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Traveling ER doctor shares experiences fighting Covid-19
03:46 - Source: CNN
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An increasing number of states and communities say they are planning to resume or expand in-person learning a year into the coronavirus pandemic, as new infections decline and vaccinations rise.

North Carolina’s governor on Wednesday announced an agreement on a bill with lawmakers – still to be passed – that would remove capacity limits from middle and high schools.

Los Angeles’ main school district this week reached a tentative deal with teachers to resume in-person classes for many of their youngest students by April. New York City’s high schools will reopen by March 22, as its other schools did earlier.

And leaders in other states, including Arizona, Oregon and New Mexico, say they’ve ordered or otherwise expect all their schools to offer in-person instruction in the next few days or weeks.

This comes as states increasingly ease other coronavirus restrictions or rules, including Texas, which on Wednesday lifted its statewide mask mandate and began letting businesses operate at full capacity. Several leading public health experts have said it’s too soon to drop those rules, concerned that more-contagious variants might fuel another case spike in just several weeks’ time.

But if anything should reopen, they should be schools, the director of the Centers for Disease Control and Prevention told ABC’s “Good Morning America.”

“Schools should be the first place to open,” Dr. Rochelle Walensky told ABC. “So, if your schools are not open, I don’t believe that we should be opening other places because we really do need to get our children back to school.”

The CDC released guidance in the past few weeks aimed at safely getting children and teachers back to school.

Although that guidance didn’t insist that teachers be vaccinated before returning to class, the CDC did recommend they be prioritized for the shots. Most states allow teachers to be vaccinated now, and all 50 will make them eligible by Monday.

 United Airlines flight attendants receive Covid-19 vaccines at United's onsite clinic at O'Hare International Airport on March 9, 2021 in Chicago, Illinois

New guidance says nursing home residents may receive visitors indoors

The Centers for Medicare & Medicaid Services on Wednesday offered new recommendations for nursing homes to allow for “responsible” indoor visitation, regardless of whether the resident or visitor has been vaccinated.

“CMS recognizes the psychological, emotional and physical toll that prolonged isolation and separation from family have taken on nursing home residents, and their families,” CMS Chief Medical Officer Dr. Lee Fleisher said in a statement.

“That is why, now that millions of vaccines have been administered to nursing home residents and staff, and the number of COVID cases in nursing homes has dropped significantly, CMS is updating its visitation guidance to bring more families together safely,” Fleisher added.

Visitation may need to be limited for residents with a confirmed case of Covid-19, residents in quarantine, and unvaccinated residents living in facilities where less than 70% of residents are vaccinated and counties with a positivity rate greater than 10%, CMS said.

The American Health Care Association and National Center for Assisted Living reported last week that US nursing homes have seen the lowest number of new coronavirus cases since CMS began tracking cases in May 2020.

‘We’re not out of the woods yet,’ Fauci says

Texas isn’t the only state moving to end its mask mandate. Utah will lift its statewide mask rule on April 10, the governor’s office said.

At least 16 states don’t have mask mandates now, and a few others, including Alabama, have said they intend to join that list within weeks.

Some public health experts have encouraged people to keep masking and distancing until significantly more vaccinations happen, regardless of what states may allow.

They point to a potential threat from more-transmissible coronavirus variants, such as B.1.1.7, the one first identified in the United Kingdom. That one, they say, is a threat in part because their share caught in surveillance testing is increasing, and because spring break trips may promote more spread.

“We’re not out of the woods yet,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN on Wednesday. “When you start doing things like completely putting aside all public health measures … that’s inviting (another case surge) when you do that.”

Still, Covid-19 inoculations are rising. More than 62 million people in the country have received at least one shot, and 32.9 million – or 9.9% of the US population – are fully vaccinated, according to CDC data.

That’s not high enough yet to crush the spread of the coronavirus through herd immunity, something experts say would take months still.

But if case rates keep dropping while the country gets more vaccines into arms, the nation will get “closer to being safe from another (case) surge,” Fauci said.

“You can never put your guard down completely. … (But) once you get a substantial proportion of the population vaccinated, that is a very, very strong defense against there being another surge,” Fauci told CNN’s “New Day.”

The country has averaged more than 55,800 new Covid-19 cases a day over the last week – a 13% decline from the week previous, and well below the nation’s pandemic peak average of more than 255,300 a day on January 10, according to Johns Hopkins University data.

The nation’s test-positivity rate, or the percentage of tests taken that turn out to be positive, averaged about 4.2% over the last week as of Sunday – one of the country’s lowest averages recorded during the pandemic, according to data collected by the Department of Health and Human Services.

But the positivity rate isn’t dropping everywhere. In Houston, Mayor Sylvester Turner said Monday his city’s positivity rate was 13.1%, higher than it was last week. Texas’ seven-day average rate as of Sunday was 7.3% – down from 9.5% a week earlier, according to HHS data.

Some states announce more people now eligible for a shot

This week, several state leaders announced they were opening up current eligibility requirements as vaccine supply expands.

Alaska took it the furthest by making vaccines available to everyone living or working in the state who is at least 16 years old – becoming the first state in the country to do so.

Pfizer’s Covid-19 vaccine is the only one available for use by people who are 16 or older, while the Moderna and Johnson & Johnson vaccines are both restricted to people 18 or older.

In Vermont, Gov. Phil Scott announced Tuesday the state will allow anyone 16 or older who has certain high-risk conditions to schedule a vaccine appointment starting Thursday.

Dr. Mark Levine, Vermont’s health commissioner, said that to make vaccine distribution more equitable, the state will allow household members accompanying eligible residents who are Black, indigenous or people of color to vaccine appointments, to also get a vaccine starting next week.

In Louisiana, Gov. John Bel Edwards also said Tuesday people 16 and older with certain health conditions are now eligible to get a vaccine.

Georgia will expand eligibility to anyone over 55 starting March 15 and to “those with high-risk conditions defined by the CDC,” Gov. Brian Kemp said Wednesday.

All adult Georgians could become eligible in April if the vaccine supply is adequate, Kemp said.

High rates of depression, anxiety and PTSD among health care workers

Rates of depression, anxiety and PTSD among health care workers during the pandemic were significantly higher than what’s expected in the general public, according to a study published Wednesday in the journal PLOS ONE.

The study found that more than 21% of health care workers have symptoms consistent with depression, compared with estimated rates of 4.4% in the general global population, according to the World Health Organization.

According to the study, 22% experienced anxiety and 21.5% experienced PTSD, compared with estimated global rates of about 3.6% for anxiety disorders, including PTSD.

“Fears for personal safety, high workload (particularly for those treating infected patients) and limited support may have contributed to fatigue, burnout and stress among health care workers,” the researchers said.

The researchers said action is needed now to address serious mental health concerns for health care workers.

The researchers, at the London School of Hygiene & Tropical Medicine, analyzed 65 studies spanning 21 countries, and nearly 100,000 health care workers were included in the analysis.

CDC wants more data before giving travel guidance to vaccinated people

When the CDC released guidance this week for what people can do when they’ve been fully vaccinated, it did not mention travel.

Walensky, when ABC asked her Wednesday why travel guidance wasn’t included, said her agency is waiting for more information – such as whether the coronavirus cases spike again, and how soon vaccine protection fades.

“This is some of the data and evidence we are watching really carefully,” Walensky told ABC. “We are watching for breakthrough infections; we’re monitoring this really carefully. And that’s some of the science that we’re waiting to emerge before we liberalize our guidance – it’s the reason we’re taking these baby steps.”

She noted that when travel surges in the US – such as over holidays – case surges follow. She also told a Covid-19 briefing that she is “looking forward” to updating the guidance once more people get inoculated.

CNN’s Lauren Mascarenhas, Naomi Thomas, Gregory Lemos, Elizabeth Stuart, Betsy Klein, Konstantin Toropin, Andy Rose, Will Brown, Jeremy Diamond and Christopher Rios contributed to this report.