Small Business

More specifically, the report found that a majority of businesses were not able to turn a profit this year. In fact, just 34 percent of small business owners said that their operations are currently profitable. But 55 percent were profitable at this point last year.

Businesses related to travel, arts, and culture experienced the biggest losses this year. But construction firms, restaurants, professional services, health services, and retail also struggled.

Many of these industries were most affected by state shutdowns. But they also tend to be areas that have been deemed "non-essential." So consumers with less disposable income may also simply be choosing to re-allocate their income. And of course, many of these industries require at least some in-person interaction, which many consumers choose to avoid.

Struggles for Minority Owned Businesses

Those numbers are even more pronounced for Black and Hispanic owned businesses. Just 26.5% of Black business owners said that their businesses are currently profitable. That's down from 40% in 2019. Among Hispanic business owners, 29.2% said their business was profitable this year. And 51.2% of them had profitable businesses in 2019.

So why is this disparity present? Much of the answer may lie in access to resources. Paycheck Protection Program (PPP) loans and Economic Injury Disaster Loans (EIDL) served as a lifeline for many businesses. But white business owners were three times more likely to receive these funds than Black and Hispanic business owners. These business owners have also been more likely to struggle with credit and securing investors. And COVID-19 infections, remote work, and lack of childcare also affected these companies more in 2020.

There were certainly inequities in business ownership and access to resources before COVID. But the pandemic has highlighted them even more. Additionally, business ownership among Black and Hispanic individuals has been on the rise in recent years. So addressing these inequities may be key to helping the small business economy recover quickly.

Businesses Adjust Due to COVID

Even though many struggled with profits this year, small businesses are still fighting. Many have been able to stay afloat and keep customers and employees safe with a few changes. Specifically, 43 percent provided PPP to employees, 34 percent allowed teleworking, and 29 percent updated policies.

Additionally, 20 percent of companies added new services to help their communities during this time. Some of these may have simply been to show support. But other companies clearly identified needs with their target customers. And this ability to pivot quickly may have helped a small amount of companies stay profitable or at least avoid huge losses.

Unfortunately, one of the areas where businesses had to adjust most this year was in HR. About 12 percent said they had to permanently lay off employees. And 56 percent either had to furlough employees or cut their hours to make ends meet. These changes allowed many businesses to stay above water. But it almost certainly hindered operations for many. And it could have a long-lasting impact on the economy as a whole.

However, 20 percent did hire new employees during the pandemic. And 41 percent expect to hire more team members within the next year. So with a bit of hard work and careful planning, many teams may be able to rebound quickly. An increase in hiring can help businesses increase output in the coming years and give more individuals access to regular paychecks. And that's one of the biggest things that is going to help small companies thrive going forward.

How Businesses Feel About the Future

It's not all bad news for small businesses this year. Despite the financial challenges, 22 percent of small businesses currently feel very optimistic about the future. And another 33 percent feel somewhat optimistic.

Of course, some policy changes may help small businesses even more. Some are hoping for more PPP loans and enhanced unemployment benefits. But 66 percent agree that stimulus checks for individuals make the biggest impact. Putting money in the hands of small business customers may be the most impactful way to help moving forward.

Overall, there's no denying the negative economic impacts of the pandemic. And the exaggerated effects on minority owned businesses highlight even more problems. But there are some bright spots in the report as well. Small businesses that pivot quickly can help people stay safe and keep their operations running. Ideally, this will all lead to a fast recovery in 2021 - at least many business owners seem to think so.

Get the latest headlines from Small Business Trends. Follow us on Google News.

More in: Coronavirus Biz Advice

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SCORE Looks at Impact of COVID-19 on Small Business in the US

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It's no secret that COVID-19 has made a huge impact on small businesses. A recent survey from SCORE outlines just how big the effects have been so far. Overall, the report, which included responses from 3,500 diverse business owners, found that more businesses are struggling financially.

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Low-income communities of color are at risk of being left behind when it comes to access to the COVID-19 vaccine once it's available to the general public.

The US Department of Health and Human Services announced that large pharmacy chains will distribute the COVID-19 vaccine.

However, some low-income communities are lacking accessible pharmacies.

Visit Business Insider's homepage for more stories.

People in many poor communities across the US are worried that a dearth of accessible pharmacies may limit their access to COVID-19 vaccines once they're available for the general public.

Rochelle Sykes, who lives on the west side of Chicago where there are no pharmacies within walking distance told CNN she's concerned that some of the most vulnerable people may be overlooked. The fact that many of her neighbors have preexisting medical conditions and lack reliable transportation makes the situation particularly dire.

"If they're going to roll out a vaccine and they're going to roll it out to grocery stores and pharmacies, I see a problem," Sykes said. "Is it going to be free? That's one question. And how are they (residents) going to get there to get it?"

The vaccines will be free of cost for most Americans.

An October 2019 analysis in the journal JAMA Internal Medicine, found that between 2009 and 2015, 1-in-8 pharmacies closed and most of them were independently owned providers in poorer urban areas.

Civil rights and public health activists told CNN they were concerned this could leave poor communities in the lurch when it comes to getting vaccinated.

"It's going to be a mad scramble particularly if this vaccine is seen as safe and effective," the Rev. Marshall Elijah Hatch Sr. of New Mount Pilgrim Missionary Baptist Church on Chicago's west side told CNN. "It's very difficult to imagine that there's going to be some kind of egalitarian distribution. We are going to have to fight."

Last month, the US Department of Health and Human Services announced that large pharmacy chains like CVS, Costco, Walmart, Rite Aid, and Walgreens will distribute the COVID-19 vaccine.

"The vast majority of Americans live within five miles of a pharmacy, and our new agreement with pharmacy partners across America is a critical step toward making sure all Americans have access to safe and effective COVID-19 vaccines when they are available," HHS Secretary Alex Azar stated in a release.

However, that may be difficult in low-income areas. In Chicago, only 23% of the 500 active pharmacies were located in areas that were majority Black, CNN reported.

In Philadelphia, the five counties with the highest percentage of Black people had only one pharmacy per square mile compared to 24 pharmacies per square mile in the five counties with the highest percentage of white people, a 2016 study from the University of the Sciences in Philadelphia found.

Efforts are underway across the country to help ensure people who may not have easy access could still get vaccinated.

Jennifer Jones Austin, the CEO and executive director of the Federation of Protestant Welfare Agencies in New York is also a member of a task force that's working to ensure there's equal access to vaccines for people of color.

They've proposed solutions like mobile clinics to help address gaps in healthcare and pharmacy access, CNN reported.

"We don't want a situation where low-income persons, people of color have to travel miles outside of their own community in order to be able to access this vaccine," Austin told CNN. "We have to figure out how to bring that access closer to home."

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Poor communities of color that don't have many pharmacies within walking distance worry they may be left behind when COVID-19 vaccines roll out to the general public next year

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Low-income communities of color are at risk of being left behind when it comes to access to the COVID-19 vaccine once it's available to the general public. The US Department of Health and Human Services announced that large pharmacy chains will distribute the COVID-19 vaccine. However, some low-income communities are lacking accessible pharmacies.

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Educational challenges and opportunities of the Coronavirus (COVID-19) pandemic

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We are living amidst what is potentially one of the greatest threats in our lifetime to global education, a gigantic educational crisis. As of March 28, 2020, the COVID 19 pandemic is causing more than 1.6 billion children and youth to be out of school in 161 countries.

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Is it safe to visit family, friends? Here's what health experts say

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Visiting family and friends in the age of social distancing and coronavirus can be tough. Health experts lay out the risks and concerns associated with visiting others, as well as tips for socializing safely.

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Yvette Alston-Johnson was seething when she got the news. Children in Paterson, New Jersey, would not be allowed to go to school in-person this fall, while many of their peers in predominantly white and affluent suburbs would return.

Alston-Johnson attended Paterson public schools, as did her five children, and she has watched the buildings fall steadily into disrepair over the years. She is now the primary caregiver for her grandson Rayahn, who is in eighth grade at the Dr. Martin Luther King, Jr. Educational Complex, where close to 90 percent of students are Black or Latino.

"I feel like we get the short end of the stick," said Alston-Johnson, who is 54. "We're always last in line when it comes to our schools and money."

"If they did more upkeep on the buildings, the teachers would have been able to teach them in the buildings."

"It's cold in those buildings in the winter and then the A.C. doesn't work in the summer; there's mice running around," she added. "If they did more upkeep on the buildings, the teachers would have been able to teach them in the buildings."

Paterson, which serves mostly low-income families, has struggled to find the money to repair its buildings. Now, like districts across the country, it is seeing the spread of the coronavirus expose a crisis of crumbling and dilapidated school buildings brought on by decades of underfunding and neglect. The consequences are especially dire for Black and Latino children and for low-income children of all races. Schools serving these students were much more likely to remain closed this fall, in part because old buildings were deemed unsafe for both children and teachers during the pandemic. The fallout has left families scrambling for child care and students struggling to keep up with remote learning.

Nationally, school closures forced 41 percent of districts with a high concentration of students living in poverty into offering remote-only instruction this fall, while only 24 percent of districts with a low concentration of students living in poverty kept their doors closed to in-person instruction, according to a report by the Center on Reinventing Public Education.

READ MORE: Districts in Debt

States have no reason to be surprised by the sharp divide in children's access to their schools. More than 40 percent of school districts need to update or replace the ventilation systems in at least half of their schools, according to a report by the Government Accounting Office. Moreover, low-poverty districts spent about $1 billion more on school construction than high-poverty districts in 2016, which comes to 41 percent more per student.

Across the United States, funding for education is largely a local endeavor. Many districts with bustling main streets and abundant resources can erect gleaming modern facilities, while districts with boarded-up storefronts and with little property wealth have little to nothing set aside to patch up crumbling infrastructure. From classrooms without air conditioning in Baltimore to deteriorating facilities in the Mississippi Delta, school infrastructure often follows the pattern of the nation's most entrenched inequalities, intertwining closely with race and wealth.

"There was evidence about the inequalities in school facilities before COVID," said Diana Quintero, a senior research analyst with the Brown Center on Education Policy at the Brookings Institution. Most money for improvements is raised locally, she said, "so schools serving disadvantaged students get less funding to make improvements."

"Now we are just seeing more of those inequalities that we know existed before," Quintero said.

Across the U.S., funding for K-12 facilities remains "inherently and persistently inequitable," according to a 2016 report. The report, a collaboration between nonprofits the 21st Century School Fund, the U.S. Green Building Council and the National Council on School Facilities, found the federal government offers "almost nothing" to address the inequities in school construction. A dozen states similarly provide no direct support to help local school districts maintain their facilities or build new ones.

This fall, New Jersey left the decision of whether to offer in-person classes or remain remote to individual districts, and the results fell sharply along racial lines. As of early October, six out of 10 students in schools that began the year with remote-only classes were Black or Latino, while just three of 10 were white.

Spending levels also tracked with which children had to stay home. The state's school funding formula sets a dollar amount each district needs to provide "an adequate education." The majority of districts that the state says are underfunded by more than $5,000 per student were offering no in-person learning, according to analysis by Mark Weber at New Jersey Policy Perspective.

"Now we are just seeing more of those inequalities that we know existed before."

"Even if you brought those districts up to adequate funding for one year, the facilities can't be fixed in that year because of years, sometimes decades of neglect," Weber said.

Alston-Johnson, sitting in her home in Paterson, said it didn't surprise her to learn that more of the wealthier districts are offering in-person learning.

"There's who's got money and there's segregation," she said. "The biggest loss is that people in upper-income neighborhoods are ahead, more ahead now. It's just going to widen the gap."

In South Carolina, maintenance workers in Dillon School District Four try to mask water-damage by gluing plywood to classroom walls. Five generations of children have passed through the doors of the district's oldest campus, East Elementary, constructed in 1926. If taxes aren't raised for a new grade school, it's possible a sixth generation of learners will attend the school too.

In communities like Dillon County, raising sales or property taxes might be too much to ask. Nearly 34 percent of residents live in poverty. The county was once known for booming textile and tobacco industries that have long since declined. Now, some of the more promising manufacturing work is more than 100 miles away, and median household income is just under $30,000.

Superintendent Ray Rogers is reluctant to ask families who struggle to make ends meet to pay more taxes on clothes and other goods to fix ailing school facilities. But short of receiving a windfall of state or federal aid, he may not have a choice.

Rogers said he is especially frustrated when he sees public schools in the affluent enclaves of the state that rival college facilities.

"We don't have revenue for something like that," he said. He doesn't begrudge districts with state-of-the-art buildings, he said, "I just wish we could do better."

Dillon Four might be one of the furthest behind. The district, where almost three-fourths of students are of color and 90 percent live below the poverty level, is projected to receive less local funding per student than any other non-charter district in the state this year. The figure is an indicator of how the district struggles to cover the basics. And when it comes to a 94-year-old elementary school, ingenuity and dedication can only go so far.

The last time a bond referendum passed was in 2007. It was an exception: Since 2000, 29 school bonds have failed in South Carolina. Even when voters agree to tax hikes, disparities among local economies mean their efforts may not be enough to cover the cost of upgrading school buildings.

"As long as you have districts with low property values that don't have much industry located in that area, clearly, they're always going to be playing catch up," said South Carolina state Rep. Russell Ott, a Democrat.

For decades, families across the country with the lowest incomes have sent their children into buildings where bathrooms are in disrepair and ventilation is poor. For these children, going to school was a precarious endeavor, even before the pandemic. They were more likely to be in poorly ventilated classrooms, swelter in extreme heat and shiver in the cold. Toxin exposure in aging structures put their health at risk.

Now, families wonder how they can trust that their children will be kept safe in these same conditions as a deadly virus rages unchecked.

This fall, Dillon Four reopened with a hybrid teaching model: Students are split into groups and alternate the days they come to campus with days they stay home to complete lessons on their own. Despite this alternative, 60 percent of the district's families opted to keep their children fully online.

Short of an infusion of funding and time for building upgrades, Rogers, the superintendent, said allowing uncomfortable parents to keep their children to stay at home was the best the district could offer. "We didn't try to force anyone to come in," he said.

In classrooms where windows work, teachers try to follow CDC guidance to open windows and circulate fresh air. But years of wear has made doing so a challenge.

"You push them up - you might not get them down," Rogers said.

In early March, just a week before most states shuttered their schools to slow the spread of coronavirus, Rebecca Garcia boarded a plane to Washington, D.C.

Garcia, the president of the Nevada PTA, spent two days on Capitol Hill meeting with lawmakers to lobby for more spending on K-12 infrastructure, as proposed in the federal Rebuild America's Schools Act. The legislation, which has remained on the House floor since last year, would prioritize $100 billion for high-poverty schools to improve the health and safety of their facilities.

Garcia said the pandemic has only hastened the need for that money.

"People don't realize how many of the issues related to reopening schools go back to decades of financial management choices made in public education," Garcia said. "Whether it's school maintenance and repairing A.C. filters, but also class sizes and portables ... Even if we could space everyone out, where are they going to safely teach? We have not invested in the infrastructure."

Back in Las Vegas, where Garcia's children go to school, leaders have faced different problems than their peers in smaller, more rural places, but they're no less daunting.

Since the 1980s, Clark County, which encompasses Las Vegas, swelled from the nation's 18th-largest school district to the fifth-largest. The district had to pour most of its capital budget into building schools to house the surge of students. Older schools, meanwhile, languished in the desert heat.

Now, the district estimates it needs to spend at least $5.4 billion to fix the roofs, replace HVAC systems and keep its aging campuses up and running. The school board in 2015 approved a 10-year plan to issue about $4 billion in new debt for all facility needs - but only about $1 billion of that will go toward renovating or updating schools. (The other $3 billion will pay for building new schools, adding space on overcrowded campuses and entirely replacing older facilities.)

About 3 in 4 students in Clark County qualify for subsidized meals at school, and a similar share identify as children of color. With the exception of students at a few rural schools, none will return to physical classes until January, at the earliest.

READ MORE: When schools reopen, we may not have enough teachers

Jeff Wagner, the district's chief of facilities, acknowledged that deferred maintenance - specifically, concerns about air quality - played a part in the district's decision to delay its reopening. "It certainly was a consideration," Wagner said. Still, he added, "the thing that keeps me up most at night are those older facilities."

Since March, the district has changed the air filters in every building and increased the intake of outdoor air into classrooms. But at the top of Wagner's wish list is to have the money - and time - to install working sinks at every school to encourage hand-washing during the pandemic.

Plumbing regularly fails at Von Tobel Middle School, a high-poverty campus that the district found needs nearly $30 million in renovations. The school relies on an "excessive" number of portable classrooms to absorb over-enrollment, and HVAC issues are a recurring problem.

Still, parent Daisy Larez hoped her two sons can return to the school in person soon.

"They're so tired of staying home and looking at computers," Larez said. One of her sons told her, "This is stupid. This isn't teaching us anything. This is just giving us busy work."

Larez attended Von Tobel herself and recalled its shoddy conditions 20 years ago. But she worried her children's academics were slipping with each day spent away from campus.

"They're not actually paying attention to what the teachers are saying" online, Larez said. "My boys are straight-A students. I don't feel like they're learning anything new."

"These problems don't go away when a vaccine comes."

In June, Democrats in the U.S. House of Representatives reintroduced and passed a version of the Rebuild America's Schools Act as part of a larger $1.5 trillion package, which has stalled in the Republican-controlled Senate. The money, Garcia said, would be critical in Nevada - one of the dozen states that currently provide no money for school facilities.

"Every dollar makes such a huge difference," she said.

Without federal leadership, it's unclear how and even whether individual states can make safer schools a priority as many state budgets buckle under the ongoing recession and ever-growing costs of a public health emergency.

In Colorado, the state has a matching program for costly construction and renovation projects. Through it, the Colorado Springs School District 11 received about $1 million to replace the water lines at one high school, but still has a backlog of about $700 million in maintenance needs. Nine out of 52 schools there have no central air system - a critical component for increasing the turnover of fresh air so necessary during an airborne pandemic - and virtually no schools have new enough equipment to meet federally recommended levels for air filtration, said Glenn Gustafson, deputy superintendent and chief financial officer in Colorado Springs.

"We had challenges with our HVAC systems long before the pandemic, and so (the coronavirus) just put the spotlight on it," Gustafson said.

The district only sets aside $1 million each year to keep up its aging facilities, Gustafson said. Between July and September, to keep students safe from COVID-19, the district spent about $400,000 of that reserve on ventilation issues alone.

In Colorado Springs, about half of students identify as children of color, and a similar share come from low-income households. High schoolers didn't return to campus until October - more than a month after their peers in neighboring Cheyenne Mountain School District 12, where 69 percent of students are white and the median household income is nearly twice that of Colorado Springs.

"Generally speaking, school districts are on their own," Gustafson said.

In Alabama, lawmakers approved a one-time infusion for school construction projects and repairs this summer. Montgomery Schools, a 29,500-student district that averages anywhere from 300 to 500 maintenance requests per week, will receive $32 million in funding for facility projects.

"Generally speaking, school districts are on their own."

It's a help. But the district has more $200 million in deferred maintenance, including replacing floors, installing new roofs, and addressing other capital needs in buildings constructed before the Great Depression.

Director of operations Chad Anderson said the task is overwhelming. For years, Montgomery residents paid the minimum property tax rate - about $100 per year on a $100,000 home. "A $3 million budget doesn't help us very much, when you have 60-plus buildings," Anderson said.

In November, voters agreed to double the district's property tax rate. The increase will bring the district closer to the average property rate in the state, but the tax hike won't start until 2023.

California is perhaps the only state investing a large pot of money to help struggling districts address air quality in schools. Roughly 85 percent of classrooms in the Golden State lack proper ventilation, researchers at University of California Davis found late last year. Assembly Bill 841, which passed in September, will provide upwards of $600 million specifically to upgrade HVAC systems in public schools, prioritizing those in underserved communities.

"I have yet to see another state that has been doing this," said Jeff Vincent, a director and cofounder of the Center for Cities and Schools at the University of California Berkeley.

"The condition in too many schools was bad and doing harm prior to the pandemic," he added. "The pandemic has shined a spotlight on that ... These problems don't go away when a vaccine comes."
This story about school buildings was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for the Hechinger newsletter.

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How deteriorating schools fuel the inequality crisis amid COVID-19

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Yvette Alston-Johnson was seething when she got the news. Children in Paterson, New Jersey, would not be allowed to go to school in-person this fall, while many of their peers in predominantly white and affluent suburbs would return. Alston-Johnson attended Paterson public schools, as did her five children, and she has watched the buildings fall steadily into disrepair over the years.

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A new viral illness called coronavirus disease 2019 (COVID-19) is currently spreading throughout the world at an alarming rate ( Dong et al., 2020). As family nursing practitioners, educators, and researchers, we work from a guiding assumption that health and "illness is a family affair" ( Wright & Bell, 2009, p. ix). Patients, clients, residents, and their families are inextricably connected. The science and practice of Family Nursing is based on a systemic premise offered by Wright and Leahey (2013) that serious illness and life challenges impact the family unit, and reciprocally, the functioning of the family unit (including their structure, development, and function) influences the health and well-being of each family member. This especially holds true for the current coronavirus pandemic which is creating unique hardships and suffering in an alarmingly large number of patients and their families around the world.

Impact of COVID-19 on Families

The assumption that disease and its prevention is a family affair is manifested in the full spectrum and scale of the current coronavirus pandemic. Measures that have been taken in many countries to control the spread of the coronavirus are having a disruptive effect on relationships in general and family relationships specifically. Families are reporting loss of community and freedom of movement in response to quarantine/lock down measures. Other tangible losses include income, access to resources, and planned activities or celebrations. Compelling and heartbreaking stories of the challenges and suffering that families are experiencing engulf us. Individuals and families who are most vulnerable are particularly at risk.

Patients, Clients, and Residents Miss Their Family and Loved Ones

Residents in long-term care facilities miss their partners and children who are no longer allowed to visit because of the COVID-19 policies to contain the spread of the coronavirus. People with intellectual disabilities who live in institutions are upset because their father, mother, brothers, or sisters are no longer allowed to visit, and they often cannot understand why.

Distressing stories abound of patients who have to deal with the news of their COVID-19 diagnosis all by themselves without a family member present and those patients who are admitted to an intensive care unit (ICU) who have to say goodbye to their family in the emergency department not knowing whether they will see each other again. A nurse working at the front line of triage reported, "His family was not allowed to come to the hospital, because they may also be infected. He was alone and couldn't say goodbye."

Families are Concerned About Their Loved Ones

Many of these patients, clients, and residents are members of families who miss their loved ones and who are worried. Mothers, fathers, and other family members of children receiving psychiatric care report being unable visit their child for an extended period of time and are afraid their child will become ill from the coronavirus. Families of very seriously ill and dying patients are not allowed to visit their loved one and may not be able to say a final goodbye.

Families and Family Relationships Are Under Pressure

The lockdown/quarantine measures instituted in many countries have also invited vulnerability and risk within families. Schools are being closed which leads to distress in many families not accustomed to being so closely confined for a long time period. Moreover, as a result of the COVID-19 crisis, much, if not all, of the support given to families who provide long-term care for an ill parent, partner, or child is lost. Families with a child who requires specialized care and guidance now have to care for their child 24 hr a day without the outside guidance provided by medical nursery, daycare, or special education services. Families who care for a father, mother, or partner with dementia or other serious illness now have to manage without day care or daytime activity. School closures have created a family environment where children are rarely allowed to leave the house and are confronted by the vulnerabilities of a family member's addiction, aggression, and violence. Children of divorced co-parents are suddenly being refused alternating parental care because one of the parents now works from home and cannot provide child care. All of these families and their interrelationships are often under great pressure as a result of the stresses created by coronavirus pandemic.

The Urgent Need for Family Nursing Now and in the Aftermath of COVID-19

Health care professionals, including nurses and doctors, are also going through a very intensive and perhaps traumatic time. As a nurse working in the ICU reported, "Many people die without family present. The sorrow that comes with it hurts the nurses mentally." It is encouraging to see how innovative and creative many nurses are becoming during this pandemic as they find ways to involve families. Despite being committed to the care of the ill person, they assure families that their family member is being cared for and will not die alone. They are sometimes able to connect family members to each other using new technology. Mobile phone or video conference calls made by the nurse allow family members to "see" the patient in the ICU or in the nursing home.

Our concerns also focus on the long-term implications for patients and their families; how will they cope once the coronavirus is under control? How will they be able to resume normal life again? Individuals and families are often flexible and resilient ( Walsh, 2016) and many will likely be able to process the experiences of this pandemic and resume their lives. However, there will also be long-term mental and physical health consequences or even permanent damage.

For example, how will patients and families recover after a long period of intensive care? Research has documented that many patients experience many physical and psychological problems after such a long period of ventilation, even after discharge to their home environment ( Rawal et al., 2017). We also know that family members of these patients also suffer greater levels of depression and anxiety ( Davidson et al., 2012).

We also hold our hearts out for families who have lost someone without being able to say goodbye and without being able to be present in the final dying phase of their loved one. How will we assist these families to cope with their loss and complex grief?

Our concerns also go out to the health care professionals, especially nurses and doctors, in the aftermath of this COVID-19 crisis. They too will need support in recovering from their suffering and distress.

The good news is that there is compelling evidence that our family nursing assessment and intervention skills can assist families to heal. This pandemic makes us more deeply aware of the important role of family in the lives of patients, clients, and residents. We anticipate that this increased awareness will help us advocate even more strongly for the importance of family nursing during and after this coronavirus crisis. Rightfully, a great amount of money and resources are now being spent to fight the COVID-19 virus. But lives saved must also be lives worth living afterwards.

We believe that family nursing knowledge, developed over the last 40 years, unequivocally offers the necessary skills to help families recover and heal from the expected and unexpected long-term consequences of this pandemic ( International, Family, Nursing, & Association, 2015, 2017). The aftermath of COVID-19 calls for a substantial increase in the resources needed to (a) enable nurses to assess and intervene with families in need of support, (b) educate nurses to offer highly skilled family nursing care, and (c) conduct research which provides compelling evidence that family nursing assessment and intervention is effective in addressing illness suffering ( Wright, 2017; Wright & Bell, 2009) and optimizing family health. Family nursing has never been more relevant or more urgently needed than now.

This Guest Editorial has been written by members of the FAMily health in Europe- Research in N ursing (FAME-RN) group:

Marie Louise A. Luttik, PhD, RN, Professor in Family Nursing & Family Care, Hanze University of Applied Sciences, Research Group Nursing Diagnostics, Groningen, the Netherlands. Email: ln.eznah.lp@kittul.a.l.m ORCID: https://orcid.org/0000-0002-7853-9773

Romy Mahrer-Imhof, PhD, Professor for Family-Centered Care, Nursing Science & Care Limited, Winterthur, Switzerland; Visiting Professor, Department of Clinical Research, University of Southern Denmark, Denmark. Email: hc.c-sn@rerham.ymor ORCID: https://orcid.org/0000-0002-8587-3817

Cristina García-Vivar, PhD, RN, Senior Associate Professor, Faculty of Health Sciences, Public University of Navarre; Researcher, IdiSNA, Navarra Institute for Health Research, Spain. Email: se.arravanu@ravivaicrag.anitsirc ORCID: https://orcid.org/0000-0002-6022-559X

Anne Brødsgaard, PhD, RN, Senior Researcher, Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre; The Capital Region of Denmark & Section for Nursing, Department of Public Health; The Faculty of Health, Aarhus University, Denmark. Email: kd.hnoiger@nesdam.draagsdeorb.enna ORCID: https://orcid.org/0000-0002-5029-9480

Karin B. Dieperink, PhD, RN, Associate Professor, Head of research, Family focused health care research Center (FaCe) and Vice Head, Department of Clinical Research, University of Southern Denmark; Department of Oncology, Odense University Hospital, Denmark. Email: kd.dysr@knirepeid.niraK ORCID: https://orcid.org/0000-0003-4766-3242

Lorenz Imhof, PhD, Professor for Community-Based Care, Nursing Science & Care Limited, Winterthur, Switzerland. Email: hc.c-sn@fohmi.znerol ORCID: https://orcid.org/0000-0001-8441-3598

Birte Østergaard, PhD, Associate Professor, Department of Clinical Research, University of Southern Denmark, Denmark. Email: kd.uds.htlaeh@draagretseob ORCID: https://orcid.org/0000-0002-9094-8123

Erla Kolbrun Svavarsdottir, RN, PhD, FAAN, Professor, School of Health Sciences, Faculty of Nursing, University of Iceland, Iceland. Email: si.ih@ske ORCID: https://orcid.org/0000-0003-1284-1088

Hanne Konradsen, PhD, Professor, Herlev and Gentofte Hospital, Department of Gastroenterology, Denmark, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Associate Professor, Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Instituttet, Sweden. Email: kd.hnoiger@nesdarnok.ennah ORCID: https://orcid.org/0000-0002-7477-125

References

Davidson J. E., Jones C., Bienvenu O. J. (2012). Family response to critical illness: Postintensive care syndrome-family. Critical Care Medicine, 40(2), 618-624. 10.1097/CCM.0b013e318236ebf9 [[ PubMed] [ CrossRef] Google Scholar]

Dong E., Du J., Gardner L. (2020). An interactive web-based dashboard to track COVID-19 in real time. The Lancet. Advance online publication. 10.1016/S1473-3099(20)30120-1 [ PubMed] [ PMC free article] [ CrossRef]

Walsh F. (2016). Applying a Family Resilience Framework in training, practice, and research: Mastering the art of the possible. Family Process, 55(4), 616-632. 10.1111/famp.12260 [[ PubMed] [ CrossRef] Google Scholar]

Wright L. M. (2017). Suffering and spirituality: The path to illness healing. 4th Floor Press. [ Google Scholar]

Wright L. M., Bell J. M. (2009). Beliefs and illness: A model for healing. 4th Floor Press. [ Google Scholar]

Wright L. M., Leahey M. (2013). Nurses and families: A guide to family assessment and intervention (6th ed.). F.A. Davis. [ Google Scholar]

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A new viral illness called coronavirus disease 2019 (COVID-19) is currently spreading throughout the world at an alarming rate ( Dong et al., 2020). As family nursing practitioners, educators, and researchers, we work from a guiding assumption that health and "illness is a family affair" ( Wright & Bell, 2009, p.

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When Chicago Public Schools opens its doors for in-person classes at the start of the new year, the district expects only about 37% of students to walk in, and white students will be overrepresented.

According to CPS data, that percentage amounts to 77,000 out of about 210,000 students in district-run preschool and elementary schools, plus special education students in cluster programs, who also have the option to return.

School district officials told board members on Wednesday that, despite these numbers, they still believe it is a good idea to offer in-person instruction. They said students are suffering devastating learning loss and in-person learning is the best remedy.

CPS Chief Education Officer LaTanya McDade fought back against the idea that reopening classrooms is inequitable because white students will take up more seats in schools. She said if the school district continues to only offer remote learning, while private and Catholic schools serving more affluent students convene in person, that disparity would be truly inequitable. All fall, McDade and other CPS leaders have highlighted how remote learning isn't working well, in particular for the school district's most vulnerable students.

Under the current plan, preschoolers and special education students enrolled in separate cluster programs start in-person learning on Jan. 11; the vast majority of K-8 students will start on Feb. 1.

Some 31% of Latino and 33.9% Black families said they would send their children into classes; these students make up more than 80% of students in the district.

Meanwhile, 67.5% of white and 33% of Asian parents said their children would be back. Only about 15% of the students in the district are white or Asian.

Valerie Coffman, who works for the social service agency Enlace Chicago, said the Latino families she works with are skeptical about sending children back because they have gotten mixed messages about safety. And even if they understand that the vast majority of children don't get seriously ill from COVID-19, they are worried about them spreading it to grandparents who are at greater risk.

At the board meeting, Yeni Pinedo, a mother from Belmont Cragin on the Northwest Side, said she thinks that students will not be happy staying in classes all day and not going to the cafeteria or gym. "Even bars and restaurants are closed. Why are these being taken more seriously than schools?" she asked. She implored the board to consider that some parents live in communities of high risk.

But Aminah Baker, a mother who has a child at Burnside Scholastic Academy in Chatham on the South Side, said she thinks it is important to have options available. "I believe it is very important for parents who do want their children to end up back in school buildings," she said, noting that different families have different circumstances. Some families might want to send their children back to school because they need more access to food, she said.

The results of the intent to release form responses shows that some schools will be expecting relatively full classes, while others will have just a few students.

According to the school district's plans, elementary school students will only go into buildings two days a week - Monday and Tuesday or Thursday and Friday - to reduce class capacity and overcrowding.

Teachers will simultaneously instruct students who are remote and those who are in person, except on Wednesday when all elementary school students will be remote. This aspect of the return plan in particular has raised concerns among teachers, prompting the Chicago Teachers Union to demand a different plan.

CTU President Jesse Sharkey argues that the students who opt to learn at home, the majority population, will get an inferior education.

There is a question about whether all the students whose parents said they will return will show up. The school district encouraged parents to choose in-person learning on the intent-to-return form, even if they were unsure. Officials said it was easier to plan for more students than fewer.

Also, parents were told that if they choose in-person learning they can switch to remote at any time. But if they choose remote learning they must stick with it until at least April.

School district officials have said they would only delay in-person learning if public health officials determine that community spread of COVID-19 is too great. The high benchmark set with the Chicago Department of Public Health is a doubling of coronavirus cases in less than 18 days. Over the course of the pandemic, the metrics for reopening schools have changed several times.

But the Chicago Teachers Union could also block reopening in January or February. The union has released a set of demands it says must be met before teachers and other staff will return. These include only resuming in-person learning when the COVID-19 positivity rate is at or below 3% and abandoning the idea that teachers could simultaneously instruct remotely and in person. The positivity rate in Chicago is now at 12.3%

On Thursday, the Illinois Educational Labor Relations Board will hold a hearing on the union's request that the board go to court to prevent CPS from reopening without adopting an enforcement agreement with the union. CPS argues it does not need to negotiate reopening issues with the union.

If the union wins an injunction, a deal could take weeks. And even if the union loses, it could still organize labor actions, including a strike.

Sarah Karp covers education for WBEZ. Follow her on Twitter @WBEZeducation and @sskedreporter.

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Only 37% Of CPS Students Say They'll Go Back To School In Person, And White Students Are Overrepresented

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When Chicago Public Schools opens its doors for in-person classes at the start of the new year, the district expects only about 37% of students to walk in, and white students will be overrepresented.

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With the holidays upon us, families everywhere are struggling to make plans appropriate for the pandemic. How do we celebrate when we can't be together as usual? How do we resolve differences of opinion about what is safe? How do we deal with more disappointment and frustration - and help our kids do the same?

We can't tell you what the right (or safe) choices are for your family, but here are some tips to make the best of holidays during the pandemic, whatever your situation. We asked our experts for advice about ways to minimize stress and help everyone in the family feel as good as possible about this unusual holiday season.

Discussions about this year's holidays can be painful, but making plans ahead of time will make the days themselves much less stressful. "I think some people are thinking, 'Let's play it by ear. We still have plenty of time before Christmas. Let's see how the COVID numbers look later,'" says Kenya Hameed, PsyD, a clinical psychologist at the Child Mind Institute. But, Dr. Hameed advises, it's better to work with the information we have now and plan accordingly. That gives everyone time to make good decisions and get comfortable with them, especially if they represent a big change in family traditions kids look forward to - like a shopping trip with grandma or a holiday party with friends.

"The more predictability we can create in this uncertain time, the better it is for kids," notes Grace Berman, LCSW, a social worker. "By making decisions early, you can really help them be prepared for what's going to happen." She suggests outlining for kids what Thanksgiving or Hanukkah or whatever you celebrate is going to look like this year, and then helping them cope ahead with it - work through feelings they might have and come up with strategies to feel better. If you wait until the last minute to figure out plans, kids won't have time to deal with any confusion or disappointment, which will make the holidays that much more stressful for the whole family.

Differences of opinion about how to gather safely may be a huge source of stress this holiday season. Safety measures for any kind of holiday gathering should be discussed clearly and decided in advance, advises Colin de Miranda, ASW, a social worker. "You need clear communication, maybe with everybody getting on a call beforehand and laying out who's comfortable with what," de Miranda says.

Will everyone be tested before coming? Where do we stand on hugging? What are our rules about masks? Avoid awkwardness and conflict (and unexpected risk to your family's safety) by making explicit agreements ahead of time with everyone who's going to be present. By setting those sorts of ground rules, Dr. Hameed adds, anyone who isn't comfortable with the arrangements has a chance to excuse themselves from participating.

Knowing that safety rules have been considered carefully is especially important if you have a child with a lot of anxiety around COVID, notes Berman. Whatever you decide to do, it's comforting for an anxious child to hear from you that the plan is a careful one: "We've thought about it and discussed it with everyone, and this is the decision we've come to. It's okay for you to feel anxious, and here are all the steps that we're taking to make sure that everyone can feel safe."

And what do you do when a guest who has agreed to a socially distanced visit comes in for the hug anyway? Time to refer to those ground rules. "You can say, 'Remember, we discussed this, and so as much as I want to hug you right now or as much as I want to be able to see your face without that mask on, I have to ask you to stick to the rules we set," says Dr. Hameed. It can also be helpful give kids a script to use if someone isn't respecting the rules: "My mom says I'm not allowed to give you a hug this year but we can wave!"
"Clarity and directness upfront will go a really long way in getting people to follow through," adds Berman. "We see that with kids, and we see it with adults as well."

Setting a clear timeline with guests can also boost compliance with rules, especially if guests are going to be drinking alcohol as the gathering does on. Invitations commonly come with a start time but not an end time, notes Dr. Hameed. "So this year, families might want to think about having a time where everyone is expected to leave.

If you're not going to be able to celebrate in the way your family is accustomed to, be proactive and find new activities to make the pandemic holidays special.

"If you're not able to share a meal with friends and family, it could be an opportunity to share in other ways, like building photo albums for family members," suggests de Miranda. Maybe you can cook and swap dishes with nearby loved ones or write letters to relatives you're not able to see in person this year.

Helping your kids think about ways to be kind and generous to others can make this year's changes easier to handle, says Berman. For example, try letting your child pick a charity your family can give to. "We know that when we're dealing with difficult emotions ourselves, doing something for someone else can really help us feel better."

When framing this year as special and creating new activities and traditions, says Dr. Hameed, let kids have a role. What would make this feel special to your kids in positive ways, not just in the negative ways that we're all aware of? What would they like to cook? What games do they want to play? Do they want to set aside time for favorite movies or listen to special music? "Being part of that decision-making process helps offset some of those negative feelings," Dr. Hameed explains.

"A lot of times, as parents, we are trying to come up with ideas for things for our kids," adds Berman. "But really, if you just ask your child, they will have ideas, and that voice that you give them is really important and a strong protective factor."

Remember that all the changes this year can also be a chance to make the holidays more kid-friendly. Maybe everyone dresses up in a costume. Maybe the kids get to try out a messy new recipe or help stuff the turkey, now that the stakes for Thanksgiving dinner aren't so high. Maybe it's a big game of hide and seek that everyone - adults included - participates in. "These might just be simple things that you wouldn't normally do," says Dr. Hameed, "but they can still make things more fun for the kids."

When children are upset about cancelled trips or not seeing cousins, it's tempting to tell them that it'll be fine, and that they'll have just as much fun at home. But it's important to validate their feelings by hearing them out. "You want to really pause and acknowledge that you're disappointed, too, and let them know that it's okay for them to feel disappointed," says Berman.

It's also helpful to model coping with that disappointment in a positive way. Talk to your kids about what you're doing to feel better (like scheduling calls with far-off friends or making a favorite recipe) and help them find their own ways to do the same.

And if kids are upset or angry about your decisions not to participate in a larger family gathering, it's important to validate those feelings too. Dr. Berman suggests language like: "I understand that you're mad right now. It's okay to feel frustrated. We made this decision because we thought it was the best way to stay safe. But it's okay to feel disappointed and mad."

That validation can go a long way in bringing down those feelings, and it gives you an opening to calmly explaining your reasoning. "Sometimes kids get upset because we're making decisions and not really giving them any information," says Berman. Keeping your kids in the conversation and letting them know that you hear them can help them feel respected even in situations that don't go the way they want.

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Holidays During the Pandemic - Child Mind Institute

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With the holidays upon us, families everywhere are struggling to make plans appropriate for the pandemic. How do we celebrate when we can't be together as usual? How do we resolve differences of opinion about what is safe? How do we deal with more disappointment and frustration - and help our kids do the same?

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The NFL's giant COVID-19 experiment ends Sunday with the improbable feat of an on-time Super Bowl, capping a season with no canceled games.

Why it matters: The season suggests that with the right resources, safety measures and cooperation - all of which have been lacking in the general U.S. response - life can go on during the pandemic without uncontrolled spread of the virus.

The big picture: The NFL decided early on that it wouldn't require its thousands of players, coaches and other staff to live in a "bubble," as other sports leagues had done.

Instead,the league scaled up the public health basics of social distancing, testing, contact tracing and isolation across all 32 teams. To prevent spread, officials were prepared to postpone games or bench players.

Jeff Miller, the NFL's executive vice president of communications, public affairs and policy, told Axios: "The approach we took was to appreciate that there was an expectation that individuals would get COVID - and what could we do to prevent it from spreading throughout our facilities."

"Our protocols were built on that premise - that living in our 32 communities during a pandemic was a risk, but we wanted to ensure that as best as possible we could prevent" virus spread.

Between the lines: Some of the NFL's findings were published by the CDC - including what the league learned about transmission of the virus.

The most important changes the league had to make over time related to "our evolution of what a high-risk contact was," Miller said.

The league discovered that risky contacts with an infected person weren't limited to 15-minute interactions within 6 feet. The definition instead became more complex, factoring in time, distance, ventilation and mask-wearing.

"Those four factors all had an interplay within them, which was, in our experience, vastly more complicated than six feet and 15 minutes," Miller said.

The bottom line: "We never saw the virus transmitted across the line of scrimmage," Miller said - even when players who later tested positive participated in the game.

The league was able to confirm this was the case through genetic sequencing.

Go deeper: Super Bowl preview

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How the NFL countered COVID-19, capping a season with no canceled games

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The NFL's giant COVID-19 experiment ends Sunday with the improbable feat of an on-time Super Bowl, capping a season with no canceled games. Why it matters: The season suggests that with the right resources, safety measures and cooperation - all of which have been lacking in the general U.S.

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ALBANY, N.Y. (WROC) - A big change that local athletes have been waiting for.

New York state updated its COVID-19 guidelines Friday to let local county health departments determine if higher-risk youth sports can be played, effective February 1, 2021.

Monroe County Executive Adam Bello and Public Health Commissioner Dr. Michael Mendoza have already signed off on the idea, saying in part in a joint statement Friday: "We support allowing these activities to begin in Monroe County."

In the update Friday:

" Effective February 1, 2021, participants in higher risk sports and recreation activities may partake in individual or distanced group training and organized no/low-contact group training and, further, may partake in other types of play, including competitions and tournaments, only as permitted by the respective local health authorities (i.e., county health departments).

Local health authorities should consider the following factors in authorizing or continuing to prohibit higher risk sports and recreational activities as, in many areas, these factors may weig against permitting such activities:

whether there has been a more-transmissible variant of COVID-19 identified in the area,

local rates of COVID-19 transmission or rate of positivity, and

local ability to monitor and enforce compliance."

Monroe County Executive Adam Bello and Public Health Commissioner Dr. Michael Mendoza issued this joint statement on Friday afternoon:
"Over the past several weeks, we have heard from many parents, families and student-athletes regarding a return of 'higher-risk' high school sports. This is an issue we've been continuously advocating for through the Finger Lakes Regional Control Room, to ensure our young athletes have an opportunity to compete safely. There have been many meetings with the Monroe County School Superintendents and Athletic Directors, as this planning requires public health and safety remain at the forefront. Our school districts have done an incredible job mitigating the spread of COVID-19. We support the Governor's proposal to allow these activities to resume on February 1, 2021, and we support allowing these activities to begin in Monroe County. We will be again meeting with area school leadership in the coming days to develop plans so that our young people in Monroe County can participate.
We know how hard the last 10 months have been for our community, particularly our students and high school student-athletes. The return of high school sports will give them a sense of normalcy, and an opportunity to compete with their friends and classmates. "

Before the update from the state, Dr. Mendoza expressed optimism about the possibility in Thursday's coronavirus briefing.

"The sports themselves have not been a major source of transmission," Dr. Mendoza said. "It's the before and after activities, the gatherings in the homes, in the locker room, etc. I think we can look at this, but the science is limited on how do we proceed with this? We have learned a bit form other parts of the country, but our numbers here are still pretty high. I'm always going to be cautious - that's part of my job, but I also think we need to be open on ways to do this safely, and our schools have demonstrated that time and time again."

Just in - @NYGovCuomo just announced that high school sports can resume February 1st- with the approval of county health directors.
Great news for athletes- and their families.@RochesterChambr
- Bob Duffy (@BobDuffyROC) January 22, 2021

Full guidance
Check back with News 8 WROC as we will continue to update this developing story.

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High-risk high school sports to resume in Monroe County after New York changes COVID-19 guidance

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ALBANY, N.Y. (WROC) - A big change that local athletes have been waiting for. New York state updated its COVID-19 guidelines Friday to let local county health departments determine if higher-risk youth sports can be played, effective February 1, 2021.

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The wait is over for thousands of Chicago Public Schools athletes.

CPS Sports Director David Rosengard emailed schools on Tuesday afternoon that boys and girls bowling, boys swimming and diving, competitive cheer and dance, boys and girls basketball and badminton can begin Thursday.

"Our top priority will continue to be keeping our staff, students and their families healthy and safe," Rosengard wrote. "As we did for our comprehensive health and safety plan for reopening schools, the district is working closely with our public health officials to ensure sports can be offered safely. Winter Sports Guidelines have been outlined and CPS is evaluating the option of voluntary COVID-19 testing for athletes."

According to IHSA rules, basketball teams will need to practice for seven days before they can play games, which means games could begin sometime next week.

"I'm so excited that our students can have this opportunity to play given that everyone else in the state is playing," Young basketball coach Tyrone Slaughter said.

The news comes just one day after Mayor Lori Lightfoot's comments at a news conference revealed she was unaware that the rest of the state was playing sports and CPS was not.

"That's not really our call," Lightfoot said. "Obviously, we're going to follow the guidance of the Illinois State Board of Education, but also the Illinois High School Association. We've been anxiously waiting for further guidance from them. As an unrepentant sports fan myself, I'd like to see kids get back. There's some loosening of the guidelines to let some noncontact sports happen. But . . . as far as I know, we haven't seen anything that's specific to, for example, high school basketball. So I'd like to see us move in that direction, but the state really controls the play, no pun intended, on that issue."

Gov. J.B. Pritzker and the Illinois Department of Public Health announced Jan. 22 that regions would be allowed to play basketball and other higher-risk sports in Phase 4 of the coronavirus protocols. On Jan. 27, the IHSA started the basketball season, and it announced Monday that CPS will be allowed to play basketball until March 20, one week longer than the rest of the state.

The newly released basketball guidelines from CPS say there will be a nine-game conference schedule and a city playoff. It says that Sports Administration "will define the number of nonconference games based on recommendations by the IHSA."

The IHSA currently has no limit on the number of games basketball teams can play.

The guidelines say boys and girls basketball games can be played Monday through Friday with sophomore games starting at 4:30 p.m. and varsity games at 7 p.m. CPS will allow teams to play any school within 30 miles, which is the limit set by the IHSA and the Illinois Department of Public Health.

"I'm going to try and speak with as many people as I can to try and identify as many games as possible to have a productive season," Slaughter said. "We feel good about the potential there of what we can have."

The CPS basketball guidelines specify that a maximum of 50 people will be allowed at games and no spectators are allowed. Here's the breakdown:

20 school representatives per team, maximum 15 players, four coaches and one discretionary administrator.

* Two security officers

* Three game officials

* Two score table workers

* One announcer/streamer

* One paramedic/trainer

* One floater (custodial staff or school based administrator)

The guidelines do not mention if media will be allowed at games. The IHSA and IDPH currently allow media to attend games, but they also allow 50 spectators, which CPS will not.

Read the full CPS basketball guidelines here: 2020-21 BASKETBALL COVID-19 Guidelines.pdf

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CPS says winter sports, including basketball, can start on Thursday

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The wait is over for thousands of Chicago Public Schools athletes. CPS Sports Director David Rosengard emailed schools on Tuesday afternoon that boys and girls bowling, boys swimming and diving, competitive cheer and dance, boys and girls basketball and badminton can begin Thursday.

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Just more than 3% of people living in the city's Upper Falls and Marketview Heights neighborhoods on the northern edge of downtown have gotten the COVID vaccine.

The average is four times higher for the rest of Monroe County, newly released state records show - favoring the east side suburbs, with Brighton and Pittsford topping 22%.

Such disparities have been suspected across the region but data is just beginning to emerge that illustrate to what extent. Similar gaps were evident in New York City when city health officials released ZIP code data there last week.
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The latest data, current as of 2 p.m. Monday, showed ZIP codes in the city of Rochester almost entirely below 10% - infuriating Mayor Lovely Warren, who is expected to outline a plan on Tuesday to begin addressing the inequities.

"My worst fears came true," the mayor said, adding: "It is absolutely atrocious what is happening to the people of our city, and it is wrong."

Overall, 13.6% of Monroe County residents have gotten at least a first dose of vaccine, according to the state's online dashboard - slightly better than the rest of the Finger Lakes counties and trailing only Ontario County (15%). The state did has not responded to requests for regional data.

Talk of equity in administering the vaccine is about closing the gap, reaching these communities with socioeconomically-related health disparities, and predominately Black and brown populations hard hit by the pandemic and with well-documented reasons for being skeptical of a vaccine.

Other factors come into play, including infection rates, and hospitalization rates. But the inequality is evident.

"We haven't done a good job," said Dr. Robert Mayo, chief medical officer for Rochester Regional Health, referring to the need to meet people where they are, offering the vaccine in a setting that is familiar, and staffed by people who reflect the community being served. "We're trying to do a better job in that cultural context."

To that end, Rochester Regional teamed up with the city, Ibero-American Action League, Black Agenda Group and Baden Street Settlement on a Saturday clinic at the Trenton and Pamela Jackson recreation center on North Clinton Avenue.

A steady flow of seniors, mainly people of color, made their way through the clinic, some escorted by caregivers or joined by spouses. Though in the middle of Upper Falls area and 14605 ZIP code, most came from outside the immediate neighborhood.

Joe and Celestine Thomas, ages 78 and 77, respectively, drove down from Avenue D in the 14621 ZIP code, where roughly 6% of residents are vaccinated.

Neither had actively sought an appointment, but took the opportunity when a friend called about the clinic, Celestine Thomas said, calling it "a great experience."

"We're happy," Thomas said.

The data includes nursing homes. But Warren said that doesn't matter, as the city has countless seniors living in their homes, unable to get a vaccine appointment. Her office has a list of 100 or more.

"You should not have to know somebody to get on a list," Warren said. "It is absolutely atrocious what is happening to the people of our city, and it is wrong."

Warren released a statement last week, lamenting that just 200 doses were allocated for the Saturday clinic. She has advocated for a weekly set-aside for vulnerable and marginalized populations, possibly aimed at specific neighborhoods.

The city, Warren said, "must be empowered to work directly with health care providers to arrange and host distribution sites at locations determined by my administration to facilitate accessible access to the COVID vaccines. I look forward to working with the State and County to ensure this happens."

Looking across the Finger Lakes, state data show the region faring much the same as elsewhere in the state - overperforming slightly in vaccinating eligible white residents while underperforming to varying degree with eligible Black and Latino residents.

"The whole approach (to vaccinations) has been backwards for communities of color," said Jason Dunn, who helps coordinate vaccination efforts through Jordan Health Center, and argues such community health centers should have seen higher priority.

Stand-up clinics are necessary, particularly for those without a primary care doctor. But Dunn, who recently retired at Jordan Health's chief operating officer, notes the provider has those established relationships with thousands of patients in the targeted ZIP codes. Yet its vaccine allotment has been minimal, even in the context of the local, state and nationwide shortage.
More: 400 doses for 4,000 people: Front-line clinics struggle with COVID vaccine supplies
Dave Carr is one who did get a vaccine, through Jordan Health, finishing up with his second dose on Feb. 10. The 71-year-old lives in the 14605 ZIP code.

"I've lost several people that I knew very well to the virus," Carr said, including one of his best friends early in the pandemic last March. "That taught me a lesson ... that I would take the shot no matter what.

"I've run into a lot of people saying, 'I'm not taking it,'" Carr said. He trusted his physician. "That's why we have doctors."
Contact reporter Brian Sharp at bdsharp@gannett.com or at 585-258-2275. Follow him on Twitter @sharproc. This coverage is only possible with support from our readers.
The state's ZIP code data estimate vaccination rates as a percentage of each ZIP code's entire population, including children. Adjusting to only the population 16 and older, for which vaccines have been approved, does not noticeably impact rates or shrink disparities. The actual eligible population in each ZIP code is not known.

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"My worst fears came true": Warren vents over data showing low vaccine rate among city residents

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Just more than 3% of people living in the city's Upper Falls and Marketview Heights neighborhoods on the northern edge of downtown have gotten the COVID vaccine. The average is four times higher for the rest of Monroe County, newly released state records show - favoring the east side suburbs, with Brighton and Pittsford topping 22%.