Category Archives: Corona Virus

HONG KONG First, it was travelers and university students bringing the coronavirus back to Hong Kong from Europe and the United States. Then, sea crews and bar patrons were the ones spreading infections.

In the latest wave, a large cluster appears to have started in ballroom dancing halls that are popular with older women, then progressed to other dancing venues and banquet-style restaurants.

For much of the year, every time Hong Kong beat back a surge of coronavirus cases, new problems would pop up weeks later, in other places and among other populations.

Similar patterns hold true in other parts of Asia that are still fighting day-by-day battles to keep their Covid-19 rates from spiraling out of control. And the latest waves of infection are proving harder to trace than earlier ones were just as winter forces more people indoors and raises the risks of transmission.

Japan and South Korea are experiencing some of their highest single-day tallies since the pandemic began, driven largely by diffuse clusters in the Tokyo and Seoul metropolitan areas. Although still below its peak for the year, Hong Kong is facing a surge on par with its summer wave, driven in large part by what experts call untraceable silent transmissions.

Were getting better at having a large testing capacity, and we have a lot of resources for contact tracing, but the cycle repeats, said Kwok Kin-on, an epidemiologist at the Chinese University of Hong Kong.

Compared with the United States and Europe, much of East Asia still has the virus relatively in check. Hong Kong, with a population of around 7.5 million, has had a total of 5,947 cases and 108 deaths, a low rate for any city.

But the recent setbacks underscore the challenges that the world will continue to face until there is a widely available vaccine. As cases have soared back to alarming levels in recent weeks, South Korea, Japan and Hong Kong have had to quickly recalibrate their strategies.

Travel bubbles that were announced with great fanfare are now on hold. Weeks after reopening, schools have been shut again. Bars and restaurants are closing early or shifting to takeaway menus.

We need solidarity in this kind of situation, but as everyone knows, its not easy, said Dr. Kim Woo-joo, an infectious disease specialist at Korea University in Seoul.

Complicating their efforts is the nature of the current outbreaks. Transmission is occurring not only in crowded venues like nightclubs, but also in settings like homes and workplaces where governments have fewer options to control peoples behavior.

On Thursday, South Korea recorded more than 500 new cases for the first time in about eight months. Experts say there doesnt seem to be a single major cluster, as there was when churches and antigovernment protests drove earlier outbreaks.

Pandemic fatigue hasnt helped. Medical personnel are exhausted, young people are bored because they cant travel, and business owners are frustrated because they have to scale back or close early.

Kim Ill-soon, who owns a tea shop in a residential neighborhood of Seoul, said that her business had dropped off after the government this week barred people from dwelling inside cafes. Takeout is still an option, but for many people, chatting over tea in person is part of the draw.

Ive been busy apologizing to my customers for the last two days, she said.

In Japan, the authorities have been reporting about 2,000 infections a day. Cases are spreading rapidly in Tokyo, which reported a record 570 infections on Friday, and around Osaka, Sapporo and other cities. Compared with summer waves, which mainly affected young people, the current one has hit many people in their 40s and older.

In a sign of the countrys alarm, Japans Imperial Household Agency said on Friday that it had decided to cancel Emperor Naruhitos annual New Year event at the Imperial Palace in January the first such cancellation since 1990, when the country was mourning the death of his grandfather.

Please dont underestimate coronavirus, Dr. Toshio Nakagawa, president of the Japan Medical Association, told reporters on Wednesday in Tokyo. We cannot let Japan become like the U.S. or Europe.

The hope is that coronavirus vaccines will soon hand health officials around the globe a new weapon to beat the pandemic. But they wont be widely available until the spring at the earliest.

Until then, and as winter approaches and caseloads soar, medical officials across much of East Asia are pleading for vigilance and rethinking their pandemic policies.

In the spring and summer, the focus was mainly on fighting clusters at their source. Officials in Tokyo and Seoul, for example, responded to ones that had spread mainly from night clubs by temporarily closing down the venues. Hong Kong imposed restrictions on sea crews after a cluster was traced to cargo ships.

This time around, officials seem determined to take a more nuanced approach, apparently driven by concerns about the economic wreckage the pandemic has already caused. But doing so in face of such a pernicious pathogen can open up new challenges.

Hong Kong is rolling out a new contact-tracing app that would allow people to voluntarily scan QR codes on their smartphones when they visit a location, enabling officials to better tackle any clusters that emerge. But such apps have had limited success in South Korea, Britain and elsewhere.

It may be difficult to persuade many people to download the app unless the government provides more details about how personal information will be analyzed. The issue of data privacy is particularly sensitive in Hong Kong because the Chinese government has been tightening its grip on the territory.

Hong Kongers are the most proactive in protecting themselves and their families, but they need to see proof of how the app would benefit them and ensure their privacy, said Leung Chi-chiu, a respiratory specialist with the Hong Kong Medical Association.

The latest waves of infection have also forced governments to slow down their tentative efforts to open up.

Hong Kongers rushed to buy airline tickets to take advantage of a planned travel bubble with Singapore, even before the details were fully known. The special flights would have allowed residents in both places to avoid 14-day quarantines upon arrival.

The travel bubble was supposed to start this week. Then Hong Kongs cases spiked, and officials postponed the start to Dec. 6.

In Japan, Prime Minister Yoshihide Suga has scaled back a roughly $16 billion campaign designed to encourage domestic tourism during the pandemic. But he has not scrapped it entirely, saying it helps to support local economies.

For people like Noriko Hashida, who sells cosmetics in Osaka, taking a vacation last week with eight of her work colleagues was worth the risk of infection.

Ms. Hashida said that a tourism subsidy from the government allowed them to spring for a luxury hotel that would have ordinarily been out of their price range. We enjoyed it so much, she said.

Still, they decided to cancel a sightseeing tour of the island because the optics were a little awkward.

We thought that the local residents wouldnt feel comfortable seeing visitors from Osaka, where infections are spreading rapidly, she said.

Mike Ives and Tiffany May reported from Hong Kong and Makiko Inoue from Tokyo. Youmi Kim contributed reporting from Seoul, South Korea.

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Why Hong Kong, South Korea and Japan Have to Keep Beating Back Coronavirus - The New York Times

In a 1988 essay on pandemics Joshua Lederberg, Nobel laureate and president of The Rockefeller University, reminded the medical community that when it comes to infectious disease, the laws of Darwin are as important as the vaccines of Pasteur.

As medicine battles bacteria and viruses, those organisms continue to undergo mutations and evolve new characteristics.

Lederberg advised vigilance: We have no guarantee that the natural evolutionary competition of viruses with the human species will always find ourselves the winner.

With the emergence of what seem so far to be safe and effective vaccine candidates, it appears that humanity may be the winner again this time around, albeit with a dreadful loss of life.

But vaccines wont put an end to the evolution of this coronavirus, as David A. Kennedy and Andrew F. Read of The Pennsylvania State University, specialists in viral resistance to vaccines, wrote in PLoS Biology recently. Instead, they could even drive new evolutionary change.

There is always the chance, though small, the authors write, that the virus could evolve resistance to a vaccine, what researchers call viral escape. They urge monitoring of vaccine effects and viral response, just in case.

Nothing that were saying is suggesting that we slow down development of vaccines, Dr. Kennedy said. An effective vaccine is of utmost importance, he said, But lets make sure that it stays efficacious.

Vaccine makers could use the results of nasal swabs taken from volunteers during trials to look for any genetic changes in the virus. Test results need not stop or slow down vaccine rollout, but if recipients of the vaccine had changes in the virus that those who received the placebo did not, that would indicate the potential for resistance to evolve, something researchers ought to keep monitoring.

There are some reasons to be optimistic that the coronavirus will not become resistant to vaccines. Several years ago, Dr. Kennedy and Dr. Read presented an analysis of the difference between resistance to drugs and vaccines. Neither bacteria nor viruses evolve resistance to vaccines as easily as they do to drugs, they wrote. Smallpox vaccine never lost its effectiveness, nor did the vaccines for measles or polio, despite years of use.

Antibiotics, on the other hand, can quickly become useless as bacteria and other pathogens like viruses and fungi evolve defenses. And resistance builds to other drugs as well.

The reasons have to do with the very basic principles of evolution and immunity. The two key differences are that vaccines generally act earlier than drugs, and that the natural immune response they promote is usually more varied, with more lines of attack. A drug may be narrowly targeted, sometimes attacking one metabolic pathway or biochemical process.

With most drugs, the virus or bacteria has already been reproducing in the patients body and if one variant is better at surviving the drugs attack, it will continue to grow and perhaps be transmitted to another person. A combination of drugs, as with H.I.V. treatment, can be more effective because it unleashes a multipronged attack

Vaccines, on the other hand, act early, before the virus begins to proliferate and perhaps change within a patients body. So there are no new variants, like those forged in the heat of a drug attack to grow and spread from the infected person.

Vaccines offer the bodys immune system a glimpse of the virus, and then the immune system builds a broad attack. For example, after a tetanus shot, a persons immune system may produce 100 different antibodies.

Some vaccines, however, do drive viruses to evolve resistance, Drs. Kennedy and Read noted in their 2015 article. A vaccine stopped Mareks disease, an illness in chickens that is important commercially. But the virus could still infect the chickens. It replicated and spread without causing disease and quickly became resistant.

In humans, a type of bacteria that causes pneumonia bacteria evolved resistance to a vaccine when the bacteria recombined in nature with existing strains that were naturally resistant. A vaccine for hepatitis B created antibodies targeting only one small part of one protein a loop made by nine amino acids, which is tiny in protein terms. It did not create a broad attack. A pertussis vaccine also appeared to drive resistance. It worked to fend off the disease, but targeted only a few proteins and was not effective at stopping infection and transmission of the virus.

The coronavirus vaccines now in development use different ways to get the immune system to respond. Some coronavirus vaccines under development or in use in Russia and China, use whole virus particles, inactivated or attenuated, to spark an immune system response.

Many other vaccine candidates, like the ones from Pfizer and Moderna, now nearing review by the Food and Drug Administration for first use as early as December, are meant to get the immune system to react to only a portion of the coronavirus, the so-called spike protein, which would seem to offer fewer targets.

But Dr. Kennedy said that was not necessarily a problem. A vaccine based on just the spike protein has the potential to generate a broad immune response, he said, because there are multiple sites on the spike protein where potent neutralizing antibodies can bind.

Although these are the first vaccines that use RNA particles to instruct the cells to make a viral protein, other vaccines use parts of the virus, rather than the whole. So far, Dr. Kennedy said, there was no evidence to show one type of vaccine would be more likely to drive resistance. We have seen vaccine resistance evolve against many different kinds of vaccines, he said, but there are also plenty of examples for each of these where resistance has never emerged.

Resistance can also evolve in ways that arent driven by how a vaccine acts. There may already be variants of the coronavirus that are less susceptible to the actions of vaccines. This concern prompted Denmark to announce that it would cull all of its mink because a variant of the virus had appeared in mink which showed in very preliminary lab tests that some antibodies were less effective against it.

The worry has lessened since the Danes announced the problem, with scientists and the World Health Organization saying they saw no evidence yet that the variant would interfere with any vaccines in development.

But Denmark, after the resignation of a minister, who announced the cull too soon, and a legislative debate that appears to be leading to approval of the cull, still plans to kill all the mink in the country.

Confused by the all technical terms used to describe how vaccines work and are investigated?Let us help:

And scientists say that caution in this kind of situation makes sense. As a virus jumps from people to animals and back again, as it has with mink, there are more opportunities for changes in the virus RNA, changes that could lead to resistance.

Researchers at the University of Pittsburgh have discovered a kind of mutation that hadnt been seen in coronaviruses before and raises fresh concerns about the evolution of vaccine resistance.

In their search for mutations, researchers have mostly focused on flips of one genetic letter to another a kind of mutation known as a substitution. But Paul Duprex and his colleagues discovered that the viruses mutating in a chronically infected patient were changing differently: They were losing sets of genetic letters.

Typically, a mutation that deletes a genetic letter is catastrophic to a virus. Our cells read genetic letters three at a time to choose a new building block to add to a growing protein. A deletion of one genetic letter can entirely scramble the instructions for a viral protein, so that it cannot form a functional shape.

But Dr. Duprex and his colleagues found that the coronaviruses in the patient could lose genetic letters and yet stay viable. The secret: The viruses lost genetic letters in sets of three. Instead of destroying the genetic recipe for a viral protein, the mutations snipped out one or more amino acids.

As much as Dr. Duprex despises the pandemic, he finds it hard not to admire the elegance of these mutations. Its so cool, its brilliant, he said.

Having found these deletion mutations in viruses from one person, Dr. Duprex and his colleagues wondered how common they were.

Searching public databases of coronavirus genomes, they discovered that deletions were surprisingly widespread. Its happening independently in different parts of the world, Dr. Duprex said.

All the deletions, it turns out, only arise in one region, the spike protein. Dr. Duprex and his colleagues found that deletions in the spike gene didnt prevent the coronavirus from infecting cells.

Dr. Duprex and his colleagues posted their study online Nov. 19. It has not yet been published in a peer-reviewed journal. The researchers are now infecting animals with deletion-mutant viruses to better understand the risk they may pose to vaccines.

Well, this paper does nothing to reduce the anxiety! Dr. Read said in an email. This is early data strongly suggesting the virus has the potential to escape human immunity.

But Drs. Read and Kennedy argue that viral evolution wont necessarily doom vaccines. Vaccine makers just need to stay aware of it, and devise new vaccines if necessary.

And there are numerous varieties of vaccines in development. The first two approaching approval in the United States both use a significant chunk of viral RNA to train the immune system. Other vaccines that are in development use the whole virus. And different vaccines deliver the virus or part of it in different ways, all of which could prompt a different immune response.

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The Coronavirus Won't Stop Evolving When the Vaccine Arrives - The New York Times

Infectious disease experts say the misconception that coronavirus is "just like the flu" is both dangerous and wrong.

Between 2014 and 2018, influenza and pneumonia on average killed 1,632 Tennesseans and 1,466 Georgians each year, according to the U.S. Centers for Disease Control and Prevention. So far in 2020, at least 13,862 people combined in both states have died due to the coronavirus, according to the COVID tracking project.

"It is a more worrisome virus, and to say [the coronavirus] is just the flu is both wrong and contributes to the problem," said Dr. Mark Anderson, an infectious disease specialist at CHI Memorial Hospital. "It lessens people's concern about it they're less likely to adopt the proper precautions, and that leads to wild, unchecked spread."

Anderson said that although there are similarities in how the two respiratory diseases present, there are also some distinct differences between the viruses.

For one, medical professionals have much more experience recognizing and treating influenza, Andrson said. And more importantly, they are able to prevent the flu through vaccinations something that's in the works but not yet available for COVID-19.

"We have vaccinations that in some years are highly effective for influenza, some years not. But almost every year, there's some degree of protection," he said. "We have drugs that work against influenza pretty well, and that can radically alter the clinical course, and those can also be used in certain circumstances for prevention, as well."

Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health, said in an online article that COVID-19 is more serious because it can cause more severe illness and most of the population has no immunity.

"Many more people are susceptible to COVID-19 because there is little preexisting immunity to the virus that causes it SARS-CoV-2. Through vaccinations and previous infections, a portion of the population has some immunity to influenza, which helps limit the number of cases we see each year," Pekosz said.

While both are highly contagious and primarily spread from person to person through infected respiratory droplets, influenza infections typically follow a similar course abrupt onset of muscle aches and fever, with cough developing a day or two later. Symptoms usually last five days to a week, and possibly less for people who got their flu shots.

On the other hand, disease progression for the coronavirus is much more unpredictable, Anderson said.

Although COVID-19 can present like the flu, it can also mimic the common cold, causing sinus congestion, sore throat and a cough that may or may not be associated with a fever, as well as loss of taste and smell. Some people experience gastrointestinal illness, and in rare cases, clotting issues that can lead to stroke or inflammation of the tissue that surrounds the brain and spinal cord.

Pekosz said another factor is that more COVID-19 survivors report long-term effects of the virus than influenza survivors.

"Lingering symptoms like weakness, shortness of breath, trouble focusing and, in some cases, kidney and heart problems are much more common after COVID-19 than after influenza," he said.

Although many COVID-19 patients experience mild or no symptoms, Anderson said that complicates our ability to control the coronavirus.

"A huge thing is the fact that it's transmitted by asymptomatic people, and a small percentage of them transmit it dramatically," Anderson said, adding that in general, people are able to transmit COVID-19 in the two days leading up to showing symptoms. "Once we gained this appreciation of the pre-symptomatic spread, that's when I think people began to get much more concerned about what this virus was going to do."

Knowing what we know now, Anderson said people should have been more concerned about the coronavirus when it first emerged. He thinks Americans may have been too complacent, because the world managed to avoid a pandemic with SARS and MERS two other coronaviruses that cause severe illness and came before COVID-19.

"I think we were lulled a little bit by the fact that we've had scares before which didn't materialize into a pandemic," he said. "As we often say in medicine, things just look so clear through the retrospective scope."

Contact Elizabeth Fite at efite@timesfreepress.com or follow her on Twitter @ecfite.

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Not 'just like the flu': Experts say misconceptions, complacency, helped coronavirus spread - Chattanooga Times Free Press

The first time, she was just 22 years old with a full-time job in publishing that didn't pay enough to cover her rent and grocery bills in Tokyo. "I was really poor," said Kobayashi, who spent three days unconscious in hospital after the incident.

Now 43, Kobayashi has written books on her mental health struggles and has a steady job at an NGO. But the coronavirus is bringing back the stress she used to feel.

"My salary was cut, and I cannot see the light at the end of the tunnel," she said. "I constantly feel a sense of crisis that I might fall back into poverty."

Experts have warned that the pandemic could lead to a mental health crisis. Mass unemployment, social isolation, and anxiety are taking their toll on people globally.

"We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," said Michiko Ueda, an associate professor at Waseda University in Tokyo, and an expert on suicides.

"That suggests other countries might see a similar or even bigger increase in the number of suicides in the future."

While the reasons for Japan's high suicide rate are complex, long working hours, school pressure, social isolation and a cultural stigma around mental health issues have all been cited as contributing factors.

The pandemic appears to have reversed that trend, and the rise in suicides has disproportionately affected women. Although they represent a smaller proportion of total suicides than men, the number of women taking their own lives is increasing. In October, suicides among women in Japan increased almost 83% compared to the same month the previous year. For comparison, male suicides rose almost 22% over the same time period.

There are several potential reasons for this. Women make up a larger percentage of part-time workers in the hotel, food service and retail industries -- where layoffs have been deep. Kobayashi said many of her friends have been laid off. "Japan has been ignoring women," she said. "This is a society where the weakest people are cut off first when something bad happens."

Compounding those worries about income, women have been dealing with skyrocketing unpaid care burdens, according to the study. For those who keep their jobs, when children are sent home from school or childcare centers, it often falls to mothers to take on those responsibilities, as well as their normal work duties.

Increased anxiety about the health and well-being of children has also put an extra burden on mothers during the pandemic.

Akari, a 35-year-old who did not want to use her real name, said she sought professional help this year when her premature son was hospitalized for six weeks. "I was pretty much worried 24 hours," Akari said. "I didn't have any mental illness history before, but I could see myself really, really anxious all the time."

Her feelings got worse as the pandemic intensified, and she worried her son would get Covid-19.

"I felt there was no hope, I felt like I always thought about the worst-case scenario," she said.

In March, Koki Ozora, a 21-year-old university student, started a 24-hour mental health hotline called Anata no Ibasho (A Place for You). He said the hotline, a nonprofit funded by private donations, receives an average of over 200 calls a day, and that the vast majority of callers are women.

"They lost their jobs, and they need to raise their kids, but they didn't have any money," Ozora said. "So, they attempted suicide."

Most of the calls come through the night -- from 10 p.m. to 4 a.m. The nonprofit's 600 volunteers live around the world in different timezones and are awake to answer them. But there aren't enough volunteers to keep up with the volume of messages, Ozora said.

They prioritize the texts that are most urgent -- looking for keywords such as suicide or sexual abuse. He said they respond to 60% of texts within five minutes, and volunteers spend an average of 40 minutes with each person.

Anonymously, over online messaging, people share their deepest struggles. Unlike most mental health hotlines in Japan, which take requests over the phone, Ozora says many people -- especially the younger generation -- are more comfortable asking for help via text.

In April, he said the most common messages were from mothers who were feeling stressed about raising their kids, with some confessing to thoughts of killing their own children. These days, he says messages from women about job losses and financial difficulties are common -- as well as domestic violence.

"I've been accepting messages, like 'I'm being raped by my father' or 'My husband tried to kill me,'" Ozora said. "Women send these kinds of texts almost every day. And it's increasing." He added that the spike in messages is because of the pandemic. Before, there were more places to "escape," like schools, offices or friend's homes.

Japan is the only G-7 country where suicide is the leading manner of death for young people aged 15 to 39. And suicides among those under 20 had been increasing even before the pandemic, according to health ministry.

As pandemic restrictions take children out of school and social situations, they're dealing with abuse, stressful home lives, and pressures from falling behind on homework, Ozora said. Some children as young as five years old had messaged the hotline, he added.

Morisaki says he thinks there's a big correlation between the anxiety of children and their parents. "The children who are self-injuring themselves have the stress, and then they can't speak out to their family because probably they see that their moms or dads are not able to listen to them."

In Japan, there is still a stigma against admitting loneliness and struggle. Ozora said it's common for women and parents to start the conversation with his service with the phrase: "I know it's bad to ask for help, but can I talk?"

Ueda says the "shame" of talking about depression often holds people back.

"It's not something that you talk about in public, you don't talk about it with friends or anything," she said. "(It) could lead to a delay in seeking help, so that's one potential cultural factor that we have in here."

Akari, the mother of the premature baby, agrees. She had previously lived in the US, where she says it seems easier to seek help. "When I lived in America, I knew people who went through therapy, and it's a more common thing to do, but in Japan it's very difficult," she said.

But both Ozora and Kobayashi say it has not been nearly enough: reducing the suicide rate requires Japanese society to change.

"It's shameful for others to know your weakness, so you hide everything, hold it in yourself, and endure," Kobayashi said. "We need to create the culture where it's OK to show your weakness and misery."

A succession of Japanese celebrities have taken their lives in recent months. While the Japanese media rarely details the specifics of such deaths -- deliberately not dwelling on method or motive -- the mere reporting on these cases often causes an increase in suicide in the general public, according to experts such as Ueda.

Hana Kimura, a 22-year-old professional wrestler and star of the reality show "Terrace House," died by suicide over the summer, after social media users bombarded her with hateful messages. Hana's mother, Kyoko Kimura, says she was conscious that media reports on her daughter's death may have affected others who were feeling suicidal.

"When Hana died, I asked the police repeatedly not to disclose any concrete situation of her death, but still, I see the reporting of information only the police knew," Kimura said. "It's a chain reaction of grief."

Kimura said the pandemic led her daughter to spend more time reading toxic social media messages, as she was unable to wrestle because of coronavirus restrictions. Kimura is now setting up an NGO called "Remember Hana" to raise awareness about cyberbullying.

"She found her reason to live by fighting as a professional wrestler. It was a big part of her. She was in a really tough situation as she could not wrestle," Kimura said. "The coronavirus pandemic made society more suffocating."

In recent weeks, Japan has reported record-high daily Covid-19 cases, as doctors warn of a third wave that could intensify in the winter months. Experts worry that the high suicide rate will get worse as the economic fallout continues.

"We haven't even experienced the full economic consequences of the pandemic," Ueda said. "The pandemic itself can get worse, then maybe there's a semi-lockdown again; if that happens, then the impact can be huge."

But as cases rise, some worry harsher restrictions will be needed -- and are concerned about how that could affect mental health.

"We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," Ueda said. "That suggests other countries might see a similar or even bigger increase in the number of suicides in the future."

Despite having to deal with a salary cut and constant financial insecurity, Kobayashi says she is now much better at managing her anxiety. She hopes that by speaking publicly about her fears, more people will do the same and realize they are not alone, before it's too late.

"I come out to the public and say that I have been mentally ill and suffered from depression in the hope that others might be encouraged to speak out," Kobayashi said. "I am 43 now and life starts to get more fun in the middle of my life. So, I feel it's good that I am still alive."

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In Japan, more people died from suicide last month than from Covid in all of 2020. And women have been impacted most - CNN

BOGOT, Colombia A little boy charges along the highway, his red plastic shoes glowing in the twilight. The suitcase he pulls weighs almost as much as he does. A truck throttles by, threatening to blow him off his feet. But Sebastin Ventura, who at just 6 has already taken on the role of family cheerleader, urges his family on.

To Venezuela! he shouts.

His mother, four months pregnant, rushes to keep up. There are hundreds of people on the highway that night, all Venezuelans who had fled their countrys collapse before the pandemic and found refuge in Colombia. Now, after losing their jobs amid the economic crash that followed the virus, they are trying desperately to get back home, where at least they can rely on family.

The global health crisis wrought by the coronavirus has played out most visibly in hospitals and cemeteries, its devastating toll clocked in cases and deaths, its aftermath tracked in lost work and shuttered businesses.

But a second, less visible aspect of the catastrophe has unfolded on the worlds highways, as millions of migrants Afghans, Ethiopians, Nicaraguans, Ukrainians and others have lost work in their adopted countries and headed home.

The fortunate ones have found a haven upon return. But many have run out of money along the way, have been rejected at border crossings or have arrived in war-torn countries only to find their past lives burned to the ground.

And so they have kept on moving.

International aid groups have begun to call these people the pandemics stranded migrants men, women and children who have been trying to get home since the virus began to spread. The International Organization for Migration said recently there are at least 2.75 million of them.

Among the most affected have been Venezuelans, who even before the pandemic formed one of the largest migration waves in the world. As the oil-rich nation crumbled in the grip of its authoritarian leader, Nicols Maduro, hunger became widespread and nearly five million people fled.

But when the virus hit, Venezuelans living abroad were often the first to lose jobs in their adopted nations, the first to be evicted from pay-per-day apartments in cities like Lima, Quito, and Bogot, Colombias capital.

In the first months of the pandemic, more than 100,000 Venezuelans left Colombia, according to immigration authorities. Others poured out of neighboring countries.

Over six months, Sebastin and his mother, Jessika Loaiza, traveled more than 1,500 miles, nearly all of it on foot first from Colombia to Venezuela, and then, unable to find a safe harbor, to Colombia again.

They began their journey in Bogot in early May, headed to the small home they owned in northern Venezuela.

Jessika, 23, said they had left Venezuela the year before, escaping the violence that had consumed her neighborhood. Local criminals had killed her husband, she said, leaving her a widow at 22.

In Bogot, she found work at a florist, making bouquets for weddings and parties. She loved it.

I had an excellent job, she says. From now on, I want this to be my art.

Sebastin started school and began to learn to read.

But when the pandemic hit, the shop closed, and she lost her work. They began sleeping on the street.

Jessika didnt want to leave Colombia. But she hoped that, back home, she could live rent free, rely on government help and outrun the cascading effects of a spreading pandemic.

Pausing on the side of the highway on one of her first nights on the road, her eyes dart toward the growing darkness, then to her son.

She is worried about where they will sleep.

Lets walk, she says.

Her family follows. With her and Sebastin is her new partner, Javier; her mother, Peggy; her brother, Jess; and her sister-in-law, Grelymar, also pregnant.

Cars roar past. Sebastins suitcase scrapes the uneven pavement, the soundtrack to his new life.

They have been on the road since dawn, but he is buoyant, racing along the shoulder like a Boy Scout on his first adventure, eager to show off what he knows, to question what he doesnt.

This is the place where the train passes, he says, stopping on a bridge above the tracks, leaning perilously over a ledge, trying to understand where the train comes from and where it is going.

He knows that they are escaping something bad, he says. The virus, he explains, it kills people.

They must be headed to something better, he reasons. Right?

Each day, they walk until their feet turn numb, beg for meals, camp on the roadside, hide from the police patrolling for quarantine breakers.

And each night, Jessika scans the horizon for a safe place to sleep a covered porch, a thicket in the forest refusing to stop until they find one.

It is June 32 days and 250 miles since they left and Jessikas T-shirt stretches thin over her balloon of a belly. Sebastin is skinnier, browned by the sun.

They are in Bucaramanga, 120 miles from the Venezuelan border. Hundreds of families all pandemic migrants crowd the edge of a park, anxious to get home. Smugglers offer rides to the border in exchange for telephones, clothing.

There, Jessikas mother, Peggy, makes a call and learns that their house in Venezuela has been taken over by the same criminals that ran them out the year before. Peggy begins to cry.

We cant go back, she says.

Stuck now between two countries and two lost homes, they decide to press on, handing the money they have left, $30, to a smuggler. When he tells them its not enough, Jessikas brother, Jess, removes his shoes. He hands those over, then scrambles barefoot into a crowded cargo truck, with the others.

It is after midnight when the truck begins its climb into the mountains. It speeds over a frigid pass. Passengers vomit. At dawn, they pull to a stop by a river, a six-hour walk from the border.

Get out, yells the smuggler. This is as far as we go.

Sebastin stretches his short legs. They are back on the road.

Jessikas hopes swell as they near the border her country! then shatter the moment they cross.

In Venezuela, she learns the government has been using its repressive security apparatus to try to control the virus. In the border town of San Antonio del Tchira, officials corral her and her family into a detention center. They are given coronavirus tests and cots in a tent with 600 others. There, they sleep under military guard for days.

Each morning, Sebastins concern is what they will eat. Meal lines are long, and theres never enough. There are no forks or knives, and so they feed themselves with their identity cards, cutting with the sharp side, spooning with the flat side.

Sebastins anxiety hits a fever pitch. He asks his grandmother constantly where they will live, what they will eat and when he can return to his classroom.

On Day 17 of detention, men in white begin calling names of returnees who have tested positive for the virus. Jess Loaiza! one announces. As the men take Uncle Jess away, Sebastin begins to scream.

After a month, the Venezuelan government lets them go. Jess rejoins the family and they head to Grelymars grandmothers home, with its pink walls and flower-print curtains, in the city of San Felipe.

They soon discover a Venezuela in far worse condition than the one they left. With quarantines in place, jobs are scarce and gasoline is almost impossible to find. Mr. Maduro has consolidated power in recent months; the prospect of a political transition, of any sort of change, feels more distant than ever.

One morning, the refrigerator holds two eggs, a piece of cheese and a bit of rice.

Desperate, Jessika, her partner, Javier, and Sebastin move in with Javiers mother, on a small farm in the town of Sabaneta the birthplace of Hugo Chvez, the father of Venezuelas socialist-inspired revolution. There are 15 of them, including Javiers brothers, their wives and children.

Sebastins legs have turned to sticks. He tries to play with the other children, but breaks away to plead to his mother.

Mom, Im hungry, he tells her. Mom, theres nothing here.

Jessika begins to replay the events of the past few months. All that walking, all those days in the rain, the cold, had amounted to nothing. Venezuela is in free fall.

At least in Colombia there is the chance of a recovery.

Jessika is eight-and-a-half months pregnant. She calls her mother to tell her she is going to walk the 600 miles back to Bogot.

With that belly? her mother says.

I came like this, she responds, and Ill return like this.

It is September. On the road, Sebastin recovers some of his old buoyancy. And once again, the highway is filled with Venezuelans.

The Colombian economy is on edge, coronavirus cases are rising and unemployment has surged. Officially, the border between the two countries is closed. But thousands of Venezuelans are streaming back to Colombia on illegal paths, having seen the conditions at home and hoping against many odds that they will find work in the cities they left behind.

Colombian officials say they expect 80 percent of those who left early in the pandemic to return. When the border reopens, they predict, 200,000 Venezuelans will enter Colombia in the first three months alone.

What were searching for is a future, says Javier.

They are once again in Bucaramanga, 250 miles from Bogot, sharing a brick-walled room with a single bed, when Jessikas water breaks and she begins to bleed. Javier hustles her up a steep hill, to a hospital. After weeks of bravery, Jessika is terrified.

Why is there so much blood? What has all that walking done to her child?

Doctors wheel her into the operating room, and, just after midnight, deliver her baby boy. Josnaiber Xavier Morillo Loaiza is underweight barely five pounds but healthy.

Outside the hospital, Javier is worried. They have no home, no jobs, not even money for the alcohol Jessika will need to clean the incision on her belly from the cesarean section.

Could it be that I will never have a home? Javier says. That I will never be able to rest?

But Jessika is unwavering. Hours after giving birth, she says she plans to wait until the doctor removes her stitches. Then Ill get up and keep on walking.

Six months after leaving Bogot, Jessika, Javier and Sebastin step off a bus at the citys Salitre terminal. The driver, seeing the infant, had given them a ride.

Jessika, just days from her 24th birthday, hugs Josnaiber to her chest. Javiers bag is so broken that it is held together by string. Sebastins shoes are worn nearly through their plastic soles.

But he bounces through the terminal, electrified by their return.

Colombias economy has begun to reopen. In the morning, theyll message the florist, and Jessika will ask for her job back. But that evening, with nowhere else to go, they curl up to sleep under a footbridge, inches from an eight-lane highway, homeless for one more night.

Julie Turkewitz reported from Colombia. Isayen Herrera reported from Venezuela. Reporting was also contributed by Federico Rios and Sofa Villamil.

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Coronavirus Strands Millions of Migrants - The New York Times

More Americans are staying home for the holidays amid COVID-19 restrictions and want a new or renewed tradition to end a dreary year on a happier note.

PORTLAND, Ore. Ani Sirois, a respiratory nurse, has spent months caring for coronavirus patients at a Portland, Oregon, hospital, and she's only getting busier as infections and hospitalizations surge before the holidays.

But on a recent sunny day, COVID-19 seemed far away as she, her husband and their 2-year-old daughter roamed a Christmas tree farm in search of the perfect evergreen for a holiday season unlike any other. The family was tree-shopping nearly a week before Thanksgiving and, for the first time, they were picking their own tree instead of buying a pre-cut one.

Its nice to have home be a separate safe space away from the hospital, and whether we can have a gathering with family or not, I know well have our own little tree with the purple lights, and thatll be something small to look forward to, she said.

The real Christmas tree industry, which has been battling increased interest in artificial trees, is glad to see that more Americans appear to be flocking to fresh-cut evergreens this season, seeking a bright spot amid the virus's worsening toll.

It's early in the season, but both wholesale tree farmers and small cut-your-own lots are reporting strong demand, with many opening well before Thanksgiving. Businesses say they are seeing more people and earlier than ever.

At some pick-your-own-tree farms, for example, customers sneaked in well before Thanksgiving to tag the perfect tree to cut down once the business opened. As demand surges, big box stores are seeking fresh trees up to a week earlier than last year, and Walmart is offering free home delivery for the first time.

The season is running approximately six to seven days ahead of what we've seen in the past. Weve never seen the demand like weve had this year, said McKenzie Cook, who ships between 1.8 million and 2 million trees a year combined from McKenzie Farms in Oregon and Happy Holiday Christmas Trees in North Carolina.

A number of reasons are driving the uptick in interest. More Americans are staying home for the holidays amid pandemic restrictions and are realizing that for the first time in years or maybe ever they will be home to water a fresh-cut tree. With holiday parades and festivals canceled, stir-crazy families also are looking for a safe way to create special memories.

Plus, fresh-cut Christmas trees are largely displayed outside, where there's a lower risk of viral spread, said Marsha Gray, executive director of the Christmas Tree Promotion Board.

The national organization says industry research tells them many people who put up an artificial tree last year plan to buy a real tree this year, and most are citing the pandemic as the reason.

Yes, its a product, its a decoration that you put in your home, but getting a real tree involves the choosing, the hunting for it, the family outing. It really is a memory maker, its a day you spend together, and it really becomes much bigger than the tree itself, Gray said. Its really making family memories and people really seem to gravitate to that right now.

The growing interest in real trees comes after the industry has struggled to attract new, younger customers in recent years as more Americans buy artificial trees.

Between 75% and 80% of Americans who have a Christmas tree now have an artificial one, and the $1 billion market for fake trees has been growing by about 4% a year despite them being reusable.

No one tracks annual sales of real trees because independent tree lots are so scattered, but those in the business estimate about 20 million trees or more are sold each year, most of them at big box stores such as Costco and Home Depot.

Oregon, the nations No. 1 supplier of fresh-cut trees, expects to ship nearly 6 million evergreens this season to places as far away as Japan and China. Other top tree exporters are Washington state, North Carolina and Pennsylvania.

The fresh-cut tree industry in 2018 launched asocial media campaign called It's Christmas. Keep It Real! to attract young families and media-savvy millennials.

This year, the Christmas Tree Promotion Board also asked Rob Kenney, creator of the Dad, How Do I? YouTube channel, to makean instructional video for newbies on how to shop for and put up a real tree, then keep it alive. It's gotten tens of thousands of views.

We want to introduce real Christmas trees to young families and new buyers and create greater demand among those people who say, Im a little nervous about just taking a tree and dragging it into my house,'" Gray said.

It appears that message is breaking through as Americans seek a happier way to close out a difficult year.

Lee Farms, a sixth-generation family farm in Tualatin, Oregon, opened for the season a week earlier than last year. It sold more than 100 trees in the first four hours and was seeing new faces at a business that normally welcomes the same customers each year.

It's almost a new or a renewed experience for a lot of families this year, said Teagan Milera, co-owner of Lee Farms. Having that real tree smells so good in your house, something to take care of and decorate together, that nothing beats that for the holiday season.

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Many people turning to real Christmas trees as bright spot amid coronavirus pandemic - WWLTV.com

Coronavirus today and the open line - Arkansas Times

On

The line is open. The COVID count is down a bit along with test numbers, but check the positive test rate. Not good.

Said the governor:

There are 1,349 new COVID-19 cases in Arkansas. This is down from last Saturday, but we will know more in the coming ten days as to how we did over Thanksgiving. Continue to take every precaution and lets not let up.

The COVID-19 pandemic is reshaping all aspects of life in Arkansas. We're interested in hearing from doctors, nurses and other health care workers; from patients and their families; from people in longterm care facilities and their families; from parents and students affected by the crisis; from people who have lost their job; from people with knowledge of workplaces or communities that aren't taking appropriate measures to slow the spread of the disease; and more.

Read the rest here:

Coronavirus today and the open line - Arkansas Times

Cough, fever, chills with fall fast on the way, symptoms alone wont be useful in distinguishing Covid-19 from similar-looking cases of the flu. That means routinely testing for both viruses will be crucial even, perhaps, after some patients have already died.

That will at least be true in New York, where officials recently announced a ramp-up in post-mortem testing for the coronavirus as well as the flu. Deaths linked to respiratory illnesses that werent confirmed before a person died are to be followed up with tests for both viruses within 48 hours, according to the new regulation.

These regulations will ensure we have the most accurate death data possible as we continue to manage Covid-19 while preparing for flu season, Dr. Howard Zucker, the states health commissioner, said in a statement last week.

Deceased hospital patients and nursing home residents, as well as bodies in the care of funeral directors or medical examiners, will be among those targeted for follow-up testing. If experts at a local facility cant perform the test themselves, they can ask the state to run the test for them at its public health lab.

Although the results of these tests will be too late to change the course of treatment for the deceased, they can still help health officials track the prevalence of both types of infections, as well as indicate whether to warn close contacts of the deceased that they may need to quarantine.

People need to know who around them was sick, said Dr. Valerie Fitzhugh, a pathologist at Rutgers New Jersey Medical School. If someone cant be tested in life, why not test them soon after death?

Putting regulations in place ahead of time will also encourage counties to bolster their testing readiness ahead of autumn and winter, when seasonal viruses like flu and respiratory syncytial virus, or R.S.V., tend to thrive, said Dr. Mary Fowkes, a clinical pathologist at Mount Sinai Hospital in New York. In many parts of the country, coronavirus cases are still ratcheting up every day and will become more difficult to track when similar sicknesses muddle the picture.

I think that is important to prepare for, Dr. Fowkes said.

In the early days of the pandemic, New York, like the rest of the country, struggled to rein in the virus. Many illnesses went untested, including those of several thousand people whose deaths were later reclassified as presumed, but unconfirmed, cases of Covid-19.

A lot has changed since the spring, said Gareth Rhodes, deputy superintendent and special counsel at the New York State Department of Financial Services and a member of Gov. Andrew M. Cuomos virus response team. After a sputtering start to testing in March, New York is now running about 100,000 coronavirus tests a day, with positivity rates hovering around 1 percent or less. While hundreds remain hospitalized throughout the state, daily deaths attributable to Covid-19 have averaged in the single digits since late August.

The new regulations also stipulate that living patients with flulike symptoms or a known exposure to the coronavirus or a flu virus should be tested for both pathogens. That makes it less likely that a case will be missed in the first place.

We track fatalities very closely, Mr. Rhodes said. At this point, he added, New Yorks coronavirus testing regimens in medical settings are pretty consistent. You cant really be a hospital in New York right now without testing, he said.

The regulation doesnt apply to all deaths just those suspected of being linked to a respiratory illness.

That means the new rules on post-mortem testing probably wont change coronavirus case numbers much, if at all. Since the announcement, made last Sunday, the Wadsworth state lab has not yet received a request to process a post-mortem test, Mr. Rhodes said.

Updated September 4, 2020

Still, the regulation may come in handy if, for example, a death were to occur en route to the hospital or shortly after arrival, or if an emergency prompted a temporary lab closure so that tests could not be immediately run. Others might die at home, or elsewhere outside the care of a hospital or nursing home, without easy access to tests.

This is designed to catch anything that fell through the cracks, said Dr. Rosemary She, a pathologist at the University of Southern Californias Keck School of Medicine.

Thorough testing can also affect which bodies are autopsied at medical examiners offices, where resources and staff have been strained, said Dr. Erin Brooks, a pathologist at the University of Wisconsin-Madison. Someone whose cause of death can be confirmed by a positive test for the coronavirus, for instance, might not need to be investigated further.

A number of pathologists noted that while coronavirus testing for sick patients is just about ubiquitous in medical settings in other states, combination testing that includes the flu, including post-mortem testing, is not as common and may need to be considered.

More laboratories will most likely need to invest in tests that can detect multiple types of pathogens at once. One of the tests run at Wadsworth, for instance, is a so-called respiratory panel, made by a company called BioFire, that simultaneously searches for genetic material from more than 20 types of bacteria and viruses, including the coronavirus and multiple types of flu viruses.

Some experts have postulated that proactive measures like continued physical distancing and vigilant mask wearing might soften the blow of this years flu season, as they appear to have done in the southern hemisphere.

But its in our best interest to prepare for the worst, Dr. Fitzhugh said, and hope for the best.

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New York Will Test the Dead More Often for Coronavirus and Flu - The New York Times

Seventeen new coronavirus cases have been reported in the state, health officials said Sunday.

Sundays report brings the cumulative total of coronavirus cases across the state to 4,682. Of those, 4,210 have been confirmed positive, while 472 were classified as probable cases, according to the Maine Center for Disease Control and Prevention.

No new deaths were reported on Sunday, leaving the statewide death toll at 134. Nearly all deaths have been in Mainers over age 60.

Heres the latest on the coronavirus and its impact in Maine:

While a small number of Maine churches have been publicly fighting the states limits on large indoor gatherings, they are greatly outnumbered by the hundreds of other congregations that have chosen to follow the rules that are meant to prevent the spread of COVID-19. Charles Eichacker, BDN

Theresa Dentremont, who died from COVID-19 on Aug. 21 at the age of 88, always had a positive attitude, loved to stay creative and work with her hands, and was the anchor for her family. Thats how family members of the East Millinocket resident remembered her in an obituary published in the Bangor Daily News. Dentremont was the first of three people so far whose deaths have been linked to an outbreak of COVID-19 that stemmed from an Aug. 7 wedding in the Katahdin region. Emily Burnham, BDN

Not many county or state fairs in the U.S. are continuing on without major changes, about 80 percent have been called off or drastically scaled down by eliminating carnival rides, concerts and tractor pulls, according to the International Association of Fairs and Expositions. Some are only allowing youth livestock competitions and auctions or opening for fair food drive-thrus. The Associated Press

Normalcy has been tough to come by during the COVID-19 pandemic, particularly for school-age children whose classroom routines havent been the same in nearly six months. That loss has been compounded for Maines sports-minded youth by the loss of their after-school passions, beginning with the spring sports season and now stretching into the start of fall activities. Ernie Clark, BDN

Pandemic-induced project delays and postponements have hurt construction companies in Maine and across the nation, spotlighting the need for more federal help and additional workforce development strategies, a recent industry report found. Lori Valigra, BDN

There is a lot of angst among Maine high school athletes involved in fall sports programs. Thats because they are still awaiting word on whether they will have a season. Larry Mahoney, BDN

As of Sunday afternoon, the coronavirus had sickened 6,262,989 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 188,711 deaths, according to Johns Hopkins University of Medicine.

Go here to read the rest:

September 6 update: The latest on the coronavirus and Maine - Bangor Daily News

We're making this important information about the pandemic available without a subscription as a public service. But we depend on reader support to do this work. Please consider joining others in supporting independent journalism in Alaska for just $3.23 a week.

As flu season fast approaches, public health officials have expressed concerns about further stress placed on hospital capacity. And this week, federal health officials told states to prepare for a COVID-19 vaccine to be available as early as November, raising questions about who will be able to get the vaccine and when.

Well continue to answer your questions about the coronavirus on a regular basis. What do you want to know? Tell us in the form at the bottom of this story or go here.

If all goes well, Alaskans could see a COVID-19 vaccine as soon as November, state and federal officials said this week. Initially, only small amounts of the vaccine will likely be available, and will be distributed in three phases.

FILE - This March 16, 2020 file photo shows vials used by pharmacists to prepare syringes used on the first day of a first-stage safety study clinical trial of the potential vaccine for COVID-19, the disease caused by the new coronavirus, in Seattle.

While some public health officials have expressed concern about a rushed timeline, Dr. Anne Zink, the states chief epidemiologist, said during a briefing Wednesday that the development of a vaccine for COVID-19 is building on a large body of existing science and data, and that just because theres a certain timeline doesnt mean that its unsafe.

Part of the reason for the relatively speedy timeline is also the great deal of resources, initiative and brainpower that has gone into developing a vaccine, she said.

The vaccine also doesnt have to be absolutely perfect at preventing 100% of infections, she added: It just has to be safe and effective.

Many of our vaccines help to minimize the risk of death and hospitalization, and even that alone has a tremendous impact of the number of people who die of a disease, she said.

The federal Centers for Disease Control and Prevention released documents last week that described how states should prepare for two coronavirus vaccines. Both vaccines have undergone extensive testing and are in currently in the final rounds of testing, according to the documents.

While the current trials are still determining whether the vaccines are safe and effective, neither vaccine caused serious side effects in their first human studies, and both spurred the creation of antibodies that could attack the coronavirus.

According to the CDC planning documents, the first group eligible to get the vaccines will include health care workers, essential workers (includes food service workers, teachers, librarians and others who interact with the public on a regular basis), and workers and residents of long-term care facilities like nursing homes.

Phase two will be reserved for those the CDC has classified as high risk for severe illness from the virus, which includes adults 65 years and older and those with certain preexisting health conditions.

During the final phase, which most likely wont begin until well into the new year, most other Alaskans would be able to get vaccinated. Two groups that have not yet been included in any of the clinical trials are children and youths (anyone below the age of 18) and pregnant women, which means the initial doses of vaccine that are scheduled to come out in November will not be available to them.

Of course, this timeline is based on the assumption that the final clinical trials go well, Alaska state officials said on a call Wednesday.

The state of Alaska is not currently considering mandating that people receive COVID-19 vaccinations once they are available, said Dr. Zink.

She added that her public health team would not get prioritized for the first phase of vaccinations unless they were directly caring for patients.

State employees dont have some special access to vaccines, she said.

The state has been gearing up for the coming flu season: Alaska has bought enough of the flu vaccine to immunize up to 55% of the population for free, though small administrative costs may be included. When the private-sector supply is factored in, up to two-thirds of Alaskans can get and should get covered this year, health officials say.

Christine Calderon gives a flu shot to Steve Hall of Eagle River at the Alaska Regional Hospital drive-through flu shot clinic in 2014. (Marc Lester / ADN)

Both influenza and COVID-19 are life-threatening respiratory illnesses with overlapping symptoms. Nine people in Alaska died from influenza in 2019, according to a spokesperson for the Department of Health and Social Services. Hospitals are not required to report the number of patients hospitalized with the flu, but hospital capacity in Alaska has been affected during flu season in the past.

The CDC has said that the timing of when you get the flu shot matters because of waning immunity, meaning that antibodies to influenza slowly decline in your body months after receiving a flu shot.

Later in September through the end of October is the ideal time to get your shot so that it lasts the duration of flu season in Alaska, state health officials have said. No matter when you get it, adults should only get one shot per year.

Only children ranging from 6 months old through 8 years old who have never gotten a flu shot before will need two doses.

I get the flu vaccine every year, and see how it saves lives, Zink said. I plan to do the same with a COVID vaccine based on the data I see so far.

Private-sector doses of the vaccine are already available in pharmacies around the state, and are available for free with insurance.

Because the state has so much of the vaccine this year, all adults in Alaska can get a free vaccine even without insurance through a provider that offers state-supplied vaccines.

You can visit the state health departments website to find a public health center near you thats distributing the flu vaccine.

If you have no symptoms, that test ideally should happen within seven to 14 days after exposure. But if you do have symptoms, you should get tested right away, per state guidelines.

Excerpt from:

Alaska coronavirus Q&A: Who will be able to get a vaccine once they're available? Why does the flu shot matter? - Anchorage Daily News