AMERICA FORWARD 2021 by STUDIO Gannett

SPECIAL EDITION

AMERICA FORWARD 2021

TRENDS Companies pivot amidst pandemic

Fortitude VACCINE Scientists race to save lives

HEALTH Boost your immune system

BEST TECH UV sanitizers, contact tracing, home office

USA TODAY SPECIAL EDITION

CONTENTS

3 202 1 S PECI A L E D ITI O N

AMERICA FORWARD

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NEWS

IMMUNITY INCENTIVES Companies compensate employees to get vaccinated

CHILD CARE CHANGE-UP

DOUBLE DUTY

CORPORATE CORRECTION

During pandemic, dads take on more duties at home

Wearing a second face mask can offer better protection

COVID-19 has changed the American business model

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FEATURES

ESSENTIAL HEROINES

TRIBAL IMMUNITY

These women stepped up to help others when they were needed most

Health ofﬁcials work to alleviate vaccine concerns among Native Americans

TEAM VACCINE The story behind the historic race to save lives

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This is a product of

EDITORIAL DIRECTOR Jeanette Barrett-Stokes jbstokes@usatoday.com

CREATIVE DIRECTOR Jerald Council jcouncil@usatoday.com

MANAGING EDITOR Michelle Washington mjwashington@usatoday.com

ISSUE EDITOR Debbie Williams ISSUE DESIGNER Gina Toole Saunders

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HOME

56 28 PRODUCTS

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MODERN LIVING Current lifestyles are changing home design trends

SUBURBAN ESCAPE

GROWTH SPURT

SMART SANITIZERS UV products offer proven germ protection

TECHNOLOGY

OFFICE ESSENTIALS

Homeowners are leaving urban areas for more square footage

Gardening has become a popular pandemic pastime

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The best work-from-home tech you should get

CLOSE CONTACT Tracing technology can help businesses keep their employees safe

DEEP BREATH Advanced air ﬁltration is key to safe indoor gatherings

SWITCHING GEARS Companies change operations to produce protective equipment

EDITORS Amy Sinatra Ayres Tracy Scott Forson Harry Lister Deirdre van Dyk DESIGNERS Hayleigh Corkey David Hyde Debra Moore Lisa M. Zilka CONTRIBUTING WRITERS Matt Alderton, Mary Helen Berg, Ana Pelayo Connery, Paul Davidson, Michael Desjardin, Gary Dinges, Stacey Freed, Gus Garcia-Roberts, Pam George, Nada Hassanein, David Heath, Nora G. Hertel, Charisse Jones, Isabel Keane, Janet Loehrke, Nora Mabie, Lee Neikirk, Ramon Padilla, Adrianna Rodriguez, Robin Roenker, Shondiin Silversmith, Mike Snider, Adam Stone, Karina Zaiets

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CAREERS

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HIP HOBBIES Age-old diversions help ﬁll the time at home

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HEALTH

STAY STRONG

FIGHTING FATIGUE

ANSWERING THE CALL Medical schools see increased interest in health care ﬁeld

PROFESSIONAL PIVOT Workers who lost jobs because of COVID-19 ﬁnd new careers

A balanced immune system is key to overall wellness

BACK PAGE Expert advice for staying the course in the battle against COVID-19

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DESERVING DOSE Dolly Parton receives the Moderna vaccine

PHOTOGRAPHS: Getty Images

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FINANCE BILLING COORDINATOR Julie Marco ISSN# 0734-7456 A USA TODAY Network publication, Gannett Co. Inc. USA TODAY, its logo and associated graphics are the trademarks of Gannett Co. Inc. or its affiliates. All rights reserved. Copyright 2021, USA TODAY, a division of Gannett Co. Inc. Editorial and publication headquarters are at 7950 Jones Branch Dr., McLean, VA 22108, and at (703) 854-3400. For accuracy questions, call or send an e-mail to accuracy@usatoday.com. PRINTED IN THE USA

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NEWS

INSTACART

Immunity Incentives Companies are paying workers who get vaccinated By Mike Snider

OMPANIES SUCH AS GROCERY chain Trader Joe’s

and discount grocery store Aldi are offering an incentive for workers to get the COVID-19 vaccine. Monrovia, Calif.-based Trader Joe’s

will give employees two hours of pay per dose for getting the vaccine, and will also allow employees to shift work schedules to make sure they have time to get vaccinated. Aldi, based in Germany with more than 2,000 stores in the U.S., will offer the same accomodations for its hourly employees. Online grocery delivery company

Instacart has begun paying its workers $25 to offset time off to get the COVID-19 vaccine. The San Francisco-headquartered company, which has about 500,000 workers who shop to fill and deliver orders from more than 40,000 stores, began giving the support stipend Feb. 1 to eligible workers as the vaccination

programs roll out across the U.S. and Canada. “With COVID-19 cases continuing to rise across the country, we’re taking proactive steps to advocate that government agencies recognize Instacart shoppers as critical essential workers CONTINUED

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who deserve early access to vaccines,” said Instacart CEO and founder Apoorva Mehta in a statement. “Our goal with the introduction of our new vaccine support stipend is to ensure that, when the time comes, Instacart shoppers don’t have to choose between earning income as an essential service provider or getting vaccinated.” In-store shoppers, full-service shoppers and shift lead workers are among those eligible for the Instacart vaccine stipend. Dollar General, which operates more than 17,000 stores in 46 states, says it will give employees the equivalent of four hours of pay if they get the vaccine. The Goodlettsville, Tenn.-based retailer says its salaried employees would get the additional pay to make up for time away from work. Dollar General says the extra pay is intended to compensate for the travel time, mileage and child care expenses that employees could incur to get the vaccine. “We do not want our employees to have to choose between receiving a vaccine or coming to work,” the

SETH HAROLD/AFP FOR GETTY IMAGES

FOOD FOR THOUGHT RESTAURANTS ARE ALSO OFFERING INCENTIVES Fast-food chain McDonald’s is offering U.S. workers in its corporate-owned restaurants four hours of pay as an incentive to get the COVID-19 vaccine. “Vaccination is essential in the fight against the pandemic, and we are actively encouraging McDonald’s employees to take this important step,” McDonald’s USA Chief People Officer Tiffanie Boyd said in a statement. Darden Restaurants, which owns Olive Garden and LongHorn Steakhouse, will provide two hours of pay for each vaccine dose (the Pfizer and Moderna vaccines currently require two doses). Darden CEO Gene Lee said in a January message to employees that, “While we will not require hourly team members to be vaccinated as a condition of employment, we strongly encourage getting vaccinated.” — Nathan Bomey

company says. An advisory committee of independent medical and public health experts working with the Centers for Disease Control and Prevention voted in December 2020 on guidelines for vaccine distribution. The panel recommended

that states prioritize grocery workers in the second group to receive shots, after health care workers and nursing home residents. Firefighters, police officers, teachers, corrections workers and postal employees are also recommended for the second group.

Incentives offer employers an alternative way to encourage workers to get the vaccine, as opposed to mandating they get shots, says Laura Boudreau, assistant professor of economics at Columbia Business School. “We know there is a fairly sizable share of the population who don’t want to get the vaccine or are reluctant to do so,” she says. “So it makes complete sense, to me, that we see employers with front-line workers trying to reduce the barriers for their employees to access the vaccines, and maybe increasingly directly providing monetary incentives.” An “infodemic” or “pandemic of misinformation” has made some companies hesitate to encourage vaccinations, says Christopher Thompson, associate professor of biology at Loyola University Maryland. But he expects to see more companies consider moves such as those from Dollar General and Instacart. Kelly Tyko and The Associated Press contributed to this story.

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NEWS

Child Care Change-up Pandemic shifts household roles for some families By Charisse Jones

OHN TYREMAN HAD ALWAYS helped around the house,

but cooking and looking after the kids ramped up when he began to work from home full time amid the COVID-19 pandemic. His employer encourages work breaks that Tyreman often spends playing catch with his 5-year-old son while his two younger children nap. And if he were to move on to a different company after the coronavirus crisis ebbs, Tyreman says he’d want the same support.

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NEWS “That kind of flexibility would now be a requirement if I were to take a new job,” says Tyreman, who works for a digital advertising agency and lives with his wife and children in Culpeper, Va. With vaccine rollouts across the country, life may soon return to some semblance of normal as parents who worked from home because their workplaces or children’s schools were shuttered increasingly go back to the office. But not all fathers may want to return to their old routines. “I’m sure some dads will take the first train back to their former lives,” says Richard Weissbourd, a senior lecturer at the Harvard Graduate School of Education. “But my guess is that at least some dads, because they have found real and deep gratification in their relationships with their kids during this time, will work hard to preserve this closeness.” Weissbourd co-authored a study released last June that found a majority of fathers felt closer to their children during the health crisis.

WILL THE BALANCE LAST? Working mothers handled the bulk of household tasks during the pandemic, a burden that led many to consider dropping out of the workforce altogether because of the strain, according to the National Bureau of Economic Research. But some fathers did take on a greater share of household responsibilities during the crisis. The number of couples who said they evenly divided child care duties increased to 56 percent during the COVID-19 crisis, compared with 45 percent who said that was the case beforehand, according to a study coauthored by academics at the University of Utah, Ball State University and the University of Texas, Austin. “More equality in terms of how housework and child care is being divided is due to ... dads being home,” says Dan Carlson, a professor of family and consumer studies at the University of Utah who co-wrote the report. It’s unclear, however, whether that increased balance will continue as the pandemic lingers, he says. “A lot of the research that has been done looks at what was going on very early in the pandemic,” Carlson says, noting that his survey was done in April 2020. “So the question is, ‘Were those short-term gains made because it was a crisis, and have those contributions faded as the reality has set in?’ ” Research on the impact of paternal leave might offer a clue. When men take CONTINUED

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The Tyreman family PROVIDED BY JOHN TYREMAN

time off after the birth or adoption of a child, studies show that they help more at home, and their participation remains higher even after their leaves of absence end. “So if we think about the pandemic in the same way ... that because of the crisis they’ve had to take on more, it’s likely their contributions will remain higher than what they were before the pandemic,” Carlson says. Still, the lion’s share of household tasks and child care fell on working mothers, according to a study by Lean In, an organization that supports women in the workforce. The report found that mothers were more than three times as likely as dads to take on most of those responsibilities and that 25 percent of women were thinking about leaving their jobs or making other professional changes because of those challenges. “More women were not only deciding to leave their jobs because of these responsibilities, but there was an increase in the fact they’d be fired or laid off if they had these responsibilities,” Carlson says, referring to the separate findings

“I’m sure some dads will take the first train back to their former lives, but my guess is that at least some dads, because they have found real and deep gratification in their relationships with their kids during this time, will work hard to preserve this closeness.” — RICHARD WEISSBOURD, senior lecturer, Harvard Graduate School of Education

in his own research. “That schooling responsibility is driving a lot of the labor market inequalities that we’re seeing.”

MORE QUALITY TIME But the crisis also strengthened bonds, with 68 percent of dads saying they felt closer or much closer to their kids during the pandemic, according to Weissbourd’s study. A follow-up survey found that fathers “seem to be talking to kids more about things that are important to them ... taking walks together, enjoying activities together,” Weissbourd says. “The pan-

demic has been miserable for families in a lot of ways, but this does seem to be a silver lining.” Now that more offices may be reopening, some fathers could face a choice. “The question is, will the forces pulling them back to resuming their past lives be so strong that some of the routines and habits and closeness start to dissipate?” Weissbourd asks. For those dads who want to hold on to that closeness, they can establish markers for a new routine. “If they’re going for walks with their kids, they should commit to doing it every week-

end,” Weissbourd says. “If they’re having meals, they should commit to having at least four meals (together) every week. If some of those things become habits, they’re much more likely to continue after the pandemic is over.” Tyreman says that his company introduced a policy last fall requiring that employees take at least one day off every two weeks to recharge. Instead of taking off a full day, Tyreman says he’ll “take an hour every day and go out and cut wood or play with the kids, and I don’t feel bad about it because it’s practiced and preached from the top down.” When the pandemic ebbs, Tyreman says he will probably go to the office one or two days a week. But he will continue to cherish the days when he is able to work remotely and spend more time with his family. “Our home is super active right now,” he says. “There are all these messes and dishes. ... Sometimes it creates conflict. But the benefits outweigh the drawbacks in that we are together.” Caroline Fairchild of LinkedIn News contributed to this story.

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Double Up Experts say two masks are likely more eﬀective than one By Adrianna Rodriguez

HEY SAY TWO HEADS are better than one, but can the same be said for masks? The answer is yes, according to Dr. Anthony Fauci,

director of the National Institute of Allergy and Infectious Diseases. “So, if you have a physical covering with one layer, you put another layer on. It just makes common sense that it likely would be CONTINUED

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Pete Buttigieg and Amanda Gorman STEFANI REYNOLDS/GETTY IMAGES; WIN MCNAMEE/AFP VIA GETTY IMAGES

more effective,” Fauci told NBC News in January. “That’s the reason why you see people either double masking or doing a version of an N95.” Double masking was in the spotlight during President Joe Biden’s inauguration, where several high-profile officials and celebrities were photographed wearing two face coverings. Pete Buttigieg, now the secretary of transportation, tweeted a photo of himself wearing a surgical mask underneath a black cloth mask. Amanda Gorman, the 23-year-old inaugural poet, also wore a surgical mask underneath a fashionably studded, red cloth one. A study published in the peer-reviewed journal Matter last July found that wearing two snug face coverings could protect against up to 90 percent of particles. It not only adds an extra layer of protection, but also makes the mask fit snugger around the face, says Dr. Loretta Fernandez, one of the study’s authors and associate professor at Northeastern University in Boston.

“So, if you have a physical covering with one layer, you put another layer on. It just makes common sense that it likely would be more effective.” — DR. ANTHONY FAUCI, director, National Institute of Allergy and Infectious Diseases

“We found that the particle removal efficiency of many surgical-style masks could be improved by up to 50 percent by simply snugging the mask material to the face,” Fernandez says. “In the lab, we did this by adding a nylon stocking, but also tested other elastic layers such as gaiters and tights and found that they also solved the problem of cutting off air leaking in from around the mask.” Americans’ renewed interest in double masking also comes as variants that appear to be more contagious emerge from the U.K, South Africa and Brazil. Officials have noted that the U.K. variant, B.1.1.7, might be deadlier in ad-

dition to more contagious. The 501Y.V2 variant, first identified in South Africa, appears to be about 50 percent more contagious. U.S. Surgeon General Vivek Murthy said in a Jan. 26 New York Times interview that the emerging variants “make the quality of the masks we use all the more important,” adding there should be a standard for masks. However, some experts are less concerned about double masking to protect against variants and more concerned about people who aren’t taking precautions at all. “The idea of double masking just sim-

ply means that you’re paying attention to wearing a better mask than you might have been before,” Emory University infectious disease expert Dr. Colleen Kraft says. “If people would just wear masks in general, we would actually be fine against the variants.” The gold standard N95 masks can be difficult to find and should be reserved for health care workers on the front lines of the pandemic. But experts say KF94 masks, from South Korea, are a good second option. Dr. Ashish Jha, dean of the Brown University School of Public Health, told the New York Times the KF94 mask is made of a similar material as the N95 and blocks 94 percent of viral particles. One notable difference is the KF94 has ear loops instead of elastic bands. “Wearing a more substantial mask or a heavier mask is always fine, but again, we just need everybody to take ownership and do that at the same time,” Kraft says. “That’s what’s going to cut down our transmission the quickest.”

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Corporate Correction COVID-19 has changed the American business model in fundamental ways By Matt Alderton

HE SORROW THAT COVID-19

has sown cannot be overstated. And yet, tragedy in some respects has borne opportunity — most of all in corporate America. There, the virus has been like a wildfire after a lightning strike: Although

it’s devastating and destructive, it’s also productive, burning dead trees to make room for young, healthy vegetation. When offices closed last spring due to the pandemic, many companies were forced to adopt more modern ways of working. One such enterprise was online bank Synchrony, which employs more than 16,500 people across the United

States. A few months into the pandemic, it surveyed its staff — all of who were working remotely — to find out what they wanted their jobs to look like after COVID-19. Eight out of 10 said they would continue working from home if the company let them, says D.J. Casto, the company’s executive vice president and chief human resources officer.

“When we looked at the data, we realized we need to capitalize on this moment to accelerate our long-term strategic thinking,” Casto says. “We decided that by being thoughtful and bold about giving our employees what they want, we could position ourselves CONTINUED

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NEWS to come out of the pandemic stronger, better and more competitive.” The changes reflect a transformation not only at Synchrony, but across corporate America.

FROM HEADQUARTERS TO HUBS For Synchrony, perhaps the biggest change to post-pandemic work will be the workplace itself: It will embrace a “hub” model wherein employees can work from home or in a hub — a local Synchrony office, co-working space or other venue — when they need to meet in person. “Our hub strategy was born because we wanted to make sure that we retain our special culture and DNA even if we allow people to work from home,” Casto says. “When the pandemic sunsets, we will still encourage groups to come together purposefully when it makes sense for collaboration, innovation, culture and diversity initiatives, and all the other things they used to do in the office ... so they can still feel connected to each other and the company.” Consulting company Deloitte is seeing similar moves among its clients. “We surveyed CEOs, and 76 percent of them told us they expect to require less office space than before the pandemic,” says Erica Volini, leader of Deloitte’s Global Human Capital practice. “But we shouldn’t interpret that as no office space. I think we’ll move away from having a single corporate headquarters, and a lot of organizations will move, instead, to having smaller offices in multiple locations.” Kay Sargent, director of workplace practice for global design firm HOK, agrees. “If I could take the word ‘office’ and throw it away, I would,” she says. “What we really need to think about is an ecosystem of spaces. ... We can work at home. We can work in an office that’s a hub. And we can work in third places that we call ‘spokes,’ which might be a co-working space or a small, companycontrolled space in the suburbs. Home might be where you put your head down and do concentrated daily work. The hub is where you’ll go to collaborate and innovate and access the best technology. And spokes will be casual, communitybased spaces for people who don’t want to work from home, or can’t.” Hubs will have fewer individual workstations and more collaborative spaces, Sargent predicts. “You may not need as much square footage, but you’ll need better square footage,” she continues. “One reason to go to the hub is to collaborate and make connections, so

HOK

Corporate design firm HOK is creating innovative spaces for companies so their employees can safely work and collaborate.

you’re going to see a lot more opportunities for socialization and innovation (such as) interactive gathering spaces, meeting spaces and scrum spaces.” Whether they manifest as new hubs and spokes or as traditional headquarters, physical offices will experience a post-pandemic resurgence, insists Anthony Malkin, president, chairman and CEO of Empire State Realty Trust, which owns New York’s Empire State Building. “There are serious flaws to working from home and to having teams that are divided and separated,” he says. “People want to work together. Like

“We decided that by being thoughtful and bold about giving our employees what they want, we could position ourselves to come out of the pandemic stronger, better and more competitive.” — D.J. CASTO, chief human resources officer, Synchrony

Aaron Burr in Hamilton, they want to be in ‘the room where it happens.’” While it might happen less frequently than it used to, Malkin thinks business travel will persist for the same reason. “If you’re not in the room where it happens, that also means you aren’t in the hallway leading to the conference room, that you aren’t there for the conversation that takes place when the phone is hung up and that you aren’t there to then grab an impromptu lunch afterwards,” he says. “Being successful in business requires CONTINUED

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you to develop authentic personal relationships, and that’s not going to change. It’s how deals get done.”

FINDING FLEXIBILITY Although the need for face time will persist, time in general will look different in the workplace, according to Casto, who says Synchrony has moved to offer more flexible work arrangements, including flextime and even compressed workweeks. “Because there’s no line anymore between work and home, our remote employees are working more and longer,” Casto says. “So we’ve created the concept of ‘flex Fridays.’ We’ve told our employees not to schedule meetings on Fridays, and to use that time to catch up on all the things they need to catch up on — whether those things are professional or personal.” Because of shuttered schools and

day care centers, employers during the pandemic had to accommodate parents as they worked around kids’ schooling and activities. Those accommodations will continue, predicts organizational development consultant Tana M. Session. “The workplace has invaded our home, so there has to be some meeting of the minds in terms of what schedules look like,” she says. “Organizations are therefore offering the option to work four 10-hour days a week, for example, or to work from 7 to 3 instead of 9 to 5.” Increased flexibility is spawning new ways of measuring performance and productivity. “‘Hours worked’ is becoming a metric of the past,” echoes Volini, who observes a shift from measuring output to measuring outcomes. “The definition of productivity is going to change pretty dramatically ... as employees are empowered to say, ‘OK. This is my end-state objective. I just need to get it done.’”

EMBRACING EMPATHY The pandemic helped Synchrony realize that employees need not only different hours, but also more support. It revamped its benefits to focus on working parents and caregivers, as well as mental health. The company now offers paid parental leave for 12 weeks and will fund backup care for children and seniors for up to 60 days in the event of an emergency. It also launched Synchrony After School and Synchrony Summer Camp — virtual programs offering tutoring, homework help, activities and enrichment for employees’ children — and hired clinically trained wellness coaches whose role is supporting employees’ physical and mental well-being. “We need to offer benefits that help employees be their best selves. Because when they’re their best selves, they perform better,” Casto says.

Other companies are embracing similar benefits, according to Session, who says employers have even modified their training priorities for leaders and managers to focus on soft skills like compassion and communication. “What we’re witnessing is a humanizing of the workplace. And it needed to happen, honestly, because companies had stopped seeing people as people and saw them, instead, as tools of production,” she says. “Increased empathy has been one of the positive outcomes of COVID-19.” From new office arrangements and schedules to new benefits, that’s what the post-COVID workplace should be all about, Volini says. “Employees want to be seen as holistic individuals who have not just work lives, but also personal lives. To succeed, organizations are going to need to support them in both.”

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Swift Sanitizers Banish bacteria and viruses with ultraviolet technology By Pam George

T Vio Orb is a ping pong ball-size device that uses blue/UV-A light to kill mold, fungus and bacteria. The waterproof orb shoots cleansing light in all directions. $149, revivelighttherapy. com

Babily’s UV-C sanitizer kills most viruses, germs and harmful irritants on items such as baby bottles and teething toys. $149.98, walmart.com

HE PANDEMIC HAS UNDERSCORED

the need to keep everyday items clean, and personal sanitizing devices now come in all shapes and sizes to use at home, at work and in the car.

Reach for the rechargeable Me-UVC EasyKlean sterilizing wand to remove 99.9 percent of common bacteria and viruses. $89.99, me-uvc.com

The Remington Airetrex 365 UV-only air sanitizer targets airborne pathogens. $199.99, airetrex365.com

The SoClean Device Disinfector uses activated oxygen to remove pathogens on jewelry, phones, earbuds and other items. $189, soclean.com

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Clean any nonporous item in 10 minutes with PhoneSoap’s HomeSoap countertop device, which also has USB-A and USB-C ports. $199.95, phonesoap.com

The Luma Pro by Violux is an eco-friendly sanitizer that’s free of chemicals and ozone. $499, violux.com

Give your airplane seat, hotel bathroom or ATM touch screen the once over with Modern Hygiene Solutions’ portable UV sanitizing wand. $69, modernhygiene solutions.com

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UVee’s Puritize Home can sanitize multiple items at once in five to 10 minutes. $149.99, amazon.com

Kill bacteria on the go with Utilimedic’s phone sanitizer, a built-for-the-car device that also features a wireless charger. $89.99, utilimedic.com

The HoMedics UV CLEAN portable sanitizer bag boasts sterilizing UV-C technology to kill up to 99.9 percent of bacteria and viruses at the DNA level. $99.99, homedics.com PROVIDED BY THE COMPANIES

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Best Tech Get the most out of your home oﬃce By Michael Desjardin and Lee Neikirk

ANY OF US ARE

still working from home in an effort to reduce the spread of COVID-19. While this sounds convenient, there are advantages to working in the office. Productivity aids like a sec-

ond computer monitor or fast Wi-Fi are easy to take for granted. At Reviewed, we have years of experience evaluating tech products, and many of our staff members work remotely year-round. If you’re finding your cozy home isn’t quite as amenable to maintaining focus as you might have thought, this suite of key products should help make your at-home workday a lot easier:

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PRODUCTS

A RELIABLE, FLEXIBLE COMPUTER MONITOR In the age of 11- and 13-inch laptops, adding a computer monitor to your home office can be transformative. But even if you are working from a larger 15.6-inch laptop, a more expansive monitor like the HP VH240a can help you maximize productivity, whether it’s by adding a second screen to display information, or just an easier screen to view for hours at a time. This monitor is our favorite affordable option. It utilizes an IPS (in-plane switching) style backlit LED screen, which offers better color and viewing angles compared to other (VA- or TN-type) screens found on most laptops. Unlike many monitors in this price range, it also offers a high degree of flexibility: panel tilting, adjustable height and portrait rotation, which are not usually flexibility features you get for less than $200. It also has inputs for HDMI and VGA (video graphics array), meaning it’ll interface just fine with most laptops (though you should check your video out-ports just in case). ▶ HP VH240a 23.8-inch full HD 1080p IPS LED monitor. $124.99, amazon.com LEE NEIKIRK/REVIEWED

JACKSON RUCKAR/REVIEWED

A GREAT PAIR OF NOISE-CANCELING HEADPHONES A quality set of headphones should be on the top of your workat-home wish list. Our current favorite, the top-rated Sony WH1000XM3, aren’t just a good investment for working remotely, they’re a good investment in general. Multiple Reviewed staffers have fallen in love with these luxurious over-ear headphones. Sony really knocked it out of the park with these: They’re lightweight, sturdy and comfortable enough that you can use them for hours. Their audio quality is as good as it gets in this price range, with up to 30 hours of battery life per charge. But their best feature is their adaptive noise-canceling: They reduce a ton of ambient sound, and can even adjust to the environment around you. ▶ Sony WH-1000XM3 noise-canceling headphones. $348, amazon.com

JEREMY STAMAS/REVIEWED

A COMFORTABLE, WIRELESS KEYBOARD AND MOUSE COMBO Laptop keyboards are notoriously uncomfortable and awkward, and using a trackpad can be dodgy — especially if your job requires scrolling through spreadsheets or using Photoshop. A quality wireless keyboard-and-mouse combo not only helps declutter your desk, it makes essential tasks like typing and navigation that much easier. The Logitech MK270 was our pick for best value, and with almost 40,000 ratings on Amazon (more than 75 percent of them 5 stars), it’s easy to see why. For about a week’s worth of coffees, you’re getting a comfortable, reliable keyboard/mouse combo with good battery life. ▶ Logitech MK270 wireless keyboard and mouse combo. $25.99, amazon.com

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D-LINK

A NEW LAPTOP TO STAY ON TOP OF WORK If you need to get a laptop to do your job from home (or are just realizing your laptop is too slow to rely on for the near future), we recommend the newest 13-inch HP Spectre x360. It offers high-end design, top-of-the-line speed and an excellent keyboard/screen/ trackpad combo — with new configurations featuring Intel’s latest 10th-gen i7 processor. If you need a MacBook or something even more powerful for creative work, we recommend the newer 16-inch MacBook Pro, which has an updated keyboard design that replaces Apple’s unreliable “butterfly” keyboard. It’s big and heavy, but it’s the best MacBook right now. ▶ HP Spectre x360 13-inch laptop. $1,355, amazon.com ▶ Apple MacBook Pro 16-inch laptop. $2,249.99, Best Buy

A WIRELESS ROUTER THAT WON’T LEAVE YOU BUFFERING If you’ve been putting off replacing your home’s unreliable wireless router, now’s the perfect time to upgrade to something that won’t let you down — especially important while you work remotely. Of all the wireless routers we’ve extensively tested, the D-Link AC1900 DIR-878 is our pick for the overall best. It doesn’t come with all of the features you might find in higher-end models (it lacks USB ports, for example), but from a performance standpoint, it’s difficult to find a better router in this price range. Case in point? The DIR-878 delivered the best performance results in our toughest, long-range wireless transfer test. Plus, the DIR-878’s setup process is a cinch, so it’s approachable for most people, regardless of technical expertise. The bottom line: There are other routers that are better suited for power users, but if you don’t have several high-bandwidth devices that all need attention, the D-Link DIR-878 is a great choice. If you do consider yourself a power user, you might want to look into a mesh Wi-Fi system. ▶ D-Link Wi-Fi smart router AC1900 DIR-878. $209.99, amazon.com

A LAPTOP STAND THAT WON’T LET YOU DOWN A laptop stand can be a back-saver when you’re working at home — especially if you don’t have a proper desk and chair setup. Having your screen at the proper height (eye level, roughly) and angle when possible is better for your neck and back, helping you work more comfortably and avoiding residual strain. We tested several, and the Rain Design 10032 mStand took our spot for best overall. It’s not exactly inexpensive, but it offers the best combination of sleek design aesthetics, durability and flexible laptop presentation. And it’s available in silver, gold or space gray. ▶ Rain Design 10032 mStand laptop stand. $39.90, amazon.com

JACKSON RUCKAR/REVIEWED

Michael Desjardin and Lee Neikirk write for Reviewed, a USA TODAY content partner offering product testing and recommendations at reviewed.com.

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Essential Caring champions emerge during pandemic to help others By Mary Helen Berg ot long after the COVID-19 pandemic reached crisis levels and quarantines were in full force across the country, a phrase began to circulate referring to front-line workers such as medical and emergency professionals: Not all superheroes wear capes. Doctors, nurses, EMTs and other first responders have worked tirelessly to battle the coronavirus epidemic, but less visible and unheralded heroes also have emerged, doing what they could to ease the crisis for their neighbors, co-workers and friends. These are the stories of four women who stepped up and brought a bright light to otherwise challenging circumstances:

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NOT ALL

superheroes WEAR CAPES

LABOR OF LOVE

AMILIKIA “T.T.” FOSTER is the type of labor and delivery nurse who

doesn’t stop caring when her shift ends. She says she’s “auntie” to many of the babies she’s helped deliver, staying in touch with their families and attending their birthday parties. She’s also auntie to her co-workers at McLaren Greater Lansing hospital in Lansing, Mich., and she was troubled to see morale plummet when the pandemic struck. “People were really depressed,” recalls Foster. “They were scared, crying, wanting to quit, and they were angry that nobody was taking this seriously.” Foster noticed that while doctors and nurses were hailed as heroes for their efforts during the crisis, housekeepers, lab and X-ray technicians, security guards, and maintenance and shipping and receiving workers — all essential staff who kept the hospital humming — were overlooked. So, Auntie T.T. picked up a pen. “I can pull people in with my words,” says Foster, who is also a poet and activist. During off hours and work breaks, she wrote scores of letters to corporations and organizations requesting donations to honor the “silent front-line” workers at McLaren. Within weeks, nonprofit charitable organization Operation Gratitude coordinated shipment of two freight trucks full of materials — $22,000 in hygiene items, Starbucks coffee, Girl Scout cookies, Liquid I.V. hydration supplements and more. Luxury lockable bag maker Cartwright and telecommunications company Figgers Communications donated masks. High Brew sent coffee drinks, and brownies arrived from the Vermont Brownie Company. Foster gathered enough donations to create 1,500 gift bags — twice as many as she hoped for — allowing her to deliver gifts throughout the hospital and to five local homeless shelters. Her co-workers’ grateful tears and hugs were her reward, she says. “I did it to see them smile,” Foster says. “I did it to build morale and let them know that we are in this together.” Foster has no plans to make more gift bags, but she does whatever she can to have a positive impact on her world, she says. For example, during last summer’s protests against racism, she organized a sit-in with performers and speakers. “I don’t know how long I have on this Earth,” Foster explains. “I need my (time) to mean something so that when I’m gone, I meant something at every moment (and) that I could mean something to someone.”

HAPPY TO HELP

hen NORA HERWICK was about 8 years old, her mom worked a second job as a seamstress and tried to teach her daughter to sew. “She made me learn,” recalls Herwick, a Navy veteran and Air Force spouse living in Dayton, Ohio. “When I was little, I hated everything about it.” She eventually became an avid quilter, and those early lessons came in handy when the pandemic hit. Herwick put aside quilting projects to sew face masks for whoever needed them. First, she sewed for her husband and his co-workers. Her prototype, using fabric from one of her husband’s old Air Force uniforms, was too difficult to breathe through. Fortunately, quilters always have a stack of fabric stashed away, she says. After Herwick modeled one of her creations on Facebook, requests began to pour in. She sewed for friends, relatives, local merchants, a cancer center and college kids returning to school. She made them free of charge, but when people insisted, she’d accept a donation to cover materials or an item of barter in exchange. After sewing 500 masks, she stopped counting. The spread of the coronavirus upended Herwick’s family life. Her 21-yearold daughter returned from college last March; her 17-year-old special needs son was learning online at home; and relocation for her husband’s new job was indefinitely postponed. “I was feeling so out of control and so helpless,” she recalls. Making masks for others gave her a productive focus. A marathon runner, Herwick often rises at 5 a.m. to squeeze in a run, handle household duties and assist her son before cutting, piecing and sewing masks for three to four hours. Colorful fabrics help break the routine. Lightning bolts decorated masks for an electrician and his crew. Spider webs and candy corn fabric celebrate Halloween. Train patterns delight her son, and for friends with a sense of humor, she used material with images of toilet paper, viruses and microbes. The masks feature two layers of cotton fabric and a pocket to add a filter. Instead of ear loops, elastic ties run behind the head and neck, a design bonus for her son, who was born with only one ear. She doesn’t consider what she’s doing to be heroic, or even unusual. As long as there’s a demand, she’ll keep sewing, she says. “I’m glad I have the chance to do it,” Herwick says. “I’m grateful to my mom for giving me the skills. I did not know I would use them in this way, but I’m grateful.”

GETTY IMAGES; PROVIDED BY TAMILIKIA FOSTER; PROVIDED BY NORA HERWICK

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NOT ALL

superheroes WEAR CAPES

ANSWERING THE CALL

n an era when “defund the police” is a rallying cry, officer ALICE DIBIASE DEAKINS of the Rockledge, Fla., police department, is moved to tears

when senior citizens thank her for personally delivering their medications during the coronavirus pandemic. “It blows my mind how such a small task has such a great reward,” says DiBiase Deakins, an 18-year veteran of the department who created its prescription delivery program in early April to help housebound seniors. Rockledge is a throwback to simpler times, a town where the police department believes that “no call is too small,” DiBiase Deakins says. So, when many seniors called the department saying they were too nervous to leave home to go to the pharmacy during the pandemic, she devised a volunteer effort to help. DiBiase Deakins’ mother is 88 and lives on her property, so she empathizes with the nearly 22 percent of Rockledge residents who are senior citizens, according to the 2010 census. Many are from out of state and have no relatives nearby to rely on. Especially for those older than 65 or with underlying health conditions, prescription deliveries were critical, DiBiase Deakins says. About 20 officers have participated in deliveries, including the police chief, but DiBiase Deakins runs the program and makes most deliveries, she says. She dons a mask and gloves and spends up to 10 hours of her off-duty time each week visiting pharmacies and dropping prescriptions safely outside front doors. While she strives for contact-free service, seniors often want to invite her in for tea or give a grateful hug. DiBiase Deakins finds it difficult not to hug back. “When they’re in tears and thanking us up and down and thanking God that we were sent to them today, it’s very touching,” she says. Requests for deliveries have declined recently, but the department will keep delivering as long as seniors continue to call, DiBiase Deakins adds. “I know it did a lot of good for them, but in turn it did a lot of good for us also,” she says.

SUPPORTING ESSENTIAL WORKERS

t 5:20 a.m., CRYSTAL PERRY-GRANT opens the door of her family child care center in Perris, Calif., to welcome the morning’s first client, a 3-month-old boy whose dad serves in the Air Force. It’s a punctual start to her 12-hour day. While a survey by the Bipartisan Policy Center and Morning Consult found that more than half of U.S. child care centers closed their doors at some point during the pandemic, Perry-Grant kept her 18-year-old business open. Most of the children she serves are elementary or middle school students whose parents are essential workers — firefighters, nurses and UPS workers. They’ve worked throughout the pandemic, and when school started last fall, they weren’t home to oversee online lessons. So, instead of caring for most children before and after school hours as she normally would, Perry-Grant transformed her playroom into a one-room schoolhouse to accommodate remote learning for 11 students at seven grade levels. She set up a dozen desks and invested in headphones for everyone so that a student who is rehearsing a play won’t be too distracted by one doing push-ups for gym class. “They’re doing jumping jacks with headphones on. It’s a madhouse,” she says. Perry-Grant keeps everyone on task while watching the baby and a few toddlers. Even on hot California days, she sometimes feeds the children lunch of homemade soup spiced with cilantro, mint and garlic to help build their immune systems. As months passed and the virus persisted, Perry-Grant tried to take care of parents, as well as their children, she says. She shared her stock of toilet paper and cleaning supplies that became scarce during the pandemic and texted parents extra photos of their kids throughout the day to lift their spirits. Perry-Grant says she has never worried about contracting the coronavirus herself, and so far, she believes healthy soups and lots of prayer — not to mention masks and sanitizing — have helped all her families stay healthy. “I was praying a lot,” she says. “We pray in the morning, at night, we just pray, pray, pray.”

GETTY IMAGES; PROVIDED BY ALICE DIBIASE DEAKINS; PROVIDED BY CRYSTAL PERRY-GRANT

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Luck, Foresight

Science

AND

HOW AN UNHERALDED TEAM DEVELOPED A COVID-19 VACCINE IN RECORD TIME

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The liquid about to go into Haller’s arm was the culmination of years of research by a handful of scientists who, by virtue of incredible research and timing, were prepared for one virus more than almost any other: a coronavirus.

By David Heath and Gus Garcia-Roberts

HEN JENNIFER HALLER, an operations manager at a tech company and mother of two, arrived at a Seattle research center on March 16, 2020, it had been about 75 days since news broke of unexplained cases of pneumonia seeming to emanate from a seafood market in Wuhan, China, and 66 days since scientists in the U.S. stared at the virus’ genetic code and vowed to produce a vaccine to shut it down. As Haller clicked through the news on her phone and surveyed the medical staff and journalists surrounding her that morning, she was just figuring out that she was, in fact, making history. She was the first COVID-19 vaccine trial subject. The country was in the grip of a disease that would infect millions and kill hundreds of thousands, and was accelerating unimpeded. And yet, Dr. Anthony

Jennifer Haller

CONTINUED TED S. WARREN/ASSOCIATED PRESS

Fauci, who had quickly become the voice of the scientific community, was already predicting a vaccine within as little as a year, a projection many of his colleagues considered wildly optimistic. But Fauci knew something many did not. Members of his team at the National Institutes of Health (NIH) and an affiliated biotech company, Moderna, had been preparing for years for just this moment. The liquid about to go into Haller’s arm was the culmination of years of research by a handful of scientists who, by virtue of incredible luck and foresight, were prepared for one virus more than almost any other: a coronavirus.

THE BACKSTORY Then-President Donald Trump credited his Operation Warp Speed for the fast development of the vaccine, and marshaling the resources of public health agencies no doubt played a critical role. Committing billions of dollars for human trials and manufacturing the vaccine even before it was tested, banking on a green light from the U.S. Food and Drug Administration, were investments that seemingly paid off. But the real credit for the rapid turnaround belongs to a series of uncelebrated discoveries dating back at least 15 years — and a constellation of unsung scientists. Chief among them is Dr. Barney Graham, who had spent much of his career trying to understand why two infants died in a 1966 vaccine trial for respiratory syncytial virus (RSV), which remains a leading cause of hospitalization for young children in the U.S. The RSV vaccine tragedy haunted Graham, and he continued his research for 31 years until, in 2013, he had a major breakthrough — one that would become vital to developing a COVID-19 vaccine. As deputy director of NIH’s vaccine research center, Graham’s mission has been to make a vaccine fast enough to stop a pandemic. He had gotten close once before when the mosquitoborne Zika virus reached the U.S. in 2016. The Zika vaccine held the record for getting from initial research into a clinical trial — roughly seven months — but that pandemic subsided before Graham could complete the small trial. At the end of 2019, Graham

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was months into plans to make another vaccine at supersonic speeds. He had chosen a virus called Nipah. Spread by bats, it last broke out in India in 2018, killing 17 of the 19 people it infected. Graham picked Moderna to make the Nipah vaccine. During the Zika experiment, Moderna had developed a vaccine 10 times more potent than the one Graham himself had created. It relied on messenger RNA, sometimes called the “software of life” because it carries out the instructions of our DNA. In a vaccine, messenger RNA (mRNA) instructs our bodies to produce just a piece of the virus, the protein on its surface. As Graham got word that the new virus in China was probably a coronavirus, he reached out to Stephane Bancel, Moderna’s CEO, by email on Jan. 6, 2020, saying that in lieu of the Nipah plan, they should develop a different proof of concept related to the Wuhan outbreak. “If it’s a SARS-like coronavirus, we know what to do,” Graham wrote. “This would be a great time to run the drill for how quickly can you have a scalable vaccine.” He later laid out the plan to Fauci. “Let’s go full-blown,” Graham said. “Let’s make a vaccine.” If everything went perfectly, a vaccine could be ready within 12 to 18 months. Fauci was sold.

Dr. Anthony Fauci JACK GRUBER/USA TODAY; GETTY IMAGES

THE VIRUS’ UNIQUE IDENTITY IS REVEALED On Jan. 10, after Chinese scientists posted the genetic sequence for the novel coronavirus, SARS-CoV-2, Graham contacted former NIH scientist Jason McLellan, now associate professor of molecular biosciences at the University of Texas at Austin and immunologist Kizzmekia Corbett, who had been working in Graham’s lab since 2014, studying the best way to defeat coronaviruses with a vaccine. The team began to tailor a vaccine to the new coronavirus; it took them only a few hours. The mRNA would be encased in a fat bubble and injected in a person’s arm. It was intended to produce a protein identical to the spike protein on the surface of the new virus. That protein, they hoped, would trigger the body to CONTINUED

Dr. Barney Graham JASPER COLT/USA TODAY; GETTY IMAGES

USA TODAY SPECIAL EDITION

produce just the right antibodies to fight back. Graham convened with scientists at Moderna two days later to sketch out the road map. Moderna would produce the vaccine, using the genetic code Graham provided. It would be the only vaccine for which the government would lead the first clinical trial, a trial Graham wanted to launch in a matter of weeks.

THE FIRST U.S. PATIENT IS CONFIRMED Days after Graham’s team designed a vaccine, COVID-19 officially reached the United States. In a Seattle suburb, a 35-year-old man who’d just returned from Wuhan became sick. After four days of symptoms, on Jan. 19 he visited a local urgent care clinic, and the next day, test results showed he was the first U.S. patient confirmed to be infected with the new virus. At the request of the Centers for Disease Control and Prevention (CDC), Providence Regional Medical Center — which ran the urgent care center — sent emergency medical technicians to transfer the infected man to the hospital’s biocontainment unit near Seattle. The patient later developed pneumonia but recovered from the illness. Local public health officials scrambled to track down at least 50 people who’d had contact with the man since his return from China, but they never found anyone sick, leaving them unsure how contagious this new disease might be. Although it still wasn’t clear that the vaccine would become such an urgent need, Moderna was already starting to produce the one Graham and his colleagues had developed. NIH put out a notice to 10 sites it uses for vaccine trials, asking them to get ready to test the experimental concoction on humans. On Jan. 27, Dr. Lisa Jackson at Kaiser Permanente Washington in Seattle learned that she would oversee that trial. Jackson dropped all her other work to focus on the vaccine. By Feb. 19, Graham and his team had the first good news from a two-week mouse study. Blood drawn from vaccinated CONTINUED

USA TODAY SPECIAL EDITION

“

It’s a big day: It’s the first Phase 3 of a COVID vaccine in the U.S.; it’s the first Phase 3 of an mRNA vaccine ever; and it’s the company’s first Phase 3 as well. So a big day came from a lot of work of a big team. — Stephane Bancel, Moderna CEO

COMMON COVID-19 VACCINE SIDE EFFECTS

HEADACHE FEVER

INJECTION

SITE

FATIGUE NAUSEA

MUSCLE PAIN

SOURCE: Centers for Disease Control and Prevention

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USA TODAY SPECIAL EDITION

mice showed they were producing antibodies to fight the virus. Corbett designed that study, gave mice the vaccine and analyzed the results. Back in Seattle, the first human trial for the coronavirus vaccine was about to start. A study design process that typically takes months became Jackson’s sole priority and was completed in days. Jackson was hiring nurses and getting supplies ready on Feb. 28 when bad news struck. Several patients at EvergreenHealth Hospital in Kirkland, Wash., had pneumonia, and testing confirmed two had COVID-19. One patient died that same day; the other, who was transported from a local nursing home, died later. Two residents of a nearby nursing home also tested positive, and 50 more were awaiting results. Overnight, Seattle became the nation’s first COVID-19 hot spot. Amid this frenzy, Haller started paying close attention to COVID-19 news. Her mother and stepfather lived not far from the nursing home, and Haller was worried about them. On March 3, she was scrolling through Facebook when a friend’s post stopped her. He had linked to Kaiser’s sign-up page as a favor for a nurse working on the vaccine. Haller didn’t care about the $1,100 stipend being offered to trial participants. She had always felt that as a white person living a middle-class life, she should give something back. So, she clicked on the link and filled out a form. Two days later, a Kaiser employee called her to review her health history and ask if she could make all the appointments, and two days after that she went into Kaiser’s offices for blood draws, a physical exam and to answer more questions. Side effects are common in vaccine trials, including pain at the injection site, fatigue, headache, muscle pain, swollen lymph nodes, nausea and fever. If any serious side effects emerged that weren’t expected, the trial would be immediately suspended or even halted for good. Kaiser instructed Haller to report to its downtown Seattle office on March 16 and asked her if she would be willing to have the Associated Press there to record her vaccination. After the shot, CONTINUED

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Kizzmekia Corbett JASPER COLT/USA TODAY; GETTY IMAGES

Jason McLellan JAY JANNER/AUSTIN (TEXAS) AMERICAN-STATESMAN; GETTY IMAGES

UNSUNG HEROES DR. JONAS SALK became an overnight hero on April 12, 1955, when the news was delivered in a University of Michigan lecture hall that the polio vaccine was 90 percent effective. With the COVID-19 vaccine, DR. BARNEY GRAHAM and his colleagues are not yet household names. Last December, Graham’s team was recognized with a scientific award created by U.S. Rep. Jim Cooper. The congressman sought to counter the Golden Fleece Award, which singles out frivoloussounding research efforts, by highlighting the research behind major breakthroughs. The 2020 Golden Goose Award went to Graham, KIZZMEKIA CORBETT, JASON MCLELLAN and others for leading the effort to create a COVID-19 vaccine. Corbett responded to the award by tweeting an inscription in a book given to her by Graham in 2009, when she was an NIH intern. It read, “I am also proud of how you have matured scientifically and professionally, and have every confidence that you will achieve your dreams and be very successful.” In a video post, Corbett pauses at times to hold back tears, saying of Graham: “Part of the reason why I was given essentially the wings to fly with this project is because I had a mentor who allowed me to use his resources and sit in the back of his laboratory and to ask scientific questions that a lot of other people didn’t really care about.” — David Heath and Gus Garcia-Roberts

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she was asked to wait a couple of hours just in case there were any reactions. She felt fine.

MODERNA’S VACCINE TRIALS HIT A ROADBLOCK “It’s a big day: It’s the first Phase 3 of a COVID vaccine in the U.S.; it’s the first Phase 3 of an mRNA vaccine ever; and it’s the company’s first Phase 3 as well,” Bancel told CNBC on July 27. “So a big day came from a lot of work of a big team.” Having fully taken the reins from Graham and his colleagues, the company now needed to recruit 30,000 people, which Bancel estimated would take up to eight weeks. Infection rates would determine when they would have results; the worse the outbreak, the faster they would have data showing whether the vaccine worked. But not long after Moderna began recruiting volunteers for its final trial in September, the head of vaccine development for Operation Warp Speed, Moncef Slaoui, noticed a big problem: The company wasn’t recruiting enough African Americans. To Slaoui, it was clear that having Black and Latino participants in the trial was key to the vaccine’s future success. The virus was disproportionately lethal for those communities, and it was important to show that the vaccine was safe for all, a detail often neglected in clinical trials. The pause to recruit additional participants of color lasted two weeks, and resulted in a 50 percent increase in Black people in the trial. It also caused Moderna to lose its vaccine front-runner status to another company, Pfizer.

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HOW MRNA VACCINES WORK Once they knew the genetic sequence of the virus, scientists took swift action preparing a vaccine that used the mRNA delivery system:

On Jan. 10, 2020, when Chinese scientists posted the genetic sequence for SARS-CoV-2, scientists at the National Institutes of Health and the University of Texas at Austin already had an action plan in place.

SARS-CoV-2

Vaccine

Shoulder

Antibody

Post-fusion

mRNA

Human cell

THE GOOD NEWS But on Nov. 16, Graham received astonishing news: The government’s data monitoring safety board had completed the first analysis of 94 volunteers in the Pfizer vaccine trial. To meet the FDA threshold in the first analysis with only 32 subjects, the vaccine would have to be at least 75 percent effective; the data showed it was more than 90 percent effective. Graham shared the news with his wife, sat down at his desk and wept tears of relief. The type of vaccine he had been perfecting for CONTINUED

The scientists suspected a vaccine that generates antibodies for the virus would be less effective when applied to the spikes on the SARS-CoV-2 surface, so they needed to find a way to lock it in the pre-fusion state and a method to deliver it. An unproven delivery platform called mRNA— messenger ribonucleic acid — was waiting in the wings.

Spike protection

mRNA

Human cell

In the vaccine, mRNA instructs the body’s cells to produce just one piece of the virus, the protein on its surface.

The virus’ RNA reprograms the cell to produce large quantities of the virus that are eventually released from the cell. The immune system recognizes those vaccine-created spike proteins as invaders and creates antibodies to block future attacks of SARS-CoV-2 spike proteins.

SOURCES: Dr. Barney Graham, National Institutes of Health; Jason McLellan, the University of Texas at Austin JENNIFER BORRESEN AND RAMON PADILLA/USA TODAY; GETTY IMAGES

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more than a decade was more successful than even he had imagined. On Dec. 17, Moderna’s top scientific leaders went before 21 independent scientists on an FDA advisory panel to present their data. The vote was 20 yeses, with one abstention (an objection to the wording, not the vaccine). Fauci now attributes the vaccine being ready so quickly to two factors, one of them unfortunate. With the coronavirus spreading rapidly during the trial, odds dramatically increased that some of the 30,000 placebo recipients in the Moderna and Pfizer trials would contract the virus. That

HARRISON HILL/USA TODAY

would prove that the vaccine worked in the other 30,000 who received it. The other reason, Fauci says, was the work Graham and his colleagues had been doing for years in their own laboratories as well as in embracing mRNA and choosing it for the COVID-19 vaccine.

YURI GRIPAS/ABACA VIA ASSOCIATED PRESS

Former President Donald Trump tours the National Institute of Health’s vaccine research center in Bethesda, Md., on March 3, 2020, with Dr. Barney Graham, left, and Kizzmekia Corbett, right.

PREPARING FOR THE FUTURE The battle to stop pandemics is not over. Currently, thousands of known strains exist in bats that could jump to humans at any time. But Graham believes we’re now better prepared. “I think with all the things that have been done during this outbreak, we would know how to make a new coronavirus vaccine once we had a new sequence,” he says. “And I think a lot of clinical testing, experimentation that’s going on now would be able to be bypassed, and you’d be able to really deliver vaccine much quicker.” Beyond that, Graham already has set his sights on the next big battle in the war against viruses: developing a universal vaccine to protect against any coronavirus. Next time, Graham wants to stop it before it starts.

Stephane Bancel ANDREW HARNIK/ASSOCIATED PRESS

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Tribal Immunity Health ofﬁcials work to alleviate vaccine concerns among Native Americans By Nada Hassanein, Nora Mabie, Shondiin Silversmith and Nora G. Hertel

hen the COVID-19 vaccines arrived at the Indian Health Center of Santa Clara Valley in California last December, youth counselor Miriam Mosqueda of the Chichimeca Guamare Tribe considered not getting one. She says she was afraid. But she thought of her immunocompromised grandparents, whom she hadn’t seen since last March. She thought of never again sipping her grandmother’s traditional vanilla atole while she told her stories, or never hearing her grandfather’s laughter as he insists she pick lemons from his tree. Her culture reveres elders, and her grandparents helped raise her. “They’re like our third and fourth parents,” she says. “I was like, I have to get this vaccine. If that means that I can protect them, too ... and safely see them, then I will do that. I can’t not take the opportunity to protect our community.”

SAGE MEMORIAL HOSPITAL

Navajo Nation police officers and Indian Health Services officials deliver the COVID-19 vaccine to Navajo Health Foundation-Sage Memorial Hospital in Ganado, Ariz., last December.

The Santa Clara Valley center is one of 340 tribal health programs or urban Indian organizations nationwide to receive vaccine allocations from the federal Indian

Health Service (IHS). Tribal nations could either receive vaccines from the IHS or their states. Native American health care workers and residents of long-term care

facilities received vaccinations as part of phase 1 of the nation’s coronavirus vaccine rollout. COVID-19 has disproportionately affected Native communities, in part, because of long-standing social inequities that have put American Indian and Alaskan Native people at higher risk for contracting the virus. A Centers for Disease Control and Prevention study found that among 23 states with data on race, American Indian and Alaskan Native people were 3.5 times more likely to be diagnosed with the coronavirus than white people, and four times as likely to be hospitalized. “It’s been devastating for many of our community members,” says Sonya Tetnowski, CEO of the Santa Clara Valley center. California has one of the largest populations of American Indians, with more than 720,000 people and 109 federally recognized tribes. “Because we’re serving a population that already has signiﬁcant challenges CONTINUED

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SIOUX FALLS (S.D.) ARGUS LEADER

Wiyaka His Horse is Thunder, a counselor at a tribal health clinic in Flandreau, S.D., receives her first dose of the COVID-19 vaccine.

PROVIDED BY GARLAND STIFFARM SAGE MEMORIAL HOSPITAL

Indian Health Service officials deliver the COVID-19 vaccine to Navajo Health Foundation-Sage Memorial Hospital.

just day to day, adding the coronavirus ... added to that stress and pressure of that community,” she says. Many patients at the center, which also serves Hispanics and migrant workers, suﬀer from diabetes, hypertension and heart disease, making them vulnerable to the virus. But tribal leaders have grappled with the challenge of helping members feel comfortable taking the vaccine and understanding its safety. Injustices against tribal communities have planted seeds of doubt in many.

‘BRINGING ALL THE FACTS TO THE TABLE’ Health centers in these communities need respected elders and tribal leaders within the groups to encourage others to get vaccinated. People of color are more likely to rely on trusted voices within their own communities for information

Garland Stiffarm, CEO of Blackfeet Community Hospital in Browning, Mont., receives the COVID-19 vaccine.

about the pandemic and the vaccine, a study by Northeastern University and the Center for Data Science at New York University suggests. Virginia Hedrick is executive director of the California Consortium for Urban Indian Health (CCUIH). “It’s about transparency. It’s about bringing all the facts to the table,” she says. Hedrick is a member of the Yurok Tribe and grew up on a rural reservation. CCUIH streams COVID-19 Facebook question-and-answer sessions every other week. She says connecting CCUIH’s messaging about the vaccines to American Indian values, such as community, has been essential. “We don’t know about this vaccine’s ability to prevent transmission. What we do know is that it will save lives. And we do know as Indigenous people that that value resonates with us — that we really have to meet our prayers halfway,” she says. “So when we’re praying for health and wellness and long life, we have to do the things that get us there.” CCUIH works with another agency to create educational digital and print ﬂyers about the vaccines featuring relatable images and messaging. “When they see images that don’t resonate with them, when they see taglines that are not important to them, they put the material to the side,” she says. “Then it’s a total missed opportunity.” In southeastern Minnesota, the Prairie Island Indian Community on the Mississippi River had early buy-in on the vaccines from its elders. In mid-December, the tribe hosted a Zoom meeting for its elders, council and Prairie Island Health Center’s primary doctor to answer questions and talk about the vaccines. “The majority of tribal elders have accepted the vaccine. They really feel a responsi-

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CAMILLE STEIN

A nurse in Fort Belknap, Mont., vaccinates Belva Bell, a tribal health nurse.

bility to protect their community,” says Katie Halsne, director of clinical operations for NeoPath Health, which runs the Prairie Island clinic. Halsne says protecting elders has been key to helping communities understand the importance of the vaccine. “We do have a profound respect for our elders. They are our encyclopedias. They are our libraries. They cannot be replaced.”

‘I CAN SAY I’M ALIVE, AND I’M DOING OK’ In Sioux Falls, S.D., a team of mental health therapists helps guide the Flandreau Santee Sioux Tribe through the stress brought on by the pandemic, discussing the vaccines with each patient. And doctors at other clinics have publicly taken the vaccine to model its safety. Family physician Courtney Keith says she wanted to be one of the first to receive the vaccine not just because she’s a health care worker treating patients, but to show the community that the vaccine is safe. “I work with a clinic that has had an abusive history with medicine,” she says. “The reason I want to be one of the first is to show I have confidence, and so six weeks down the road, when people are thinking and saying, ‘Should I get it?’ I can say, ‘I’m alive, and I’m doing OK.’ ” Blackfeet Nation health care workers in Montana received their first doses of the Moderna COVID-19 vaccine in mid-December. The Nation peaked in cases mid-October at about 400 diagnoses. In preparation for vaccine distribution, the tribe’s COVID-19 Incident Command shared a video featuring a “rez dog” puppet who interviews a nurse practitioner.

The puppet asks about the cost of the vaccine, whether he will need to continue to wear a mask after being immunized and about potential side effects. “The idea of the PSA is to help ease people’s minds, give them a sense of comfort and an education on the vaccine,” says the tribe’s public information officer, James McNeely. After Mosqueda got vaccinated, she was finally able to visit her grandparents. “I could worry about myself getting side effects after the vaccine, or I can think bigger picture,” she says. “If I have chills the next two, three days but in the long run, my community as a whole will be safer, then I’m OK with that.” Danielle Ferguson of the Sioux Falls (S.D.) Argus Leader and Chelsea Curtis of The Arizona Republic contributed to this story.

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TRI POINTE HOMES WASHINGTON

Modern Living Pandemic lifestyles are changing home design trends By Stacey Freed

HE COVID-19 PANDEMIC HAS

changed the way we live in our homes: Office workers now type away at their dining room tables; kids attend classes from the family room sofa; young-adult children have moved back into their old

bedrooms. We’re more concerned with cleaning, disinfecting and indoor air quality. And according to a recent study from the National Kitchen & Bath Association, the way we’re using our homes now will have a substantial influence on design going forward. According to the survey, as people spend more time at home, they want larger kitchens and

bathrooms, more outdoor living space, easy-to-clean surfaces and integrated smart-home technology for added convenience and peace of mind. And designers and builders across the country are responding to these new requests. CONTINUED

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LAYOUT KEY 1. The family entry provides an area to wash up upon arrival. 2. The kitchen space has been designed to optimize every square foot and functions as the hub of the home. 3. A large, walk-in pantry provides extra storage space. 4. A table-height island extension can serve as a study, work or craft space for family members. 5. This nook serves as a secondary office space. The location provides privacy but is still connected to the hub of the home. SOURCE: Dahlin Group Architecture and Planning and Garman Homes

Concept home designed by Dahlin Group and Garman Homes

DAHLIN GROUP ARCHITECTURE AND PLANNING AND GARMAN HOMES

THE NEW NORMAL “Home offices are here to stay. Entryways will change. There will be even more emphasis on outdoor spaces,” says Teri Slavik-Tsuyuki, founder of Encinitas, Calif.-based marketing firm Tst Ink. Slavik-Tsuyuki, Belinda Sward, founder and chief strategist of Carlsbad, Calif.-based Strategic Solutions Alliance and Nancy Keenan, president and CEO of Dahlin Group architecture firm in Pleasanton, Calif., conducted an America at Home Study last April and then again in October. They gathered insight from nearly 4,000 respondents across the country about what home means to them, how they were using their homes and what features they would be willing to pay extra for in a new home. The study led to a design meeting between Dahlin Group and Raleigh, N.C., production builder Garman Homes. Using a “model” family of two adults — one of whom leaves for work elsewhere each day and one who works remotely from their home — and two young children who need flexible play/workspace, the companies designed a 2,600-square-foot home that would be “attainable for most” people in North Carolina’s research triangle area, says Garman co-founder and CEO Alaina Money-Garman. The house, which combines modern

“We tried to create opportunities to control the flow of people and germs. Our research showed a high preference for a stand-alone guest suite.” — ALAINA MONEY-GARMAN, CEO, Garman Homes and traditional aesthetics, has a garage off the back, near the owner’s entry, since that’s how many people enter their home. On the front of the house is a porch and main entry. With an eye toward germ and dirt containment, this entry was a major focal point of the design discussions. Inside the front door is a large mudroom where visitors can store coats and shoes. It sits next to a guest suite, and the whole area can be isolated from the rest of the house. “We tried to create opportunities to control the flow of people and germs,” Money-Garman says. “Our research showed a high preference for a stand-alone guest suite.” The rear entry also has a mudroom area and a powder room and can include laundry facilities as well as a refrigerator. “It’s a good place for children’s backpacks to live,” Money-Garman adds. “And it’s another way to protect the main living spaces.” Other major features include a main

floor flex room, envisioned as a school space or playroom, and two dedicated home offices, one of which is a pocket office tucked in the back of the kitchen that can be closed off. The open-floorplan kitchen has an L-shaped island; one side is an eating area, and the other holds a sink that faces into the family/living room for visibility of most of the main floor. “We need this space to perform for us so we can be parents, schoolteachers and do our jobs,” Money-Garman explains. Upstairs are three bedrooms. The primary suite (no longer referred to as the master bedroom) in back includes a small bonus room for a private tucked-away space; two bedrooms in the front of the home are next to a large family bathroom. “We wanted to make the space extraordinary for kids, so they don’t want to come in and use the parents’ bathroom,” Money-Garman says. David Riedman, president of Roches-

ter, N.Y.-based Riedman Companies, a home and apartment builder, says that he’s also been watching the trends and is preparing for the future. “The way we’re looking at flex space is going to be heavily influenced by the pandemic, and it’s going to be driven by different lifestyles,” he says. He foresees more home gyms, dedicated home office spaces and pocket offices.

AIR-QUALITY CONTROL Another issue that’s on the minds of many homeowners is indoor air quality, particularly because of the aerosolized nature of the COVID-19 virus. Phil Lane, vice president of Bayshore Mechanical Services in Rochester, N.Y., says more homeowners are asking about higher levels of filtration, temperature and humidity control. “ASHRAE (the American Society of Heating, Refrigerating and Air-Conditioning Engineers) recommends that an HVAC system should be operated in a normal range of 68 to 78 degrees Fahrenheit and 40 percent to 60 percent relative humidity,” Lane says. As for COVID-19 concerns, “higher level MERV (minimum efficiency reporting value) filters will address some viruses, but the Centers for Disease Control and Prevention recommends a HEPA filter to really absorb coronavirus.”

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The Anderson family JERALD COUNCIL

Trading Places Real estate market adjusts to pandemic living

By Adam Stone

ED ANDERSON’S TOWNHOUSE IN the historic Eastport

neighborhood of Annapolis, Md., was already a little snug for him and his two high school-age kids. Then COVID-19 really put the squeeze on. “It’s adequate, but it’s very tight. There’s no garage and no basement, so the bikes have to be in the living room,” Anderson explains. An associate at Morgan Stanley, he is working from home while his kids are distance learning. “We all have to sit around and do our work at the dining room table, or

my kids do their schoolwork with their laptops sitting up in bed.” That was last November. A month later, Anderson purchased a four-bedroom colonial-style home on the other side of town with a garage and a basement. He’d been thinking about making a move for a while, “but it was COVID that put me over the edge,” he says. He’s not alone. In recent months, the pandemic has reshaped homebuying trends across the nation. People are looking for more living space. Some are leaving dense cities for elbow room in the CONTINUED

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HOME says Jessica Lautz, vice president of demographics and behavioral insights at the association. “We saw the home office at the top of the list for months as the home feature that everyone needed and wanted,” Lautz says. “It then transitioned to a bigger kitchen, a nicer bathroom. As we are all home 24/7, people are needing to embrace their home in different ways, whether that’s having more counter space or just having a more luxurious bathroom. It all makes a difference.” A Zillow survey conducted by The Harris Poll found a similar trend. Some 66 percent of those surveyed say that if they could continue working remotely, they would consider moving. Realtors say their experiences align with these findings. In addition to more space for a dedicated office, more homeowners are requesting “space for a functional classroom, an in-law suite so parents can help take care of the kids — or sometimes all three,” says Bill Golden, a real estate agent with Re/MAX in Atlanta. “Homes with office space in particular are in high demand,” he says. “Once folks have spent time working at home, they come to realize that the dining room table doesn’t make a great office, at least not if you actually will use it for meals.” With housing inventory tight, homes built with office space in mind are a hot commodity. “We’re in such a hot market,” says Pendleton, who is based in Seattle. “Everyone would love a designated home office right now, or a basement where the kids can run rampant, but most people are constrained by budget. At the end of the day, that budget is the ultimate reality check.” suburbs. And there’s been a rise in virtual tours, with real estate agents leveraging technology to show more homes with less human contact.

ZILLOW

MORE SPACE With parents and children working and learning from home, it’s not surprising that families are seeking larger living spaces. “People started feeling really claustrophobic in the early months of the pandemic, when work and school and family was all happening (under) one roof,” says Amanda Pendleton, Zillow lifestyle expert. The National Association of Realtors (NAR), for example, found that 18 percent of sellers who closed in April 2020 or later say they sold their house because it was too small, versus 13 percent who had the same complaint pre-pandemic,

URBAN FLIGHT While there hasn’t been a wholesale exodus from cities, real estate professionals say the pandemic has prompted some city dwellers to rethink the pros and cons of urban living. Nearly a third of Americans are considering moving to less densely populated areas, according to Harris Poll data. Urbanites are almost twice as likely to have recently browsed a real estate website for homes and apartments. Realtors are reporting much the same: A survey by NAR found that 5 percent of members say COVID-19 was causing their clients to shift their sights away from cities to the suburbs. This trend has translated to a small but measurable shift in actual buying. The CONTINUED

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The pandemic has led to a sharp increase in the number of virtual tours, allowing real estate agents to show more homes with less human contact.

suburbs allow buyers to have more space at a time when the No. 1 reason why people say they are selling is because their home is too small. It also gives them the outdoor space and the yard, as well as a less dense neighborhood, which so many people are craving right now. At the same time that people are seeking more breathing space, remote work is expanding options for those who previously were constrained to live within a comfortable commuting distance. “With the ability to work or school from home, families and individuals have been moving away from larger metro areas like New York into the less expensive suburban markets,” says Loren Keim, professor of practice with Lehigh University’s Goodman Center for Real Estate in Pennsylvania. Priscilla Holloway, a real estate agent and new construction expert at Douglas

Elliman Real Estate in Suffolk County, N.Y., has seen it ﬁrsthand. “People are coming out to the Hamptons. Over 21,000 requested an address change to Suffolk County since the start of the pandemic. We Realtors have been very busy,” she says. “People don’t want to share elevators. They don’t want to share their washer and dryer,” Holloway says. “There is just more space. For the same amount of money as a co-op or a condo in Manhattan, you can get a nice four-bedroom house in Westhampton.”

VIRTUAL TOURS In addition to shifting trends around size and location, the pandemic has caused a change in the way homes are shown. Realtors increasingly are leveraging technology to oﬀer virtual visits, either in the form of prerecorded tours or

live “in-person” walk-throughs. Tania Isacoff Friedland, a member of Warburg Realty in Manhattan, has been offering virtual tours throughout the pandemic. “A virtual tour is a FaceTime tour on my iPhone,” she says. “In one instance, it was a buyer who was in Montreal and who cannot leave the country right now because of COVID constraints. I walked through the apartment. I showed them around, first as a general tour and then going back to look at the details, honing in on the highlights.” Zillow noted a sharp uptick in the use of its virtual tools, reporting a near doubling of the number of 3D tours created in the week after the pandemic took hold. Realtors have embraced these virtual tours that offer both safety and efficiency, Lautz says. “People are still looking at homes in person, but they are being more strategic. They are seeing fewer homes

in their search process. With limited inventory, it’s a way to be strategic in how you see a home,” she says. Of all the pandemic-inspired real estate trends, experts say, this shift toward remote visits seems most likely to persist. “Even once COVID is no longer an issue, the virtual tours will be there,” says Isacoff Friedland. “Buyers will probably still want to see things in person before buying a home, but a virtual tour can narrow your choices and save you time. It’s becoming a normal part of the initial legwork of the search.” For those looking to buy in what has lately been a very tight marketplace, Lautz advises: “Have patience. Know that you might put down multiple offers before you buy a house. And find a really good Realtor who knows the area and knows what is available.”

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Garden Variety Grow-your-own movement takes root during the pandemic

By Ana Pelayo Connery

URING THE COVID-19 PANDEMIC, trips to the grocery

store have become more anxiety-ridden and the food supply chain has been more susceptible to shortages. These conditions have led to an increased interest in having access to fresh produce in your own backyard. Gardens and greenhouses have gained popularity, with some retailers reporting record sales last year. It’s not the first time Americans have turned to

Mother Earth to help them get through a crisis. During World War I and World War II, “Victory Gardens” sprouted because of food shortages. Today, the pandemic has morphed the farm-totable movement into the yard-to-table movement, with vegetable gardens sprouting in yards everywhere. Gardening is also a great activity for all ages, providing a way to bond with loved ones. Tim Fye, owner of Canterbury Greenhouse in Green Bay, Wis., has noticed CONTINUED

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an increase in demand for common vegetables and fruits like strawberries, grapevines, blueberries and raspberries. When Roots on 9th, located on Green Bay’s west side, posted on its Facebook page that it had received a shipment of patio citrus trees, all 78 were purchased in four hours, says owner Jamie Hemenway-Peotter. Joe Masabni, a horticulturist with the Texas A&M University AgriLife Research and Extension Center in Overton, has been busy responding to a barrage of emails from people interested

in growing produce. He’s not surprised. “Vegetable gardening is always popular with middle-aged and older populations,” he says. “In times of uncertainties, it is even more popular as people worry about having enough food and resort to growing their own.” In addition to growing your own food, gardening is a form of exercise and is very labor intensive, says Masabni. “The most important benefit for gardening is that it is the exercise that people do and continue to do for the longest time in their lifetime,” he says.

“Some people run for 20 years, swim for 40 years, but gardening has been shown to be the (activity that people will continue to do the) longest.” “According to the Journal of Health Psychology, gardening is also a great stress reliever, which most of us can use now more than ever,” says Kevin Warhurst, vice president of Merrifield Garden Center, with three locations in Virginia. “Just 30 minutes of gardening lowers cortisol hormones, the fight-orflight response.” For those new to the hobby, Masabni

suggests doing some research. Check with master gardeners in your area, search the internet for reliable information on what works in your climate, test your soil and become educated on good and bad insects. “Gardening is a skill that takes years to master,” Masabni says. “Preparation is key to success. Success in gardening is 50 percent preparation and 50 percent regular, daily activities. Expect huge successes and big failures, even if you did everything right. It happens. Learn from it and try something else.”

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TIPS FOR OUTDOOR OR URBAN GARDENING

TRY A SEED-STARTER KIT Tender plants, including tomatoes, basil and peppers, or flowers such as marigolds, moon vine and salvia, can be started indoors and planted outdoors in pots or window boxes later in the spring, says Kevin Warhurst, vice president of Merrifield Garden Center in Virginia. “You can use a seed-starting mix, plant the seeds in trays or small pots and place them in the sunniest area possible and keep them moist.”

GO FOR EASY-TO-GROW PLANTS Gardening expert Randy Schultz says some indoor plants need almost no care. A snake plant has air-cleaning properties, according to recent studies, needs little light and “it’s just plain hard to kill.” USE VEGETABLE SCRAPS Many leafy vegetables such as romaine lettuce will regrow from the parts you don’t use. Just cut off 1 to 2 inches at the base and place it cut-side up in a bowl or shallow saucer filled with about a half inch of water. Place it in a sunny spot until the roots start to grow, then transplant it into soil in a pot. GROW A VEGETABLE GARDEN If you’ve got a sunny patio or balcony, self-watering growing containers make it easy to grow two full-size tomato plants or whatever vegetables and herbs you choose. The built-in reservoir automatically keeps plants watered. FLOWERING PLANTS ADD COLOR Many flowering plants are easy to grow, says Schultz. African violets thrive in bright, indirect sunlight and abutilon plants are a good choice for a sunny windowsill.

GET THE LIGHT RIGHT Research what kind of light your houseplants need. Grow lights, which offer the full spectrum of light plants need, can help if your home has low-light conditions. LED lights are very efficient, long-lasting and do not use hazardous glass or chemicals, Warhurst says. “Place the grow lights close to the plants and leave them on for 12 to 16 hours per day.” Low, indirect light is best for plants such as pothos and Chinese evergreens. REPOT HOUSEPLANTS Snip dead heads and trim foliage on houseplants. Judicious trimming of a pothos, for instance, produces new plants in new pots and promotes fullness in the original. “If they’ve been in the same container for more than three years and they are not growing as fast as usual, it’s probably time to move them into slightly larger containers,” says Warhurst. USE PROPER POTS Make sure pots have holes in the bottom for drainage. When repotting, add some potting mix to the bigger container. Plant roots need oxygen, but if water doesn’t drain, the roots can drown and the plant will die. Before you transfer, “Cut into and loosen the outer, circling roots and gently pull them away from the root ball to ensure they are ready to tap into the new potting mix,” Warhurst says. FERTILIZE HOUSEPLANTS Don’t forget fertilizer, Warhurst says. You can add it to water or use fertilizer encased in a resin coating and placed in the soil where it will be slowly released to the plant over several months. — Gary Dinges, Kendra Meinert and Maria Puente

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Retro Recreation Quarantines prompt resurgence of age-old hobbies By Gary Dinges

HEN IT COMES TO finding activi-

ties to occupy your time during the coronavirus pandemic, what’s old is new again. Knitting and solving jigsaw puzzles are among the hobbies that countless Americans have embraced since COVID-19 restrictions began. With health experts discouraging in-person gatherings while encouraging social distancing, these age-old creative outlets are experiencing renewed interest. They also offer a welcome distraction from the barrage of COVID-19 headlines.

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“Making handmade things is always a good thing. These gifts are being made with love during this crisis.” — AMANDA NEAL, manager, Tempe Yarn & Fiber

KNITTING Amanda Neal, store manager at Tempe Yarn & Fiber in Arizona, has seen a steady stream of orders from regulars, as well as newcomers looking for something to help pass the time while they’re staying at home. The business offers curbside pickup and also ships yarn and other items. “Most of them are just bored,” she says of her customers. “Some are a little stressed out. They want to keep their hands busy while they’re watching TV and keep their hands out of the refrigerator. It really does help your brain and keeps you occupied, not focusing on the scary times we’re living in.”

Typically a favorite activity of seniors, Neal says she’s seen younger women pick up knitting during the pandemic. Many turn to YouTube for guidance on how to get started. Blankets are a popular option for novices: “It’s just a big square or rectangle,” Neal says. Experienced knitters are opting for more complex projects, such as sweaters. “Making handmade things is always a good thing,” she says. “These gifts are being made with love during this crisis.” Robin Suber, one of Neal’s longtime customers, has been knitting for 15 years. Lately she’s been working on a number of shawls, and she also knit-

ted a face mask. “Knitting during the pandemic has been a source of comfort and calm in all the chaos,” she says. “It is something that people can do and not be tied to something that has to be start-tofinish fussy. It can be picked up and put down over and over. It can be as simple as a one-stitch pattern or as complex as lace.” The knitting community is a close one, Suber says, and she’s hopeful groups can resume meeting in person soon. “I am looking forward to the time we can all be back to some semblance of normal and can get together.” CONTINUED

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PUZZLES Jigsaw puzzles — originally images painted on wood that were then cut into multiple pieces — date back to the late 1700s. Later, most puzzles were printed on either cardboard or paper board. Some of the largest and more challenging puzzles on the market today have in excess of 40,000 pieces and span more than 20 feet. Membership in the Jigsaw Puzzle Swap Exchange jumped about 50 percent per month during the early months of stay-athome orders, organizer Aleta Gerard says. Exchanges help connect jigsaw puzzle fans, allowing them to swap completed puzzles for new ones. “Puzzles are a great stress reliever,” says Gerard, whose operation is based in Palm Coast, Fla. “They are also great for mental stimulation and a wonderful alternative to digital addiction. Puzzles can provide a much-needed family time activity.” Gerard has been a puzzle fan since childhood. “Puzzles were a common activity in the home when I was growing up,” she says. “They were great when the weather was bad and you couldn’t be out. Now that I

no longer have children at home and have more free time, they give me a break and allow me to let my mind unwind from the thought-provoking computer work that I do.” Keri McClellan, a member of the Jigsaw Puzzle Swap Exchange, says she’s had a number of friends reach out lately asking to borrow some of her puzzles. “I have made several puzzle drops to friends’ doorsteps, and people are always texting me pictures of their completed puzzles,” says McClellan, who agrees with Gerard. “Puzzles offer a family pastime that every age can participate in, at any hour of the day.” Catherine McCarthy, another puzzle swap member, says she completed a dozen 1,000-piece puzzles between March and May of 2020. “Puzzling is a great way to pass the time during the quarantine and stay in place,” she says. “It makes me feel productive. It also forces me to focus on the present rather than on the news and all of the anxiety that comes from watching and listening to all that is going on. This positive distraction is welcomed at this time.”

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Stay Strong A balanced immune system is key to overall wellness By Karina Zaiets and Janet Loehrke

INCE OUR LIVES HAVE been upended by the COVID-19 pandemic, it seems our immune systems have received more attention than ever before. But many unhealthy behaviors brought on by the pandemic can make it more difficult for our bodies to fight off infections. Here are some tips for maintaining a balanced immune system to protect you from illness:

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NEARLY

8 in 10 ADULTS SAY THE PANDEMIC IS A MAJOR SOURCE OF STRESS IN THEIR LIVES SOURCE: American Psychological Association

FUEL UP No supplement will cure or prevent disease. However, a proper diet can help prepare the body to better fight disease. “The thing about foods is that they combine a bunch of nutrients and vitamins into a complete package,” says Sandra Darling, a preventive medicine physician at Cleveland Clinic. “You can’t extract one compound like antioxidant green tea and just take that one compound and expect to have benefits. It doesn’t work like that.” Vitamin C can stimulate the production of white blood cells, which are key to fighting infections. Citrus fruits, strawberries, red bell peppers and kiwis are rich in vitamin C. However, high doses of some vitamins can be toxic, especially when taken regularly. Beta carotene functions as an antioxidant, a compound that helps defend your cells from damage caused by potentially harmful molecules called free radicals. Eating a diet rich in antioxidants can help reduce risk of chronic diseases and boost health. Carrots, sweet potatoes, spinach and broccoli contain high amounts of beta carotene. Vitamin A, which the body creates from beta carotene, helps the lungs work properly in addition to other benefits. Studies have shown that compounds in garlic can boost the

disease-fighting response of some types of white blood cells when they encounter viruses. Eating it while you are sick can help decrease how long you stay sick and reduce the severity of symptoms. Garlic can also lower the risk of becoming sick in the first place. Ginger may help decrease inflammation and relieve congestion. It may also soothe nausea and digestive issues. Health-promoting bacteria in the colon are also an important part of the immune system, Darling says. Focus on high-fiber foods, and specifically foods that contain the type of fiber called inulin. Good sources of inulin include artichoke, asparagus and chicory root. Yogurt contains live and active cultures or probiotics. Try to choose the low-fat plain kind rather than the flavored varieties that can be loaded with sugar. Don’t forget to drink plenty of water, and try to avoid snacking on foods that are high in fat, sugar or salt. Experts advise that if you snack, choose fresh fruits and raw vegetables instead. “Pack carrot sticks, pack almonds,” says Erin Michos, a cardiologist at the Johns Hopkins School of Medicine. “I’m a snacker, so I’m not going to tell you not to snack. I am just going to say snack CONTINUED

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“The thing about foods is that they combine a bunch of nutrients and vitamins into a complete package. You can’t extract one compound ... and expect to have benefits. It doesn’t work like that.” — SANDRA DARLING, preventive medicine physician, Cleveland Clinic on things that are good for your body, that boost your immunity.”

CATCH SOME Z’S Studies indicate that sleep plays a crucial role in the functioning of the immune system. Breathing and muscle activity slows down, freeing up energy for the body to fight off illness. Sleep is important for improving T-cell response. T-cells respond to viral infections and boost the immune function of other cells. Cytokines, a type of protein in the immune system that target infections, are also produced and released during sleep. Studies have also shown that sleep even improves the effects of vaccines. The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults ages 18 to 60 sleep at least seven hours each night, but according to the Centers for Disease Control and Prevention, 1 in 3 adults don’t get enough sleep. Insufficient sleep makes it more likely one will catch the common cold or the flu. One study showed that people who sleep less than six or seven hours per night have a higher risk of developing a cold. Research shows creating a good sleep routine is essential for a good night sleep and helping your immune system. Limit the amount of caffeine and alcohol you consume before bed. Alcohol can make

you sleepy, but can affect your sleep cycle. Caffeine can cause you to feel wired, making it difficult to fall asleep. Darling also recommends avoiding electronic screens for at least 60 minutes before sleep. Experts also advise creating a sleep schedule that includes a consistent nighttime routine before bed. Brushing your teeth, reading a book and other activities can give your body signs it’s time for you to wind down for the day.

GET MOVING Moderate exercise improves cardiovascular health, lowers blood pressure and helps control body weight. It also promotes circulation of the cells and substances of the immune system, which allows them to do their job efficiently. It may also reduce inflammation and help your immune cells regenerate regularly. Unfortunately, only about 1 in 5 adults and teens get enough exercise to maintain good health, according to the American Heart Association. Moderate physical activity is recommended during the pandemic and can also combat obesity, heart disease and diabetes. Health experts recommend a moderate-intensity exercise routine, two to three times a week, for up to 45 minutes for good immune health. Try to CONTINUED

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aim for at least 150 minutes of moderate exercise per week, or 30 minutes, five days a week. However, avoid pushing yourself too hard for too long. Studies have shown that prolonged (more than 1.5 hours) intense exercise performed without food intake can temporarily suppress your immune system, providing the opportunity for infections to take hold. To determine whether the exercise is moderate or vigorous, you can use the “talk test.” “When you’re doing a moderate activity like brisk walking, you can talk but you can’t sing,” Darling says. “And then if you are

doing vigorous physical activity, like swimming laps or jogging or playing tennis, you would not be able to talk or sing.”

STRESS LESS Nearly 8 in 10 adults say the pandemic is a major source of stress in their lives, according to the American Psychological Association. Stress causes your body to release cortisol, the body’s primary stress hormone. Increased cortisol levels in the bloodstream can cause inflammation, which alters how your body’s immune system responds to infections. Long-term inflammation promotes

imbalances in immune cell function and can even suppress immune response. Children and the elderly are particularly vulnerable to stress on the immune system. According to Johns Hopkins Medicine, controlling your stress is key to improving your immune system. Once you know your triggers — workloads, kids or relationships — experts advise you make small changes to help manage your stress levels. If you can’t minimize stress, make sure to have a coping mechanism that works for you, says Michos. Some of the activities that can help include meditation, exercise, journaling, yoga

and other mindfulness practices. Stay away from adverse coping mechanisms like smoking or drinking too much alcohol. Smoking can weaken your body’s defenses. However, don’t go overboard. Too much immune response can cause your system to malfunction as well. “You’ve probably heard about autoimmune diseases like lupus or rheumatoid arthritis, or even in COVID, where the immune system might go into overdrive,” Michos says. “So, we don’t want hyperimmunity either. What you’re talking about is trying to have overall balance, so everything is working in check.”

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Tired of COVID-19? Expert advice to ﬁght off pandemic fatigue

By Isabel Keane

FTER MONTHS OF PANDEMIC quarantines, social

distancing requirements and other restrictions, public health experts are warning against “COVID fatigue.” In place of socially distanced outdoor gatherings, people may be tempted to escape uncomfortable weather and spend time indoors with their loved ones. Some are growing tired of wearing masks and following guidelines. Wendy Keller, an administrative director at Behavioral Health Services of the Hudson Valley based in Newburgh, N.Y., describes COVID fatigue the way someone might

talk about running a marathon. “It’s almost like we saw the finish line and now we’re realizing there’s a spike, and another wave is coming,” Keller says. “And we don’t want to accept that.” Much like marathons — grueling and seemingly endless — getting to the pandemic finish line requires stamina. But it’s within our human capabilities, public health experts say.

WHEN WHAT’S FAMILIAR BECOMES DANGEROUS Finding healthy alternatives to activities we once took comfort in is crucial, experts say. “Pandemic fatigue is CONTINUED

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HEALTH not about people wanting to be jerks. It’s not about people wanting to harm other people. It’s about fear and denial,” Keller says. “It’s about desperately craving something that’s comforting.” As a society we’re not great at delaying gratification — we want to feel good, and we want to feel good now, Keller says. But in a pandemic, that’s easier said than done. “We’re very used to instant gratification. If you have a question, you can Google it. If you want something, Amazon brings it to you two days later. We are not great at delaying gratification — and that’s really all we’re being asked to do ... so we can be safe,” says Keller. The newness of certain protocols — wearing masks, staying 6 feet from others and frequently washing and sanitizing hands — has worn off. The adrenaline that kept mitigation strategies intact has been replaced in part with stress and anxiety. “When you layer the pandemic with the political and social unrest that we have been faced with, people are more vulnerable to breaking rules and seeking out the things that would provide them with a sense of comfort. The things we’re familiar with make us feel like we’re in control,” Keller says. From a psychological perspective, riskier behaviors like large gatherings where no one wears masks, or superspreader events, are caused by the fear of losing what we once had. “We’re wanting to go back to the things that are familiar to us, rather than live in fear or admit that we’re still at risk,” Keller says.

“If you think about the stages of grief, there’s denial, anger, bargaining, depression and acceptance. I think those stages really mirror what people are feeling.” — JEN BUCHWALD, clinical psychologist, Hudson Valley Center for Cognitive Therapy

WHY OUR BRAINS PARDON RISKY BEHAVIOR Jen Buchwald, a clinical psychologist at the Hudson Valley Center for Cognitive Therapy in Upper Nyack, N.Y., echoes that sentiment, noting other emotions often tie in with fear. “If you think about the stages of grief, there’s denial, anger, bargaining, depression and acceptance. I think those stages really mirror what people are feeling,” Buchwald says. “For people feeling anger, it’s a question of, ‘Who’s to blame for this?’ Or rather, they are angry toward their financial situation or so angry for people they know who have gotten sick or have died.” There’s also the bargaining stage of, “Well, if I do this activity, but don’t do that activity, am I OK?” she adds, noting people tend to look at situations categorically. CONTINUED

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HEALTH Viewing the pandemic as an ever-changing situation is necessary, according to Buchwald. “People may be thinking, ‘Oh, I was doing X, Y and Z in the summer and I didn’t get sick, so I can keep doing that.’ But they may have been able to do those things safely when the infection rate was low. It’s important to be evaluating the infection rate in your area, and basing your calculations around that.” Stress and anxiety — two things we’ve

seen no shortage of lately — also have an impact on the way our brains process the information we use to make our decisions. “There’s a phenomenon studied in social psychology called cognitive dissonance and that’s when there’s a conflict of information that causes stress,” Buchwald says. “To dissolve that stress people choose one side over another.” “Someone who is a cigarette smoker hears about how smoking can cause

cancer. That’s going to cause stress for them, and so they’ll either decide to give up smoking or that they’re not going to believe that smoking causes cancer,” Buchwald explains. When it comes to the pandemic, to relieve stress and dissolve anxiety, people will “basically convince themselves that either they themselves are not at risk or their family or community members are not at risk. They stop thinking about it in order to not feel that type of stress or anxiety,” she says.

Despite this, health professionals say there is reason to be hopeful, pointing toward the vaccination rollout that’s underway. “There is an end in sight. And I think if we can focus on that, it makes it a little easier to make sacrifices today,” says Buchwald. “I think it’s helpful to think in terms of, ‘at least this.’ Like, ‘At least we have technology,’ and ‘Thank goodness there are people working in supermarkets and food delivery.’”

TIPS FOR BATTLING COVID FATIGUE uGet outside and exercise. “We’re not meant to be cooped up inside. It’s important to be active,” says Mark Kittleson, chair of public health at New York Medical College in Valhalla, N.Y. “And exercise can help depression immensely.” uKeep structure. “Even though somebody may have less to do, it’s important to not sleep all day. It’s important to get dressed every day and go outside, even if it’s cold out,” Buchwald says. uTake a breath. To combat anxiety, breathing is key. “When we get anxious, we stop breathing. When we have masks on, it makes that aspect of anxiety much worse,” Keller says. “Find a safe place, get away from people, pull down your mask and take a deep breath if you’re feeling anxious.” uStay connected. Find creative, new ways to do things safely, whether on Zoom or with socially distanced activities while wearing masks. Experts say connecting with people is important, and there are still

ways to do so during a pandemic.

uPick up a new hobby. “I’ve been thinking about what it is that I’ve always wanted to do if I had more time, that I could do at home. Is that playing a musical instrument or learning a foreign language or painting? Even if it’s not ideal, it’s important to have some activities like that,” Buchwald says. uLimit alcohol intake. “We’re seeing much more high-functioning alcoholism,” Keller says. “Drinking in isolation is causal to depression.” uLimit the amount of news you consume. “Watching CNN for three hours and all they talk about is the pandemic can be pretty depressing. I don’t think we need to be constantly reminded,” says Kittleson. uVolunteer for a cause. “Help someone else out instead of worrying about your own comfort,” Keller says. — Isabel Keane writes for the Rockland/ Westchester (N.Y.) Journal News.

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Smart Solutions New contact tracing technology can help stop the spread of COVID-19 By Adam Stone

ONTACT TRACING IS A key component to tracking and containing the COVID-19 pandemic. Let people know when they’ve been in proximity to an infected person, and there’s a chance you can contain the spread of the virus. But traditional tracing techniques are slow and labor intensive.

Technologists at international conglomerate Honeywell see a better way forward. They’re leveraging business-operations intelligence to drive tracing efforts. “Descriptive analytics can provide a record of which workers have been in close proximity with one another: Who was in a common area together, or on a shift together,” says Hilmer Rivera, global general manager of software for Honeywell.

A range of technology companies have stepped up in recent months with IT offerings that help to take the guesswork out of contact tracing.

‘THIS IS NOT BASED OFF GUESSWORK’ Last June, customer relationship management company Salesforce released Work.com, a platform that leverages shift and scheduling data to support employee

contact tracing. Suppose an employee tests positive for COVID-19. Aided by software, “You can go back and identify where people were on the floor, what meeting rooms they shared together, and you can notify them about any potential contact they may have had (with that employee),” says Monica Girolami, Salesforce’s vice CONTINUED

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TECHNOLOGY president of product and solutions marketing. Unlike conventional contact tracing, which relies on people’s recollections of where they’ve been and who they have seen, “This is not based off of guesswork,” says Girolami. “No one knows exactly who they saw on a specific floor during a given day, so you need a system that tracks all of that.” Technology providers say their ITdriven solutions help to mitigate people’s privacy concerns around contact tracing. Take for instance the data-platform company Splunk, whose technology taps into employee badges and other forms of operational data to support tracing in noninvasive ways. “Your badge data is a digital fingerprint. Your Wi-Fi access point is a digital fingerprint. When you combine that with other data, you create a common operating picture, so that you can see where people were throughout the day,” says Lerry Wilson, Splunk’s senior director of innovation and digital ecosystems. By leveraging those existing sources of data, he says, it’s possible to make those connections without appearing to infringe on people’s privacy.

“People have really come together to share information and to make sure we ended up with the right solutions as early as possible.” — LARRY BREEN, chief commercial officer, NearForm

‘DATA CAN HELP YOU TO GET THERE FASTER’ Such data-based tracing can also help to speed the notification process. While human tracers still are needed to communicate with those potentially affected and offer guidance, “Data can help you to get there faster,” Wilson says. Others are looking to speed the process by making it easier for people to take action. Technology company TeamSense, for example, uses a “secure token” to deliver notification messages. Instead of going through a complicated log-in process to identify themselves, message recipients can simply click on a link. “If we send a link with a secure token, we can validate who they are while still allowing them to have a sense of anonymity. It also makes for a very fast connection,” says TeamSense CEO Sheila Stafford. “Now the employers have a much more open line of communication with that workforce. If there’s something the workers need to know immediately, they can send that message right now.” ‘THIS IS HOW YOU BREAK THAT TRANSMISSION CHAIN’ The biggest technology players have also stepped up in support of tracing CONTINUED

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efforts. Both Apple and Google make use of smartphone Bluetooth communications to build a digital record of which individuals have been in close proximity to one another. To utilize this data and make widespread contact tracing possible, users need front-end tools that will alert them when they’ve been near someone who has self-reported as COVID-19 positive. To facilitate this interaction, tech company NearForm has developed phone apps for state governments in New York, New Jersey, Pennsylvania and elsewhere. “We created an efficient, privacyfirst citizen engagement app,” says Larry Breen, chief commercial officer at

NearForm. By leveraging the back-end data from Apple and Google, “We can identify as early as possible anybody who may have been in contact with an infected person. That is how you break that transmission chain.”

‘AI IS THE ONLY WAY TO ... ENGAGE TENS OF MILLIONS’ Meanwhile, others are looking to artificial intelligence as a way to ease the burden on human contact tracers. LifeLink, which provides interfacing technology for the health care industry, has been developing an AI-driven chatbot capability to help notify those who may be at risk.

“Conversational AI chatbots, deployed via intuitive mobile text-messaging, are proving to be an effective way to talk to people about their health,” says Greg Johnsen, CEO of LifeLink. He notes that the company’s platform, which provides chatbot technology to some of the country’s largest health care providers, is conducting more than 850,000 automated conversations per month. Chatbots can help, Johnsen says, by enabling contact tracing to take place on a far larger scale. “If you consider the magnitude of the contact tracing challenge, conversational AI is the only way to reach out and engage tens of millions of potential exposure moments.”

Taken together, the wide range of tech-driven tracing solutions has helped to protect privacy while simultaneously making contact tracing faster and more widely available. In the midst of the pandemic, technologists say, close cooperation among a range of stakeholders has helped to bring digital solutions to the fore in support of these efforts. “There has been a great level of collaboration among governments, health authorities and technology companies,” Breen says. “People have really come together to share information and to make sure we ended up with the right solutions as early as possible.”

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Breathe Easier Ventilation and air ﬁltration play key roles in preventing the spread of COVID-19 By Ramon Padilla

S THE NATION REOPENS

after COVID-19 shutdowns, people across the country are making decisions about returning to the office or

sending their children back into school buildings. But how can you make the right call? Knowing air quality terminology can help you ask the right questions and make informed decisions. CONTINUED

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TECHNOLOGY they talk, talk loudly, when they breathe, small respiratory aerosols are released,” Miller says. If you’re in a classroom, office or other enclosed space, these aerosols can build up over time. “It’s like if you’re in a smoky bar,” Miller says. “When it opens, there’s not a lot of smoke, but the more people smoke, it becomes a cloudy room. You can think of virus being released like that.”

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INDOORS INCREASES RISKS “Often indoors, people are the source of contaminants,” says Shelly Miller, a professor of mechanical engineering at the University of Colorado Boulder and indoor air quality expert. Your chances of being infected depend on the size of the room and whether there are people infected with COVID-19 inside. “When

“Particles need not be larger than the space between fibers to be captured, so filters can effectively capture the fine particles produced by respiration that may contain SARSCoV-2 or other respiratory pathogens.” — WILLIAM BAHNFLETH, professor of architectural engineering, Pennsylvania State University

DETERMINING PROPER VENTILATION The ventilation rate is the volume of outside air provided per unit of time. Air change rate is the ventilation rate of a space divided by the volume of that space. “The air change rate tells you how fast you can clear the room from any airborne contaminants,” Miller says. “And specifically for coronavirus, if you can clear any airborne virus out quickly, you’ll reduce the transmission risk.” Most air-conditioning and heating systems cycle about 20 percent of fresh air into a building while recirculating the remaining 80 percent or so for energy efficiency. The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) provides air ventilation standards for commercial buildings, including schools, day care centers, computer labs and woodshops. These minimum ventilation rates vary depending on the type of activity occurring in the room. Outdoor air dilutes contaminants produced by the occupants and by the building itself, so rates are based on both the maximum number of people the room is designed to hold and the size of the room. A woodshop for example, has a higher recommendation compared with a classroom based on activities like sanding or cutting wood. Pre-pandemic, for a 1,000-square-foot classroom designed for 35 people, including teachers and students ages 9 and older, ASHRAE recommends a ventilation rate of 500 cubic feet per minute of outside air. “If the ceiling height in the classroom is 10 feet, that’s three total outside air changes per hour,” says Miller. “During the pandemic, we’re recommending trying to double that.” One of the best ways to reduce the risk of transmission is to reduce the number of people in your office or classroom. This allows for social distancing that reduces CONTINUED

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risk of close-contact transmission. It also reduces the number of probable infections that will occur if there is an infected person in the classroom. And as an added benefit, more outside air is provided per person, which contributes to better overall air quality. “If I drop the number of students from 35 to 17 now, the ventilation provides twice as much outside air per person, and that’s awesome,” Miller says. Increasing ventilation with outside air has been proved to reduce transmission of airborne diseases by lowering the concentration of infectious particles in the air. In a 2019 study of an outbreak of tuberculosis at Taipei University in Taiwan, rooms were underventilated with a rate of 3.6 cubic feet per minute/ per person and carbon dioxide levels were found to be in a range of 1,200 parts per million (PPM) to 3,000 PPM. Tuber-

“The air change rate tells you how fast you can clear the room from any airborne contaminants. And specifically for coronavirus, if you can clear any airborne virus out quickly, you’ll reduce the transmission risk.” — SHELLY MILLER, professor of engineering, University of Colorado Boulder culosis, like COVID-19, is an airborne disease. The university increased the ventilation rate to 51 cubic feet per minute/person, resulting in carbon dioxide levels dropping to 600 PPM, and the outbreak ended. “If you’re in a space with other people that may be infectious, you want to blow the air from inside out,” Miller says. “You’re taking the virus that might be in the air in the room and blowing it

outside, and when you’re blowing the air outside, fresh air will come in from other places.”

AIR FILTRATION IS KEY Air filters also play a big role in improving indoor air quality. While you want to increase the amount of outside air that is brought into the room, you also want to filter the air that is recirculated. One thing you might want to ask your

office building manager or school representatives is whether heating, ventilation and air conditioning, or HVAC, filtration has been improved. Minimum efficiency reporting value, or MERV, is a rating that reflects the efficiency with which a filter can collect particles in different size ranges in a single pass. The higher the number, the better filtration a room will have. Many HVAC systems are built to run MERV-8 filters that allow air to flow faster with less resistance. But this higher flow comes at a cost: They trap only 40 percent of particles in the 1-micron size. On the other hand, if the system can handle the resistance of a MERV-13, the filtration is significantly improved. “For a MERV-13, the filtration efficiency CONTINUED

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HEPA filters remove 99 percent of airborne particles from the air. The filter on the right was used in an industrial setting for one month.

for a 1-micron particle is 85 percent or more,” Miller says. “We’d like to be able to efficiently remove particles around 0.5 to less than 5-micron because we know particles that size can contain the virus.” Mechanical filters increase in efficiency as particle size gets larger, and due to diffusion and electrostatic attraction, also increase in efficiency as particles get smaller. “Particles need not be larger than the space between fibers to be captured, so filters can effectively capture the fine particles produced by respiration that may contain SARS-CoV-2 or other respiratory pathogens,” says William Bahn-

fleth, professor of architectural engineering at Pennsylvania State University and chair of an ASHRAE Epidemic Task Force that created a building readiness plan to help guide reopenings.

CAN HEPA FILTERS OR ULTRAVIOLET LIGHT HELP? Portable HEPA (high efficiency particulate air) rated air filters remove more than 99 percent of airborne particles regardless of the particle size. Miller’s team partnered with Harvard University to create a calculator to help schools find the right air cleaner based on room size and type.

“When supplemental air cleaning is needed, in-room filter units containing HEPA filters are recommended because they remove nearly all particles in the size range of concern on a single pass,” Bahnfleth says. Germicidal ultraviolet light (UVC) can be very effective at damaging viruses. “Germicidal UV has the ability to damage the DNA of microorganisms and they can no longer replicate,” Miller says. “Coronavirus is very susceptible to germicidal UV, so if it’s irradiated for a certain amount of time it’s inactivated, and it can no longer infect you.” Companies such as Sterilray offer a variety of disinfection products

that kill bacteria, viruses and molds using wavelength technology. Other air disinfection applications on the market use fixtures that are attached to the wall, and light is beamed overhead across a room. Bahnfleth notes that “these ‘upper room’ systems can reduce the amount of active virus in the air by an amount equal to 10 air changes per hour or more of outdoor air at a much lower energy cost.” Other applications involve placing a UVC light in the recirculating air duct that takes air from a room, irradiates it, then cycles the clean air back into that same room.

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JOHN F. MARTIN/GENERAL MOTORS

A General Motors employee loads a sanitizing machine with face masks at the company’s manufacturing facility in Warren, Mich.

Stepping Up Manufacturers switch gears to provide pandemic supplies

By Adam Stone

HEN THE COVID-19 CRISIS hit, executives at

athletic apparel manufacturer Under Armour looked for a way to pitch in. “We are part of the greater community and we are here to serve,” says the company’s chief innovation officer Clay Dean. “We felt it was important for us to

contribute back to the community in this really dire time.” The Baltimore-based company pivoted production, eventually manufacturing and donating tens of thousands of face masks to the University of Maryland Medical System, Johns Hopkins Health System and other front-line health care workers. CONTINUED

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TECHNOLOGY XXXXX Under Armour wasn’t alone. At the height of the pandemic, employers across the U.S. manufacturing sector shifted on the fly to produce face masks, shields, gowns and other personal protective equipment (PPE). By December 2020, the U.S. was producing some 150 million N95 respirator masks per month, up from roughly 20 million per month pre-pandemic, according to the Alliance for American Manufacturing. At Under Armour, the rapid shift meant putting existing equipment to new uses. “We have these big industrial cutters that will allow us to cut 100 sheets of material at a time,” Dean says. “That allowed us to do 150,000 masks a week, with one big cut and then an origami-fold without any sewing needed. It allowed us to be really efficient in how we produced these things.” Office furniture manufacturer Affordable Interior Systems enlisted a national cadre of volunteers to sew more than 150,000 masks for the United Way last spring. “We had the material but our labor couldn’t keep up, so we would ship precut kits to the volunteers. They would sew the masks and send them back to us, and we would get them donated all over the country,” says Tracy Reed, vice president of marketing and communications. The volunteers, known as “Rosies” for the WWII icon Rosie the Riveter, produced some 600,000 masks, Reed says.

PUBLIC-PRIVATE PARTNERSHIPS In some cases, governmental agencies made good partners as manufacturers quickly shifted their production lines toward PPE. Kia Motors Manufacturing Georgia (KMMG), for example, offered to make equipment for front-line workers and with help from the Georgia Department of Economic Development, the car maker was able to create 15,000 face shields at the start of the pandemic. The economic development authority “was instrumental in providing the resources, including ties to other supply chain partners,” says Chris Miller, KMMG vice president and chief administrative officer. “We’re very good at making cars, but making face shields was a departure from the norm,” he says. “With the Georgia Department of Economic Development office, we were able to establish new partnerships and produce this much-needed protective equipment.” The Michigan Economic Development Corp. (MEDC) likewise supported Almont, Mich.-based Trims Unlimited in its PPE efforts. That company, which

UNDER ARMOUR

Athletic apparel company Under Armour produced tens of thousands of face masks for Maryland health care providers.

usually offers cut and sewing services for the automotive industry and the military, bought new, highly specialized equipment in order to support production of medical masks and gowns. “We purchased the equipment in the hopes that we were going to get some help,” says plant manager and co-owner Bill Welch. “We started manufacturing product, we shipped product and the next day we got word from MEDC that they would support us with $150,000 in funding for the equipment. With that help we were able to drop the price on the masks for the hospitals.” Others leveraged their ties to the tech industry to make the shift. Bedford Industries, in Worthington, Minn., for

example, makes twist-ties used for bakery and produce. In the pandemic, the company repurposed those wires to make nose bridges for face shields. Oracle NetSuite software enabled Bedford to set up an e-commerce platform to get those new items into the field efficiently. “We built four production lines just to help solve the face mask problem,” says Jay Milbrandt, president of Bedford Industries. “We saw all the major medical companies ramping up their production and we moved to get ahead of that big volume of calls.”

MISSION CRITICAL Speed was essential in bringing PPE to market during the early days of the

pandemic, when hospitals were scrambling for protective gear. In hindsight, General Motors (GM) executives say their company, and the manufacturing sector as a whole, showed great agility in a moment of crisis. In March 2020, “Most of us had little to no knowledge about face masks,” says Bruce Stone, GM’s senior manager of global interiors and thermal cabin comfort. Within a week of firing up its PPE effort, “We had sourced the materials, designed and built assembly equipment and produced our first mask in Warren, Mich. This was one of my proudest moments at General Motors.” CONTINUED

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TECHNOLOGY That sense of pride may be one of the enduring impacts of the pandemic on the manufacturing sector, where workers nationwide pitched in to produce critical supplies at a time of urgent need. “Our employees saw us giving back to the community,” Reed says. “They wanted to contribute, to help keep people safe, and they were so grateful to see this organization use its talent and resources to help.” Going forward, experts say it remains unclear whether and to what extent President Joe Biden’s use of the Defense Production Act (DPA) may encourage other manufacturers to support the nation’s PPE supply chain. “It depends on how aggressively President Biden uses the broad authorities under the DPA,” says Angela Styles, a partner at law firm Akin Gump who specializes in government contracts. Rather than issuing a directive to the manufacturing sector, she says, the White House is more likely to seek a cooperative model for encouraging future PPE production. “Industry and the Department of Defense have worked collaboratively for decades,” Styles says. The expectation going forward “is that President Biden will continue with this collaborative approach to ensure sufficient supplies of PPE are available now and for the stockpile.”

TRIMS UNLIMITED

Trims Unlimited in Almont, Mich., shifted its operations to produce medical gowns and other personal protective equipment.

COVID-19 CONTRACTS From protective equipment and pharmaceuticals to medical supplies, American manufacturing companies have stepped up to help produce COVID-19 essentials for multiple government agencies. Manufacturers with the largest COVID-19 government contracts include:

u3M uParkdale Advanced Materials uPhlow Corp. uHanesBrands uEmergent BioSolutions uJanssen Pharmaceuticals uThermoFisher Scientific SOURCE: Federal Procurement AIS

Massachusetts-based Affordable Interior Systems enlisted a national cadre of volunteers to sew more than 150,000 face masks.

Data System

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CAREERS

STAN LIM/UC RIVERSIDE

University of California, Riverside instructor Dr. Rebeca Gavan lectures second-year medical students last November.

Answering the Call Medical and nursing students step up to serve

By Robin Roenker

AUREN LOPEZ, 24, HAS listed

“doctor” as her dream career for as long as she can remember. “When school assignments would ask, ‘What do you want to be when you grow up?’ I’d write doctor, even before I knew how to correctly spell the word,” says Lopez, a native of Chino Hills, Calif. Now enrolled as a first-year medical student at the University of California, Riverside, Lopez is one step closer to achieving her dream — in the midst of a

global pandemic. When COVID-19 cases began to spread across the U.S. last spring, Lopez — accepted at UC Riverside for fall 2020 admission — was working a gap year as a medical scribe in a Southern California emergency room. In that role, she saw several COVID-19 patients firsthand. Despite the challenges of the pandemic, Lopez did not second-guess her medical school plans. In fact, the pandemic only strengthened her career resolve. CONTINUED

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CAREERS “It was so motivating, watching these physician role models who were handling the pandemic by thinking on their feet in terms of treatment and medications — especially during the early days,” says Lopez. “They were the front-liners. I have never felt more that I belonged somewhere. That experience really solidified my decision to go into emergency medicine.”

PART OF THE SOLUTION Lopez is not alone. Across the country, students are stepping up in record numbers to serve in the time of COVID-19. Dubbed the “Fauci Effect” by some media outlets — after Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases — applications to U.S. medical schools for fall 2021 enrollment were at an all-time high, up 18 percent nationally over the previous year, according to the Association of American Medical Colleges (AAMC). “The typical, or average increase in applications from one year to the next is roughly 2.5 percent, so to see an 18 percent jump is really impressive,” says Geoffrey Young, AAMC’s senior director of student affairs and programs. AAMC is working to understand the factors driving the increase through incoming student questionnaires — including theories that the pandemic caused students to forgo traditional gap year work or travel plans or offered students more time to complete medical school applications when undergraduate studies shifted to virtual learning. It could also be that the spotlight on public health in the past year — including media coverage of Fauci and other front-line health care workers — actually did encourage some students to apply. “We believe that the Fauci Effect is one factor,” says Dr. Mary McSweeney, assistant dean for admissions at the University of Wisconsin-Madison School of Medicine and Public Health, which saw a 25 percent increase in applications for its fall 2021 incoming class. “You have these altruistic young people seeing Dr. Fauci on TV — seeing a man of science in the era of a pandemic — speaking to their hearts about helping the public get through this terrible disaster,” McSweeney says. But the effect isn’t limited to medical schools. Nationally, nursing schools across the country witnessed a 6 percent increase in applications in 2020, according to the American Association of Colleges of Nursing (AACN). CONTINUED

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University of Central Florida nursing student Delainey Dietz administers a COVID-19 vaccine in Orlando, Fla., on Feb. 5.

FRONT-AND-CENTER VOLUNTEERING At the height of the pandemic, many medical and nursing schools were forced to move much of their classwork online. Even now, many are operating on a hybrid — part online/part in-person — schedule. “In the middle of March through June (2020), most medical schools, including ours, essentially shut things down,” explains Dr. Craig Hoesley, senior associate dean for medical education at the University of Alabama at Birmingham (UAB). Pre-clinical medical students at UAB moved to Zoom lectures and small group meetings virtually. Third- and fourth-year students, meanwhile, were pulled out of clinical rotations. Unable to see patients for several months, they were instead instructed through virtual activities — including the addition of a new virtual course on disaster medicine, inspired by the pandemic. Faced with additional downtime during COVID-19, many

students sought opportunities to help their communities. “These are students with a heart to serve. Rather than just sitting around in their apartments, they got out and got busy,” Hoesley says. “They were front-and-center volunteering.” Nationwide, medical and nursing students were often on the front lines of community outreach efforts — helping distribute personal protective equipment, conducting COVID-19 testing, assisting with contact tracing, offering child care for health care workers and even grocery shopping for elderly neighbors. This February, University of Central Florida nursing program senior Delainey Dietz was thrilled to help administer COVID-19 vaccines at a community vaccination event in Orlando. “You could see people’s eyes smiling,” says Dietz. “They were so excited to finally take a step toward living life a little more normally again.” — Robin Roenker

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STAN LIM/UC RIVERSIDE

Dr. Jennifer Zamora, right, conducts a mock clinical exam with medical students at the University of California, Riverside.

“There genuinely is this sense that students want to get out there and do their part to reduce the pandemic and move health care forward in general.” — DR. TAKESHA COOPER, admissions committee chair, UC Riverside medical school

“I think there has always been a strong interest in nursing as a career,” says AACN President and CEO Deborah Trautman. “What the pandemic did was really highlight the critical and central role that nurses play in keeping people healthy — in a way that I don’t recall any other crisis in the country doing.” At the University of Nebraska Medical Center (UNMC), undergraduate nursing program applications are up 19 percent during the pandemic, while applications to the school’s accelerated baccalaureate

degree program — for students with degrees in other fields who wish to move into nursing — are up 27 percent, according to Juliann Sebastian, dean of UNMC’s College of Nursing. “What we hear from our applicants is that they want to be part of the solution. They care about making a difference,” says Sebastian.

MOVING HEALTH CARE FORWARD Rather than scaring students away, it seems the pandemic has motivated them

to serve. “COVID reaffirmed my desire to go into medicine,” says Thomas Schrauth, a first-year medical student at the University of Wisconsin-Madison’s School of Medicine and Public Health. Schrauth was working as a certified nurse assistant at a hospital in Kenosha, Wis., when COVID-19 patients first started arriving last spring. “Inspiring is probably the wrong word CONTINUED

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University of Alabama at Birmingham medical school students UNIVERSITY OF ALABAMA AT BIRMINGHAM MEDICAL SCHOOL

because the loss of life was devastating, but for me, COVID was very reinforcing. The pandemic made it clear that longstanding health disparities — things like health care access and socioeconomic status — are what caused these disproportionate impacts, and those need to be addressed in our health care system moving forward,” Schrauth says. At UC Riverside — which received 1,100 more medical school applications for fall 2021 than in any previous year — many applicants “wrote (in admission essays) about how they’ve been inspired to enter the health care field as physicians from seeing the devastation of the pandemic in their own communities,” says Dr. Takesha Cooper, chair of the medical school admissions committee. “There genuinely is this sense that students want to get out there and do their part to reduce the pandemic and move health

care forward in general.” Independent of her studies, UNMC nursing senior Lizzy Kangas continued to work as a hospital patient care technician, often in COVID-19 units, throughout the pandemic. It’s an experience she feels will inform — and improve — how she approaches care for the rest of her nursing career. “I watched our nurses suit up and bravely take care of COVID patients at a time when this was still brand new,” says Kangas, a native of Omaha, Neb., who will graduate this May. “We didn’t know about long-term effects. We didn’t know about the rates of spread. They did not put on ‘brave faces.’ They were brave. There was no faking it,” Kangas adds. “Nurses have always been there for their patients physically, emotionally and mentally. But COVID really amplified that.”

UNIVERSITY OF ALABAMA AT BIRMINGHAM MEDICAL SCHOOL

University of Alabama at Birmingham medical students join in a moment of reflection as part of a shared commitment to improve the health and safety of people of color.

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Professional Pivot Workers who lost jobs because of COVID-19 ﬁnd new careers

GETTY IMAGES

By Paul Davidson

S THE HEALTH CRISIS

continues to rage across the country and more temporary job losses become permanent, a small but growing number of laid-off and working Americans in hard-hit industries like restaurants, retail and travel are switching to new careers or occupations. Sixty-three percent of workers who lost jobs because of the outbreak have changed their industry, and 4 percent have changed their field or overall career path, according to a Harris Poll survey for USA TODAY. Some businesses have closed for good or downsized. This January, 3.5 million people surveyed by

to the American Association of the U.S. Labor Department said Community Colleges (AACC). they had permanently lost their Typically, enrollment surges during jobs. The crisis has especially a downturn. Community college affected low-wage workers in service enrollment has likely been affected industries who typically don’t have by parents’ child the skills to change care responsibilities fields without more “I just couldn’t amid lingering school education and trainclosures as well as ing, says Anthony wait any longer. financial distress. “If Carnevale, director they’re worried about of the Georgetown I had to start my paying rent and University Center on future.” putting food on the Education and the table, taking a class Workforce. — SEAN COTHREN, is not going to be at The usual paths pharmacy technician the top of their list,” for reshuffling the says Martha Parham, workforce have also AACC’s senior vice president of been disrupted by the pandemic. public relations. Community colleges, ground zero Yet, there are signs that many for workers retraining for new laid-off workers are taking quicker, occupations, saw enrollment fall less-expensive routes to new 7.5 percent last year, according

careers. Although overall enrollment is down sharply at El Paso Community College in Texas, enrollment in short-term classes that let students earn certificates in fields such as medical records, auto repair and heating and air conditioning maintenance was up 15 percent in 2020 compared with 2019, says college President William Serrata. From February 2020 to April 2020, Udemy, which offers online courses ranging from 30 minutes to 40 hours, saw U.S. enrollment surge 120 percent in professional skills classes such as digital marketing, web development and financial analysis. Coding Dojo, which offers 14-week software development courses, says 46 percent of the CONTINUED

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350 students who began virtual classes last July had been affected by the pandemic through layoffs, reduced hours or other impacts. “Most anyone can learn how to code, just like anybody can learn to speak English,” says company CEO Richard Wang. “You’ve got to be passionate for the subject.” Finding a new career passion can be easier said than done, but these three workers were able to pivot during the pandemic and find success in new fields:

FROM HUMMUS SALES TO FORKLIFT OPERATOR Sarah Freeman of Charlotte, N.C., sold her hummus at a local farmers market, but shut down the business in March 2020 amid state closures. “I got very nervous very fast,”

Sarah Freeman

Christian Meza

PROVIDED BY SARAH FREEMAN

PROVIDED BY CHRISTIAN MEZA

Freeman says. “I had no idea what to do.” Freeman got a temporary warehouse job at Amazon, working the 7 p.m. to 5:30 a.m. shift, but figured it was a stopgap measure. “I thought this is just a means to an end until I figure out a better solution.” Then she realized she kind of liked it. Freeman worked at a center that received packages from vendors, sorted them and sent them to distribution centers to be shipped to customers. She scanned the packages, placed them on a pallet and moved the pallet to a holding area. She broke the monotony by talking to co-workers while shuttling packages, and they sometimes held friendly competitions to see who could move them fastest. Freeman also became a “process

guide” who shuffled workers to different lines depending on who was on break or out sick, and eventually began training new employees, a role that reminded her of the pleasures of talking to customers at the farmers market. And she even learned to operate a 10,000-pound forklift. “I was terrified,” she says, “but I was able to go at my own speed.” She quickly got used to reporting to multiple managers in a regimented system after previously being her own boss and making her own hours. While she no longer enjoys the rewards of a good hummus sales day, “I also get that feeling when my area at Amazon has a good and smooth day. ... I make things run better.” After three months as a temporary employee, Freeman became

a permanent staffer and moved to a day shift that includes similar duties but requires her to transfer packages from a truck to a conveyor belt. And it includes health benefits. She decided to stay at Amazon, she says, because “I see a line I can take” to become a department manager. “You can move up in the world.”

FROM BARTENDER TO SOFTWARE PROGRAMMER For eight years, Christian Meza, of Pacific, Wash., relished his job as a bartender. He enjoyed listening to customers’ stories, helping them pick a drink based on their mood and hobnobbing with local celebrities like former Seattle Mariners pitcher Felix Hernandez. CONTINUED

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Sean Cothren LARS BLACKMORE/AMERIDANE PRESS

Even after the COVID-19 pandemic sidelined him during a monthlong state shutdown last spring and shrank his income, he held on, hoping the crisis would ease and business would bounce back. But by July, he realized, “My industry is not going to be the same. I can’t sit here making $25 a shift.” Meza got the idea to learn software programming after two customers told him about a Coding Dojo boot camp they’d taken. “I liked solving problems,” he says. He got jobless benefits earmarked for people changing careers and a student loan to cover his $13,000

tuition and enrolled at Coding Dojo. His new field offers a different kind of adrenaline rush. “I wake up and I just want to write code,” Meza says. Plus, “There’s always going to be a need” for programmers.

FROM ARTIST TO PHARMACY TECHNICIAN Last September, Sean Cothren of Charlestown, N.H., began a 14-month program to become a pharmacy technician after he was laid off from his job at a ceramics store in the spring. An artist who loved helping customers, Cothren says he waited three months before

looking for another position, but realized “I just couldn’t wait any longer. I had to start my future.” Cothren enrolled at the Dartmouth-Hitchcock medical center in Lebanon, N.H., which provides classes and apprenticeships for medical assistants, pharmacy technicians and surgical technicians that result in permanent jobs, paying students while they’re learning. Years ago, Cothren took a CPR class and realized he could combine his knack for customer service with his interest in health care. “It’s really great to learn how drugs work” and the regulations that

govern them, says Cothren, who works in a hospital pharmacy two days a week. He likens learning about what different drugs do to a previous job in a record store, where he mastered different music genres and the names of bands. Like drugs, “Records were kept in a database,” he says. “It felt like something I had done before.” He notes that his starting annual salary of $35,000 to $50,000 is in line with his retail pay, but the future earnings potential is far greater. And, he says, “Health care is not going away anytime soon.”

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DOLLY PARTON VIA STORYFUL

‘Vaccine, Vaccine’ Dolly Parton gets a dose of her own medicine By Kristin M. Hall

OLLY PARTON HAS WRITTEN

hundreds of songs during her decades-long career, and it turns out her tune Jolene was just the right one to mark her COVID-19 vaccination. “I even changed one of my songs to fit the occasion. It goes, ‘Vaccine, vaccine, vaccine, vaccine, I’m begging of you please don’t hesitate,’ ” Parton sang in a March 2 social media post, just before

receiving her shot. Parton wore a purple shirt with shoulder cutouts just for the occasion, along with a matching purple mask, and was laughing and cracking jokes with the doctor. “That didn’t hurt. Just stung a little bit,” she said afterward. Then she smiled at the camera saying, “I did it! I did it!” The Grammy-winning legend turned 75 this year. In 2020, she donated $1 million to Vanderbilt University Medical Center in Nashville, Tenn., for coronavirus research. “My longtime friend Dr. Naji

Abumrad, who’s been involved in research at Vanderbilt for many years, informed me that they were making some exciting advancements towards research of the coronavirus for a cure,” Parton tweeted last April, encouraging her fans to also make donations. Abumrad, a physician and professor of surgery, treated Parton after a car crash in October 2013, and the two built a friendship. “Without a doubt in my mind, her funding made the research toward the vaccine go 10 times faster than it would be

without it,” Abumrad told The Washington Post last year. Speaking on BBC’s The One Show last November, Parton said she was “so excited” to hear the news about the Moderna vaccine and “felt so proud to have been part of that little seed money that will hopefully grow into something great and help to heal this world.” Kristin M. Hall writes for The Associated Press. McKenzie Sadeghi contributed to this story.

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