The man asked a manager not to have a party because he had an anxiety disorder. What followed spiraled into a legal dispute over whether the man had a panic attack or a violent outburst.A Kentucky man who was fired days after he had a panic attack at his workplace over an unwanted birthday party was awarded $450,000 by a jury last month for lost wages and emotional distress.The man, Kevin Berling, had been working at a medical laboratory, Gravity Diagnostics in Covington, Ky., for about 10 months when he asked the office manager not to throw him a birthday party because he had an anxiety disorder, according to a lawsuit filed in Kentucky’s Kenton County Circuit Court.Mr. Berling’s lawyer, Tony Bucher, said the party had been planned by other employees while the office manager was away and that the situation had quickly spiraled out of control.Mr. Berling had a panic attack after he learned about the planned lunchtime celebration, which was to have included birthday wishes from colleagues and a banner decorating the break room. Mr. Berling chose to spend his lunch break in his car instead.The next day, Mr. Berling had a panic attack in a meeting with two supervisors who confronted him about his “somber behavior,” Mr. Bucher said. He was fired three days later in an email that suggested that Mr. Berling posed a threat to his co-workers’ safety.In a court filing, the company said it had fired Mr. Berling because he was “violent” in the meeting and had scared the supervisors, who sent him home for the day, took his key fob and told security personnel that he was not allowed to return.A month after the meeting, in September 2019, Mr. Berling sued the company for disability discrimination.After a two-day trial, a jury reached a verdict on March 31, concluding that Mr. Berling had experienced an adverse employment action because of a disability. Jurors awarded him $150,000 in lost wages and benefits and $300,000 for suffering, embarrassment and loss of self-esteem.The judge in the case has not yet entered a judgment regarding the verdict, which was reported by LINK nky, a local news website.John Maley, a lawyer for Gravity Diagnostics, said on Saturday that the company would file post-trial motions challenging the verdict on legal grounds and asserting that one juror had violated court orders about obtaining information outside the trial.Mr. Maley said that the case had not met the standard for a disability claim because Mr. Berling had never disclosed his anxiety disorder to the company and had not met the legal threshold to qualify as having a disability.Mr. Maley said that the company had the right to fire Mr. Berling — a lab technician whose employment status was at-will, meaning he could be fired for any legal reason — because he had clenched his fists, his face had turned red and he had ordered his supervisors to be quiet in the meeting, scaring them.“They were absolutely in fear of physical harm during that moment,” Julie Brazil, the founder and chief operating officer of Gravity Diagnostics, said on Saturday. “They both are still shaken about it today.”Mr. Bucher said that the reaction the company had described was Mr. Berling’s effort to calm himself during a panic attack after one of the supervisors had criticized his reaction to the party.Mr. Berling asked them to stop talking and used physical coping techniques, including a move that Mr. Bucher described as having his fists closed but “up around his chest, sort of closed in, almost hugging himself.”Mr. Berling was sent home for the rest of the workday and for the next day. At home a couple of hours after the meeting, he texted one of the supervisors to apologize for his panic attack, according to the complaint.Before that week, Mr. Bucher said, Mr. Berling had received “outstanding” monthly reviews. The company said that he had never received a negative review, nor had he been disciplined, according to court documents.Mr. Berling is happy in his new job at a school, Mr. Bucher said, and though his panic attacks increased in frequency after that week in 2019, they have gradually diminished.Anxiety disorders are the most common mental health disorder in the United States, and they affect an estimated 40 million adults in the country each year, according to the Anxiety and Depression Association of America.Bisma Anwar, a mental health counselor for the therapy app Talkspace, said in an email that it was a good idea for people who experience anxiety disorders and panic attacks to discuss those issues with a supervisor at work who could be a source of support when the employee is struggling.Ms. Anwar said anxiety on the job could be a result of workload as well as social pressures.“Social anxiety can also get triggered in the workplace when interacting with managers and co-workers becomes expected,” Ms. Anwar said. “If an employee is uncomfortable and feels anxious by having a birthday party in their honor or taking part in a celebration for others, then they should be allowed to opt out from it.”

Mask requirements prevented Covid-19 cases and deaths in Missouri, the state found, but data supporting that conclusion was not released until a month later.Mask mandates were effective as the Delta variant of the coronavirus was driving a surge in Covid-19 cases across Missouri, according to an analysis that the state’s Department of Health and Senior Services conducted in early November.But the state did not immediately share that data with the public. Instead, the information was released on Wednesday, a month later, because of a public records request by The Missouri Independent, a nonprofit news organization that reported the findings, and the Documenting Covid-19 project at the Brown Institute for Media Innovation.The records include an email dated Nov. 3 from the director of Missouri’s Health Department to a staff member in the governor’s office. The email included two graphs that compared the rates of reported Covid-19 cases and deaths in parts of Missouri with and without mask mandates.The director, Donald Kauerauf, said in the email that there were many variables to account for when assessing the effects of mask requirements in Missouri this year, but that the analysis ultimately showed that such requirements were effective.“I think we can say with great confidence reviewing the public health literature and then looking at the results in your study that communities where masks were required had a lower positivity rate per 100,000 and experienced lower death rates,” Mr. Kauerauf wrote.The analysis compared the reported case and death rates in the parts of the state without mask requirements to rates in St. Louis, St. Louis County, Kansas City and Jackson County, where mask mandates had been in place.The study looked at the period from April to October, when the Delta variant was driving an increase in coronavirus infections worldwide.During that time frame, there were 15.8 cases per day for every 100,000 residents, on average, in the areas that required masks, compared with 21.7 cases per 100,000 residents in unmasked communities, according to The Missouri Independent’s analysis of the data. Regions without mask requirements recorded one death per 100,000 residents every 3.5 days, compared with one death per 100,000 residents every five days where masks were required, The Missouri Independent said.Gov. Mike Parson, a Republican, has said he supports wearing masks to slow the spread of Covid-19, but he has repeatedly spoken out against mask requirements. In July, he said on Twitter that issuing mask mandates while a vaccine is available eroded public trust. “The vaccine is how we rid ourselves of COVID-19, not mask mandates that ignore common sense,” Mr. Parson wrote.Mr. Parson’s office and the state health department did not immediately respond to requests for comment on Thursday.In Missouri, new cases have risen from a daily average of about 1,000 in early November to more than 2,000 this month, and hospitalizations are up 32 percent over the past 14 days, according to a New York Times database. More than 15,540 people have died from Covid-19 in Missouri, according to the database.In late November, a circuit court judge in Missouri ruled that public health orders issued by local health departments to prevent the spread of the coronavirus violated the state’s constitution.Mask are still required, however, in St. Louis and St. Louis County. Kansas City ended its requirement on Nov. 5, and the Legislature in Jackson County voted to end its mask requirement in early November.The Coronavirus Pandemic: Key Things to KnowCard 1 of 4The Omicron variant.

In a letter from 1787 to be sold at auction this week, the Russian empress called for widespread access to a precursor of the smallpox vaccine.As smallpox outbreaks ravaged communities in the 18th century, one of the first people in Russia to embrace a precursor to vaccines was Catherine the Great, the empress famed for promoting the latest knowledge in the arts and sciences from her throne.Catherine’s support for an early form of inoculation is captured in a letter to be sold at auction in London on Wednesday. In it, she instructs a governor-general to ensure that a smallpox prevention method called variolation was readily available in his province.According to a translation of the letter provided by the auction house, Catherine, like many world leaders today, sought widespread protection against an infectious disease that was devastating her empire. “Such inoculation should be common everywhere,” she wrote, “and it is now all the more convenient, since there are doctors or medical attendants in nearly all districts, and it does not call for huge expenditure.”MacDougall’s, an auction house in London that specializes in Russian art, is auctioning the letter along with a portrait of Catherine by Dmitry Levitsky. In the portrait, the empress wears a small crown and an ermine-lined cloak.The items together are worth an estimated $1 million to $1.6 million, according to the auction house.The auction house listing does not identify the current owner of the objects, but it says they are from a private collection in Russia. The painting was previously exhibited in museums in St. Petersburg and Moscow, it says.A director of the auction house, Catherine MacDougall, said the initial announcement about the auction led to more than 100 interview requests from news organizations in Russia, where there is great interest in Catherine’s inoculation efforts.Variolation “should be common everywhere,” Catherine wrote, “and it is now all the more convenient, since there are doctors or medical attendants in nearly all districts.”MacDougall Auctions The letter is dated April 20, 1787, and addressed to a Russian army officer, Piotr Aleksandrovich Rumiantsev, who was known as Count Zadunaysky. Catherine wrote in the letter that one of Rumiantsev’s most important duties “should be the introduction of inoculation against smallpox, which, as we know, causes great harm, especially among the ordinary people.”Catherine and her son Pavel Petrovich were inoculated nearly two decades earlier, in 1768.At the time, people were inoculated using variolation, the practice of exposing people to material from an infected pustule of a patient with smallpox. The process was used for hundreds of years in India and China before being adopted in Europe. Enslaved people from Africa introduced the treatment in the United States. It is similar to, but distinct from, vaccination, which uses a less harmful version of a virus.Many people were wary of the practice, which sometimes led to deaths or outbreaks of a mild form of smallpox.These concerns prompted Catherine to show her support for it.Lynne Hartnett, an associate professor of history at Villanova University, said Catherine was terrified of smallpox, which had infected her husband and killed the fiancée of one of her closest advisers.She invited an English physician, Thomas Dimsdale, to St. Petersburg to inoculate her, her son and members of her court. “She was doing it as a way to show the Russian people that it was safe and it could keep this disease at bay,” Professor Hartnett said.Catherine provided Dimsdale with a carriage and protection in case she died and he needed an urgent route out of Russia. Instead, she recovered from the inoculation and a holiday was declared to celebrate the event.Afterward, Catherine wrote to her ambassador in Britain, Count Ivan Grigorievuch Chernyshev: “Starting with me and my son, who is also recovering, there is no noble house in which there are not several vaccinated persons, and many regret that they had smallpox naturally and so cannot be fashionable.”

Hospitals in Massachusetts will cut back on nonurgent scheduled procedures starting on Monday because of staffing shortages and longer patient hospital stays, according to the state’s health authorities.Coronavirus cases have been rising in Massachusetts for several weeks, but hospitalizations have risen at a lower rate. The pressure on hospitals relates to other consequences of the coronavirus pandemic, the authorities said.The staffing shortage, largely driven by the pandemic, has contributed to the loss of approximately 500 medical, surgical and I.C.U. hospital beds in Massachusetts, according to the state. And hospitals are seeing an influx of patients who need more complex treatment for health issues because they delayed visiting the doctor when Covid cases were higher.