How Bad Was 2020 for Tourism? Look at the Numbers.

#masthead-section-label, #masthead-bar-one { display: none }The Future of TravelA Year Without TravelThe Impact on the EnvironmentReimagining Tourism in HawaiiAdvertisementContinue reading the main storySupported byContinue reading the main storyA Year Without TravelHow Bad Was 2020 for Tourism? Look at the Numbers.The dramatic effects of the coronavirus pandemic on the travel industry and beyond are made clear in six charts.Idle planes stored at an airport in the Netherlands in November.Credit…Siese Veenstra/Agence France-Presse — Getty ImagesStephen Hiltner and March 8, 2021, 4:30 p.m. ETNumbers alone cannot capture the scope of the losses that have mounted in the wake of the coronavirus pandemic. Data sets are crude tools for plumbing the depth of human suffering, or the immensity of our collective grief.But numbers can help us comprehend the scale of certain losses — particularly in the travel industry, which in 2020 experienced a staggering collapse.Around the world, international arrivals are estimated to have dropped to 381 million in 2020, down from 1.461 billion in 2019 — a 74 percent decline. In countries whose economies are heavily reliant on tourism, the precipitous drop in visitors was, and remains, devastating.According to recent figures from the United Nations World Tourism Organization, the decline in international travel in 2020 resulted in an estimated loss of $1.3 trillion in global export revenues. As the agency notes, this figure is more than 11 times the loss that occurred in 2009 as a result of the global economic crisis.The following charts — which address changes in international arrivals, emissions, air travel, the cruise industry and car travel — offer a broad overview of the effects of the coronavirus pandemic within the travel industry and beyond.

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Biden Cancels Visit to Emergent Facility After Times Report on Its Tactics

#masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutNew Variants TrackerAdvertisementContinue reading the main storySupported byContinue reading the main storyBiden Cancels Visit to Vaccine Maker After Times Report on Its TacticsThe White House scrapped a trip to a vaccine plant in Baltimore run by Emergent BioSolutions after a New York Times investigation into the company.Emergent BioSolutions has more than $600 million in contracts with the federal government to manufacture coronavirus vaccines and to expand its “fill-and-finish” capacity for completing the process of manufacturing vaccines and therapeutics.Credit…Samuel Corum for The New York TimesSheryl Gay Stolberg and March 8, 2021, 3:51 p.m. ETWASHINGTON — President Biden on Monday canceled a visit to a coronavirus vaccine plant run by Emergent BioSolutions after The New York Times published a lengthy investigation into how the company gained outsize influence over the nation’s emergency medical reserve.Instead of visiting Emergent’s facility in Baltimore on Wednesday, the president will convene a meeting at the White House with executives of the pharmaceutical giants Merck & Co. and Johnson & Johnson, who were also to attend the session in Baltimore, White House officials said. Merck and Emergent are each separately partnering with Johnson & Johnson to manufacture that company’s coronavirus vaccine.“We just felt it was a more appropriate place to have the meeting,” Jen Psaki, the White House press secretary, told reporters.Emergent has more than $600 million in contracts with the federal government to manufacture coronavirus vaccines and to expand its “fill-and-finish” capacity for completing the process of manufacturing vaccines and therapeutics. A senior administration official said only executives from Merck and Johnson & Johnson would attend the White House session on Wednesday.An Emergent spokeswoman did not immediately respond on Monday to questions about the cancellation. The spokeswoman, Nina DeLorenzo, had previously defended the company’s business with the government in written responses to questions, saying, “When almost no one else would invest in preparing to protect the American public from grave threats, Emergent did, and the country is better prepared today because of it.”The Times investigation focused on the emergency reserve, the Strategic National Stockpile, which became infamous during the coronavirus pandemic for its lack of critical supplies such as N95 masks and other personal protective equipment.Decisions about how to spend the repository’s limited budget are supposed to be based on careful assessments by government officials of how best to save lives, but The Times found that they were largely driven by the demands and financial interests of a handful of biotech companies that have specialized in products that address terrorist threats rather than infectious disease.The Coronavirus Outbreak

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Understanding the resilience of barrier islands and coastal dunes after storms

When a coastline undergoes massive erosion, like a hurricane flattening a beach and its nearby environments, it has to rebuild itself — relying on the resilience of its natural coastal structures to begin piecing itself back together in a way that will allow it to survive the next large phenomena that comes its way.
Drs. Orencio Duran Vinent, assistant professor, and Ignacio Rodriguez-Iturbe, Distinguished University Professor and Wofford Cain Chair I Professor, in the Department of Ocean Engineering at Texas A&M University, are investigating the resilience of barrier islands and coastal dunes after high-water events and storms. In doing so, they are helping engineers and researchers assess the vulnerability of coastal landscapes.
Their full findings were published as related articles in the Proceedings of the National Academy of Sciences titled “Probabilistic structure of events controlling the after-storm recovery of coastal dunes” and “Stochastic dynamics of barrier island elevation.”
“If you understand how dunes grow, then you can take action, for example, in terms of vegetation or artificial barriers, to protect the coastline,” Rodriguez-Iturbe said. “But you cannot protect or manage, in this case, dunes and barrier islands if you don’t first understand the dynamics taking place.”
In general, there are two types of high-water events along the coast: natural disasters like hurricanes and tsunamis, which cause waves that devastate the shoreline, and lesser storm surges, which do not cause widescale damage but still affect the coastal environment. As Duran Vinent explained, it is these smaller, routine events that control the post-storm resiliency of dunes and barrier islands that play a key role in protecting coastal communities by absorbing some of the impact from surges.
“Those events are not really strong enough to erode a mature dune completely, but they are strong enough to prevent one from growing in the first place after a storm that erodes the dunes and the vegetation ecosystem,” he said.

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With that in mind, the research team first studied the structure and properties of such smaller high-water events from around the world, utilizing buoy and other data to calculate characteristics like beach elevation, wave runup and water level to analyze them.
Their findings were twofold: first, they confirmed that the high-water events happen randomly and unrelatedly to one another. Then the team discovered that high-water events around the world shared the same general characteristics and had the same typical frequency per year with a given intensity when measured at beach level.
“This means that we can actually say something about the typical size of these nuisance flooding events or the typical size and frequency of events affecting the recovery of the coastal environment,” Duran Vinent said. “Regardless of location, we have a unified description. And this simplifies the work for policymakers or managers a lot because then they don’t need complex calculations.”
The team took their newly discovered information and applied it to developing a model that would determine the elevation of a barrier island and, ultimately, whether or not a dune would be able to succeed. Additionally, this model provides a valuable tool in rebuilding coastlines that have been broken down and deteriorated over time, as it gives engineers a way to see how tall a dune or barrier island needs to be in order to prevent frequent overwashes and, thus, ensure ecosystem survival.
“The dynamic between high-water events and the geomorphology of barrier islands is complicated because the impact of any high-water event depends on how big the dunes are,” Rodriguez-Iturbe said.
“And then while the dune is growing, you have these high-water events randomly interrupting its growth,” Duran Vinent said. “This means that there is a competition between the frequency of the high-water erosional event and how fast the dune is growing.”
This competition became the base of their analytical equation developed to determine whether or not a dune would be able to succeed, mathematically mapping in which conditions a barrier island would be resilient or vulnerable.
Dunes on barrier islands are vitally important, Duran Vinent explained, because they prevent water events from breaching the island and protect the vegetation on the back of the island from flooding, allowing a diverse set of vegetation to grow that is otherwise intolerant to seawater.
The research team also included ocean engineering graduate students Tobia Rinaldo and Kiran Adhithya Ramakrishnan, as well as collaboration with Dr. Benjamin E. Schaffer, research associate at Princeton University.

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Speeding treatment for urinary tract infections in children

A study led by UT Southwestern and Children’s Health researchers defines parameters for the number of white blood cells that must be present in children’s urine at different concentrations to suggest a urinary tract infection (UTI). The findings, published recently in Pediatrics, could help speed treatment of this common condition and prevent potentially lifelong complications.
UTIs account for up to 7 percent of fevers in children up to 24 months old and are a common driver of hospital emergency room visits. However, says study leader Shahid Nadeem, M.D., assistant professor of pediatrics at UTSW as well as an emergency department physician and pediatric nephrologist at Children’s Medical Center Dallas, these bacterial infections in infants and toddlers can be difficult to diagnose because their symptoms are similar to other fever-causing conditions.
If a diagnosis is delayed, he explains, a UTI can develop into a serious infection that can cause lasting consequences. For example, UTI-related kidney scarring has been linked with hypertension and chronic kidney disease later in life.
To diagnose a UTI, doctors must culture a urine sample and wait for it to grow telltale bacteria in a petri dish containing nutrients. However, says Nadeem, this process can take up to two days, delaying treatment. Consequently, he and other doctors typically rely on testing urine for a white blood cell-linked protein known as leukocyte esterase (LE), then confirm the presence of white blood cells — a sign of immune activity — by looking for them in urine under a microscope.
In children, he adds, the number of white blood cells can be highly variable, with some of this variation potentially due to varying urine concentration. As such, it’s been unknown what white blood cell number threshold should be used to begin treating a suspected UTI based on urine concentration.
To determine these parameters, Nadeem and his colleagues searched medical records of children younger than 24 months old who were brought to the emergency department at Children’s Medical Center between January 2012 and December 2017 with a suspected UTI and had both a urinalysis — in which their urine concentration and the presence of LE and white blood cells were assessed — and a urine culture. The search turned up 24,171 patients, 2,003 of whom were diagnosed with a UTI based on urine culture.
Using their urine’s specific gravity — the density of urine compared with water, a measurement that serves as a surrogate for concentration — and the number of white blood cells present in the field of a high-power microscope, the researchers came up with cutoff points for three urine concentration groups: For low urine concentrations, children needed only three white blood cells to suspect UTI; for moderate concentrations, that number was six; and for high concentrations, it was eight.
For each of these concentration groups, leukocyte esterase remained constant, says Nadeem — suggesting that it’s a good trigger for analyzing urine for the presence of white blood cells.
Knowing how many white blood cells tend to be present in urine samples at different concentrations in children with UTIs could help physicians start treating these infections before they receive urine culture results, he adds, giving relief to patients and their parents and preventing complications.
“The earlier we can start treatment, the better it is for these young patients,” Nadeem says. “Our results add more information to physicians’ toolboxes to make this decision.”
Other UTSW/Children’s Health researchers who contributed to this study include Mohamed Badawy, Oluwaseun Oke, Laura M. Filkins, Jason Y. Park, and Halim M. Hennes.

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How Emergent BioSolutions Put an ‘Extraordinary Burden’ on the U.S.’s Troubled Stockpile

#masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutNew Variants TrackerAdvertisementContinue reading the main storySupported byContinue reading the main storyHow One Firm Put an ‘Extraordinary Burden’ on the U.S.’s Troubled StockpileThe shortage of lifesaving medical equipment last year was a searing example of the government’s failed coronavirus response. As health workers resorted to wearing trash bags, one Maryland company profited by selling anthrax vaccines to the country’s emergency reserve.Emergent, led by Robert Kramer (bottom right), has long dominated the national stockpile’s budget with its anthrax vaccines. Dr. Nicole Lurie (top right) unsuccessfully tried to scale back the investment during the Obama years. Her successor, Dr. Robert Kadlec (top left), was a Trump appointee focused on bioterrorism. Sales remained high through the pandemic.Credit…Eleanor ShakespeareChris Hamby and Published

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Study of coronavirus variants predicts virus evolving to escape current vaccines

A new study of the U.K. and South Africa variants of SARS-CoV-2 predicts that current vaccines and certain monoclonal antibodies may be less effective at neutralizing these variants and that the new variants raise the specter that reinfections could be more likely.
The study was published in Nature on March 8, 2021. A preprint of the study was first posted to BioRxiv on January 26, 2021.
The study’s predictions are now being borne out with the first reported results of the Novavax vaccine, says the study’s lead author David Ho, MD. The company reported on Jan. 28 that the vaccine was nearly 90% effective in the company’s U.K. trial, but only 49.4% effective in its South Africa trial, where most cases of COVID-19 are caused by the B.1.351 variant.
“Our study and the new clinical trial data show that the virus is traveling in a direction that is causing it to escape from our current vaccines and therapies that are directed against the viral spike,” says Ho, the director of the Aaron Diamond AIDS Research Center and the Clyde’56 and Helen Wu Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons.
“If the rampant spread of the virus continues and more critical mutations accumulate, then we may be condemned to chasing after the evolving SARS-CoV-2 continually, as we have long done for influenza virus,” Ho says. “Such considerations require that we stop virus transmission as quickly as is feasible, by redoubling our mitigation measures and by expediting vaccine rollout.”
After vaccination, the immune system responds and makes antibodies that can neutralize the virus.

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Ho and his team found that antibodies in blood samples taken from people inoculated with the Moderna or Pfizer vaccine were less effective at neutralizing the two variants, B.1.1.7, which emerged last September in England, and B.1.351, which emerged from South Africa in late 2020. Against the U.K. variant, neutralization dropped by roughly 2-fold, but against the South Africa variant, neutralization dropped by 6.5- to 8.5-fold.
“The approximately 2-fold loss of neutralizing activity against the U.K. variant is unlikely to have an adverse impact due to the large ‘cushion’ of residual neutralizing antibody activity,” Ho says, “and we see that reflected in the Novavax results where the vaccine was 85.6% effective against the U.K. variant.”
Data from Ho’s study about the loss in neutralizing activity against the South Africa variant are more worrisome.
“The drop in neutralizing activity against the South Africa variant is appreciable, and we’re now seeing, based on the Novavax results, that this is causing a reduction in protective efficacy,” Ho says.
The new study did not examine the more recent variant found in Brazil (B.1.1.28) but given the similar spike mutations between the Brazil and South Africa variants, Ho says the Brazil variant should behave similarly to the South Africa variant.

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“We have to stop the virus from replicating and that means rolling out vaccine faster and sticking to our mitigation measures like masking and physical distancing. Stopping the spread of the virus will stop the development of further mutations,” Ho says.
The study also found that certain monoclonal antibodies used now to treat COVID patients may not work against the South Africa variant. And based on results with plasma from COVID patients who were infected earlier in the pandemic, the B.1.351 variant from South Africa has the potential to cause reinfection.
New study contains comprehensive analysis of variants
The new study conducted an extensive analysis of mutations in the two SARS-CoV-2 variants compared to other recent studies, which have reported similar findings.
The new study examined all mutations in the spike protein of the two variants. (Vaccines and monoclonal antibody treatments work by recognizing the SARS-CoV-2 spike protein.)
The researchers created SARS-CoV-2 pseudoviruses (viruses that produce the coronavirus spike protein but cannot cause infection) with the eight mutations found in the U.K. variant and the nine mutations found in the South African variant.
They then measured the sensitivity of these pseudoviruses to monoclonal antibodies developed to treat COVID patients, convalescent serum from patients who were infected earlier in the pandemic, and serum from patients who have been vaccinated with the Moderna or Pfizer vaccine.
Implications for monoclonal antibody treatments
The study measured the neutralizing activity of 18 different monoclonal antibodies — including the antibodies in two products authorized for use in the United States.
Against the U.K. variant, most antibodies were still potent, although the neutralizing activity of two antibodies in development was modestly impaired.
Against the South Africa variant, however, the neutralizing activity of four antibodies was completely or markedly abolished. Those antibodies include bamlanivimab (LY-CoV555, approved for use in the United States) that was completely inactive against the South Africa variant, and casirivimab, one of the two antibodies in an approved antibody cocktail (REGN-COV) that was 58-fold less effective at neutralizing the South Africa variant compared to the original virus. The second antibody in the cocktail, imdevimab, retained its neutralizing ability, as did the complete cocktail.
“Decisions of the use of these treatments will depend heavily on the local prevalence of the South Africa and Brazil variants,” Ho says, “highlighting the importance of viral genomic surveillance and proactive development of next-generation antibody therapeutics.”
Reinfection implications
Serum from most patients who had recovered from COVID earlier in the pandemic had 11-fold less neutralizing activity against the South Africa variant and 4-fold less neutralizing activity against the U.K. variant.
“The concern here is that reinfection might be more likely if one is confronted with these variants, particularly the South Africa one,” Ho says.

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Study finds two servings of fish per week can help prevent recurrent heart disease

An analysis of several large studies involving participants from more than 60 countries, spearheaded by researchers from McMaster University, has found that eating oily fish regularly can help prevent cardiovascular disease (CVD) in high-risk individuals, such as those who already have heart disease or stroke.
The critical ingredient is omega-3 fatty acids, which researchers found was associated with a lower risk of major CVD events such as heart attacks and strokes by about a sixth in high-risk people who ate two servings of fish rich in omega-3 each week.
“There is a significant protective benefit of fish consumption in people with cardiovascular disease,” said lead co-author Andrew Mente, associate professor of research methods, evidence, and impact at McMaster and a principal investigator at the Population Health Research Institute.
No benefit was observed with consumption of fish in those without heart disease or stroke.
“This study has important implications for guidelines on fish intake globally. It indicates that increasing fish consumption and particularly oily fish in vascular patients may produce a modest cardiovascular benefit.”
Mente said people at low risk for cardiovascular disease can still enjoy modest protection from CVD by eating fish rich in omega-3, but the health benefits were less pronounced than those high-risk individuals.
The study was published in JAMA Internal Medicine on March 8.
The findings were based on data from nearly 192,000 people in four studies, including about 52,000 with CVD, and is the only study conducted on all five continents. Previous studies focused mainly on North America, Europe, China and Japan, with little information from other regions.
“This is by far the most diverse study of fish intake and health outcomes in the world and the only one with sufficient numbers with representation from high, middle and low income countries from all inhabited continents of the world,” said study co-lead Dr. Salim Yusuf, professor of medicine at the Michael G. DeGroote School of Medicine and executive director of the PHRI.
This analysis is based in data from several studies conducted by the PHRI over the last 25 years. These studies were funded by the Canadian Institutes for Health Research, several different pharmaceutical companies, charities, the Population Health Research Institute and the Hamilton Health Sciences Research Institute.

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New discovery explains antihypertensive properties of green and black tea

A new study from the University of California, Irvine shows that compounds in both green and black tea relax blood vessels by activating ion channel proteins in the blood vessel wall. The discovery helps explain the antihypertensive properties of tea and could lead to the design of new blood pressure-lowering medications.
Published in Cellular Physiology and Biochemistry, the discovery was made by the laboratory of Geoffrey Abbott, PhD, a professor in the Department of Physiology and Biophysics at the UCI School of Medicine. Kaitlyn Redford, a graduate student in the Abbott Lab, was first author of the study titled, “KCNQ5 potassium channel activation underlies vasodilation by tea.”
Results from the research revealed that two catechin-type flavonoid compounds (epicatechin gallate and epigallocatechin-3-gallate) found in tea, each activate a specific type of ion channel protein named KCNQ5, which allows potassium ions to diffuse out of cells to reduce cellular excitability. As KCNQ5 is found in the smooth muscle that lines blood vessels, its activation by tea catechins was also predicted to relax blood vessels — a prediction confirmed by collaborators at the University of Copenhagen.
“We found by using computer modeling and mutagenesis studies that specific catechins bind to the foot of the voltage sensor, which is the part of KCNQ5 that allows the channel to open in response to cellular excitation. This binding allows the channel to open much more easily and earlier in the cellular excitation process,” explained Abbott.
Because as many as one third of the world’s adult population have hypertension, and this condition is considered to be the number one modifiable risk factor for global cardiovascular disease and premature mortality, new approaches to treating hypertension have enormous potential to improve global public health. Prior studies demonstrated that consumption of green or black tea can reduce blood pressure by a small but consistent amount, and catechins were previously found to contribute to this property. Identification of KCNQ5 as a novel target for the hypertensive properties of tea catechins may facilitate medicinal chemistry optimization for improved potency or efficacy.
In addition to its role in controlling vascular tone, KCNQ5 is expressed in various parts of the brain, where it regulates electrical activity and signaling between neurons. Pathogenic KCNQ5 gene variants exist that impair its channel function and in doing so cause epileptic encephalopathy, a developmental disorder that is severely debilitating and causes frequent seizures. Because catechins can cross the blood-brain barrier, discovery of their ability to activate KCNQ5 may suggest a future mechanism to fix broken KCNQ5 channels to ameliorate brain excitability disorders stemming from their dysfunction.
Tea has been produced and consumed for more than 4,000 years and upwards of 2 billion cups of tea are currently drunk each day worldwide, second only to water in terms of the volume consumed by people globally. The three commonly consumed caffeinated teas (green, oolong, and black) are all produced from the leaves of the evergreen species Camellia sinensis, the differences arising from different degrees of fermentation during tea production.
Black tea is commonly mixed with milk before it is consumed in countries including the United Kingdom and the United States. The researchers in the present study found that when black tea was directly applied to cells containing the KCNQ5 channel, the addition of milk prevented the beneficial KCNQ5-activating effects of tea. However, according to Abbott, “We don’t believe this means one needs to avoid milk when drinking tea to take advantage of the beneficial properties of tea. We are confident that the environment in the human stomach will separate the catechins from the proteins and other molecules in milk that would otherwise block catechins’ beneficial effects.”
This hypothesis is borne out by other studies showing antihypertensive benefits of tea regardless of milk co-consumption. The team also found, using mass spectrometry, that warming green tea to 35 degrees Celsius alters its chemical composition in a way that renders it more effective at activating KCNQ5.
“Regardless of whether tea is consumed iced or hot, this temperature is achieved after tea is drunk, as human body temperature is about 37 degrees Celsius,” explained Abbott. “Thus, simply by drinking tea we activate its beneficial, antihypertensive properties.”
This study was supported in part by the National Institutes of Health, National Institute of General Medical Sciences, National Institute of Neurological Disorders and Stroke, the Lundbeck Foundation and the Danmarks Frie Forskningsfond.

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Boris Johnson: 'Inevitable' Covid transmission risk with schools return

Prime Minister Boris Johnson says it’s “inevitable” that there will be a risk of increased Covid transmission with millions of children returning to school in England. He explained that reopening schools could be done now because a proportion of the population had been vaccinated.However, he warned that we must be “very, very cautious” and said that the government would be led by data, not dates.Read more: First day back at school has ‘gone well’, say heads

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Monica Alexis, Nurse’s Aide With a Calling, Dies at 83

#masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutNew Variants TrackerAdvertisementContinue reading the main storySupported byContinue reading the main storyThose We’ve LostMonica Alexis, Nurse’s Aide With a Calling, Dies at 83Ms. Alexis worked in hospitals in New York and Pennsylvania, helping her patients with “the most important things.” She died of complications of Covid-19.Monica Alexis, born in Trinidad, came to the United States and became a nurse’s aide with a commitment to helping patients.Credit…via Alexis familyMarch 8, 2021, 12:27 p.m. ETThis obituary is part of a series about people who have died in the coronavirus pandemic. Read about others here.Growing up in Trinidad in the 1940s, Monica Alexis was known in her family for a precocious sense of compassion.Her older brother suffered from severe diabetes and she bandaged his swollen feet nightly. After a cousin became a doctor, she decided she wanted to pursue a career in health care one day.When Ms. Alexis was in her 20s, a friend told her that she knew of Caribbean women who were finding steady work as health care aides at hospitals in New York City, and that the pay was much better than in the Trinidad. By the 1970s, Ms. Alexis had settled in Astoria, Queens, and she was helping patients as a nurse’s assistant at NewYork-Presbyterian Hospital in Manhattan. After that, she worked at Reading Hospital in Pennsylvania for nearly two decades.As a nurse’s aide, Ms. Alexis was responsible for the everyday tasks that allow hospitals to focus on saving lives. She brought meals to patients and made their beds. Standing 5-foot-2, she hoisted people twice her size to bathe them. When engaged in sensitive duties like removing catheters from elderly men, she reassured them with sass: “Why are you shy? Don’t be silly. I have three sons. You don’t have anything I haven’t seen before.”As years passed, hospital colleagues often encouraged Ms. Alexis to become a registered nurse, but she wasn’t interested.“She wanted to stay a nurse’s assistant,” her daughter, Melissa Alexis, said. “She felt that becoming a registered nurse would take her away from what she wanted to do for her patients. The stuff you don’t think about. The little things. But they are the most important things.”The Coronavirus Outbreak

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